March 13, 2017

Yes. Right. I think we are going a little
. . . we have . . . we have gone a bit far.
But Attorney General , go ahead, if you can
help us in any way.
Hon. Trevor G. Moniz: Well, I do not have document s
in front of me , so I do not know the details that the
Member is speaking of, so I really cannot assist at this
point.

I thought . . . Attorney General.
Hon. Trevor G. Moniz: Mr. Speaker, this is really g oing to the exact minutiae I was, when we discussed it .
. . I do not want to get into how many, you know, pieces of paper we bought and how many pens we had.
The media relations firm is a very small part of all of
this. And the public really have no interest in that. They are very reasonable charges. They are not large —

The Chair recognises the Honourable
Member from constituency 29, MP Zane De Silva.
1100 13 March 20 17 Official Hansard Report

Bermuda House of Assembly Hon. Zane J. S. De Silva: Thank you, Mr. Speaker.
Mr. Speaker, I rise on a sad note this morning
to announce the passing over the weekend of my nonblood step- mother, Lynnette Harvey from Sunnyside
Park. She has been unwell for some time and this
weekend she has left us to join the Father that she
loved so dearly, in heaven, Mr. Speaker. I certainly
send out my condolences to the family.
Also, my blood great -aunt passed over the
weekend, a lso a constituent of yours, Mrs. Lydia Madeiros, who stayed in the housing complex behind the
gas station there. She lived a good life, 98 years old,
she was —

You are being very kind this morning;
what are you looking for?

[Laughter]

Hon. Zane J. S. De Silva: Well, hopefully, you will be
a little bit . . . you will remember this later on today,
Mr. Speaker, because I tend to stray from time to time
and you are quite capable of pulling me back on the
straight and narrow.
Mr. Speaker, whilst I am on my feet, I would
also like to have this House to give congratulations to
another young lady that you will know, Judy Scott,
who has been working at Port Royal Golf Course for 34 years tomorrow.

Isn’t that something.

Hon. Zane J. S. De Silva: Thirty -four years tomorrow.
And MP Mr. Kenny Bascome, the Honourable Member would like to associate himself with those r emarks , as well as Minister Jeanne Atherden.
So she has worked there, Mr. Speaker, from
opening day and she is part and parcel of the furniture
and everything else at Port Royal. [She is] still one of,
I think, ambassadors of Bermuda. She is always pleasant. I mean, 34 years at a job, she answers the
phone, she has that smile on her face when she goes to work mornings, and she makes early mornings, as you know. When she is at work, she is there at seven o’clock on the dot. She is ready, willing, able and a lways smiling.
Thank you, Mr. Speaker.

All right. Thank you. Thank you, Honourable Member.
The Chair will recognise now the Minister of
Health and Seniors. Minister Jeanne Atherden, you
have the floor

Hon. Jeanne J. Atherden: Mr. Speaker, I would like
this House to send condolences to the family of Leo
Eric “Chummy ” Flood. Mr. Flood was a constituent of
mine and although most persons might be more fami liar with his wife, Jennifer, whenever I would go to visit he was always in the background talking about issues that were concerning him. And I know that Member Walton Brown, who is also a constituent, would want
to be associated with this. Unfortunately, today the
service is at the time I am doing the Budget Debate,
but I know that we will all be thinking about Jennifer
and her family.

I not singing and I do not have my
harmonica. I will not comment any further.
Let me just rise to be associated with the
comments, the condolences for Mr. Flood, out on
Stovell Bay Road, Mr. Speaker. I grew up two houses
down from Mr. Flood, so I have known him basically my entire . . . since I was 12 years old. We had many
robust conversations over the decades. When I made the venture to run out on Spanish Point in 2007, he and I had further chats. He did not vote for me, but we had a lot of respect for each other. We just had a long relationship ever since 1972.
Mr. Speaker, Mr. Flood and my mother were
the de facto Neighbourhood Watch for Stovell Bay
Road. So they looked out if anyone suspicious was walking up and down the . . . they worked together to
get issues addressed. And I know with the passing of Mr. Flood it is a loss to the community. It is a loss out in the Spanish Point area. I just wanted to rise to


Bermuda House of Assembly acknowledge an individual who throughout his life had
been respectful in his disposition, an honest man, and
someone with whom you could always have good r obust conversations with.
So with that, I will take my seat, Mr. Speaker.

Good morning.
Hon. Nandi Outerbridge: Mr. Speaker, I rise to ask
that this Honourable House send congratulations to
the Alpha Phi Alpha Fraternity Inc., and this is for the
Alpha Ball that took place this Saturday. The Honourable Member from the other side commended the A lpha’s for a successful Alpha Week, but the Ball was definitely to be commended. It was a great night for all, and my colleagues, Ministers Simons and the
Premier, Minister Richards, and I believe Members who sit in another place were all in attendance. This year’s theme was “Reclaim. Restore. Renew.” The guest speaker, Mr. Patrick Tannock, delivered a bri lliant message. So it was a great night and I just want to commend the Alpha’s for all that they do and for the
evening that we had this Saturday.
Thank you.

Thank you, Minister.
The Chair will recognise the Minister Cole
Simons.
Hon. N. H. Cole Simons: Thank you, Mr. Speaker.
Mr. Speaker, I rise this morning to send sp ecial congratulatory remarks to Dr. Carika Weldon. This
young Bermudian lady, she is a PhD scientist. She specialises in genetic engineering. She works on the
Human Genome Project in various UK universities.
She had the vision of bringing a conference to Bermuda earlier this year and she brought that vision to fruition . The theme of the conference was “Reviewing
the Bermuda Principle” which is a cornerstone to genetic research. She was able to attract many scientists who specialise in genetic splicing. The scientists
were from the US, Canada, Spain, France, Japan, Singa pore, and Switzerland. While here, the scientists
also met with young Bermudian students. So I want to congratulate her on her vision. I want to support her
because of the fact that she planned this conference
herself and brought these scientists to Bermuda. This demonstrates what determined young Bermudians can do when they set their minds to it. So, again, con-gratulations to Dr. Carika Weldon.

All right. Thank you.

Hon. N. H. Cole Simons: I would also like to send
condolences to the family of David Anthony
Le’Strange. He was a consummate hotelier and tourism professional. He was the manager of the Mid
Ocean Club, Fourways Inn, and the Hamilton Pri ncess. He was a connoisseur of wine and he was
known for his warm hospitality and his cooking. S o,
again, condolences to his wife, Susan Le’S trange, and
he will be sorely missed by the professionals in our tourism industry.
Thank you.

Thank you, Mr. Speaker.
I would like to ask this House to send two
congratulatory messages. One to Dr. Lynette Thomas
who is Bermuda’s foremost authority on kidney dis-ease, and she is actually getting ready to open up the
Island’s first private dialysis unit. Dr. Thomas is also
Bermuda’s first board certified nephrologist. On the heels of International Women’s Day last week, which we celebrated with “Be Bold for Change,” I can think of no other better example of a person’s boldness than that of Dr. Lynette Thomas who, as I indicated, is
a woman and is Bermuda’s first nephrologist —who is
a woman—and is also opening up Bermuda’s first kidney disease private dialysis unit —who is a woman.
So I would like to send congratulations to Dr. Thomas.
I would also like to send congratulations to
Inter-Island Communications, former Member of Parliament, Glenn Blakeney and his wife, Gw en, who,
again, had a very successful Bermuda Idol compet ition this weekend. I attended along with my colle ague,
the Member from constituency 6. There were some 13 participants this year. By far, it was perhaps the best Idol competition. In fact, it shows the wealth of talent
that Bermuda has and it is an opportunity for Berm udians to showcase their talents, not just singing in
churches or at weddings and so forth, but actually with an international judge.
The winner this year was Ms. Ariana Smith.
All participants performed stellar. Bermuda has a
great opportunity. We have great talent here and I
would like to send congrats to Inter -Island Communications because they allow the showcase for our local talent to be able to reach for the stars. Many of them would not have an opportunity elsewhere to be able to perform in front of a professional judge who has r ecording contracts, and the like, h is CV was huge, so
the opportunity that Bermudians had to be able to per-form in front of him was great. I would like to send congratulations to Inter -Island Communications for
having that type of event so that local Bermudian artists have that platform to be able to perform.
1102 13 March 20 17 Official Hansard Report
Berm uda House of Assembly Thank you, Mr. Speaker.

The Chair recognises the Member for
Finance, the Honourable E. T. Richards, who has . . .
it looks like you have four.
FIRST READINGS
BERMUD
A PUBLIC ACCOUNTABILITY
AMENDMENT ACT 2017
CUSTOMS TARIFF AMENDMENT ACT 2017
INTERNATIONAL COOPERATION
(TAX INFORMATION EXCHANGE AGREEMENTS)
AMENDMENT (NO. 3) ACT 2017
USA -BERMUDA TAX CONVENTION
AMENDMENT (NO . 2) ACT 2017
Hon
. E. T. (Bob) Richards: Thank you, Mr. Speaker.
Mr. Speaker, I would like introduce for consi deration of the Honourable House of Assembly for first
reading of the following Bills: Bermuda Public A ccountability Amendment Act 2017; Customs Tariff
Amendment Act 2017 (under Governor’s recommendation); International Cooperation (Tax Information
Exchange Agreements) Amendment (No. 3) Act 2017;
and the USA -Bermuda Tax Convention Amendment
(No. 2) Act 2017. The

Thank you, Honourable Members.
The first O rder is resumption in the Committee
of Supply for consideration of the Estimates of Rev enue and Expenditure for the year 2017/18.
The Chair will recognise the Minister of F inance.
Hon
. E. T. (Bob) Richards: Thank you, Mr. Speaker.
I move that the House now resume the Committee of Supply for further consideration of this year’s
Estimates for 2017/18.

Honourable Members, we are now in
Committee of Supply for further consideration of the Estimates of Revenue and Expenditure for the year 2017/18.
The Bill for consideration this morning is a
three- hour debate. The heads will be Cabinet for three
hours , Heads 9, 43, 51, and 80. That would be Cabinet Office—9; Department of Information and Digital Technologies —Head 43; Department of Communic ations —Head 51; and Project Management and Pr ocurement —Head 80. Page B- 64.
I call on the Premier.


Bermuda House of Assembly CABINET

Hon. Michael H. Dunkley: Good morning, Madam
Chairman and good morning to honourable co lleagues.
Madam Chairman, I move that Head 9 —
Cabinet Office; Department of Information and Digital Technologies —Head 43; Department of Communic ations —Head 51; and Project Management and Pr ocurement —Head 80 be now taken under consider ation.

Please proceed.

HEAD 9 —CABINET OFFICE

Hon. Michael H. Dunkley: Thank you, Madam
Chairman.
It is my p leasure this morning to present the
budget for the Cabinet Office, the four heads that
have been selected by the Opposition. First, I will start with Head 9—t he Cabinet Office.
Honourable Members can find the relevant i nformation on pages B -43 to B -46, of the Estimates of
Revenue and Expenditure in the Budget Book.
Honourable Members will know that the Cab inet Office is the government’s corporate headquarters and, as such, the Office coordinates cross -Ministry
initiatives and provides advice and guidance for all
government departments and, by extension, all stak eholders.
Additionally, the Cabinet Office coordinates
external affairs via it s economic policy and foreign
affairs activities. The objectives for the Cabinet Office
are set out on page B -43. If you will allow me, Madam
Chairman, I will refer to page B- 43 for the depar tment’s objectives:
• to strengthen governance, transparency , and
accountability across the public sector;
• to deliver efficient and effective services to the
Premier, Ministers, and Cabinet, as well as
provide oversight and coordination of the civil
service ;
• to raise the quality of civil service capacity;
• to develop and improve Government policies as well as provide assistance to all gover nment departments in the implementation and
coordination of those policies; and finally
• to lead and give support to initiatives to modernise business systems and processes in
government.
These objectives inform the work executed by
the sections and the departments that fall within the Ministry’s remit. As a reminder, the departments i nclude:
• Department of Statistics, Head 14;
• Department of Human Resources, Head
26 (which the Opposition has decided not to debate during this debate here this
morning);
Whilst, Madam Chairman, I will not explore
the service delivery specifics for each of the depar tments as part of my Head 9 budget presentation, I
think it is important to highlight the coordinated body of shared services that complete the sections and
units within the Cabinet Office, that includes management consultancy services, policy and strategy, foreign affairs, and protocol which all align to deliver
the Government’s strategic goals and objectives.
The Cabinet Office Ministry, Madam Chairman, is appropriately positioned to represent a coordinated approach to the governance of Bermuda’s affairs and to provide a more coordinated, efficient ,
and effective infrastructure for all other d epartments
and ministries , as set out in the SAGE recommendations.
I will now turn to the proposed budget for
2017/ 18, which can be found on page B- 43.
The current account estimates for Head 9,
Cabinet Office, t he allocation is $6,912,000. The comparative figure for financial year 2016/ 17 is
$7,070,000, an overall decrease $158,000. Madam
Chairman, if you reflect back about seven ye ars to the
budget for 2010/11, the budget for this area of the Cabinet Office was $8,426,000. So we have seen a $1.5 million decrease during that time.
Madam Chairman, the general summary of
expenditure by programme business unit is set out on
page B -43, halfway down the page. The first pr ogramme area is [0901] , that is the General Administr ation. This obviously includes General Administration; Professional Development and Travel; Protocol and Hospitality; Policy and Strategy; Public Access to I nformation; Management Services; and the unfunded
Commission of Inquiry line report, when that report was done in the current financial year.
For the sake of clarity, I will lead Honourable
Members and the listening audience through each of these line items, explain the year over year variance,
the planned expenditure going forward, and an overview of the work for every line item included.
So, I start, Madam Chairman, with cost centre
[19000], General Administration. The budget for the
current financial year is $2, 720,000. The estimate for
the next financial year 2017/18 is $3,191,000. And for
those who are quick at math that is an increase of
$471,000, or approximately 17 per cent.
Madam Chairman, the $4 71,
000 variance is
mainly due to an increased allocation for Overseas Consultancy Services and the redistribution of funds between cost cent res.
Honourable Members will know that Ken Le vine & Company has long served Bermuda as a Was hington D C lobbyist for the Government. I am advised
that this relationship dates back over two decades.
1104 13 March 20 17 Official Hansard Report

Bermuda House of Assembly During the fiscal year 2016/17, our current
budget year, an allocation of $100,000 was set to
cover the retainer for the Washington DC lobbyist.
Madam Chairman, potential US tax reform
and its impact on Bermuda as an international bus iness centre necessitates a stronger lobbyist presence in Washington, DC. Thus, an increase of $150,000
has been allocated to the budget for this purpose for the coming financial year.
The balance of the $471,000 variance is also
attributed to organi sational structure changes requi ring the redistribution of funding for two posts, a r eceptionist post and a project and p olicy coordinator posts.
Madam Chairman, the other manpower in this
sub-programme includes an allocation for the s ecretary to the c abinet/ head of the civil service , the d eputy
head of the civil service , ministry comptroller, health
and s afety c oordinator, and six a dministrative officers.
The total salaries and overtime budget for the
12 full-time positions is approximately $1,526,000; the
local and overseas consultants allocation is $337, 000
and $275,000 respectively. The contractor’s allocation is $100,000. These funds are used to support the work being carried out by the public sector negotiating
team , Washington, DC, l obbyists (as already indica ted) and ad hoc contractors and consultants as may be
required. Madam Chairman, ad hoc contractors and
consultants may typically include overseas legal
counsel and/or special project work that may arise from time to time. For instance, the Government continues to work towards regulari sing the contracts for
our UK Office employees, specialist UK employment
counsel is being used to assist with the nuances peculiar to employment contracts in that jurisdiction.
Madam Chairman, the Boards and Commi ttees’ allocat ion of $187,000 is funding to support
Bermuda’s membership in CARICOM. Honourable
Members will know that the Bermuda Government is
an Associate Member of CARICOM and , accordingly ,
is required to make payment of an appropriate contr ibution to the budget of CARICOM Secretariat as de-termined by the organi sation.
Other high value line items in the 19000 General Administration sub- programme include Building
Rental of $210,876 paid to Ingham & Wilkinson for our
129 Front Street, Hamilton location that houses the
offices of Management and Consulting Services, Pol icy and Strategy, and Health and Safety. The maint enance and cleaning services line item is $48,000 and covers all Cabinet Office locations.
Madam Chairman, the line item for electricity
is $90,000 and the balance of the funding accounts for all other standard office administration expenses such
as telephone, printing, and supplies.
The General Administration programme i ncludes resources to serve as principal advisor on pol icy matters to the office of the Premier and to provide
strategic and business planning and management to the Cabinet. In the 2017/18 fiscal year the service can expect the delivery and implementation of an operating plan designed to clarify deliverables within each ministry and department. The guide will identify and outline
the Government’s legislative goals. It also aims to en-sure there is a shared understanding within the se rvice of the Government’s way forward for the people
of Bermuda.
Further, the “Making Policy Happen” in Bermuda Guidance will be amended and disseminated to permanent secretaries and heads of departments.
The service can also expect the continuance
of public service reform . Honourable Members will
already be aware of the implementation platform for the advancement of many SAGE recommendations
that the Government accepted. Efforts will continue to increase efficiency and reduce operating costs.
The public service negotiating team, led by
Gary Phillips, supported by John Harvey and Martin
Law, will continue best efforts to renegotiate the terms
of six collective agreements and work towards harm onisation of those agreements . Their efforts will be
complemented by a human resource working group
charged with aligning human resource policies, some
of which have implications for the agreements .
Public Service Commission Regulations designed to increase accountability within the service will
be advanced and an amended Conditions of Emplo yment and Code of Conduct will be completed.
Madam Chair man, efforts will continue to
stream line the service and strictly manage the number
of employees. The Government has gradually r educed the number of public sector employees from
5,262 as of March 31, 2013, to 4,613 as of Jan uary 31, 2017, a 12.3 per cent decrease, or 649 pe ople.
Other steps taken towards the reform of the
public service include, as recommended, increasing
Government employees’ capacity for implementing change through a sharper focus on organi sational development activities. When reports are commissioned
from the Management Co nsulting Section, or more
commonly known through the corridors of Gover nment as MCS, a d epartment head or p ermanent secretary must be identified as the “project sponsor ,” responsible and accountable for implementation of a
report’s recommendations. Recommendations to be
monitored include those from internal and external
consultants, the Auditor General, Internal Audit, an d
the Office of the Ombudsman.
Madam Chairman, an MCS project monitoring
sy
stem has been put in place that includes periodic
reports to Cabinet and the MCS has been empowered
to support, monitor , and report on implementation of
recommendations from studies produced across all of
Government. I will outline later in my presentation
highlights of work being undertaken by MCS.
Madam Chair man, as recommended, succession planning and talent management efforts to enBermuda House of Assembly force permanent secretary performance management
processes and to identify future opportunities for
heads of departments have advanced. Leadership competencies have been identified and more than 20
applications were received from senior officers see king upward mobility in the service ; and, a formal succession planning programme will soon be implemented.
Madam Chairman, as recommended, steps
have been taken to enhance accountability for nonperformance among leaders within the service . Permanent Secretaries have undertaken Financial I nstructions refresher training , and efforts are underway
to implement a decentralised system -wide Financial
Instructions Training programme led by comptrollers
in each Ministry. The aim of the programme, a joint initiative between the head of the civil service and the
Financial Secretary is to:
• restore a culture of compliance within the se rvice;
• m ove the service from general awareness of
Financial Instructions to intimate awareness of Financial Instructions content; and
• cause individual officers within the service to
know how to apply Financial Instructions to the delivery of services within their specific remit.
It is quite important, Madam Chair man, and I
am pleased to be able to highlight this today with the
support of the Deputy Head of the Civil Service and
the team who are in the Chambers.
This programme moves the Service from a
very centrali sed Financial Instructions training pr ogramme delivered on an occasional basis by the D epartment of Human Resources for persons who opt -in,
to a much more decentrali sed, department specific,
mandatory training programme delivered routinely by ministry comptrollers . I think this will certainly increase
the level of awareness, compliance, and the outcome of results, so I am delighted to see some progress in this area.
Comptrollers have been provided with a modular template to be customis ed for deliver y within their
ministry and/or departments based on the issues identified b y the permanent secretary, head of department,
comptroller, internal audit, or other relevant entity.
I am pleased to report that several m inistries
have already commenced implementation and it is
expected that the programme will become fully oper ational a cross the service in the coming months. I b elieve this is very positive evidence that the civil service
leadership is making it clear and leading by example
to underline the importance of following Financial I nstructions and the Conditions of Employment and
Code of Conduct [CECC] for the Service.
Madam Chair man, as recommended, the Service is also managing non- performers more effectiv ely. To ensure that the correct processes are followed
in every situation, the Human Resource team has been specially trained and has been tasked with r esponsibility for lending support to the discipline pr ocess in all Government d epartments. A Crown Cou nsel has been assigned to human resource matters
who serves as a technical expert to guide the Head and Deputy Head of the Civil Service, supervisors, and employees through the proper processes.
And finally , Madam Chair man, under the d irection of our Health and Safety Coordinator we will establish and c oordinate the Central Safety and
Health Committee for the Government of Bermuda. As
an employer it is important that we have a little bit more oversight and so we will develop a three- year
Corporate/Operational Plan for Occupational Safety and Health in Government. This follows aggressive steps that have already been taken towards the deli very of housekeeping guidance and training to ensure the reduction of m ould in government buildings for the
protection of the health and safety of all government
employees.
Madam Chairman, I think all colleagues are
aware that there have been some challenges in recent
years and this is a step to get on top of them so we do
not have the problems that continue to build on themselves And this is a very important step that we will
take. So I applaud the leadership in the civil service
for taking this approach and I look forward to working with them to make sure there is proper oversight and the results actually get delivered.
Madam Chairman, I now turn my attention to
cost centre 19005, Overseas Travel, Professional D evelopment and Travel. That is still on page B -43. The
original estimate for the year 2016/17, the current f inancial year , was $128,000. The estimate for next
financial year is $138,000. I reflect back again to a number of years to 2010/11 and the same budget was
$440,000. We have seen a great savings taking place
and the work is still getting done.
Madam Chairman, Honourable Members can
observe from review of the Travel line item in the Subjective Analysis of Current Account Estimates , which
you will find on page B -44, there was an original es timate of $177,000. About a third of the way down the
page, Madam Chairman, as you follow along. Obv iously, the number I just mentioned of $128,000 is specific to the Cabinet. This $177,000 goes broader and covers all members within that department.
You see that the revised estimate for 2016/17
is $272,000. The increase in the current year is solely
attributable to travel expenses related to the Commi ssion of Inquiry, specifically the Chairman who was required to travel back and forth between Bermuda
and the United Kingdom on a number of occasions
during the course of the Inquiry proceedings. This i ncludes, airfare, accommodations, subsistence, and
incidentals.
Going back to page B -43 and that cost centre
19005, the variance of $10,000, or 8 per cent over the
previous year is anticipated to cover the increased
1106 13 March 20 17 Official Hansard Report

Bermuda House of Assembly travel activity in 2017/18, which is minimal, but i ncreased slightly due to the following reasons , which I
will outline now.
Honourable Members might have picked up
on it, but Bermuda was unanimously voted as Chai rman of the UK Overseas Territories Association which
took effect in February of this year. Under the UKOTA
Constitution, Chairmanship is held and managed by
our London Office Director as a r epresentative, however, the Premier serves as President of the Political
Council. Whilst minimal, there will inevitably be some
small travel to fulfil the related obligations from time to
time.
Other anticipated travel during the next fiscal
year will include activity associated with developing new, and rei nforcing established relationships, with
Senators and Representatives on Capitol Hill with the change in administration, and obviously with Brexit
discussions which will continue in the UK.
Madam Chairman, I would like to take this opportunity to note the critical importance of all the times
that any Premier travel s for very important Gover nment business. The Cabinet Office, while I have been the Premier , has stayed within the very reduced travel
budget of $128,000 this year, and $138,000 next year, and I have highlighted some of the increased travel
from before. In addition, Madam Chairman, we have implemented high levels of transparency and ac-countability with the introduction of a travel website, where myself, and all Ministers, should put travel details and cost of travel as soon as possible upon the
site, and that includes their receipts for travel and then
make sure that all the costs are there. So they put
details of the travel and all the costs associated with it. I am delighted that we have raised the level of trans-parency and accountability for it , and Ministers are
doing quite well in putting their details forward. Som etimes some of the bills take a little longer to get, and I would rather not have estimates, I would rather have exact details put out there.
Madam Chairman, I will now turn my attention
to the [cost centre] 19010, Protocol and Official Hospi-tality. The budget for the current financial year
2016/17 was $382,000. The estimate for the next f inancial year is $553,000. The budget in financi al year
2010/11 was $706,000.So we see from year to year the budget can change, depending on events that are
taking place.
Madam Chairman, the Protocol and Hospitality team plays a leading and critical role in arranging
ceremonial functions, official dinners and receptions at Camden and, of course, facilitating many VIP deleg ations and visitors on arrival and departure at the L. F.
Wade International Airport. The team is also respo nsible for managing the operation of Camden at all
times.
The increase of $171,000, Madam Chairman,
in Protocol and Hospitality is directly related to antic ipated increase in official protocol and hospitality ac-tivity expected throughout the next financial year.
Much of this activity, Madam Chairman, will be driven by the number of dignitaries who we expect will visit Bermuda to support and watch AC35 [35
th America’s
Cup] teams compete. As you know, there are six teams representing six countries from around the globe. Official functions related to the America’s Cup
at this point will include an official reception at Camden, an official America’s Cup Dinner, and an official Off-Site Reception.
Also during the month- long America’s Cup
event, Bermuda is blessed to host the Tall Ships. The Government will also host an official Tall Ships reception. I believe at last count, Madam Chairman, there
were over 20 tall ships confirmed to be in Bermuda that week in early June, and I understand well over 1,000 crew members will be manning those ships. I think everyone in Bermuda is excited to see that spec-tacle. It has been a number of years. I can still recall
when I was a teenager seeing one, I think it was in the
early to mid- 1970s, and going off and watching the
start at that time. So it will be an exciting time.
In addition, Madam Chairman, the standard
ceremonial events will include the Queen’s Birthday
Parade, the Remembrance Day Parade, and, of
course, the Convening of Parliament. Other events on the calendar are the much- looked- forward- to annual
Cup Match reception, the Christmas reception, and various community outreach receptions that are held from time to time. This activity is similar to activity u ndertaken in the current fiscal year. And this year, among many other activities that were held, we hos ted events such as a Fireminds Youth Reception, Car-ibbean Community Reception, a farewell dinner to the Governor in June, the Annual Cup Match reception, a luncheon for a visiting Chinese delegation, an appr eciation reception for the Fire and Police Services after the hurricane in October, and the Premier’s annual Christmas reception— these were some of those held.
Honourable Members will note that there are
two posts associated with this programme, a protocol
officer and a caretaker post for Camden. I want to
take this opportunity to mention that salaries and over-time budget are set at $127,096, and the wage and overtime allocation is $83,250. The salary allocation is directly related to the protocol officer, while the wage allocation funds the caretaker post.
Madam Chairman, typically, the hosting of
official functions requires added resources to facilitate various aspects of the proceedings, and therefore the contract allocation at $35,000 is used to support ve ndors to undertake specific tasks. The balance of the allocation covers equipment rental, food and beverage, building maintenance, cleaning, repairs, and
general administration. And before I go on to the next [cost centre], let me thank the protocol officer and all of those involved for making that area run very eff iciently. Quite often, they are asked to do things at the last minute because of the arrival of VIP delegations,


Bermuda House of Assembly and they have had to operate under very tight budget
conditions. And they have been very resourceful. So I
compliment them on the work that they have done.
I will now focus on [cost centre] 19015, Policy
and Strategy, still on page B- 43. You will see the ori ginal estimate of $938,000. The estimate for 2017/18 is $836,000, a decrease of $102,000. Policy and Strat egy in 2010/11 was $1.462 million, so there has been a
big decrease in that over the years. The decr ease,
Madam Chairman, in regard to the current year’s f inancial budget and the next year’s budget of $102,000 in Policy and Strategy relates directly to a decrease in manpower of one full- time position. Honourable Members might be aware that the new Policy
and Strategy Unit within the Cabinet Office is an amalgamation of the former Central Policy Unit and the Sustainable Development Unit. The amalgamation has resulted in the elimination of the Director of Sus-tainable Development post. The section head, now
titled Manager, Policy and Strategy, reports to the ex-isting post of the Deputy Head of the Civil Service.
One of the principal goals of the merger,
Madam Chairman, was to realise a more centralised approach to policy and strategy development while
strengthening decision- making and improving effectiveness. The Policy and Strategy Section will assist with the creation, development, implementation, and monitoring and measurement of policy and strategy initiative s. The Policy and Strategy Section will conti nue to coordinate and deliver responses for international agency information requests, among those to
include the Foreign Office, the United Nations, and, of course, CARICOM.
The Policy and Strategy Section has also
been delegated the responsibility for the administr ation for the Public Access to Information regime, or
better known as PATI. This section will, among other
tasks, be charged with maintaining a list of information officers, ensuring information statements are current, developing guidelines, producing templates, delivering PATI training, providing advice and guidance, and
managing the designated legal advisor.
Within the section, Madam Chairman, there
are seven officers: a manager, five policy analys ts,
and an administration officer. The total salary budget
is $738,563. The balance of the funds in this pr ogramme includes building maintenance, cleaning, and
standard administration expenses.
I move now to [cost centre] 19050, which is
Public Access to Information. The original estimate for
the current financial year is $142,000. The estimate for the next financial year 2017/18 is $142,000, as well. I note that a few years ago there was an alloc ation, I think it was in 2011/12, of $210,000, which was never used. So you see, this budget remains unchanged. And the funding for this budget line item will be used, Madam Chairman, to retain a dedicated legal consultant to assist the Policy and Strategy Section with the ongoing implementation of the Public Acces s to Information and to ensure that the Government is in
compliance with this Act.
Honourable Members will know, or if I jog their
memory they will remember, that section 61 of the
Public Access to Information Act requires the Minister to ensure that appropriate measures are taken by public authorities with regard to the training of staff for
the purpose of facilitating compliance with the Act. As already discussed, the responsibility to assist in the discharge of the Minister’s responsibility on the Act has been designated to the Policy and Strategy Section within the Cabinet Office. A PATI legal consultant will be retained to provide advanced training to Information Officers and to Heads of Department to pr ovide ongoing legal review of PATI requests and r esponses to ensure compliance, and to work in consultation with the Information Commissioner’s Office to complete the PATI Administrative Codes of Practice.
Next year, Madam Chairman, it is anticipated
that [cost centre] 19050 will be put into the [cost c entre] 19015, Policy and Strategy.
The next [cost centre], Madam Chairman, is
Management Services, 19055. The [original] estimate for financial year 2016/17 is $728,000. The estimate
for the 2017/18 financial year is $809,000, which is an
increase of $81,000. The budget for Management Services has increased by 11 per cent, and the additional $81,000, Madam Chairman, will cover the salary of a trainee management consultant post. The man-power within this area consists of a senior management consultant, who directs three management consultants, and a knowledge manager, with a salary budget of $697,548.
The Management and Consulting Section is
an internal consultancy unit that is actively engaged, Madam Chairman, in seeking solutions for better public service delivery. The unit provides high- quality
consulting services to Government ministries, depar tments, and agencies to assist them to maximise their
performance and to improve public service delivery. The unit develops and applies relevant frameworks
and analytical approaches that guide managers in the
identification of organisational problems that serve as the basis for recommendations. Management and Consulting Services also advise public service clients on organisational design and job evaluations, and provide project management to implement recommendations.
Madam Chairman, in 2017/18, the Management and Consulting Services Section (which I r eferred to already as MCS) will complete current pr ojects and respond to new project requests with par tnership agreem ents.
The MCS prioritisation of major projects attached to the Government’s initiatives will be estab-lished in conjunction with the Cabinet Office and the respective permanent secretaries of each Ministry. Where deemed necessary, the CSE (Civil Service Executive) and other internal stakeholders, such as
1108 13 March 20 17 Official Hansard Report

Bermuda House of Assembly the Department of Internal Audit, the Department of
Human Resources, and the Policy and Strategy Unit,
will become involved.
Madam Chairman, other than salaries and
standard operating expenses, there is a $94,000 line item within the Management Services allocation for contractor fees. These funds will be reallocated to
salaries upon approval for the trainee management
consultant.
Madam Chairman, if you will allow me, I will
provide you now with a snapshot of some of the i mportant work that MCS has been doing, ongoing. And I will go through some of the ministries. For the Cabinet
Office, a functional review of government boards and
committees: MCS continues to advance reviews that align with the Public Servi ce Reform Initiative, including government boards and committees, of which there are nearly 200, Madam Chairman. The review will determine whether any government boards and
committees should be discontinued or merged, or if
other operating changes may be required by legisl ative amendment. And this process has started, and some good headway has been made.
Also within the Cabinet Office, the Department
of Human Resources (DHR) (Head 26), they are look-ing at the Human Resource organisational structure. A project team led by the Deputy Head of the Civil Ser-vice (who is with us today), along with two working groups (HR Planning and IT), have been in place since June 2016 to review the integration of Human
Resource services via the creation of a shared services mo del for transactional activities, leveraging of
technology, and the standardisation of knowledge, skills, and systems. An MCS report will be presented for consideration, hopefully in June of this year.
Within the Ministry of Tourism, Transport and
Municip alities, under the Department of Marine and
Ports [DMP] (Head 30), there isthe operational and organisational review currently taking place. Within the Transport Control Department (TCD) (Head 34), there is a structural and an operational review taking
place. Again within Head 34, TCD, there is a review of
business models for vehicle inspections and emission
testing.
Under the Ministry of Health and Seniors,
there is a Human Resources review of the Office of Chief Medical Officer. For the Ministry of Home A ffairs, there is an organisational and operational review of Head [29], the Registry General. In the Department of Immigration (Head 27), Madam Chairman, there is an operational and organisational review of the Com-pliance, Corporate, and Finance Divisions. And also within that Department of Workforce Development
[DWD] (Head 60), there is an operational and organ isational review. Moving to the Ministry of Social D evelopment and Sports, there is an amalgamation of
the Department of Archives and Department of Libra ries that is currently being reviewed. And in the Com-munity and Cultural Affairs Section, Head 52, there is office consolidation of the Community Education and
Development Programme. Within the Ministry of N ational Security, under Head 12, the Customs Depar tment, there is an organisational review.
These works are all at various stages of deli very and/or implementation, Madam Chairman, and are
further evidence that the Government is deeply engaged in working towards evolving and reforming the
civil s ervice. Madam Chairman, I will pause and reflect
for a moment here on the critical nature of this work. I have the opportunity on a regular basis . . . along with
the Deputy Head of the Civil Service, I regularly schedule meetings of all the department hea ds within
the Cabinet Office and hear first -hand from them of
the work that is ongoing. And I look forward to those meetings because, when it comes to a department like MCS or any of the departments through there, I am continually impressed by the quantity of work that
is taking place and the quality provided, that the direction is given there. So in MCS, there is a lot of work
that is taking place, and that is one of the areas we need to continue to drive because it will look for eff iciencies within the service and make those happen.
And I would like to thank the departments who
asked for review or who are working on a review, be-cause it is critical. I am sure, as Opposition Members and my colleagues will know, it is critical that at all times we review the structures that we work on be-cause efficiencies can take place over time, as the structure has to change because of the signs of the
times. Whether it is in Immigration, looking at how we
run that system, or whether it is in Marine and Ports or down at TC, every department should have a critical review. So I thank members of the civil service for working with MCS on the critical work that they do.
Madam Chairman, now I will turn my [atte ntion] to [cost centre] 19060, the Commission of I nquiry. There is a budget allocation on page B -43 for
the current financial year 2016/17 of $480,000. That allocation, as you can see, has risen up to $1,169,000. I believe the money has been well spent.
The amount that has been revised, I was informed by
the commissioner when they presented the report to me a few days ago, it might come in slightly under that budget allocation.
I think it is appropriate at this time that I give
an update, Madam Chairman. In late December of
2015, by the authority of the Commissions of Inqui ry
Act 1935, and with the support of the Governor and
the head of the Civil Service, I announced the inten-tion to form the Commission of Inquiry to investigate the issues raised in the report of the Auditor General on the Consolidated Fund of the Government of Be rmuda for the financial years ending 2010, 2011 and 2012, on March 31
st.
That report, which was tabled in the House of
Assembly, Madam Chairman, the previous month, had marked the fifth straight year that the Government Financial Statements were given a qualified opinion.


Bermuda House of Assembly That was five straight years in which the Auditor General could not say that the Financial Statements of the
Government of the day in fact presented a true and fair picture of the management of the people’s money. The report described serious problems of accountabil-ity and control in the administration of the public purse, problems that I believe we all agree harm the
financial well- being of Bermuda.
The Auditor General pointed to (and I quote)
“ingrained tendency within government to overspend
budgets in ways that raise questions about the cred ibility of the budget process, spending controls, and
cash management.” The most serious area of concern, Madam Chairman, identified by the Auditor
General was Government’s failures to obey its own Financial Instructions. These instructions exist to i mpose financial controls that are consistent with interna-tional best practice and essential to upholding princ iples of accountability, of value for money, fairness,
and transparency.
The Auditor General reported millions of dollars spent without Cabinet approval, millions of dollars
paid without signed contracts, and tens of millions of dollars committed to contracts not tendered and mi llions paid to consultants without prior approval. The results , to me, at the very least, are disturbing. And at
that time, I said, Madam Chairman, and I quote, “There is no future for Bermuda, as we know it, if there are no adequate safeguards to prevent the prac-tices described by the Auditor -General from taking
place . . . They have contributed to the unsustainable
spending deficits that have pushed public debt to the absolute limits of our ability to manage it.
“The situation is a danger to our international
reputation, our solvency, even our self -government.
We ne ed to be sure that we have the right controls in
place for the future.”
The Commission of Inquiry, consequently,
was formed to investigate the issues raised in the A uditor General’s Report on the Consolidated Fund for the Government of Bermuda for those t hree years.
And more specifically, I set out the terms of reference: (1) to identify breaches of Financial Instructions and
how they arose; (2) to consider the adequacy of saf eguards and the system of accountability; (3) to make
recommendations to prevent recurrence and to mit igate financial operational and, of course, reputational
risk; (4) refer any evidence of possible criminal activity
which the Commission may identify to the Director of
Public Prosecutions or to the police; and (5) to draw to
the attention of the Minister of Finance and the Attor-ney General any scope which the Commission may identify to secure recompense under the Public
Treasury Act including Financial Instructions and, of
course, civil asset recovery.
While this was a Government initiative undertaken for the better governance on behalf of all of the people of Bermuda, I was pleased that this initiative was wholly supported by the Governor and the Oppo-sition. On February 24
th, 2015, the day the Commi ssion was appointed, the then- Govern or George Fergusson said, “It is right that these [serious questions raised by the Auditor General] should be fully invest igated. . . All Bermudians have an interest in ensuring
that the apparent breaches of financial instructions and related rules and conventions cannot be repeated
. . .”
Former Opposition Leader, Mr. Marc Bean,
who was then the Leader of the Progressive Labour
Party, also welcomed the appointment of the Com-mission, saying (and I quote), “Bermudians need to know that our civil servants, elected officials or Government Ministers have not acted either unethically or
illegally, but also that no one is above the law. ”
Madam Chairman, these words reflect my
sentiments and concerns exactly and, I am sure, those of my colleagues. And they underscore a gov-ernment -wide determination to find out and to fix what
has not been working for the public interest. So, Mad-am Chairman, the Commission recently completed its report. It is a very extensive report. And this weekend, I was delivered a PDF copy, which now can be found online. And for members listening, I will read out the
address:
www.gov.bm/commission- inquiry -report -
commission . I would urge anyone with an interest to
go online and to read the Commission’s report.
And before addressing some of the reco mmendations, Madam Chairman, I want to express my
sincere thanks in this Honourable Chamber today and
appreciation to the work of the commissioners, who
dedicated themselves through arduous hours to the work that they were given. I do not think they realised at the time the breadth and the depth of the work that had to take place. But to Chairman Sir Anthony E vans, the Honourable John Barritt, Mr. Kumi Bradshaw,
and Ms. Fiona Luck —congr atulations on the commi tment and doing a very good job. I have also taken the
opportunity to reach out to them and write them a let-ter of thanks. They certainly, in my opinion, carried out their work with diligence, fairness, and impartiality.
And there ar e two aspects of the Commi ssion’s approach to its work that I believe, Madam Chairman, deserve particular mention. First, its close attention to upholding its independence, which it did by engaging all persons with whom it dealt, including the Government, at an arm’s length; its commitment to
transparency, where Sir Anthony reflected, in stating
publicly, that the Commission’s intention was to estab-lish all relevant facts and expose them to the public gaze so far as lawful privilege will allow. They did thi s
through public statements on the purpose and the progress of their work, and their open hearings and
online updates for those hearings.
Madam Chairman, the Commission in its r eport said it was gratified with the level of cooperation it
received in conducting its work, citing witnesses called, the Office of the Auditor General, the secretary to the Cabinet, the heads of government departments,
1110 13 March 20 17 Official Hansard Report

Bermuda House of Assembly and many civil servants, who helped at all times to
facilitate this work. And as Premier, Madam Chairman,
I take this opportunity to echo that appreciation, be-cause it reflected professionalism under difficult cond itions by those in the civil service, and also a far -
reaching civic responsibility and a willingness to help strengthen governing principles of Bermuda so t hat
our Government can perform better for the people whom we are elected to serve.
Madam Chairman, it is incumbent on all of us
as citizens, as Parliamentarians, and as a government to do our best at all times to make things work better for the people. And the Commission of Inquiry stands
as an example of that.
Madam Chairman, I would now like to provide
a brief overview of the Commission’s work and its findings. In keeping with the terms of reference, the
Commission focused on the Auditor General’s reports
for those three years. And they reviewed thousands of
pages of documents and called 21 witnesses. The
primary focus of their work can be found in section 3 of the report, which contains audit findings that the Auditor General said pointed to “a general failure to follow the rules (Financial Instructions) established by
Government for the safeguarding of public assets.”
There are 17 headings within section 3 [of the
Auditor General’s report] involving either government
transactions with third parties outside of Government or issues involving failures to comply with internal ac-counting or procedural standards. The headings the
Auditor General used to describe what the Commi ssion characterised as “ third-party issues ” are indic ative of the serious matters the Commission was asked
to review —headings such as:
• Millions paid without signed contracts or
agreements;
• Significant contracts not tendered; Duplicate payments; Overpayments; and
• Millions paid for professional services without
prior approval .
In addressing t hird-party issues, Madam
Chairman, the Commission focused on 12 transac-tions. These included the TCD Testing Centre, Go vernment department renovations and building pr ojects; the purchase of sand and rock for asphalt; con-struction of the Magistrate’s Court; Hamilton Police
Station; untendered contracts to Ambling and Global Hue; Port Royal Golf Course improvements; and the Heritage Wharf development.
Madam Chairman, in light of the rumours at
the outset of its work that police were investigating some of these matters, the Commission learned
through questions submitted to the Bermuda Police
Service that investigations were underway and ongo-ing. On this point, I want to commend the Commission for their care and their consideration that it took in ad-dressing its responsibility to refer any evidence of
possible criminal activity to the Director of Public
Prosecutions or the police. In particular, its caution in pointing out —and I want to make sure that Members
listen to this very carefully —its caution in pointing out
that a finding of possible criminal activity should not
indicate evidence of guilt and that the naming of an individual does not imply any finding of guilt.
Indeed, the Commission noted that it was not
required nor entitled to make any finding of innoc ence
or guilt. It was required only to refer to the police and the Department of Public Prosecutions any evidence of possible criminal activity. And in that regard, the Commission did find evidence of possible criminal activity in seven of its inquiries in two third -party i ssues and , in accordance with the terms of reference,
referred them to the Bermuda Police Service. These findings were made in relation to contracts awarded to Ambling and Global Hue, the TCD Testing Centre, the purchase of sand and rock for asphalt, the Magistrate’s Court and the Hamilton Police Station project, the Port Royal Golf Course improvements, and the
Heritage Wharf cruise ship pier.
Madam Chairman, members of the public can
find these findings online at the address which I mentioned earlier. And as they potentially could be part of
a police investigation, I will withhold any further comment at this time (as the Opposition Leader makes
some type of comment under his breath.)
The second part of the Commission’s section
3 inquiry centred on issues involving failures to com-ply with the Government’s internal accounting or pr ocedural standards. This work was conducted in accordance with the Commission’s mandate as gazetted
April 15
th, 2016. And I quote: “To make recommendations to prevent and/or to reduce the risk of recurrenc-es of any violation identified and to mitigate financial, operational, and reputational risks to the Government of Bermuda.”
Madam Chairman, the Commission made 50
recommendations for the safe and effective manage-ment of the public purse and has organised those into
10 areas which focused on . . . and I will go through
those 10 areas:
• establishing more effective working relatio nships between Government Ministers and
senior civil servants;
• improving transparency and s afeguards
against conflicts of interest;
• improving the effectiveness of Financial I nstructions;
• clarifying accounting officer responsibility;
• strengthening the offices responsible for saf eguarding the public purse;
• enhancing parliamentary oversight of Government spending;
• holding civil servants responsible for responses to the Auditor General’s report;
• making Government financial reports more timely;
• reviewing personnel and processes in the civil
service; and


Bermuda House of Assembly • holding quangos more responsible.
Madam Chairman, these recommendations
are welcome by the Government because they set the
stage for the very thing the Commission was set up to achieve, which was, as I stated in December of 2015,
“to break the back of bad habits, to heighten public understanding of the issues, and to return the princ iple of accountability to the centre of government bus iness at every level.”
Now, Madam Chairman, u nfortunately, acting
on many of these recommendations that have been
made will not be a simple exercise. But such is life.
Nothing comes easy —but the value of hard work.
Many of these recommendations will require analysis followed by consultation. P ossible impacts on the
Government’s collective bargaining agreement with
the Bermuda Public Service Union will have to be taken into consideration. And perhaps along the way, legislative change will be part of some of the changes after we go through the process.
What I will commit to , Madam Chairman, at
this time is that this Government will start its review of
the Commission ’s recommendations forthwith . And we
will update the public as we progress along. Our initial
and primary focus will be on Financial Instructions, which the Commission recommended be given the
force of law by making them R egulations.
In my view, Madam Chairman, the failure to
follow Financial Instructions was the major fault at the centre of the findings by the Auditor General in her report on those three years, and it is incumbent on us
as a government to fix it. And it is incumbent on the
Opposition and the people of Bermuda to support us
as we move forward. We will also advance the princ iples of transparency in the management of the public
purse, as we have done in our years as the Gover nment. In that regard, Madam Chairman, we will take a
very close look at making oversight of F inancial Instructions more current and contemporaneous.
Madam Chairman, t hese are forward directions this Government will take us as a result of the
report of the Commission of Inquiry. The reforms it
generates will continue a multiyear pr ocess that , to
some extent, was started in a r eview conducted in
2011 by KPMG in its advisory role. During that review, it found that half the projects reviewed did not comply
with Government policies and procedures , with negative consequences for value for money and for the
perception of fairness in the Government’s procur ement process.
The report of the Commission of Inquiry is the
next step in this drive to strengthen the overall go vernance of Bermuda and, more specifically, to institute
the very real ch ecks and balances necessary to make
the Government more accountable and transparent to the people whom we serve.
That brings to an end comments on [cost centre] 19060, Commission of Inquiry Report, Madam Chairman. As I said, it can be found online at www.gov.bm/commission- inquiry -report -commission
. I
want to take this opportunity to thank the Director of DCI [Department of Communication and Information], who is in Chambers today, for getting that online in a short period of time. The report was delivered to me only over the weekend (the PDF copy of the report).
Madam Chairman, now I turn my attention to
0902, Economic Policy & Foreign Affairs, which i ncludes the two [cost centres], 19035, the London O ffice; and 19045, the Washington, DC, Office.
Madam Chairman, it is important to note that
the Government has established an External Affairs Strategic Planning Committee. The committee is cochaired by the Cabinet Secretary, Dr. Derrick Binns;
and Willis Bermuda Chairman, Mr. Paul Scope. Me mbers include Pamela Burrows, who works for the Gov-ernment of Bermuda; Cheryl Lister, National Anti -
Money Laundering Committee; Karla Lacey, from the Bermuda Tourism Authority; Jeremy Cox, of course,
whom we all know, Bermuda Monetary Authority;
Ross Webber, from Bermuda Business Development Agency; Richard Winchell, from ABIC; Leila Madeiros, from ABIR; and Travis Gilbert, who works for the Gov-ernment of Bermuda.
Madam Chairman, an analysis was undertaken, and it was determined that the Government’s external affairs activities in many cases were fragmented and needed a clear strategy requiring the support and collaboration of the public and private sectors. The committee has focused on communication and colla boration, strategic alignment, and execution of indivi dual action plans. This work has resulted in the creation of the Brexit Action Plan to assist stakeholders with navigating the results of the recent referendum dec ision of the UK to leave the European Union, which
took place last summer, and the advanced work being
done on the AML ATF [anti -money laundering/anti -
terrorist financing] Review Action Plan to prepare
stakeholders for the upcoming IMF [International Monetary Fund] review, which is so critical and i mportant to Bermuda and our reputation.

[Change of Chairman]

Hon. Michael H. Dunkley: Mr. Chairman— you guys
switched up on me while I was taking a drink of water. Mr. Chairman, how are you this morning, sir?
Numerous additional projects or action plans
have been priorities in support of a phased roll-out of
critical initiatives. They also include OECD (review, common reporting standard, and country -by-country
reporting); a review of the Panama Papers, which was released with a great deal of fanfare; and a US cross -
border tax review, which is a very important matter for us, based on the new administration in Washington, DC.
This public/private sector working group has
been extremely active and committed to achieving our collective success. The commi ttee has met about a
1112 13 March 20 17 Official Hansard Report

Bermuda House of Assembly dozen times to complete the strategic plan and has
already had a number of meetings to address its i mplementation. Further, there are working groups and a
communications committee that have invested add itional time to this very important initiative.
Turning specifically to the [cost centre] 19035,
the London Office, the original estimate for 2016/17,
Mr. Chairman, is $1,032,000. The estimate for the
next financial year is $1,037,000. There is a $5,000 increase. The London Office budget includes an all ocation for three posts: the Director and UK Repr esentative, and two administrative staff, with total sala-ries allocated at $311,973.
Mr. Chairman, in collaboration with the D epartment of Workforce Development, the London O ffice has implemented an internship programme to provide an opportunity for Bermudian graduates in the UK to gain experience in the field of international rel ations and diplomacy.
[Change of Chairman]

Hon. Michael H. Dunkley: And as the Chairman
changes seats again and Madam Chairman is back, I
have to say that I have been impressed by this pr ogramme and the individuals who have worked in the
programme. And they have provided valuable assi stance during the time that they have been there. So I would commend the London Office for the oversight and the training provided in a vibrant environment.
The London Office is a great working environment,
and the City of London always has a lot going on in
the political world, so congratulations .
Madam Chairman, the London Office is the official representative of Bermuda and the Government
of Bermuda in the UK. This office continues to provide
a service to the Government by upholding our rel ationship and guaranteeing a very high- level dialogue
with the UK Government, particularly thro ugh i ncreased engagement with Departments of Her Majesty’s Government (HMG) across Whitehall, while wor king in cohesion with the Governments of the Overseas Territories where there is shared policy across the territories. The London Office is responsible for en-gaging with both Houses of Parliament; the UK Di plomatic Corps, such as Embassies and High Commi ssions; the United Kingdom Overseas Territories Ass ociation; the Commonwealth Secretariat, along with all UK-based commonwealth associations. It also engages with Bermudians living in the UK, including st udents; the general UK public, to include private com-panies; civil societies; and those who have a general or vested interest in Bermuda.
The London Office continues to allocate
space for what I call satellite operations, including the Bermuda Civil Aviation Authority and the Bermuda Shipping and Maritime Authority. The London Office is responsible for upholding the commitments made by the UK Government and governments of the overseas territories. I will go through a bit of the recent work that
the London Office has taken at this point, Madam Chairman.
You might be aware that in January 2014,
Bermuda became signatory to the Overseas Associ ation Decision (OAD), which manages the relationship between the European Commission and the Overseas
Countries and Territories (OCT) on relevant matters
within the European Union. The London Office is r esponsible for Bermuda’s engagement under the Over-seas Association Decision. The purpose of that en-gagement is to share in best practice on how each
overseas country or territory creates sustainable development through participating in EU partnerships,
and adding value to its economic development through innovation, competitiveness, and green growth. Sharing of these values provides overseas countries and territories with a special relationship within the EU through programming and political vis ibility in Europe. The London Office will continue to engage with the European Commission.
Madam Chairman, as a result of the UK’s
withdrawing from the European Union, the London
Office, through our UK- based representative, will continue to ensure that Bermuda is engaged throughout the long and somewhat tedious negotiation process under the Joint Ministerial Council [JMC], European Negotiations. Once Article 50 of the Treaty of Func-tioning of the European Union is triggered by the Prime Minster, the action will really heat up at that
time. But a lot of work has taken place from the end of
the referendum till now.
Madam Chairman, the London Office also
serves as the Government’s official consular service to Bermudians living and studying in the UK and Eu-rope. The assistance provided by the London Office
includes providing assistance to students and during
medical emergencies, social and f amily issues, crim inal proceedings in the UK, and immigration issues.
High-value line items included in the London
Office allocation other than salaries include the overseas conferences at $20,000, and building rental expense of $570,000. The balance of the allocation will cover standard operating expenses.
As I close my comments on this [cost centre],
I want to take this opportunity to thank Kimberley Dur-rant and her team for the excellent work that they do.
As Members are aware, I was recently over there for
JMC meetings specifically to discuss Brexit. And I am always impressed by the advanced planning and work that the team does. I always can look forward to a gift in my hotel room when I arrive. It is a binder that is much bigger than this brief, which outlines all the d etail and gives me an outline of every person you might come into contact with so you know what they do and why they do it. So I am sure that I can speak for ev eryone who has had experience with the London Office that they go above and beyond the call of duty, and it


Bermuda House of Assembly is most appreciated because they have a lot of important work to take place.
As I turn my attention now, Madam Chairman,
to [cost centre] 19045, the Washington, DC, Office,
the original estimate for the financial year 2016/17 is $529,000. There is an estimate for financial year 2017/18 of $206,000, or a decrease of $314,000.
Madam Chairman, the DC Office allocation has decreased by 60 per cent.
And the office is in the process of being
closed. The 2017/18 allocation will cover any rental expense that is required, insurance and utilities, but only until such time that the space can be sublet, as
there are several years left on that rental lease. The
process of subletting the space is being undertaken by the Ministry of Public W orks in consultation with the
building agent in Washington, DC. Madam Chairman, I have to believe that, given the recent change in US Government and the Trump Administration and the
proximity to Capitol Hill, the prospects of renting the
prime location are indeed quite high.
Madam Chairman, it is this Government’s
view that the strategy to step away from a bricks -andmortar presence in DC, extend our lobbyist reach and
coordinate stakeholder efforts via the External Affairs
Strategic Planning Committee wil l serve Bermuda
Government’s needs more effectively than a physical presence at this time. I also note, Madam Chairman, for the sake of this [cost centre], that international business has a significant presence in DC, and we
have many partners in the US an d certainly in DC
from whom we can continue to get our work. And it is
easy to travel and access people we might need.
Madam Chairman, I now invite Honourable
Members to refer to page C -4, which shows Capital
Account Estimates for Capital Development. And I will
run through those for the next couple of minutes. First, the Cabinet Office, Cabinet Building Services. There was the original estimate of $500,000 for 2016/17. There is an estimate of $500,000 for 2017/18. Madam Chairman, these funds are allocated for the renov ation of the Cabinet Office Building. It is anticipated that the work, which commenced in October 2016, will conclude shortly. The 2017/18 allocation will be used mainly for finishing works and, of course, to fit out the building. This project is being undertaken by the pr ofessionals within the Ministry of Public Works. As indicated on page C -4, the revised estimate for 2016/17 is
$1 million up from the original estimate of $500,000.
The increase is a result of a change to the scope of work. I will get to some specifics of money spent,
shortly.
But before I do, let me refresh the memory for
Honourable Members that, on the 12
th of May 2016,
the Secretary to the Cabinet, in his capacity as the employer, was issued a Notice of Contravention under
the Occupational Safety and Health Act 1982. The notice directed the immediate removal of staff from the unsafe working environment, owing to asbestos
contamination, black mould, and elevated CO
2 levels.
The notice, which I said was issued on
May 12th, directed that the building be vacated by the
18th of May. Ultimately, the Cabinet Office relocated
within a short time after the issuance of the notice.
Neither asbestos and mould abatement nor rental expenses associated with the relocation, formed part of
the original capital development costs. And I might refer back. The Cabinet Office had been scheduled for renovation since, I think, 2004, and kept being put off. Sometime last year, I believe, Cabinet approved two specific things to take place in the Cabinet Office, and
the work was going to be done when employees operated out of that building.
The first was, you will recall, Madam Chairman, probably . . . I think it was in 2015 during the
Throne Speech, we were inside because of bad weather. And as the heavens opened up, it also appeared that the roof opened up. And we had a flood of
water coming down from above. And so, it was very clear that we had some serious challenges with the building, that it was not sealed properly. And as any Member who had been in there will know, none of the
windows opened. They have been in there, I think, since God created wood, perhaps. And so, there were two contracts that were approved by Cabinet. One, to replace all the windows in the building. And secondly was to seal the building. That work was going to take place, as I said, when the work by people who worked
in the building stayed in the building.
Because of the finding that there was asbestos and mould in the building, we were required to
move out. Madam Chairman, to date, $874,000 has
been spent on the project and it is estimated that $192,000 more in commitments, hence the revised
estimate for the current financial year. And let me just
go through some of the budget allocations, and I am happy to give more detail to Members of the Oppos ition if they need me to. But some of the large ones —
the contract to improve the outside sealing of the
building has included almost $70,000 to reseal and re -
plaster the walls. And as you can see, they are star ting now to plaster. It was not a simple plaster, but they
had to hack out certain areas, and fix it up and then plaster. That has taken place and they are now star ting to actually put the sealer on the outside of the wall.
And it will be coloured slightly different, where the pi llars will be highlighted, so the building stands out.
The supply of new windows was almost
$241,000. There are a lot of windows in that building,
which you never know until you count them. And there were some windows in the building that were covered
up. For example, in the old Senate Chamber, on the
wall facing the Sessions House here, so that would be
the north wall, there were a couple of windows that no one knew from inside the building; they were covered up. All the windows have been replaced. Because it is
a historic building, they were specific windows that
1114 13 March 20 17 Official Hansard Report

Bermuda House of Assembly had to be milled. And then, as we found, once the
windows were removed by the professionals, they
found, because they were so long, so old, there were reinforcement cedar beams above which had to be taken out and re- plastered so the windows would fit
into the side.
Scaffolding for the building for the time of the
work was about $24,000. Roof repairs were quite sig-nificant. It is a flat roof, so everything settles unless you can run it off —$21,000. Plastering of the interior
walls, as well, after work was done, is about $35,000. The installation of the windows was just under $62,000. Painting will be just under $28,000. Electrical
work, the building did have its original electrical in it,
and many of the sockets were not working, and it was very difficult for many of the things that we tried to do. The Internet service in there was just awful. So elec-trical was $220,000. Plumbing, it had to be totally replumbed. And there will be now better bathrooms
upstairs, I believe, male and female bathrooms up-stairs —two bathrooms upstairs, two bathrooms dow nstairs. Plumbing is $30,000.
And then, one of the real challenges down
there was the air -conditioning. So there is new HVAC
in there of $80,000. And there is an IT allowance, as
well. Asbestos abatement cost about $30,000. And the whole building had to be fumigated, and that is about $35,000. So that just gives an overview of the work done to date.
So this concludes, Madam Chairman, my
presentation on Head 9, the Cabinet Office. And as I conclude, I would like to take this opportunity to thank the many hard- working civil servants in that area. We
have had some challenges recently with the passing of two of our beloved members of our team. But the office continues to work well even with these challenges. I want to take this opportunity to thank the
Head of the Civil Service, Dr. Derrick Binns, and the Deputy Head, Ms. Cherie Whitter, for the work she and her team do. I think they understand that, no mat-ter what time of day or night —because I have a tec hnology device, I will send e- mails like I did yesterday
to the Deputy Head of the Civil Service. And even on a Sunday, she got right back to me. But I know she was not in church at the time; I would not send it dur-ing that time.

HEAD 43 —DEPARTMENT OF INFORMATION AND
DIGITAL TECHNOLOGIES

Hon. Michael H. Dunkley: So, Madam Chairman, I
will now turn my attention to the Department of Infor-mation and Digital Technologies, Head 43. It is my
pleasure to present this head. And it can be found on
. . . skip over the Department of Statistics, which I
would have thought would be a good one to debate
today, and the Department of Human Resources, which I thought would have been a good one to de-bate today. We have all day. You put your time in. You could have put more time in, could have taken
some time for Transport, where you could not have
filled them on Friday afternoon, and put it into Cabinet Office.
It is my pleasure to present this Head 43,
which can be found on pages B-5 6 to B -59 of the E stimates of Revenue and Expenditure. The Department
of Information and Digital Technologies, currently the
Information Technology Office (or ITO), is mandated to empower ministries, departments and civil servants to improve productivity and services by providing IT consulting services and core IT infrastructure at a rea-sonable cost. Furthermore, Madam Chairman, it is
empowered to work with departments and ministries
to identify and progress opportunities for the creation and deployment of online content, transactions, sy stems, and services that meet the needs of gover nment, citizens, businesses, and the voluntary sector.
Madam Chairman, the evolved department,
which is an amalgamation of ITO, various sections within E- Government, and the telephone technology
functions from the Ministry of Works and Engineering, will become known as the Department of Information and Digital Technologies effective April 1
st, 2017. And
I will repeat that: It is an amalgamation between ITO, various sections of E -Government and the telephone
technology functions from the Ministry of Works and Engineering.
The department objectives —and I will list
them, Madam Chairman, but they can be found in the
Budget Book on page B- 56:
• maintaining and securing the IT Infrastructure
that host applications used by departments;
• supporting IT projects underway throughout government;
• delivering and managing IT services used by
departments;
• sustaining disaster r ecovery s ystems for s elected departments;
• supporting IT governance proces ses for government;
• delivering training on IT systems to improve effectiveness and productivity;
• measuring and communicating the satisfac-tion and usage of government services to departments;
• assisting departments with documenting and
improving business processes; and
• assisting d epartments with defining and developing e -technology solutions.
Madam Chairman, the General Summary,
Expenditure Programme by business unit, sets out nine programmes under 4301, which you can find on page B -56. These include Administration and Ma nagement, Device Support, Network Support, Service Support, Digital Services, Business Systems, Systems
Support, Training, and Security Section. The current
account estimates for 2017/18 for this Head 43 are
$6,976,000. The comparative budget figure for the


Bermuda House of Assembly current financial year 2016/17 is $6,142,000. As I alluded to earlier, Madam Chairman, the increase is due
to the merger with the E -Government Department, as
well as the assumption of responsibility for telephone services. The year -over-year increase is $834,000.
The overall net effect is a 14 per cent increase.
I will now take this opportunity to walk Honourable Members through the programme areas and provide an overview of the planned expenditure.
First, in cost centre 53000, on page B-5 6,
Administration and Management. Original estimate for the current financial year 2016/17 is $1,357,000. And the estimate for financial year 2017/18 is $1,306,000,
a decrease of $51,000, or about 4 per cent. The A dministration Section assists with budget preparation,
expenditure control, and accounts payable. The sec-tion processes about 2,500 invoices annually. It facil itates human resource administrative functions for the 41 posts that make up the Department of Information
and Digital Technologies.
Madam Chairman, there are seven full -time
positions in this section: Deputy Chief Information O fficer, Senior Manager of Administration and Training,
Senior Manager of Business Systems, Senior Manager of Infrastructure, Officer Manager, Administrative
Assistan t, and Computer Services Clerk. The salary
allocation is $734,036.
Madam Chairman, the department is located
in the East End of the Island at Channel House, on Longfield Road, Southside, with a budgeted rental
expense of $497,000, paid to Bermuda Land Dev elopment Corporation. The balance of the allocation
covers telephone, equipment, vehicle repair, office supplies, and general administrative expenses. The $51,000 variance is the result of not funding the ac-counts payable clerk/receptionist post. And those d uties will be assumed by others within the area.
Madam Chairman, in regard to cost centre
53030, Device Support, there is an estimate in the budget for this financial year of $347,000 and an est imate for the next financial year of $346,000, a 1 per
cent decrease. This section is responsible for the design, operations, and support of personal computers, printers, and mobile devices throughout government. The section supports the hardware and software for approximately 3,000 devices across government, and will resolve an estimated 3,500 service and repair
calls in any one year. The section works with gover nment departments to design specific device configur ations to meet their IT needs, as well as assist with providing counsel on developments in the industry ,
which is fast changing. The Device Section works with departments to mitigate any IT security risks.
Madam Chairman, there are four full- time p ositions here, Chief Systems Engineer, Systems Engi-neer, and two Operations Analysts, at a cost of $334,124. The balance of the funding is used for staff
training or any local consultants, as required. The var-iance of $1,000 is just in a reduction in anticipated
professional services.
Madam Chairman, as you will know, advances in this area have resulted in the establishment of
more efficient and less costly device services for the Government. It is anticipated this section will deploy approximately 100 advanced devices and approx imately 200 legacy [desktop] devices in 2017/18. I am told that advanced devices are innovative next -
generation computing devices, or simply plug and play. And the legacy devices are what some would consider outdated devices that it is essential to con-tinue to use within our system. We all fall into one or
both of those categories.
Madam Chairman, I now turn to Network
Support, which is cost centre 53035. The original estimate for the current financial year is $1,756,000, and an estimate for the next financial year of $1,799,000, an increase of $43,000, or about 2 per cent. The Network Support team plays an important role in gover nment department office moves and, of course, renov ation projects, as well as special events hosted by the Government that depend on computer communic ations and Internet access. It is anticipated that this
section will respond to approximately 860 service r equests in the next fiscal year.
There are five full -time positions, a Chief Network Engineer, two Network Engineers, one Oper ations Analyst, and a Unified Communications Officer. The salaries budget is $516,427.
Madam Chairman, the telephone data line
allocation is budgeted at $1,152,495, which is $56,000 less than the 2016/17 allocation. These funds, Madam Chairman, support connectivity for all 140- plus go vernment locations throughout the Island—140 gov-ernment locations throughout the Island, as well as
our overseas offices. Madam Chairman, $75,000 is
allocated for Overseas Networks, which is the prov ision of Internet services. This is a reduction of $40,000 from the current year. The balance of the funding, Madam Chairman, is for software maint enance, training and other admin expenses.
Madam Chairman, the decrease in telephone
data lines and overseas networks is offset by the i ncrease in full -time positions and local consulting fees.
The combined salary and consulting fees is increased by $142,600. This is not new money, Madam Chai rman; these funds have been reallocated from the Works and Engineering Ministry budget. The Network Support Section anticipates replacing its Primary Data Centre aged core network infrastructure in the next financial year to ensure network communications [ser-vices] for all government departments continue to operate without service disruption. The infrastructure will
enhance overall security against the growing cyber threats that we all experience, and deliver modernised telephony services for all government departments. This upgrade will ultimately reduce the Government’s telephony expenditure.
1116 13 March 20 17 Official Hansard Report

Bermuda House of Assembly I now turn my attention for a few moments to
cost centre 53040, Service Support. The original est imate in 2016/17 is $316,000. The estimate for the
coming year of 2017/18 is $244,000, a decrease of $72,000, or 23 per cent. The Service Support team
manages the Network Operations Centre, Madam Chairman, that provides a single point of contact for
reporting faults or service requests via the service desk. The area provides user account and password administration, and monitors all computer activity. The centre responds to alerts on the various components of the IT Infrastructure. Madam Chairman, there are three full -time
positions, a Service Supervisor, and two Service An alysts. The total salaries budget is $236,899. The ba lance of the funding supports software maintenance, local consultants and staff training.
The variance of $72,000, Madam Chairman,
is attributable to a decrease in salaries of $68,000 as
a result of not filling the Service Administrative Officer
post and also due to a minimal decrease in staff trai ning of $2,000 and a decrease in local contractors of $2,000.
It is anticipated, Madam Chairman, that the
Service Support Section will manage more than 12,000 service requests in the year ahead.
Madam Chairman, I now turn my attention to
Digital Services, cost centre 53050. There is no mon-ey under the budget for the current financial year, but an estimate for 2017/18 of $656,231. Madam Chairman, this new unit, Digital Services, will continue activities commenced under the Department of E -
Commerce.
Hon. E. David Burt: Point of information.

Yes, Data Entry, but thank you very
much.
Hon. Michael H. Dunkley: Same thing, yes. Thank
you. This unit researches, designs, prototypes, pilots and launches new digital services with a view to
making the Bermuda Government more efficient, r educing costs and improving customer service [through digitisation]. It is anticipated new digital services will be rolled out across Government, mainly through the new portal o r mobile apps, in the near future.
Madam Chairman, there are five full -time p ositions here, Chief Information Officer [CIO], Senior
Manager of Digital Services, two Business Analysts and a Relationship Coordinator. The total salaries budget is $547,007. The balance of the funding su pports subscriptions, any local consultants that are r equired, software maintenance and, of course, staff training. Madam Chairman, while this is a new section in the Information and Digital Technology Department, it is not new money. These funds were transferred from the former Department of E- Government.
While funding for the Chief Information Officer
post has been allocated under the Digital Services unit, this is the most senior post in the restructured department. And, Madam Chairman, I can inform honourable colleagues that recruitment will com-mence for this post in the coming weeks. The post -
holder will lead on the formation and implementation of Information Systems (IS) and Information Technol-ogy (IT) strategy for the Government.
The post holder will be responsible for making
critical long - and short -term strategic decisions r egarding the coordination of information systems, i nformation assurance, enterprise and architecture d evelopment, systems development/management and information systems and information technology man-agement to ensure Government’s organisational suc-cess. Madam Chairman, the Chief Information Officer will also be responsible for influencing development of
the IS/IT through portfolio management and stak eholder relationship management and the Gover nment’s telecommunications function.
Each of the four unit heads within the depar tment will report directly to the CIO. Ultimately, the funding for this post will be centralised under the A dministration and Management programme area.
Madam Chairman, I turn now to cost centre
53060, Business Systems Support. Original estimate
in 2016/17 budget year is $568,000. The estimate for 2017/18 is $644,000. That is an increase of $76,000.
Madam Chairman, Business Systems provides project
support and IT service management. The Business System Section provides one single point of contact for departments at management level. The unit su pports all business applications used by various go vernment departments.
Madam Chairman, there are six full -time pos itions here—three Computer Services Officers, a Bus iness Analyst and two Support Analysts. The total sa laries budget is $582,884. And the balance of the funding supports software maintenance, staff training and local consultants.


Bermuda House of Assembly Madam Chairman, the variance is attributable
to an increase in salaries of $73,000 as a result of
filling the Support Analyst post, and an increase of $3,000 for staff training.
Madam Chairman, it is anticipated that the
unit will support approximately 40 new and existing
projects throughout the coming fiscal year. Project
support activities include IT consulting that consists of
assisting departments with project start -up, requir ements definition, procurement, vendor and [project] management, as well as coordination with IDT and vendor system engineering teams to build the IT infr astructure required by the project. This section will r esolve approximately 350 service requests, as well as conduct probably about 140 routine department ser-vice management meetings throughout the next fiscal year.
This section, Madam Chairman, works in conjunction with other business units within the depar tment and will take a leading role in guiding and, of course, assisting government departments in as-sessing IT business needs, and providing research support to avoid and reduce [superfluous] IT project spending generally across all government depar tments.
I turn now to the next cost centre, Systems
Support, 53070. There was an original estimate in the current budget year of $1,440,000. There is an est imate in the next financial year 2017/18 of $1,699,000, or an increase of $259,000.
Madam Chairman, the Systems Support Section is responsible for design, deployment, operations
and support of the servers and system software that
host the applications used by departments. It also de-livers system engineering consultation, design and deployment services for IT projects; addresses capacity shortfalls, ageing technology —we all know how
quickly technology can age—industry developments;
and mitigates IT security risks.
Madam Chairman, there are eight full -time
positions. They consist of two Chief Systems Engi-neers, two Systems Engineers, three Operations Analysts and a Technical Analyst. The total salaries budget is $675,275.
Madam Chairman, a budget of $501,000 is
allocated to Facilities Rentals for our hosted data cen-tre, which is our primary facility. This facility houses
government servers such as E1, the tax system and
all core government systems. There are approximat ely 400 servers located in three data centres; the two secondary centres are located in government buil dings.
Madam Chairman, $425,000 has been all ocated for software maintenance, which covers licence renewal for all of the core systems. The balance of the funding wi ll support staff training and any local consultants that are required.
Madam Chairman, the variance of $259,000 is
attributable to an increase in salaries of $82,000 as a result of filling the Systems Engineer post. Also, an
increase in facilities rental costs of $204,000 is offset
by a decrease in software maintenance of $27,000.
Madam Chairman, it is anticipated that the
section will resolve more than 1,450 service requests in the coming year.
Madam Chairman, I would turn to the next
cost centre of Training, 53080. There is a budget all ocation of this year for $75,000. The original estimate of last year was $150,000. This section develops course material and delivers about 150 courses and 100 in- house assistance sessions annually. It is anti cipated that the training delivery will remain somewhat
unchanged in 2017/18.
There is one full -time Training Officer. The
total salaries budget is $75,093. The balance of the
funding supports staff training exercises.
Madam Chairman, the variance of $76,000 is
attributed to a decrease in salaries of $76,000 as a
result of not filling a Trainer post.
The last cost centre in this area, 53090, is for
Security. Original estimate of $207,000 in 2016/17, and that remains unchanged in 2017/18. The Security Section undertakes cybersecurity risk matrix reviews
and provides recommendations to address imminent
and potential cyberthreats on government IT systems. Madam Chairman, we know that this is a growing area of concern. Unfortunately, there are many people out in the community and in the world who will try to plug into anything and make things happen.
Madam Chairman, there are two full -time p ositions here, a Security Manager and a Security Analyst. The total salaries budgeted for the next financial year are $176,864. The balance of the funding is for security testing and for any local consultants that might be required.
This unit is responsible for monitoring IT sec urity vulnerabilities and, of course, recommending mit igation plans. This includes security policy review and
revision, as well as compliance audits. The unit coor-dinates about three disaster recovery exercises annually and audits security updates on about 300 servers
monthly.
Madam Chairman, IDT will focus on continuing implementation of IT security, and the plan i ncludes implementing security processes and techno logy that will impact all components of the IT infr astruc ture and consequently will involve all sections of
IDT. Madam Chairman, I will refer to some specific actions, which will include:
• improving account management processes
that will control and require increased author isation to enhance security on levels of access;
• improving IT s ecurity p olicy compliance, i ncluding training and the roll -out of compliance
systems by department and users;
1118 13 March 20 17 Official Hansard Report

Bermuda House of Assembly • continuation of installing and enhancing sy stems to monitor threats and vulnerabilities;
and
• improving and modernising protection sy stems at the network border, and internally within the network and on any device.

This is a growing area of concern, and I a pplaud the department for focusing in on it. Because
just as you cure something, there is another challenge that pops up.
Madam Chairman, I would now like to draw
Honourable Members attention to page C -9, Capital
Expenditure. You will find that in 2016/17 the estimate
was $475,000. For the next financial year, there is
another $475,000 that has been allocated. Madam Chairman, this is primarily used to replace ageing desktop computers, screens, printers and mobile de-vices across government. The plan is to replace desktops and laptops that are more than five years old and, of course, unable to support the latest Microsoft operating system and related government IT services. Also included in this allocation is $150,000 for upgrad-ing software licences and on remote devices.
Madam Chairman, in regard to Network U pgrade [76169], there was an estimate of $680,000 in the current financial year. There is another estimate for $680,000 in the next financial year. This allocation is primarily used to maintain and upgrade the Go vernment Network and support departmental relocation and renovation projects. Of the total budget, $580,000
is allocated to upgrade core network primary data
centre infrastructure and gateway security. Madam
Chairman, this investment will improve services to include voice and wireless that will also reduce ex-penditure on data circuits accounted for in the Com-munications budget.
You will see there is an allocation in the current financial year for $400,000 for Systems/Servers Upgrade. There is $400,000 allocated to the next f inancial year, as well. The budget allocation provides funding to maintain and upgrade the servers and sy stem software that support all business applications used by departments. Included in the allocation is funding to increase capacity to accommodate depar tment projects and to complete an ongoing project to replace the old Microsoft 2003 operating system. Madam Chairman, also included is an amount of
$220,000 to upgrade e- mail and Internet border sec urity systems, core government server farm capacity,
and an amount of $160,000 to refresh e- mail systems
to the latest standard, and Microsoft server software licences.
E- Government Initiatives, there is a $300,000
allocation in the current financial year, and $250,000 for the next financial year, which we will debate in this
budget today. This is a decrease of $50,000. This al-location provides funding for a pilot project for applic ation integration to feed digital services front end portal systems and the development of e- payments and e -
forms, Madam Chairman.
In regard to Security, in the current budget
year 2016/17, there are $200,000 allocated, and in the
next financial year, $100,000. Madam Chairman, this allocation will be used to invest in systems to enhance cybersecurity and, of course, mitigate the omnipresent
and increasing Internet threats that we face. The initial
investment will be used to procure and set up systems that will continuously monitor the entire IT infrastruc-ture for threats and vulnerabilities. These systems will raise alerts that will trigger a response to rectify any weakness.
This concludes a brief overview of the Capital
Expenditure explanations.
Madam Chairman, the Department of Information and Digital Technology is critical to sustaining the effective operations of the Government. They have continued to realise cost reductions while mai ntaining a discerning watch on the Government’s core IT Infrastructure. During the next fiscal year, core net-work upgrades and continued IT security will be the priority, with the overriding objective to protect and
sustain reliable IT services for the departments.
Madam Chairman, you might know that former Director Mike Oatley retired from the service last
year. And I would like to take this opportunity to thank him for his dedication to the Government for many years. The department is in the process of restructur-ing, and it is anticipated that a CIO will be appointed
to lead the department. I would like to take this opportunity to thank Acting Directors, Mr. Shawn Light-bourn e and Mr. Peter Smith, and the entire staff for
the excellent service that they continue to provide to the Government.
That concludes the presentation on Head 43,
and I will now turn my attention to the next head up for debate, Head 51.

HEAD 51 —DEPARTMENT OF COMMUNICATIONS

Hon. Michael H. Dunkley: Madam Chairman, Head
51, Department of Communications, can be found on
page B -60 of the Budget Book, and it goes through to
page B -63.
The Department of Communications is mandated to be the source of trusted communication between the Government, public service and residents
of Bermuda, using media and technology to educate and to inform.
The department’s objectives are set out on
page B -60. The primary objectives for the department
are to develop and implement communications campaigns that provide information about Government’s initiatives, services and programmes; to provide in-house graphic design and photographic services; to produce television programmes; and to maintain an external portal that provides timely and accurate i nformation to the public. Colleagues can refer to page


Bermuda House of Assembly B-60 of the Budget Book for a more detailed overview
of those objectives.
The Current Account Estimates, Madam
Chairman, for Head 51, the allocation for 2017/18 is
$2,945,000. This is a 27 per cent increase over the
current year budget of $2,318,000. Madam Chairman, the variance is due to the transfer of the portal deve lopment section of the Department of E -Government,
as well as the transfer of the telephone operators from the Minist ry of Public Works to the Department of
Communications and Information. Effective April 1
st,
2017, Madam Chairman, the Department of Comm unications and Information will become, simply, the
Department of Communications.
The vast majority of the department’s budget
is allocated to salaries for the Department of Comm unications. Currently, this is $2,469,000. That is 84 per
cent of the total budget within the department. The
remainder of the budget will cover the department’s
operating expenses.
Madam Chairman, as new media and tec hnology continue to be introduced, the department will
obviously have to keep pace by periodically replacing equipment as it becomes obsolete. They will also
work to stay abreast of how the public want to consume information, and this means the department will investigate and introduce new media platforms on which the public can interact and access government information and services.
The department budget is set out in six pr ogramme areas, which you can find at the bottom of page B-60:
• Administration;
• Communications (formerly, Public Affairs);
• Government Television Station;
• Creative Services;
• Portals Management (formerly, EGovernment; and
• Customer Service Representatives (formerly,
Telephone Services).
Madam Chairman, the underlying premise of
the new department is that it will become an infor-mation hub for the Government and, of course, the people of Bermuda. The six sections will form a single unit that will collect, synthesise and distribute information internally and externally. Each section will be
responsible for information dissemination based on their specific area of expertise.
I will now walk you, Honourable Members and
the listening audience through the planned expendi-ture for each section:
First, Madam Chairman, Adm inistration,
61000. There is a budget for the current financial year of $465,000; the budget for the next financial year of $459,000, a decrease of $6,000. This section is r esponsible for the strategic leadership and overall management of the department. There are three full -
time positions, a director, an administrative officer and an accounts clerk. The salary allocation is $276,984. Madam Chairman, there is also an allocation
for investment in staff training for the 30 full -time staff
within the department, at $21,861, and a further $10,000 has been set aside for any local consultants that are required. The balance of the funding will be used for telephone, equipment, cleaning, office sup-plies and the other standard office administration expenses. Madam Chairman, the $6,000 variance is
attributable to minor efficiency savings as a result of renegotiating long- term service contracts.
Madam Chairman, Communications cost centre 61030, has an original estimate for the current f inancial year of $598,000. And an estimate for the next
financial year of $687,000 represents an increase of
$89,000. The Public Affairs Section will become the Communications Section. This name has changed to reflect the realigned strategic direction of the depar tment and is in keeping with industry standard, Madam Chairman.
There are seven full -time positions, an Assi stant Director, Communications; five Communications Officers; and an Internal Communications Officer. The salary allocation is $657,104, while there has been $29,000 set aside for advertising, and the balance for
telephone and any administrative expenses that are
required. The $89,000 variance is due to the addition of the post of Internal Communications Officer. Mad-am Chairman, this is a new post, and it is a redefined post of Receptionist that is no longer required by the
department.
Madam Chairman, there are more than 4,000
employees within Government, which necessitates a very comprehensive structure to be put in place to effectively communicate with all of the civil servants. The new post of Internal Communications Officer will develop methods to enhance communications within
the organisation, leveraging existing channels, including the recently introduced intranet —GovConnect.
Working closely with the Communications Officers, the Internal Communications Officer’s remit will include continuously evolving and expanding the recently i ntroduced intranet, GovConnect, and to keep it updated and, of course, accurate.
Madam Chairman, it is anticipated that the
five communications officers will collectively prepare and release in excess of 100 press releases, an-nouncements and advisories each month, and manage ministerial participation in more than 100 comm unity and government events per month. Further,
communications officers w ill use social media and
other electronic channels to upload roughly 40 advis ories and announcements each month. Madam Chair-man, of course, the aim is to ensure that the comm unity is well informed about the Government’s services, programmes, policies and l egislative initiatives.
By way of a small example, Madam Chairman, in the current fiscal year, Public Affairs Officers provided critical support during Hurricane Nicole. And I would like to thank everyone involved, certainly Nea
1120 13 March 20 17 Official Hansard Report

Bermuda House of Assembly Talbot, for the information provided, and the Minister,
Minister Baron, for the excellent work during that Category 4 storm which hit Bermuda last October. I was
speaking to somebody who deals with media worl dwide, and on that day that was the eighth most repor ted news media item throughout the world. So ha ndling a message like that is critically important, not
only to get out what is right, but let people know that
Bermuda is okay and we will recover quickly. The d epartment works closely, of course, with the Emergen-cy Measures Organisation, and we were able to keep the members of the public reliably informed through-out the storm and, of course, after the storm as well.
Other highlights of the delivery through the
department, I will first start with the Cabinet Office: the promotion of the Government’s Throne Speech initi atives; communications management of all the Prem-ier’s overseas visits including a successful visit to the Azores to fortify business links and cultural relatio nships between both countries; the creation and launch of the AskYourPremier e- mail account, which again
opens up the availability by members of the public directly to the Premier; and of course, as I have pr ovided updates on from time to time, Madam Chai rman, the 2016 Census.
Public Affairs Officers managed a multi -media
campaign focused on recruitment and public particip ation. Electronic gathering of information was very po pular, where we saw it reached about 30 per cent. And
the Census team is now targeting the remaining 5 per
cent, I believe (hopefully, it has crept down to 4 per
cent) who have not completed a questionnaire form. A robust communications effort has ensured that res idents are well aware of their duty to complete the Census questionnaire, and I take this opportunity, Madam Chairman, to invite those 4 per cent who have
not done it yet to complete the questionnaire, because we would like to get it done as soon as possible.
And with that, perhaps you would like to adjourn for lunch?

Good afternoon. We are about to r ésumé the debate on the Cabinet Office. I think the Premier was on Head 51, and I believe we have Head 80 after that.
Premier, you have the floor. And be mindful
that this debate ends at eight minutes after three. So, we have an hour and eight minutes remaining.
Premier, would you like to resume now?
Hon. Michael H. Dunkley: Thank you, Mr. Chairman.
I will pick up where I left off on Head 51, Department
of Communications.

HEAD 51 —DEPARTMENT OF COMMUNICATIONS
[Continuation thereof]

Hon. Michael H. Dunkley: I left when I was giving an
overview of some of the work in very summary form of
what public relations officers have done within the Department of Communications. And I just finished the Cabinet Office; I will now turn to a few of the other
ministries just to give a flavour.
In Legal Affairs, there was promotion and
awareness of the opening of Bermuda’s first Mental
Health Treatment Court.
In Home Affairs: promotion of training and
certification programmes and internships with the Department of Workforce Development which resulted in opportunities with the Loren at Pink Beach, Bermuda
College, and the Bermuda Hospitality Institute.
Also, they held Civil Union public awareness
campaign meetings in various places throughout the
Island.
Ministry of Tourism, Transport and Municipal ities: The Government announced that among the
many initiatives that took place this year that Norw egian Cruise Lines has agreed to a long- term relationship with Bermuda that included the provision of tender service for passengers between the Dockyard
berthed ships to the town of St. George and their add itions of silt from the harbou r to supplement needed
infill for the creation of Cross Island. In addition, there
was work done on the smaller cruise ships in Hamilton and St. George in returning to the three port destin ation.


Bermuda House of Assembly Mr. Chairman, in Public Works , a couple of
initiatives: A Public Affairs Officer assisted with
providing communications management and support
for public information sessions regarding the formation
of the Strategy for Sustainable Water and Wastewater Servicing in St. George’s Parish. Attendees had the
opportunity to review the project and display materials
and give feedback.
In regard to Public Works as well, Mr. Chai rman, two government trainee civil engineers , Mr. R icardo Graham -Ward and Ms . Allanette Hayward work
in the Ministry of Public Works and were placed on
secondment in the private sector to gain vital work
experience which will go towards their accreditation as
chartered engineers. They both completed their threemonth internships at the South Basin site with BCM McAlpine.
In regard to the Ministry of Health and Se niors: The public and potential visitors, obviously, as
you and Members are aware, have bec ome concerned over time about the Zika virus and reports
around the world. So in Bermuda when it was found that a reggae artist who performed here and it was
subsequently reported he had contracted Zika before
arriving on the Island, together with the Ministry of
Health, the Department of Communication and Information launched a concerted public health campaign which kept the public informed about the incidence of travel -related Zika and raised awareness of the community’s role in vector [control ]. And this is very important because, obviously, in situations like that there is much concern raised and perception needs to be linked with reality. And I think they did a great job in that area.
So, t hese are just a few examples from var ious ministries, but the work of the department is si gnificant and I would like to just acknowledge the Director who sits with us today on the great work that she does in leading the team through her job, which is r eally, seven days per week.
The next [cost centre], which can be found in
page B -60 Mr. Chairman, is the Government Telev ision Station . The original estimate for 2016/17was
$669,000. The estimate for 2017/18 is $582,000, a decrease of $87,000, or 13 per cent. There were se ven employees and there are six employees in 2017/18.
Mr. Chairman, CITV is the government -owned
television station and has been in existence for 10 years. The station focuses on innovative educational, informational, cultural , and historical television.
As I mentioned, there are now six full-time
employees, a general manager, programme manager,
senior producer, producer, television editor, and vide-ographer. The total salaries budget is $481,226 and
an additional $30,000 has been allocated for local consultants. Each year an RFP is issued for an individual or company to provide technical and equipment maintenance services to CITV. The consultant also trouble shoots and provides support in the event of a
technical fault.
Mr. Chairman, the government television st ation is located on the grounds of the Berkeley Institute
where they are billed for electricity via the school at an
amount of $38,940 which is budgeted for electricity.
The balance of the budgeted funds will cover supplies, equipment , and general administrative expenses.
Mr. Chairman, the 13 per cent decrease, or
$87,000 variance in this programme area, is simply
due to the transfer of the information systems officer
post from CITV to the Portals Management team in
another head.
Mr. Chairman, the station continues to highlight the Island’s heritage and provides insight into
Government’s policies, initiatives , and programmes.
CITV, has produced many documentaries over the last year and are steadily working to capture the sights and sounds of AC35. We can expect to see
some awesome and specta cular imagery and sporting
at its best on our very own CITV television station.
This station also has the capacity to record i nterviews and develop shows that support government
initiatives , as seen from time to time, and can provide
live broadcasts to keep the public up to date on topical issues that Bermuda residents want to get more i nformation about.
During the current financial year, Mr. Chairman, the station added the ability to stream all its
broadcasts live over the Internet. This allows the st ation to have a far greater reach than it had previously.
People in Bermuda and from around the world can now tune in regardless of where they are to learn about Bermuda’s culture, history and heritage, and what is going on in the Island.
I now turn my attenti on to cost centre 61050,
Creative Services. The original estimate in the current budget year of 2016/17 is $586,000. The estimate for 2017/18 is the same, $586,000. And the employee numbers remain the same, as does the budget.
Creative Services is the keeper of the government’s visual identity. This identity ensures there is a common thread to the look and feel of the infor-mation that is released by the Government of Berm uda. This past year, the department revisited and u pdated the Visual Identify Programm e, taking into account changes within government, the advent of new
media as an integral part of stakeholders daily lives,
the interconnectedness of the portals ( www. gov.bm
and the employee Intranet) , and all collateral material
that is issued by the gover nment.
I want to take this opportunity to thank me mbers of the Creative team for the work they do. Quite
often in short time, putting things together, they do a
tremendous job, and as somebody who appreciates that type of creativity, because I think my mother and my sisters got it all and I got little, I certainly do appr eciate it, Mr. Chairman.
1122 13 March 20 17 Official Hansard Report

Bermuda House of Assembly I turn my attention now to Portals Management, cost centre 61060. There was no budget alloc ation in the current financial year, but there is an alloc ation in the next financial year of 2017/18 of $478,000,
because this section was formerly part of E -
Government and will now amalgamate with the D epartment of Communications in April 2017.
Portals Management is responsible for the
development, upgrading, and content of t he gover nment portals. The current portals are www.gov.bm
and GovConnect. The Portals team will be aligned to ministries and departments which will ensure each area within government has the support they need for
timely p ortals management. The Portals team will
guarantee the information on both platforms is acc urate and regularly updated. One of the priorities of the
team will be to develop and upgrade the backend of gov.bm to keep pace with the demands for online se rvices .
Mr. Chairman, there are four full-time pos itions, an Assistant Director, Portals , and three Portals
Administrators. Of the total budget for Portals Man-agement, $340,674 is allocated directly to salaries;
$73,000 for software maintenance and $52,200 for
support .

POINT OF CLARIFICATION

Hon. E. David Burt: A point of clarification, if the
Premier may. Would he just repeat the number for
after salaries?

Premier, continue.
Hon. Michael H. Dunkley: Sure. Of the total budget
for Portals Management, $340,674 is allocated to sa laries; $73,000 for software maintenance; and $52,200
for PC software. The remaining funds will cover standard office administration expenses.
Mr. Chairman, I now turn to the last cost ce ntre on page B -60, that of 61070, Telephone Customer
Services. Again, like the last cost centre, there is no estimate for the current financial year. There is an es-timate of $153,000 for three employees for the next financial year. This is another new programme to the Department of Communications. Previously, this pr ogramme was managed by the Ministry of Works and
Engineering.
Telephone Customer Services, formally
known as Telephone Services, provides information to
callers to the government’s main switchboard, at phone number 295- 5151 (I think everyone in Bermuda
probably knows that) , for people who are seeking answers to questions or who wish to be connected to a department or individual.
Those three full -time positions certainly have
a very busy job with answering the phones. There is a
budget allocation of $146,782. There are funds all ocated for equipment , furniture and fixtures , and other miscellaneous expenses at $6, 500 altogether. All of
that was transferred from the Ministry of Works budget
into the budget for the Department of Comm unications.
Mr. Chairman, in the future this section could
evolve into a government call centre, providing a cen-tral location for frequently asked questions. More
complex questions would obviously be sent to the
specific departments. But it is anticipated that the
amalgamation of the telephone operators and portal
teams, with the design and media relations teams will
result in government’s communications becoming far more efficient. And this is something that I applaud
this department and the director for taking a leadership role on because, clearly, we can always improve.
I turn now to Capital Expenditure. Honourable
colleagues, and Mr. Chairman, you can find that on page C -9 under Capital Acquisitions.
The Department of Communications has been
allocated $288,000 in fiscal 2017/18 v ersus $428,000
in the current financial year . Of this sum, $38,000 will
be used to procure computer hardware upgrades for the newly combined teams of the Department of Communications; and $250,000 will be used for the
integration software to connect the Government Portal
website to the numerous databases throughout go vernment.
In closing, Mr. Chairman, let me take this opportunity to acknowledge and thank the Director, Aderonke Bademosi Wilson and her hard- working
team at the Department of Communications for their hard work, dedication, and professionalism. I look forward to their successes as they become a more d ynamic department dedicated to communication excel-lence internally and, of course, externally as well .
The last Head that the Opposition had scheduled for debate is Head 80, and that would be Project Management and Procurement.

HEAD 80 —OFFICE OF PROJECT MANAGEMENT
AND PROCUREMENT

Hon. Michael H. Dunkley: This can be found on pages B-64 to B -66 and C -9 of the Budget Book.
Mr. Chairman, it is my pleasure to have the
opportunity to present Head 80 here this afternoon,
the last Head within the Cabinet Office, the Office of
Project Management and Procurement .
The Office of Project Management and Pr ocurement provides oversight and guidance to public
authorities regarding project management and pr ocurement activities to ensure that contracts are
awarded to providers of goods, services , and works
based on the principles of transparency, competition, and the use of objective criteria in making decisions.
The current account estimates for the coming
financial year 2017/18 budget allocation for the office
is set at $773,000. The comparative budget figure for the current financial year is $852,000. The decrease is


Bermuda House of Assembly due to a reduction in the budget allocation for salaries.
This will result , Mr. Chairman, in an annual savings of
approximately $79,000. The overall net effect is a
9 per cent decrease from the current year budget anticipated expenditure.
The office’s budget consists of the project
management and procurement programme as noted on page B -64. I will now take a few moments to walk
Honourable Members through these numbers and
provide an overview of the planned expenditure.
The first area is the Programme Business Unit
8000 (which yo u will find at the bottom of page B- 64)
and there are two cost centres attached to this : cost
centre 90000, Administration; and t he unfunded cost
centre of the AD&C [ Architectural Design and Construction]- Architect Support Services.
Mr. Chairman, in regard to Administration, I
have already gone through those numbers and shown
that there are $852,000 allocated to the current year;
with a decrease of $79,000 for the coming financial
year to make that total $773,000. There are eight em-ployees in the current financial year; seven in the next year.
Mr. Chairman, this programme business unit
is responsible for the overall management and admi nistration of the Office. Thus , the majority of the funds
are allocated to salaries which account for $724,000. This represents a decrease of $87,000, or approx imately 11 per cent over the current budget for this
2016/17 financial year. The temporary post of project
manager has been discontinued.
The Office is comprised of seven professionals including a director, procurement manager, senior
project manager, quantity surveyor, trainee quantity
surveyor, contracts and compliance manager , and
administrative assistant. These professionals have
expertise in procurement, project management, quantity surveying, contracts, compliance, and administr ation.
Mr. Chairman, quantity surveying is a specialised area with limited local expertise. The Government
has therefore invested in the development of a young Bermudian, Ms. Renee Burt , who is currently on s econdment in the United Kingdom. Ms. Burt is actively engaged in a training programme with Pantelli Ass ociates , a UK based quantity surveying and project
management firm, to prepare to qualify to become a
quantity surveyor. This phase of her training requires
direct work experience in a reputable organi sation so
that she can meet the requirements of the Royal Inst itute of Chartered Surveyors.
Mr. Chairman, the balance of the budget all ocations under this cost centre 90000, Administration,
are set out in the subjective analysis of current account estimates on page B -65, and I will run through
some of the particulars :
• Three thousand dollars has been allocated for
other personnel costs. This is the same
amount as in the current financial year. • Eight thousand dollars has been allocated for
training. This represents an increase of
$2,000 over the current financial year.
• Seven thousand dollars has been allocated for travel expenses. This represents an i ncrease of $4,000 over the budget allocation
for this year.
• Seven thousand dollars has been all ocated
for communications, which represents an i ncrease of $1,000 more than the budget alloc ation for this year.
• No budget amount has been allocated for the rental of office space as it is not required.
• Three thousand dollars has been allocated for repair and maintenance services, which is the
same for the current financial year.
• Twenty -one thousand dollars has been allocated for the acquisition of materials and su pplies. This represents an increase of $1,000.
Mr. Chairman, during fiscal year 2017/18, the
office plans to implement the guidelines for managing
capital projects and the Code of Practice for Project Management and Procurement.
Mr. Chairman, Honourable Members will know
that the draft Code of Practice for Project Management and Procurement was published in November 2016. Stakeholder consultation concluded on Jan uary 31, 2017.
Mr. Chairman, in the [ 2016 ] Speech from the
Throne, the Government committed to place a Code of Practice for Project Management and Procurement within a new unified legislative framework for pr ocurement that will replace the relevant sections of the Public Treasury (Administration and Payments) Act
1969 , and the Good Governance Acts of 2011 and
2012, and will meet the requirements of the United
Nations Convention Against Corruption. The office is working with the Attorney General’s Chambers to de-velop the procurement legislation that will form part of the new legislative framework.
Mr. Chairman, Honourable Members will know
that the office was established in part to advise on, guide, and support the development of, and adherence to, procurement regulations and policy. In this regard, it is expected that the office will conduct trai ning sessions to educate public officers on the Code of Practice for Project Management and Procurem ent,
the procurement procedure manual, and the project management guidelines.
Mr. Chairman, in keeping with its statutory o bligation to identify and apply performance measures to
ensure that the Government obtains the best value for
money, the office will continue to assist public author ities to develop and implement procurement strategies that leverage the Government’s purchasing power.
In an ongoing effort to reduce operating costs,
the office will identify commodities that can be purchased at rates which are more favourable to the
Government. This will involve a process of consolidat1124 13 March 20 17 Official Hansard Report

Bermuda House of Assembly ing purchases of goods and services that are commonly used by public authorities.
The office will negotiate framework agreements with key suppliers to take advantage of opportunities to further reduce costs and increase the level
of the government’s efficiency in providing services to the public. In a similar vein, steps will be taken to
identify and renegotiate or terminate contractual arrangements that do not provide the best value for
money.
The office will perform periodic compliance,
project management , and procurement audits on capital projects to satisfy its statutory obligation to ensure that best practices are adhered to in the oversight of
capital projects. Mr. Chairman, the office is committed to strengthening financial accountability across the government to reduce the likelihood of the realisation of risks such as non- performance, fraud, and misappropriation of assets that were identified in the Report
of Auditor General on the Consolidated Fund of the
Government of Bermuda for the financial years 2010,
2011 , and 2012. The office will take the steps necessary to ensure that the policies, procedures , and best
practices that pertain to capital expenditures are followed by all public officers.
Mr. Chairman, the office will also make every
effort to minimise the occurrence of violations by pu blic officers of compliance rules and standards, and to
eliminate practices that were the subject of the Com-mission of Inquiry’s investigation into the findings set
out in the Auditor General’s report.
Mr. Chairman, in line with the SAGE Commission’s recommendations with respect to improving the
Government’s effectiveness and efficiency in the d elivery of services, the office will implement a purchas-ing and tendering system; standardise tender doc umentation; and implement an electronic tender doc ument drafting tool. These initiatives will provide tec hnological support for the implementation and applic ation of policies and procedures that govern project
management and procurement activities, and will enhance the controls, checks , and balances that are in
place to protect public funds.
Mr. Chairman, capital expenditure for the current fiscal year of 2016/17 is $67,000. The estimate
for 2017/18 is $150,000, an increase of $83,000.
Funds budgeted for capital acquisition for the
next year are set out on page C -9. The funds will be
used to acquire and implement an electronic purchas-ing and tendering system.
In closing, Mr. Chairman, the office is working
hard to support the Government’s efforts to provide
oversight of all government procurement. I want to
take this opportunity to acknowledge and thank the
Acting Director, Graham Simmons, and the hard-working and dedicated staff of the Office of Project Management and Procurement.
Mr. Chairman, that concludes my present ation. The Opposition Leader had asked me one ques-tion before lunch, well, five questions before lunch, I
do not have all the answers at this point in time, but I
read my e- mails. I f the Leader of the Opposition would
like to go, I will save the answers for later.
I now open the floor up—

Premier, thank you for your present ation.
The floor is now open for any other Members
who would like to participate in this debate. I reco gnise the Leader of the Opposition from constitue ncy 18, Mr. David Burt.

Hon. E. David Burt: Thank you very much, Mr.
Chairman. Please give me two minutes, I just want to
e-mail the Premier the questions for Head 80.

Just to remind you that this debate
ends at eight minutes after three.
Hon. E. David Burt: Thank you, Mr. Chairman.
Just for the listening public, as is my practice,
I send my questions to the Permanent Secretary for
the Ministry of Finance before; this is my first time doing the Cabinet Office. So this will be the Premier’s
first time with this, but I always send my questions to the civil servants so they can assist the Minister with the answers, and hopefully have time to research them and get those answers, as opposed to trying to find them when they are asked and having to record
them themselves. I find that it works a little bit easier
that way, Mr. Chairman.
Thank you, Mr. Chairman. I appreciate the
Premier sharing his brief, sorry, not sharing his brief, reading his brief. I was disappointed, of course, that
the Premier did not feel the need to share his brief, as
I have said on numerous occasions, the Honourable
Premier says that we should be working together more often, but it seems as though the Honourable Premier does not necessarily practice what he
preaches all the time. But we will excuse that.
The first question I had under the Cabinet O ffice, you would remember, Mr. Chairman, that we not-ed in our Budget Reply, we cannot support the closure of the Washingt on, DC, office at this time, especially
given that one of our main threats to our very exis tence as an international financial centre and our continued competitive advantage will come from the United States in addition to Brexit. It is interesting to see the Honourable Premier speak about and laud the
work of the London Office, but not in the same exact way give that type of laudable [praise] to the Office in DC, which is, of course, is our largest trading partner.
And just by reference, Mr. Chairman, I lo oked
on page B -46, and I look at some of the performance
measures of the Cabinet Office, and we take a look at the original forecast and different items which were supposed to be done, and we are talking about meet-ings with key members of Congress, meetings with


Bermuda House of Assembly the diplomatic community, meetings with international
business contacts, et cetera. And one would think that
given where we stand, right now in the space of inter-national relations, that this is something that the Go vernment would like to take on in a more serious
measure. So it is one thing that we said we cannot support their decision for that because we do not b elieve it is in the best long -term interest of the country.
However, the Government did note that the
money that has been allocated to our lobbying effort in Washington, DC, has increased from $100,000 to $250,000, and I was just wondering if the Premier could share the hourly rate for the lobbyists in Was hington, DC, and just confirm that there is only one lob-byist that we have, or if we engage multiple lobbyists in that.
The second question that I have, Mr. Chai rman, deals largely in line with the Cabinet Office, and that is the issue of the Public Service Commission,
and just the question as to if the Premier can enlighten us as the Premier made public reference to the revocation of Public Service Commission Regulations which may have been issued in error. I would like if the Premier could possibly provide an update as to
what is the status of the revocation of the Public Service Commiss ion Regulations which we have, b ecause, of course, we have heard it being said and now we know the various legal actions that have been threatened by a number of unions. And there is a question as to where we stand on that particular item.
The Premier did not necessarily mention that in his
comments, so it will be good to know, from his per-spective as the leader of the Cabinet Office, with overall responsibility for the management of the civil service, where does he stand on that particular r egard.
The third question I have, Mr. Chairman, is in
regard to Financial Instruction training. It will be noted that we had questions last Friday to the Minister of Finance when he stated that there was going to be enhanced training that is going to be taking place i nside the departments, however, he was unable to
state what that enhanced training was. However, the Premier today said that with the Financial Instructions Training they have moved to a new model of decen-tralised training. That is what he said, and he said it is
taking place in various ministries and some ministries
have commenced their decentralised training. So the
question that I have for the Honourable Premier is, How many ministries have commenced this decentral-ised training? And how many training/instruction ses-sion have they had? I think that is something that is rather important.
The Premier, of course, then spoke about the
travel budget. He noted the climb in the expected travelling budget this year to last, even though the travel budget is $100,000 over its original estimate for
this year. And this is not a question that was written, but I was hoping that the Premier could give an expl a-nation as to the increase of $100,000 in travel this
year as opposed to what he originally expected. Orig inally it was expected to spend $177,000, but now we
are up to $272,000. I think of particular note, when we talk about the travel budget, that clearly this is travel for a whole lot of different individuals because if you add up the travel expenses which appear for the
Premier on his website during this point in time it in no way, shape or form comes close to $272,000. So the question is, Where, exactly, is that money going? And who, exactly, was that travel for? And what was the reason for the increase, or expected increase, up to
$272,000 this year for travel?
The next thing on travel, Mr. Chairman, is the
item of ministerial travel and the ministry of travel website which the Premier announced to much fan-fare after there were issues that I think the Premier and a number of his ministers heading to Washington,
DC, to attend an opening . . . that is what it was, a
launch of a perfume scent and the ensuing furore. So the Premier said he is going to launch imminently a travel website. The travel website —

Hon. Micha el H. Dunkley: Point of clarification.

Thank You.
Leader of the Opposition, continue on.
Hon. E. David Burt: Thank you, very much. I appr eciate the Premier’s clarification. I will do my best not to
yield in the future because as everyone will note, the exact time that the website was launched was follo wing the trip to New York that he and his ministers went for the launch the Lili Perfume. And, I mean, you do not have to disagree with me; it is part of the public record, Mr. Chairman. It is stated right there.
So, we understand where it came from. The
challenge is, however, Mr. Chairman, as with many
things, it is not necessarily what they say; it is what
they do. So we understand that the travel website i tself, as the Premier admitted, is slow to update, but it seems the only ministers who actually seem to regu-larly update their information are the Premier himself, and the Minister for Economic Development.
I noted, for instance in the month of January
2017, there is no travel listed for any ministers. And I
would just like to ask the Premier to clarify whether or not any of his ministers travelled in January 2017. And the reason I can ask the Premier this, as you well know, Mr. Chairman, as a former Minister, is that an y1126 13 March 20 17 Official Hansard Report

Bermuda House of Assembly time a Minister travels they must write and seek permissio n from the Premier to leave the Island so the
Premier has these travel records.
So in that, I would also ask, and these were
questions that were submitted in a written basis, if he
could please advise how many ministerial trips were approved for the following months: October, November, and December of 2016, in addition to January
2017. If we are going to have transparency, the Prem-ier will note that it only works if people actually submit the information. We can talk about transparency if we want, but if we do not actually share the information, for instance we talk about transparency when we are
going to be a transparent Government we do not di sclose information, it is all talk. What we need is less
talk and more action.
The fifth question that I have, Mr. Chairman, is
regarding the original budget for Capital Works at the Cabinet Office. The Premier spoke about the works
that have gone on there. We understand that those
works were supposed to be concluded a little bit sooner [than] expected, but they are ongoing and it seems the scope continues to increase and increase and increase. Of course, we have not heard anything
about overspends or various items like that, but the
question that we would have is what was the original allocated budget when we started this project, and where are we right now?
When I say the original allocated budget, I
would like to ask what was the original figure submitted for the Cabinet approval to commence this work? I
think that much is important.
We can understand that figures may inflate
from year to year, but at the very beginning this was something that was supposed to be of a more limited scope, and it seems to be something that is a rather
large scope at this point in time.
Finally, and this is a new question, Madam
Permanent Secretary (sorry, that I was not able to
send in advance), but if the Premier could identify the
individuals and companies that have been paid under
professional services. And this is page B- 44, the r evised figure for 2016/17 for professional services, li ne
item in the budget has doubled from last year to this
year. Last year the professional services or consul tants line item, was $1 million and this year it is $2 mi llion. So, that is a rather significant doubling, and I
would like to know if the Premier could please identify
the companies or the three main companies that have been paid under professional services for this est imated $2 million in consultant bills for the Cabinet O ffice.
With that, Mr. Chairman, I will move on to
Head 43, which deals with the former Information and Technology Office, which has now been renamed the Information and Digital Technology Office.
The first question I have for the Honourable
Premier is that out of the budgeted posts of 36 in 2017, how many of those posts were actual ly vacant in the Information and Technology Office? We understand there are some vacancies there. We still see
that some posts are still in the books, but we know
that posts are frozen due to VERIP [Voluntary Early
Retirement Incentive Program] and we know there are
some occasions which took place in ITO, so the ques-tion is, How many vacant posts are there out of the
total allotment that was there and budgeted in the
original budget of 2016/17 of 36? How many of those
particular posts are vacant.
Regarding the Portal budget, and this seems
to be shared between two particular ministries, b ecause we have some items that are in Head 43 and
some items which are in Head 51, Department of
Communications and Information, can the Honourable Premier please indicate the name of the company that received the contract for the new portal, if this is a Bermudian company or a non- Bermudian company,
and what is the total amount of funds to date that have
been paid to this company under this contract? This
contract has been going on for quite some time, so I was hoping that we could get the total funds paid to date, because I am not sure if all of it is in current, or if some is in capital, some is in current. So I would a ppreciate some clarity on that, Mr. Chairman, so the people can get the answer as to how much they are
actually spending on this portal which contains a lot less information than the old portal did.
I do see that the question I asked, that the
Premier had mentioned a new position of CIO. I assume that this is going to be a replacement for the
former Director of ITO. He mentioned it while he was
reviewing line item 53050. So I just wanted to confirm that this is going to be the person that is going to be leading the new Information and Digital Technology sectio n. And if it is, I would like if the technical officers
would please provide the Premier whether or not that position has been graded, and if it has, what PS level has that position of Chief Information Officer been graded for.
Moving on to Digital Services, 53050, the
Premier said that there will be various digital services which are going to be launched by this office. I was hoping that we could get some examples. I see, I am going to assume the Acting Director of this depar tment over there, Mr. Shawn Lightbourne, whom I used to work closely with in a former life, I was wondering if he could possibly . . . or if the Premier could
elaborate on what digital services are intended to be
offered by this department.
There is a question I had which I submitted in
writing which said that the Premier said that these are not new positions, but that these are positions which
were transferred from E -Government. E -Government
had seven positions; we see five new positions which
appear under here in this department. And then over
when we get to Department of Communication Infor-mation, who has also received positions from E-Government, we see there are four positions created


Bermuda House of Assembly in Portal Management. So the five plus the four equals
nine new positions, however, there were only seven
positions from the Department of E -Government. So,
the question is, Where did those two new positions
come from? And also, assuming that the head of E -
Government’s position was abolished, the director of E-Government, and those responsibilities are going to
be rolled into the new chief information officer. Can the Premier please account for all the, I guess I will call it now three additional posts? Because he said these were being transferred. But it does appear that new posts are being created. So, if there could be
some understanding on that, because we lost seven,
and we are just trying to understand where these
posts are going.
And if I am incorrect, I am more than happy ––
because I see some persons shaking their heads –– I
am more than happy to get clarification. I am just tr ying to understand exactly where that goes.

[Inaudible interjection]
Hon. E. David Burt: No, I understand the way this
works, Premier. You do not provide the answers; you
just read the answers that the wonderful civil serva nts
provide for you.
Regarding question number five, Mr. Chai rman, I would hope that the Premier could please list
the companies that have received payments as con-sultants and vendors of the following subjective line
items: And that is, Communications, which is $1.4 mi llion; Professional services, which is $44,000; Rentals,
which is $1 million; and Repair and Maintenance, which is budgeted in the current revised estimate of $350,000. They are quite significant numbers paid to outside consultants, and it would be good to know
where exactly this money is going.
Regarding the travel budget, I saw the Information and Technology Office travel budget was zero,
which was quite surprising to me knowing the needs of the Information Technology Office. So I was just
wondering if the Premier can confirm that no one from
ITO travelled to any conferences this year, or required
any, because if that is the case, then the travel budget should probably not be zero. So I just ask them to confirm, because it did look a little bit suspicious, un-derstanding what takes place in ITO.
On to item seven, Mr. Chairman, I am going to
Capital, and these are issues under Capital Acquis ition for the old ITO. So this is under Capital Acquis itions, and there are a number of capital acquisition s
that are taking place. The question is, Can the Prem-ier identify the vendor/consultant who received pa yments under these capital line items which amount to (the revised estimate for this year is) $1.75 million?
And then finally, Mr. Chairman, regarding
specifically capital line items 76639, E -Government
initiatives, and 76866, regarding IT Security, for a total revised spend of $350,000, down from the original estimate of $500,000. If the Premier could please
elaborate on what, specifically, has been accomplished with those $350,000 in both IT Security and E -
Government initiatives this year.
Moving on if I can, Mr. Chairman, to Head 51,
to Communications. I will note that the Honourable Premier listed under cost centre 61030, Communic ations, a number of ministries and work that has been done. However, one of the things that he did not list is, of course, the Ministry of Finance. And we understand that the Government had a very heavy propaganda campaign in support of their airport redevelopment project with videos that were released which contained information that was clearly not factual but
came out from the Department of Communications and Information. So the question I would ask the Hon-ourable Premier is how much money was spent on the support of the One Bermuda Alliance’s airport red evelopment project? I know there were ads on the tel evision, there were videos that were produced, I know there were ads in the newspaper, a significant amount of money. So, my question is, How much money was spent in support of the airport redevelopment project, especially in the number of videos that were created?
If they cannot give a specific expense for the
number of videos that were created, I am sure that in that department they track the number of man hours used in the creation of those videos, because, clearly,
you have to track what your employees are working on, so it would be good if they could please provide
that particular information so that we can understand
the extent of government support to the airport rede-velopment project from the Communications standpoint.
I will move on to the current year fiscal spend
also to our local media companies. But that question
is not as important, Mr. Chairman, as I know that there
are a number of departments paying for that as o pposed to DCI. So I will just skip that question and move on to my third question, which is under line item 61060, Portals Management. The Premier said that
there were four posts in this particular department,
four new posts, some being transferred, some being new, some being created. I was wondering if he could please indicate the PS levels of these four posts in this individual sub -department.
The Premier has stated that under the current
account, I guess, because we were looking at the sub-jective analysis of current account, he said that $73,000 was paid on software maintenance under the current account. I was wondering who that software maintenance was paid to. Traditionally software maintenance is for programmes that have software
licensing. But it is my understanding that the portal
was built on a free code base . So if it was built on a
free code base, the question is where is this $73,000 going, and to whom? Additionally, he said that $52,000 was for PC software. I was hoping the Prem1128 13 March 20 17 Official Hansard Report

Bermuda House of Assembly ier could say exactly what this PC software entailed
and who that $52,000 is expected to be paid to.
The final question I will ask is, out of these
four posts which are under this Portals Management, I
guess they are going to new posts, transfers and all the rest, are all those posts filled right now, and, if not,
how many of the four are not filled?
Regarding Capital, moving on to the Depar tment of Communications and Information, page C -9,
Mr. Chairman, the question that I have for the Hon-ourable Premier is who are the three largest vendors who receive payments under capital line item 76591 and how much were they actually compensated for in
2015/16, revised estimate of 2016/17, and who is the
anticipated cost of the $250,000 in 2017/18 expected to go to? Is that all to the single portal vendor? Are
there other vendors that are there? That is the reason I asked for the top three vendors, just to get an under-standing of the consulting work that is taking place
there. And the reason why I say that, Mr. Chairman,
as you will we ll know that in our Vision 2025 doc ument we have stated that it is our belief that more work can be done by students at Bermuda College, especially when it talks about maintaining the government portals and developing digital services. The
reason why is because we believe that it is that type of training that can give our students real world exp erience and it is that type of work that can not only save the government money on high price IT consultants, such as myself, but it can also prepare our young st udents, and possibly do a better job of creating a lot more digital services at a reduced price. So that is the reason I am asking the question, because we want to understand how much money we are really spending on consultants who may not even be Bermudian c onsultants.
Moving on to Head 80, Mr. Chairman, on the
Office of Project Management and Procurement, the question is if there was a rationale for the abolition of the posts in reduction of one. I heard the Premier say they got rid of a project manager, I think it was, but I
just want to know if there was any particular rationale
for the abolition of that post.
Another question I would like to ask is whet her or not there are any posts that are vacant in this department currently. I understand that originally there
were eight and now it is revised to seven and then
there is . . . I looked for seven. I was just wondering if
all seven if those posts are filled or if there are vacan-cies in the department.
The Premier spoke a little bit about the Pr ocurement Code of Practice. I guess I would ask the Premier what is the status of this Code of Practice?
He went through certain remarks saying that the drafts
went out. Is there an expectation that from submis-sions that came from members of the public that those drafts will be revised in any way, shape, or form? And
is there a view to table that draft Code of Practice i m-mediately so that we can actually bring into effect the
Good Governance Act of 2011?
Additionally, there is a question of the impl ementation of Financial Instructions as well. I understand the Premier noted the fact that he is going to be engaged in a legislative review to amend a particular piece of legislation, or to bring a new piece of legisl ation which will combine and create a single unified piece of legislation. But, Mr. Chairman, as we saw from the Auditor General’s report, where she tabled her financial statements on Friday, she raised her concern again about the ongoing incidences of non-compliance with Financial Instructions by the Government. And that is not the Commission of Inquiry,
but is the Auditor General who is saying that. I should point out, Mr. Chairman, that although the One Ber-muda Alliance has been in office since 2012, we have not yet had a single Auditor General’s annual report going on for five years. So it will be interesting to see
what the new annual report says, if the Auditor General is saying in raising her concerns about the co ntinued violation of Financial Instructions.
So, given those continued violations of Financial Ins tructions, and given that we already have laws
in place under the Good Governance Act 2011, will the Premier give consideration to tabling the regul ations immediately so that we can bring them into ef-fect, while the Government works on a new procur ement fr amework? Or are we supposed to just let the
procurement framework exist as it is right now so that
we can have more complaints from the Auditor General of non- compliance with Financial Instructions? Or
will the Premier actually take the action which is r equired and which was recommended by not only the
report which was commissioned by the former Gov-ernment, but was also recommended by not only the
SAGE Commission but also the Premier’s very own
Commission of Inquiry.
The Premier said that the Office of Project
Management and Procurement would negotiate with key suppliers. I was hoping the Premier could identify
and elaborate who these key suppliers may be. R egarding performance measures, question five, Mr.
Chairman, on page B -66, it says that the compliance
audits have been discontinued. I was wondering if there was any specific reason for the discontinuing of the compliance audits. I note there is a new target, it
says “Perform project management, [procurement]
and contract compliance [audits] on capital pr ojects.”
However, the compliance audits on contracts on pr ocurement processes seem to be discontinued. So I am wondering if there can be any enlightenment as to why that has taken place.
Moving on to capital, Mr. Chairman, if I may,
going to the Office of Project Management Procur ement, I am looking at the purchasing and tendering system which originally had $67 million budget ed this
year and none was spent, and then $150,000 is set to
be spent next year. Can the Premier please elaborate


Bermuda House of Assembly regarding the electronic tendering system? What
stage is this project currently in? And will the Gover nment continue to use the existing system, or have
they decided to embark on a new one?
I will reserve the balance of my time for some
answers.

Thank you for your contribution, O pposition Leader.
Does any other Member wish to speak to the
debate that we are currently under, the Cabinet O ffice?
Premier, would you like to answer some of the
questions that the Opposition Leader put to you? Be mindful that we have just about 15 minutes left, roug hly.

Hon. Michael H. Dunkley: Thank you, Mr. Chairman.
Let me start out by answering the questions in
two ways, one, if I do not get to any questions I am
happy to follow up afterwards; and second, in regard to . . . I think it is important to repeat this, and I said it
last week in another debate, that if Honourable Mem-bers would look at the Budget Book they will see a
number of different line items as far as expenses go.
And one line item is obviously the budget for nex t
year, the one next to that is the revised budget for the current financial year, and the one next to that is the original budget for the current financial year. The ac-tual number to the left takes three years to get through
the process. And I say that because I think people
need to reflect again that the revised budget for the current financial year is a budget that is put in well in advance of the budget being printed to get the num-bers up to date, and that budget can change before the end of the financial year based on more money
being spent, or less money being spent on a line item.
And I will give an example: The Honourable
Member from constituency 18 who just presented, in
regard to travel, was referring to page B -44 in the
Budget Book specific to travel where for the whole
Cabinet Office travel was originally budgeted at
$177,000. And the revised estimate is for $272,000. So, as I said during my brief, that increase from $177,000 to $272,000 is directly related to the Com-mission of Inquiry travel. And I listed out some of the cost. The accounting officer for the Cabinet Office who
does a great job has provided me the information on
that. And the actual expenditure to date for that sub-jective line item on travel is actually $207,000. So it is well short of the $272,000 that is printed. The Com-mission of Inquiry accounts for $86,000 of the travel in that line item.
Now, if you back up, Mr. Chairman, to page B -
43, you would see under the General Summary, cost centre 19005, Professional Development and Tr avel,
you will see that the travel budget is listed as $128,000 for the current financial year and the revised estimate is $128,000, and the estimate for next year is $138,000. That accrues directly to myself within the
Cabinet Office. So you need to understand the difference in those two numbers. And the Honourable Member from constituency 18 who spoke to this went to some lengths to talk about the travel budget. And I hope that the explanation that I have given in regard to the commission of Inquiry will allow him to have a
better understanding of what took place.
I just looked at a number of the questions and
in regard to the Honourable Member asking for travel
for the months of October, November, December and January, I will research those and provide all the sp ecific information to the Honourable Member as soon
as I have an opportunity to research the requests made to travel and the addition to the travel network that we posted.
It is interesting that the Honourable Member
tried to rewrite the actual facts behind things, and I noticed with interest that the Honourable Member
likes to make comments that information was not fac-tual in relation to certain things. And one of the things he referred to here was the airport development and some information put out about that, but then he stretched to questions on travel.
And I ask the Honourable Member , is he sa ying that if he was in the position he would not take that trip to New York to promote Bermuda, promote Ber-muda small business and make sure that we c ontinue
to fly the flag? I think that is the important thing. One of the things that I have continued to do since I have
been the Premier is to make sure I scrutinise travel
very closely —and more closely for myself than an yone else because I am spending someone else’s money. This is not my money; and I take it very ser iously. As you can see, I make sure that we scrutinise how we go places, what we do. And at all times, Mr.
Chairman, I make sure that the schedule while we are away is jam -packed, so much so that even as busy as
I am I tire myself out at the end of the day. And I will continue to operate like that because it is the people’s money and I have no problem answering any questions on travel at any time.
The Honourable Member from constituency 18 asked about consultancies. The consultant from
DC who has been used, as I said, I think over two
decades, his hourly rate is $550. I am happy to run through some of the numbers here. For the current
financial year, which ends at the end of this month, it
is estimated about $144,000 will be spent on this. In
the last year it was $281,000; the year before that was $297,000; and the year before that was $218,000. I have gone back a number of years and the high for spending on that consultant was in 2008 when
$409 ,000 was spent on that consultant. And I have
looked at the average because I think it is important to
highlight these things.
We need consultants, we need lobbyists, but
one of the things that I found . . . and no disrespect, no disrespect at all to the gentleman who has done
1130 13 March 20 17 Official Hansard Report

Bermuda House of Assembly this work for many, many, many years. But if you do
not keep them on a short leash and ask them to do
things that are important to you, they can rack up the charges very quickly. And since I have been the Premier, the average expenditure on that consultant
has been $235,000. But for the two, four, six, seven years before that the average expenditure was
$341,000.
And for that reason we, in the Cabinet Office,
are going to take a review of the consultant because
now is the time, with the change of an administration, to make sure we look to see if we are getting the val-ue for our money. And I am not aware of a review being done recently, but we are going to take a look to
make sure we are getting value for our money and to make sure, based on the challenges we face in Was hington DC, that we have the right person in place to do what we have to do.
So the budget allocation has increased to
$250,000 this year. One, because an allocation in the last year of $100,000 was just a little bit short, and we believe the allocation for this year of $250,000 is more appropriate when we combine that with work we will be doing with our industry partners to continue to be in
the right place at the right time to deal with the challenges we face in Washington DC.
Now in regard to the closure of the Washington DC Office, I am sorry, but the Opposition Leader, the Member from constituency 18, says that they do
not agree with the closure. Well, I am sorry we are
going to have to agree to disagree on that. I have taken a very close look at it. I believe we can be very ef-fective in ensuring that we get value for money and, frankly, I have to say in spite of the good people who were working there, in the past few years there was a lot of promotional and tourism aspects that were being
used and that is why we have the BTA. We need to
get the BTA to do their job, and as far as government work, we need to do it in conjunction with our partners in there. And I believe because of the closeness of Washington DC we can make these things happen in
an appropriate way and we can save some money
while we do it. So we take the relationship very ser iously, we have a lot of work to do and we will make sure that we get the work done.
In regard to the Cabinet Office renovations, I
informed the Honourable Member s who were listening
at the time (during my brief) that the original budget was $500,000. It was increased through the year to $800,000. I have informed them also that there were two specific contracts that were originally appr oved by
Cabinet: One for the manufacture of the windows, which I believe was about $200,000; the second one
for the installation of windows which was about
$100,000. There was also a contract for the sealing and repair of the building outside, $70,000, I believe, for sealing of the outside, and $40,000 for the actual coating that goes into that. Through the work that was taking place and through the notice from the Ministry responsible for Health and Safety we had to vacate it.
That is when we found the asbestos challenges and
that is when we found the mould abatement challen ges that we have had to work through and deal with.
Now in regard to other questions in the three
minutes that I have left, I will deal with—

[Inaudible interjection]

Hon. Michael H. D unkley: Two minutes left? All right,
well, I will try to give some answers in regard to those.
The status of the Public Service Commission
revocation: The revocation is simply a matter of the Governor and that is something that we have been
trying to work through with them as well.
In regard to the Financial Instructions, so far
the Ministry of Social Development and Sport has started the process and had a number of meetings with their various staff across the Ministry. And they
have also confirmed that there have been multiple
sessions taking place. I am still waiting for more an-swers, as I told the Honourable Member, in regard to the travel stuff that was listed.
I know there was another question that I
would like to reply to for the Honourable Member .
Yes, it was in regard to ITO. There are two vacant
positions: the Accounts Payable Clerk/Receptionist and a Training Officer.

One minute left.
Hon. Michael H. Dunkley: In regard to the new portal, I provided answers in the House for this, the d evelopers of the new government portal are OPIN
Software Company, a Canadian company that was selected following a very detailed and rigorous tendering process. The total cost at the end of February is,
development and support and hosting, $134,780 with four years of support for $86,400.
The CIO position, yes. The funds were put in
place in 53050. All new positions were placed in that
cost centre and the funds were vired from Administr ation.
On the question in regard to Digital Services,
please give an example of digital services that will be.
One example is interactive forms across multiple service areas will be rolled out and an electronic payment
platform will be pursued and the identification of new
digital services —

[Gavel]

We are now moving on to the next
Ministry to be debated this afternoon. It is the Ministry of Health. There are five hours allocated for this and
we will be debating Heads 21, 22, 24 and 91.
Will the Minister . . . we are just waiting for the
Minister to get herself sorted out.
Minister, are you ready? Okay.
Minister Jeanne Atherden, you can have the
floor now.

MINISTRY OF HEALTH

Hon. Jeanne J. Atherden: Mr. Chairman, I move that
Head 21, Ministry of Health and Seniors Headquar-ters; Head 22, Department of Health; Head 24, Hosp itals; and Head 91, Health Insurance be now taken
under consideration.

HEAD 21 —MINISTRY HEADQUARTERS

Hon. Jeanne J. Atherden: Mr. Chairman, the current
account estimates for Head 21, Ministry of Health and
Senio rs Headquarters, begin on page B -129 of the
estimates book. A total of $11.186 million has been
allocated for t his head, which represents 6 per cent of
the budget allocated for the Ministry as a whole.
The allocation for Headquarters saw a 15 per
cent increase over the previous year, or $1.454 mi llion, primarily due to the transfer of the grants for rest
homes fro m the Ministry of Social Development and
Sport, which will be similarly reflected in their budget.
Mr. Chairman, Head 21 is charged with
providing strategic direction, policy guidance, man-agement, and coordination of services operated by the Ministry of H ealth and Seniors. There are three
programmes, subdivided into seven cost centres wit hin Head 21 that I review in turn. The programmes are
listed on page B -130:
• 2101 —General, which includes Grants, Administration and Policy Development ;
• 2102 —Office of the Chief Medical Officer; and
• 2103 —Ageing and Disability Services .
The Ministry Headquarters long- term objectives are set out on page B- 130 and include:
• Ensuring the residents of Bermuda have the
ability to secure affordable health insurance
which enables acc ess to essential health se rvices; • Addressing quality by ensuring that our health
services are safe and effective;
• Working together to ensure our health system
is efficient to improve its financial sustainabi lity and population health;
• Holding the Ministry accountable and ensuring
effective and transparent leadership.

General —Programme 2101
Hon. Jeanne J. Atherden: Mr. Chairman, I will first
review the budgets under General Administration.
The General Administration, cost centre
31000, budget for 2017/18 is $1.557 million. This re presents a decrease of approx imately $45,000, or 3 per
cent when compared to the budget for 2016/17. This
was largely due to administrative transfers to support
other programmes within Headquarters. The General
Administration budget provides for the funding of seven Headquarters staff who conduct accounting and operations management functions; and covers oper ational, administrative and utility expenses for the Min-istry Headquarters.
Grants, cost centre 31015. Mr. Chairman, the Mi nistry Headquarters provides funding for various organisations that deliver services to the community. In
2017/18 the Ministry will formally take over the grants for rest homes from the Ministry of Social Develop-ment and Sport. There were minimal changes to grant
levels for the upcoming fiscal year; and on page C -17
is the list of the grants awarded for 2017/18 as follows:
• LCCA for Overseas Medical Care ($2.862 million);
• The Nursing Council ($45,000) ;
• Bermuda Health Council ($799,615);
• Age Concern ($38,065);
• Lorraine Rest Home ($502,639);
• Matilda Smith Williams Home ($250,000);
• Admiralty House Senior Islanders Club
($41,690);
• Summerhaven ($300,000);
• Packwood Rest Home ($300,000);
• The Sexual Assault Resource Team ($9,540);
• Public Health Scholarships ($100,000, increased from $69,000 in 2016/17 to support students in public health professions); and
• Tomorrow’s Voices ($13,055) .
Mr. Chairman, these organisations provide
services essential to the community and the Ministry
of Health and Seniors. Despite the budget caps necessary across government, the Ministry was able to maintain 2016/17 grant levels for all grantees.
Mr. Chairman, in 2016/17 grants for residential care homes were transferred from the Ministry of Social Development and Sports to the Ministry of Health and Seniors to better support the regulation of
residential care homes by Ageing and Disability Ser1132 13 March 20 17 Official Hansard Report

Bermuda House of Assembly vices under the direction of the Chief Medical Officer.
Administering the grants and registering all homes
within one Ministry serves to consolidate oversight of this important sector.
Lastly for this unit, Mr . Chairman, in 2016 the
Ministry awarded the D r. Barbara Ball Public Health
Scholarship to 10 recipients. I would like to take this
moment to recognise and congratulate our 2016 scholars:
• Gerteikquia Hatherley ;
• Deidra Ferguson;
• Dwaynisha Pearman;
• Chioma Nwasike;
• Rachel Card;
• Meliseanna Gibbons ;
• Morrissa Tucker ;
• Teleza Pitcher ;
• Stephanie Wright ;
• Reglindis Ratteray .
The Dr . Barbara Ball Public Health Scholarship was established to support students of health professions of relevance to public health. In 2017/18 we are pleased to be increasing our funding available by $30,000 to support and encourage Bermudians into essential public health professions. We have a
great need to increase the Bermudian workforce in
this area and I hope more and more bright and com-passionate people of all ages will consider careers in this noble sector, which promises rewarding and guaranteed job opportunities.
Mr. Chairman, the scholarship is open now
and applications are accepted until the first week in
April 2017. The information is on our web site.

Bermuda Health Council

Hon. Jeanne J. Atherden: Mr. Chairman, the Current
Account Estimates for the Bermuda Health Council
can be found under Head 21, Grants, on page C -17.
In 2016/17 the Health Council celebrated its
10-year anniversary as a quango established to reg ulate, coordinate and enhance the delivery of health
services on our Island. It has a broad mandate, which
contributes most efficiently to the stewardship of Be rmuda’s health system.
Mr. Chairman, the grant to the Bermuda
Health Council in 2016/17 was $799,615. This is 57 per cent of the Council’s current funding for core
operations. Since April 2014, this operating budget
has been supplemented by a transfer from the Mutual Reinsurance Fund (MRF); the MRF transfer for 2016/17 is $1.09, resulting in revenue of $625,000 for a total operating budget of $1.382 million. The Council has efficiently prioritised its activities and collaborated
with local and international organisations to extend its
productivity and effectiveness.
Mr. Chairman, to build upon its track record of
financial transparency, the Health Council worked in close collaboration with the Auditor General to table its audited financial statements and Annual Report
2015/16, within the first Parliamentary Session in A ugust 2016.
Mr. Chairman, in 2016/17, the work of the
Health Council was centred on four strategic areas:
care quality and standards, regulation, health system financing and economics, and audit and governance.
Some highlights of the year’s achievements are as
follows:
Care Quality and Standards : Mr. Chairman,
the Health Council publishes professional registers on its website, providing the public with information about regulated professionals registered to deliver health
care on the Island. These registers are produced by
the Office of the Chief Medical Officer and provide essential structure of health system financing and care quality accountability.
The Health Council monitors the regulation of
health professionals by appointed statutory bodies
and reviews annual self -assessment reports on stat utory board composition, and licensing and complaints
handling procedures. In 2016, statutory boards r eported 16 complaints and 2 legal actions; t his co mpares with 2015 where 26 complaints and 3 legal actions were reported.
Mr. Chairman, the Health Council looks at
ways to improve patient care; for example, it collaborated with the Chief Medical Officer, Bermuda Hosp itals Board (BHB), nephrologists, and the Pan Amer ican Health Organisation (PAHO) on specific initi atives, including enhancing screening for chronic kid-ney disease. Chronic kidney disease impacts the lives of thousands of individuals on- Island, costing more
than $30 million annually to manage.
Regulations: Mr. Chairman, to further improve
care quality by protecting the public from avoidable
harms and enhancing oversight in the health system,
the Health Council continued its voluntary registration process of health care facilities with 245 of 334
(73 per cent) providers registering with the Health Council. The Health Council also launched a Patient
S.A.F.E.ty Campaign in September 2016 to educate
the public about proposed laws that would enhance oversight of health care facilities.
The Health Council continues to ensure employees have access to health insurance coverage by increasing its enforcement of employers’ compliance
with the Health Insurance Act 1970. Mr. Chairman,
between April and December 2016, the Health Coun-cil investigated complaints representing 2,046 em-ployees. After investigation, 74 per cent, or 1,519 employees regained active insurance coverage, protec ting their legal entitlement and preventing out -ofpocket spending for these individuals.
Health System Financing and Econom ics: Mr.
Chairman, the Health Council published its annual National Health Accounts Report, which details health system finance and expenditure for the prior fiscal year. In the fiscal year ending 31
st March 2015 total


Bermuda House of Assembly health system expenditure was $686 million, per cap ita expenditure was $11,102—both of which have decreased from the previous year. The management of system expenditure and its related effect on public affordability continues to require intense collaboration from diverse stakeholders, strategic multiyear dec ision-making from leadership, and creative vision as a
country for long- term health system sustainability. The
Health Council anticipates releasing the full report soon.
In addition, Mr. Chairman, every year the
Health Council conducts the actuarial review of the Standard Premium Rate, and publishes the Actuarial
Review Report inclusive of premiums for the Mutual
Reinsurance Fund and the Standard Health Benefit. This report provides a measure of accountability as the Health Council facilitates sustainable financing of the mandated, minimum basic health insurance pac kage.
The Health Council also collaborated with the
hospital, insurers, patient advocacy groups, health professionals, business leaders and others to deter-mine ways to reduce fragmentation in health system financing in order to improve efficiency and sustainability.
Public Education: Mr. Chairman, public education is vital to improving the quality of care and
health costs in Bermuda, and the Health Council has
intensified efforts locally through seniors and advoc acy groups, schools, social media and town halls. I nternationally, the Health Council has represented Bermuda’s health system in the US at the Global Ag eing Roundtable facilitated by the Wall Street Journal; in Bonaire at the Caribbean Conference on Health Financing Initiatives; and in Jamaica and Costa Rica at the invitation of the Pan American Health Organis ation (PAHO) to discuss implementation of national health plans, information systems for health, and pharmaceutical dr ug procurement strategies.
Mr. Chairman, looking forward to 2017/18, the
Health Council will continue its accountability to the
public to progress in its mandate and add value to the
health system through collaboration, quality improv ements, regulation, and monitoring. As the global con-text of health sector trade, use of complex medical technologies, ageing demographics and expanding prevalence of chronic disease are realised locally in
Bermuda, the Health Council must be even more dil igent in meeting these evolving challenges. In partic ular, the Health Council has been tasked with reviewing
the regulatory infrastructure for the Standard Health Benefit, continuing discussions and executing imple-mentation for health financing reforms, managing f inancially ves ted referrals and the entry of health tec hnology, implementing a unique patient identifier as a foundation for a universal Electronic Health Record, and coordinating a pilot on health information systems in collaboration with PAHO. Lastly, Mr. Chairman, I would like to express
my sincere gratitude to the 2016 Bermuda Health Council Board members whose expertise and dedic ation contributed to these achievements:
• Mrs. Simone Barton —Chair;
• Ms. Kirsten Beasley —Deputy Chairman;
• Mr. Richard Ambrosio;
• Mrs. Alena Cr ockwell;
• Dr. Edgar Griffith;
• Ms. Lorraine Lipschutz;
• Dr. Darrien Ray;
• Dr. Fiona Ross;
• Mr. Andrew Simons;
• Ms. Alexis Swan;
• Mrs. Venetta Symonds;
• The Chief Executive Officer of BHeC,
ex officio ;
• The Financial Secretary, ex officio ;
• The Permanent Secretary, Ministry of Health, ex officio ; and
• The Chief Medical Officer, ex officio .
To end, I pause, Mr. Chairman, to thank Dr.
Ross for her continued support and commitment to
the Health Council in 2016. I would like to welcome the Board for 2017, which includes 14 returning me mbers.
Corporate Services, cost centre 31020: The
Corporate Services Unit (CSU) budget can be found on page B -130 of the Budget Book. Mr. Chairman, the
budget for Corporate Services for 2017/18 is $516,000. This represents an increase of $205,000, or
66 per cent. The increase is due to the re -
establishment of previously frozen Policy Analyst pos itions in order to advance essential legislative initiatives.
Corporate Services' responsibilities include
policy development, research and analysis, legislative
review, PATI implementation and compliance, and direct service delivery. It is manned by three Policy Analysts with dedicated policy and legislative initia-tives supporting the Officer of the Chief Medical O fficer, the Department of Health and Ageing and Dis ability Services.
In particular, this year the team delivered:
• Quarantine Amendment Act in order to meet international health regulations;
• Amendment proposals for the Residential Care Homes and Nursing Homes legislation to ensure the safety of persons in residential
care homes;
• Development of a Long Term Care Action Plan 2017;
• Outlined solutions to address vulnerable persons and an Office of the Public Guardian;
• Supporting implementation of the court order to administer Summerhaven;
• Establishme nt of a Ministry -wide complaints
policy and procedure; and
1134 13 March 20 17 Official Hansard Report

Bermuda House of Assembly • Improvements in public education and online
presence through our website and social m edia.
In addition, Mr. Chairman, Corporate Services
is responsible for PATI within the Ministry Headquar-ters. I am very pleased to report that the Ministry has
met all PATI requirements since the law came into effect on 1
st April 2015. However, the requirements
under the PATI Act have proved to be very demand-ing on existing resources and adherence to PATI r equirements has necessitated postponement of initi atives and operational activities under the Ministry’s mandate. Indeed, public officers’ work to meet Gov-ernment initiatives has been delayed to prioritise compliance with PATI. This may not be serving the public in terest and will need to be reviewed.
The Ministry’s Corporate Services also continues to support the Ministry of Environment in the development of the legislative framework for Bermuda to be in compliance with CITES [Convention on the International Trade of Endangered Species of Wild Flora and Fauna].
Looking to 2017/18, Mr. Chairman, the Corporate Services Unit expects to bring to this honourable House: amendments to the Residential Care Homes and Nursing Homes Act; amendments to the Allied Health Act; solutions for an Office of the Public Guar dian; and a Long Term Care Strategy, to name a few
key initiatives.

Office of the Chief Medical Officer –Programme
2102

Hon. Jeanne J. Atherden: Mr. Chairman, the budget
for the Office of the Chief Medical Officer (CMO) can
be found on page B- 130 of the Budget Book.
Mr. Chairman, you will note that the budget for
the Office of the CMO had a minimal increase of $12,000 to accommodate salary adjustments. The
budget of $888,000 for fiscal year 2017/18, although
is not significantly different from the 2016/2017 budg-et, represents a reduction of 3 per cent compared to 2015/16 funding. However, the remit of the Office of CMO has not been similarly reduced over the past two years. In fact, the expectations and requirements of
the Office continue to expand by necessity, to keep pace with 21
st century demands.
This is the fourth year of operation for the O ffice of the CMO as a separate entity within the Minis-try, following the reorganisation of the Ministry of Health Headquarters in 2012. The Office of the CMO
operations are distinct from the Department of Health,
although the two remain interdependent and must col-laborate closely to implement their health protection, health promotion, health monitoring and public health strategi c planning roles.
Mr. Chairman, the budget for the Office of the
CMO is divided into two cost centres: cost centre 31030, Healthcare Registration and Regulation; and
cost centre 31040, Epidemiology and Surveillance.
The broad remit of the Office requires its staff
of six full- time equivalents, one secondee, and one
part-time consultant pharmacist to:
1. Register and regulate approximately 2,100
health care professionals;
2. Monitor and control importation of drugs and pharmaceutical products, including reporting to international authorities on controlled drug importation;
3. Prevent and control disease outbreaks in the community and monitor community health st atus;
4. Implement a variety of statutory functions r elated to health; and
5. Serve as the national focal point for intern ational public health communication and col-laboration on strategic goals.
Mr. Chairman, the budget of the Office of the
CMO is an investment in prevention and community health protection whose value cannot be over -
emphasised.
The past year’s work in the Office of the CMO
has focused on implementing the Bermuda Health Strategy 2014 –2019, particularly the priority action
items identified in the Bermuda Health Action Plan. These include guiding collaborative work on health system workforce planning, establishing a chronic disease register, focusing on diabetes, hypertension
and chronic kidney disease; and enhancing the regulatory effectiveness of the Bermuda Medical Council, according to the amended Medical Practitioners Act which was enacted April 2016.
Mr. Chairman, these ongoing responsibilities
and strategic lines of action will continue in earnest in
the coming year due to their long- term relevance to
our health system’s quality and sustainability. These
activities will assure that our health system is suppor ted by the right numbers and skills mix of health care professionals who deliver the highest quality services
with the most ethical and professional conduct.
These activities are also expected to provide
ongoing health information as our communi ty wages
public health war against the debilitating chronic noncommunicable diseases (NCDs), such as diabetes and kidney disease, which threaten our productivity
and economic prosperity.
Mr. Chairman, in addition to these strategic
activities, other important projects were continued with
the support of the Pan American Health Organisation (PAHO) and the Caribbean Public Health Agency (CARPHA). A multidisciplinary cooperation to validate
the elimination of maternal to child transmission of
HIV and congenital syphilis by international standards will continue to be supported by the Office of the CMO’s Epidemiology and Surveillance Unit.
The partnership with Bermuda Tourism A uthority on the regional Tourism and Health initiative


Bermuda House of Assembly will also continue. This initiative includes implementing
a web- based hotel disease surveillance system and
food- handlers safety certification program, both aimed
at enhancing prevention and early detection of di seases and making our tourism product an exceptional
value. In the year ahead, the Health Ministry will con-tinue its outreach to the Ministry of Tourism, encouraging a cross -Ministry commitment to the Tourism and
Health initiative. As we know, tourism flourishes in a
safe, healthy environment.
Mr. Chairman, I just want to observe one
thing , because I think it is very important , as we di scuss some of these things , for us to understand that
as it relates to the initiative with respect to CARPHA, it was very important because I think in an earlier de-bate there was some concern about tourism and about how we were going to turn and make sure that with respect to tourism we ensure that Bermuda rec-ognises that tourism is important and health is one of
those things that we have to make sure that . . . when
things happen in Bermuda we do not get people
scared away because of a health scare or something
along those lines. And that is why we actually have a multiyear agreement with CARPHA to talk about ge tting together with them and making sure that we have a clear understanding of what we do, what we report to them and this is tied into a joint understanding with ourselves with the Tourism Authority. And I just want enhance on that because it is not just like we are sa ying that we are thinking about something. Last year
we put something into effect and it is actually working.
Mr. Chairman, the Office of the CMO cost
centre also protects the Island from importation of
poor quality medications and from the illicit diversion of controlled drugs. The drug control function of the Office assures that Bermuda’s prescription medic ations are safe and effective and that scientific ev idence supports the use of all substances which may pose a risk of abuse if they fall into unscrupulous hands.
The Office of the CMO acknowledges the
emerging evidence on the risks and benefits of can-nabis -containing medicinal products and will continue
efforts to make products which are established as safe, and which have minimal abuse potential, readily available.
Finally, Mr. Chairman, I wish to highlight the
fact that the Office of the CMO plays a major role in preparedness for public health emergencies of all types. Creating a system of rapid identification and timely, appropriate response to outbreaks or occur-rences of public health significance is a core respon-sibility of the Office.
The joint collaborations with Bermuda Police
Services, Bermuda Civil Aviation, Bermuda Hospitals Board Emergency services and other health protec ting entities will be an ongoing priority for this Office. The Office will refine the national public health r esponse plan so that the island is capable of mounting an effective response to all hazards encountered, and
that we are prepared to welcome and host the many
visitors expected in the coming year with confidence that their visit to the Island will be safe and enjoyable.

Ageing and Disability Services

Hon. Jeanne J. Atherden: Mr. Chairman, the Current
Account Estimates for the Ministry’s Ageing and Dis ability Services can be found listed as the National O ffice for Seniors and the Physically Challenged (the Office) under Head 21 on page B –130.
The Ageing and Disability Services, or ADS,
has a total budget of $2.883 million, representing a 3 per cent decrease over the previous year, or a
$102,000 reduction.
Mr. Chairman, ADS was established with the
mission to facilitate improved quality of life for seniors and persons with intellectual and physical disabilities
through assurance, coordination and delivery of pr ogrammes in collaboration with a public/private network
of stakeholders. Its small team w orks tirelessly to assist hundreds of persons every year through direct interventions, and indirectly through regulation of care
homes and care providers.
ADS serves as a repository of services, information and assistance for seniors and persons with
disabilities in need, in addition to their regulatory functions. It operates under two programmes: 31135—
Office for Ageing and Disability Services; and 31160 —
K. Margaret Carter Centre (KMCC).
Mr. Chairman, seniors are a central focus for
ADS, and the primary functions in this regard are case management, compliance, advocacy and awareness.
ADS develops and coordinates services for seniors and their families in addition to providing case management. ADS has nine full -time positions. Although
not all are filled at present, the Ministry is in the pr ocess of recruiting. Most of the work supporting seniors
is in the form of case management, regulation of care homes and the Senior Abuse Register.

Case Management

Hon. Jeanne J. Atherden: Mr. Chairman, the primary
focus of ADS case management is to connect seniors
and persons with disabilities with required services
and follow up with the relevant authorities where the
circumstances require it.
Many of the cases are complex and require
constant or ongoing monitoring, some of which require the involvement of the Senior Abuse Register. Other cases are resolved once the client’s concern has been
addressed, a short -term need is met, or long- term
care services have been secured. In 2016 the Case
Management team managed 244 c ases.
I pause at this time, Mr. Chairman, to mark
condolences for case manager, Dennika Williams, who passed away in 2016. This sudden and unex1136 13 March 20 17 Official Hansard Report

Bermuda House of Assembly pected loss has been tragic for her family and the
small ADS team, and she has been deeply missed by
all of us at the Ministry.

Compliance

Hon. Jeanne J. Atherden: Mr. Chairman, ADS conducts two vital components of regulation to protect
seniors and persons with disabilities.
The Senior Abuse Register Act 2008 is designed to bring awareness to Bermuda regarding sen-ior abuse, protect seniors from abuse, provide for the mandatory reporting of abuse, initiate investigation of
alleged senior abuse, and establish a register of persons who have been convicted of abusing a senior.
In 2016 there were 30 investigated cases of
alleged abuse (13 substantiated and 17 unsubstant iated). Abuse types are defined as: psycholog ical/emotional, physical, sexual, and financial exploit ation. These cases were either investigated and su bsequently case managed by the Case Management Team alongside the Registrar for the Senior Abuse Act, or referred to the Bermuda Police Service for fur-ther investigation.
The Residential Care Homes and Nursing
Homes Act 1999 is overseen by the Chief Medical Officer, but its enforcement is conducted by ADS wit h
respect to complaints and inspections. In this regard the inspections are performed by a multidisciplinary
team of health care professionals. In 2016, all 22 care
homes have been inspected by the majority of inspection teams; however, due to staffing shortages, certain disciplines were unable to complete their asses sments. As a result, work is underway to improve the overall inspection system which will coincide with i mprovements to the legislation.
And I would pause here, Mr. Chairman, just to
say that in between December and January I was able to visit all 22 of the care homes, because I take the position that if I have the responsibility in the Ministry, I need to know what is happening and at least be able
to understand some of the issues first -hand. I t was a
very interesting exercise. And I think it gave me the
opportunity to see what was going on, to reinforce some of the concerns that the care homes had and also to look at some of the challenges that we might be able to look at going forward to increase the sustainability. But I am just saying that it is important because I believe if you are in charge of something, you need to get out there and get your feet wet.
Continuing on in terms of what should happen
with respect to the Residential Care Homes and Nur sing Homes Act and what ADS does:
• A separate inspection is conducted by the Bermuda Fire and Rescue Service. Fire safety is an area of concern as some homes are
challenged to meet the required standards.
• The Ministry of Health and Seniors is working
to strengthen the regulatory requirements for Residential Care Home and Nursing Homes
(RCHNH). The Act and Regulations will be
amended this year to enhance care quality requirements and to create a more flexible regulatory framework for care homes. The amendments are being drafted at present.
• The ADS also conduct monthly education
sessions with administrators/owners, which
are ongoing, to increase understanding and build capacity for compliance. This is in addi-tion to the one- on-one work by inspectors and
ADS with care homes to ensure compliance with the legislated standards.
• As regulators, ADS recognises the amount of
time and guidance required to move all registered care homes towards best practice standards. Best practice standards will be en-couraged and ultimately enforced under the amended legislation governing the registr ation, operation and standards of care in these
homes throughout Bermuda.
• The standing of each care home, based on
the results of the auditing and registration
process, is published on the Ministry’s website
as part of ADS’s regulatory function. Homes
that receive conditional registration are moni-tored and inspected more closely to assist in improving compliance.

Long Term Care Action Plan

Hon. Jeanne J. Atherden: Mr. Chairman, in July
2016, the Ministry of Health and Seniors, in collabor ation with community stakeholders, began planning the
way forward to address long term care in Bermuda.
Goal 7 of the Bermuda Health Strategy 2014– 2019
commits to the implementation of strategies to meet
the long- term needs of seniors and persons with
chronic illnesses, and physical, cognitive or mental disabilities to better provide for the needs of vulner able populations and manage costs. The Long Term
Care Action Plan, published in January 2017, is the
first step for such strategies.
The global trend of ageing populations is
equally pressing in Bermuda. As life expectancy has
increased, many more people are living longer beyond
retirement and Bermuda is currently not able to cope
with the changes this brings. The problem is co mpounded by the proliferation of new technologies, de-clining birth rates and a shrinking workforce, which have increased dependency ratios and put pressure on available funding and resources.
The Ministry of Health and Senior s is taking
action now to address the long- term care needs of
seniors and persons with disabilities by increasing the available resources and capacity to ensure persons requiring long- term care can enjoy active, healthy
ageing and age at home to the greatest extent poss ible. This includes a range of initiatives including: i nBermuda House of Assembly creasing access to supports for caregivers, evaluating
financing solutions and promoting private sector i nvestment in the development of the long- term care
sector.
And I just want to stop there just for a moment
because I have tried to make sure that we discussed
some of these earlier. In addition to that, obviously,
we recognise that in terms of promoting that and in
terms of resources, one of the resources is also the human resources in talking about having persons that
are eligible to be able to care and have the qualific ations. So we continue to have those conversations, you know, with the Bermuda College and other places. And when I come to talk about another Ministry we
will talk abo ut what we do with respect to Workforce
Development. But it is not just about the bricks and mortar; it is really about the people as well. So I would
be remiss if I did not just mention that.

Office of the Public Guardian

Hon. Jeanne J. Atherden: The Mi nistry is conscious
of the challenges faced by persons without decisionmaking capacity who, for a range of reasons, may not
have a next of kin or anyone to adequately make decisions about their care and finances on their behalf. The Ministry committed to exploring the establishment of an Office of the Public Guardian to assist in such cases. To date options have been identified for the establishment of this role to protect high- risk cases
where there is no one to take responsibility for a vul-nerable person. Recommendations for implementation will be put forward in the upcoming fiscal year.

Disabilities

Hon. Jeanne J. Atherden: Mr. Chairman, ADS develops and coordinates programmes and services that
promote improved quality of life for persons with dis abilities. Services offered include:
• Awareness and advocacy for persons with
disabilities;
• Monitoring buildings and dwellings for acces-sibility requirements; and
• Providing information on new technology and
adaptive equipment.
ADS’s work within disabilities is n ot a single
agency effort. The office works with many other stakeholders to ensure that initiatives and pr ogrammes geared to persons with disabilities are suc-cessful.
The Disability Advisory Council (DAC) is appointed by the Minister to advise the government on issues as it relates to persons with disabilities.
One of DAC’s community initiatives this year
was a town hall meeting entitled “Knowing your Dis ability Rights” under the Human Rights Act at Somer sfield Academy on 1
st December 2016. Topics di scussed included reasonable accommodation by em-ployers and navigating the services of the Human
Rights Commission. The meeting was well attended
by community stakeholders as well as parents and caregivers of persons with disabilities.
Mr. Chairman, ADS also has under its remit
the K. Margaret Carter Centre (KMCC). KMCC has a budget of $1.867 million that funds 19 staff delivering
direct client services. KMCC is a Government -
managed training and production centre that provides
ability -focused enrichment programmes and training
for 53 persons with cognitive disabilities aged 18 to 50-plus.
Components of their integrated production
programmes are:
• Employment Training;
• Functional Skills;
• Production Centres;
• Wellness;
• Treatment (Occupational Therapy Services);
• Adult D ay Centre.
An important component of ADS’s work r evolves around increased employment for persons with
disabilities:
• Adopting the International Labour Organis ation Report (2013) the Employment Training
Division at the K. Margaret Carter Centre links
clients to various business resources. The
Centre serves 53 clients and, to date 85 per
cent of the clients have been placed in community -based employment, 70 per cent parti cipate in in- house contract work and 80 per
cent participate in the production of food and
crafts for sale and distribution.
• Through the Training/Employment and Pr oduction initiatives, clients continue to acquire workforce skills, and productive community
partnerships are being developed with respect to job opportunities.

In addition, awareness- raising is a critical
component of ADS’s activities:
• ADS participated in the Department of E -
Commerce Senior’s Cyber Day promoting I nternet Security.
• The UN International Day of Persons with Disabilities was observed on December 3,
2016. On December 2
nd, Ageing and Disability
Services along with the Bermuda Institute of
Architects hosted a City of Hamilton Access ibility Walk starting at the Ministry of Health
Headquarters and finishing at City Hall.
Mr. Chairman, in September 2016, K. Margaret Carter Centre established a relationship with Greenrock whose remit is to empower individuals and
companies to do their part in making Bermuda more
socially, economically and environmentally sustain able. Through this partnership, in January 2017, K. Margaret Carter engaged in a one- year pilot pr ogramme with Somerfield Academy. The aim is to i n1138 13 March 20 17 Official Hansard Report

Bermuda House of Assembly crease students’ knowledge of working with persons
with disabilities, as well as gaining an understanding
of their needs.
Finally, Mr. Chairman, with regard to improving the quality of life for persons with disabilities, a great deal of time and resources has been spent on the interim management and administration of Summerhaven. The facility has been under the care of the
Ministry of Health and Seniors since December 8,
2016 wh en the Ministry requested and obtained a
Magistrate’s Court Order for the Ministry to temporarily take over the administration due to serious concerns about the health and well -being of residents. In addition, following a litany of complaints about the Board’s mismanagement, the Registrar General appointed a Receiver who has been working with the Ministry’s Administrators to rectify the serious clinical, gover nance and financial deficiencies at the facility. Signif icant steps have been taken by the Ministry to ensure
the safety and well -being of all residents and oper ational compliance with legislation.

Education and Awareness

Hon. Jeanne J. Atherden: Lastly, Mr. Chairman,
ADS undertakes awareness -raising activities to direct
the public to information and resources.
Outreach opportunities this year have inclu ded 12 presentations at various events from senior
seminars and luncheons to accessibility trade shows,
such as Seniors’ luncheons and the Bermuda Architects.
In addition, ADS’s presence on the Ministr y’s
web pages is being enhanced to provide accessible information on the services available and how to ac-cess them, and this year will see an enhanced outreach to professionals, caregivers and the public to
ensure broader awareness of services available and improve their take- up and effectiveness.
To close, Mr. Chairman, ADS is a small but
highly active team. We are actively working to i ncrease staffing levels so that it can fulfil its mandate in full and better meet the needs of seniors and persons with di sabilities.
Mr. Chairman, this concludes my remarks on
Head 21.

[Inaudible interjection]

Hon. Jeanne J. Atherden: Yes, I am, Mr. Chairman.
Just give me one second to transition if you do not
mind.

HEAD 22 —DEPARTMENT OF HEALTH

Hon. Jeanne J. Atherden: M r. Chairman, good
health does not happen by chance. Good health is
shaped and nurtured— it is connected to the environments in which we live, work , play and learn; it is tied to the resources available in our communities and r esearch shows that it is undoubtedly linked to a person’s access to health care.
Mr. Chairman, a central role of the Depar tment of Health is to give access to primary health care
and to protect and promote the health of the Island’s
residents by assuring conditions where people can be healthy and thrive. The department’s mission is : “To
promote and protect the physical, psychological and
social well- being of the community to enable the i sland’s residents to real ise their optimum quality of life,”
Through work in the Island’s schools, screenings and health fairs, the Department of Health raises
awareness of prevention and early detection. We
teach the public about the small, easy steps they can
take to protect their health. Through research, data
collection, health education, and direct services, the Department of Health lays the foundations and cr eates the conditions that put healthy choices within
reach.
The Department of Health prevents mosquitoborne diseases; makes sure new mothers have the
resources and knowledge they need to have healthy babies; assures food safety, investigates illness outbreaks; provides access to vaccines; tests drinking
water; ensures safe working and housing conditions; and so much more.
Mr. Chairman, the Department of Health is
Head 22 and its current account estimates are l isted
on pages B -136 to B -147. The 2017/18 budget est imate is $27.339 million dollars for the department. As
can be noted on page B- 139 of the Budget Book, the
department employs 261 full -time equivalents, including various health practi tione rs, medical officers, dentists, nurses, therapists, officers, dieticians, laboratory analysts and administrative staff.
Mr. Chairman, the Department of Health i ncreases the capacity of every citizen to achieve opt imal health and well -being from conception through to
old age. Health behaviours are complex and can
change with each life stage and the changing motivations and beliefs of individuals. The intent and vision
of the Department of Health is healthy people in
healthy communities.
Mr. Chairman, the Mat ernal Health & Family
Planning Clinic service seeks to achieve a reduction in unplanned pregnancies through the availability of affordable general and emergency contraceptives. Our
clinic services had a total of 2,403 visits for family
planning.
We aim to promote safe mother hood and
healthy outcomes for newborns through: the availabi lity of antenatal care for underinsured and uninsured
women; collaborate with other members of the o bstetric and health care teams; and offer free childbirth e ducation, nutritio nal advice and appropriate immuniz ation for all pregnant women.
We utilis e evidenced based research to formulate guidelines for the promotion of cervical health


Bermuda House of Assembly and the prevention of related cancers, and we pr omote healthy sexual behaviour and healthy choices in
reproductive health.
A team of verifiers from the Pan American
Health Or ganis ation visited Bermuda last year to
evaluate the successful elimination of maternal to child transmission of HIV and congenital syphilis.
Mr. Chairman, the 2017/18 budget es timate
for Maternal Health and Family Planning is listed as cost centre 32040 on page B- 136 and the 2017/ 18
budget estimate is $509,000.
Mr. Chairman, the child health programme is
a community, clinic and school -based programme that
provides preventive and curative health services and
assures conditions for optimum health and learning for infants, children and adolescents. This is conducted
through health and developmental assessments, screenings, referrals, treatment of minor ailments, health education, health promot ion and anticipatory
guidance.
Health supervision services are provided
through the school nurses to school aged children with emphasis on preventive health services and health education, including asthma education, management and moni toring. The percentage of Primary
One students receiving a child health screening ac-cording to the established protocol is expected to be 70 per cent this year.
Mr. Chairman, the 2017/ 18 budget estimate
for Child Health is listed as cost centre 32030 on page
B-136 and the 2017/18 budget estimate is $1.74 mi llion. In 2017/18, the Health Visiting Team engaged in
targeted child development work with vis its at nine
months to assess , via standardized testing using the
SOGS , Schedule of Growth Skills , deficits in development as early in the life course as pos sible. The
Health Visitors are Department of Health nurses that
visit 94 per cent of new mothers in their homes to ensure the best start in life for infants and to ensure that
every new mother is supported and connected to services and guidance.
Mr. Chairman, the Expanded Programme on
Immunization assures universal access to routine childhood immunizations for all infants and children through both public and private sector serv ices.
The percentage of infants and children aged
zero to 24 months appropriately immunized for age is
expected to be at 95 per cent this year. Bermuda obtains many of its vaccines through the Pan American Health Organi sation, which ensures vaccines are acquired at the most cost effective price.
Mr. Chairman, Occupational Therapy (OT)
and Physiotherapy (PT) services are provided to maximise the functional potential of infants, children, and
persons with physical disabili ties. The Early Interve ntion Team emphasises the importance of supervised tummy t ime, fine and major motor skills development ,
and choosing safe baby equipment. The therapy pr o-gramme works to raise individual and family awar eness of specific motor problems.
A streamlined screening process is used by
the OT/PT team servicing all Government Pre-Schools and Primary schools for the early identific ation of students at risk of motor deficits that may i mpact school functioning. Students who are at risk are
identified and placed in groups to enhance their motor skills , while students with moder ate to severe motor
issues were referred for evaluation.
Mr. Chairman, the 2017/18 budget estimate
for Physiotherapy and Occupational Therapy is listed as cost centres 32080 and 32120 on page B- 136 and
the 2017/18 budget estimate is $1.078 million and $931,000, respectively.
Mr. Chairman, the Speech and Language
Programme provides therapy services to infants and children who have, or might be susceptible to, speech- language delays or disorders in order to pr omote their communicative and social well- being.
Early Intervention Speech and Language
Screening and Assessment Clinics identify potential clients and provide therapy services as early as pos-sible. Last year 473 clients were referred and 368 cl ients were assessed. Demand for services has signif icantly increased over recent years. Primary 1 Speech
and Language Screenings facilitate early ident ification
of potential clients. Approximately 500 incoming P1
students received Speech and Language Screening assessments last y ear.
The Speech Language Pathology , or SLP,
team worked on many fronts to improve collaboration with parents, caregivers, and educators to provide greater clarity on intervention goals and how much therapy needs to happen, and the shared responsibi lity of families, teachers , and caregivers for children in
need. Mr. Chairman, the 2017/18 budget estimate for
Speech and Language Services is listed as cost cen-tre 32100 on page B -136 and the 2017/18 budget estimate is $1.55 million.
Mr. Chairman, Oral Health provides dental
services to Bermuda’s chi ldren. Prevention, consult ation, and dental hygiene is provided for children up to 18 years of age, as long as they remain in school. The preventive dental staff visit s each classroom in the
pre-school and primary school settings to provide dental education. Fluoride supplementation in the form of
drops and tablets is provided in school or at home, free of charge, and enjoys an 86.7 per cent uptake
rate. Because of dental officer recruitment challenges
there was an interruption in the provision of the Scree n and Seal programme for children in grades
P2, P3 , and M2.
Mr. Chairman, comprehensive dental care
services are provided in the clinical setting. There were 2,646 appointments provided in the regional Health Centres, Mangrove Bay, Hamilton, and St George’s, in the prisons , and occasionally in the hospital. The vast majority, 82 per cent of clients, demon1140 13 March 20 17 Official Hansard Report

Bermuda House of Assembly strated improved oral hygiene status at recall. The
theme of last year’s Oral Health campaign was
“Choose Water”; a theme equally as important to pr eventing tooth decay as to halting the rise in obesity and diabetes.
Mr. Chairman, the 2017/18 budget estimate
for Oral Health is listed as cost centres 32150, 32155 ,
and 32160 on page B -137, and the 2017/18 budget
estimate is $1.493 million.
Mr. Chairman, healthy children learn better.
Research has found that students’ health affects their grades, attendance, behaviour, and whether they graduate. And we also know that education is one of
the many social determinants that influence a per-son’s health throughout t heir life. The Department of
Health and the Department of Education have a long history of collaboration to keep students safe and to teach them healthy habits.
Healthy Schools assure that public and pr ivate schools foster the connection between education
and health. The Premier’s Youth Fitness Programme provides support to PE teachers to assure regular student fitness assessments including body compos ition, flexibility, aerobic fitness, and strength. The goal
of the programme is to increase the number of c hildren having moderate to vigorous activity for an hour a day and therefore to get 70 per cent of our kids into
the healthy fitness zone.
Mr. Chairman, I must also indicate that this
programme, which was started last year in September, is one of those things which we keep seeing
growing. And the Premier, the Minister of Education, and I have had the opportunity to go to the various schools and to see how the children’s awareness of health and what they need to do with respect their own health and what they can do for it is improving.
So, I am very pleased that this is developing and we will, of course, keep the House informed of the pr ogress.
Mr. Chairman, school nurses play a role in
raising the capacity of children to safeguard their own
reproductive health as they mature into sexually active
adults.
The Department of Health provides the Communicable Disease Clinic and services to prevent and control the spread of communicable diseases, ed ucate the community about sexually transmitted infections, HIV, and other communicable infections and
provide education to promote safer sex practices.
Free, confidential testing for sexually transmitted in-fections is provided to men and women. Treatment is provided for those with positive test results and con-tact tracing is performed.
Several promotional campaigns promoting
sexual health are also facilitated and provided: “Know
Your Stat us” and “Have the Conversation”; HIV/AIDS
Awareness Month for the month of June; and World
AIDS Day in December. Mr. Chairman, the 2017/18 budget estimate
for the Communicable Disease Clinic is listed as cost centre 32050 on page B- 136 and the 2017/18 budget
estimate is $406,000.
Mr. Chairman, as our young people mature
and graduate from the learning environment and into the work environment the Department of Health’s role
in promoting health continues.
The environments in which we live and work
are some of the greatest determinants of health— poor
housing and unsafe workplaces can have a detrimental effect on a population.
The Environmental Health team provides a
variety of functions, and has eight programme areas to assure safe and healthy living and working condi-tions including:
• Food and Beverage Safety ;
• Water and Sanitary Engineering;
• Housing C onditions Control ;
• Vector Control;
• Institutiona l Hygiene;
• Nuisance Control ;
• Port Health; and
• Occupational Safety and Health.
The budget estimates for Environmental
Health are listed as cost centres 32170, 32171,
32172, 32173, 32175, 32180, 32190 , and 32270 on
page B -137, and the 2017/18 budget estimate is
$3.177 million, which is a 2 percent reduction on
2016/17.
The Occupational Safety and Health pr ogramme oversees workplace safety in general and specifically performs permitting of asbestos abat ement, licensing of radiation equipment , and investigation of industrial accidents to assure workplace safety.
The Environmental Health team via the Food
and Beverage Safety programme licens es local food
establishments. A “Scores on Doors” programme is
being implemented where an establishment’s last Health Inspection Grade will be posted and visible to patrons and members of the public.
The Environmental Health Officers assure that
tobacco vendors are in compliance with the Tobacco Control Act 2015 with the intent to protect minors from tobacco initiation and use. The Act also restricts the
outdoor use of tobacco at public transportation term inals and at educational and health care settings to
further control exposure to second hand smoke.
Mr. Chairman, to improve customer service,
the Environmental Health section has reviewed and
upgraded several of its policies. The process involves
updating guidance, application forms, and providing additional information on the new Government website a t www.gov.bm/department/health
.
Mr. Chairman, Vector Control is a hardworking team that gets results and ensures that threats of mosquito borne diseases such as Zika do not manifest themselves in Bermuda.


Bermuda House of Assembly On average, 28 houses a day are inspected
for mosquitoes and over the course of last year
17,000 homes were checked. Cautions are given r equiring occupiers to remove stagnant water and to
prevent mosquito breeding. Even though there have been to date six imported cases of Zika there has n ot
been any local transmission. Bermuda’s containment
of Zika is thus far giving our tourism economy a much-needed boost as honeymooners are choosing Berm uda over countries with higher risk of Zika transmission.
And I guess I would have to remind ourselves that last year it was Chikungunya and there have been other diseases, and as we do this we make sure that people
know that Bermuda is safe and they want to come
here.

[Inaudible interjection]

Hon. Jeanne J. Atherden: Chikungunya?
[Inaudible interjection]
Hon. Jeanne J. Atherden: Yes.
Mr. Chai rman, the Department of Health
works to ensure that Bermuda is in compliance with
the International Health Regulations 2005 at the L.F. Wade International Airport and at the various Sea Ports. The Quarantine Act and Regulations 2017 will
require a dedicated team of health officers assigned to assure sanitary conditions at points of entry, on conveyances , and to assure that the travellers are free
from infectious diseases of public health significance.
Port health collaborates with partners to assure the
safety and quality of imported commodities including
foods, animals , and products of animal origin.
Mr. Chairman, Bermudians love to travel and
the Travel Health Clinic provides consultation and vaccination for travel abroad to high- risk areas. There
were 1,084 travel clinic consultations. Flu Express is
well established with over 1,200 doses being admini stered over a two- week period throughout the I sland.
Mr. Chairman, c hronic disease such as diabetes do not have rapid onset like communicable dis-eases, and can take years to become established. Non-c ommunicable diseases have common risk factors and preventative factors that must be understood and leveraged to reverse the current trends towards
illness of Bermuda’s population.
The common risk factors are:
• Sede ntary lifestyle;
• Overweight and obesity ;
• High blood pressure;
• Poor diet with low consumption of fruit and vegetables ;
• Poor diet with high consumption of processed
foods high in sugar, salt , and fat ;
• Alcohol use, and
• Tobacco use. Mr. Chairman, e ven though B ermuda is struggling with high chronic disease rates, there is high
awareness of the need for healthy eating and active living, which is encouraging. Last year’s Celebrating
Wellness event moved to the City Hall parking lot from Victoria Park and promoted the importance of physical activity and healthy eating in boys to men. Over 500
persons were in at tendance. I would like to encourage
everyone to take the challenge and commit to choosing water ; moving more and exercising daily; and eating your vegetables .
Mr. Chairman, I guess, when I talk about this
it reminds me of that Michael Jackson song the Man
in the Mirror because I believe everybody in Bermuda
should be looking at themselves in the mirror and tal king about change and talking about what they need t o
do to effect change because it really is about each
one of us doing something differently. And so I will
keep highlighting that theme—the Man in the Mirror
and change.
Mr. Chairman, the Department of Health’s
Health Promotion Office has made a concerted effort
to better reach the growing number of residents that
turn to the web and to social media for their information. Please “like” the Department of Health on F acebook; in exchange you will enjoy topical health matters that are updated and streamed daily including :
Department of Health services and initiatives, health
and fitness tips, healthy eating, local and global health news and inspirational health stories , and quotes. I
would just like to say to everyone out there listening to us that a special prize will be given to the one -
thousandth “like” by the end of March 2017 —so
please log on.
Mr. Chairman, t he 2017/18 budget estimate
for Health Promotion and Healthy Schools are listed
as cost centres 32240 and 32265 on page B- 137 and
the 2017/18 budget esti mate is $329,000 and
$129,000, respectively. And this is something which I mentioned earlier and I am glad that we are highlight-ing it again.
The increase in the Healthy Schools budget
allows for the creation of the role of Case Manager for the Premier’s Youth Fitness Programme, to work in conjunction with the PE teachers to support students identified as at -risk for overweight, obesity, underweight, and whose FitnessGram results place them
outsi de of the Healthy Fitness Zone. Each identified
student will have an Individualis ed Wellness Plan to
include a Team Approach with parents, the PE teac her, school counsellor, the student, Nutrition Services,
and possi bly his or her physician. And I cannot stress
the team approach because you can see all the pe ople that are there as part of the team.
Mr. Chairman, Nutrition Services continues to
promote the new Bermudian dietary guidelines the Eat
Well Plate . Through the Health Promotion Office,
Power’95 monthly radio shows, websites, and partnering with the Bermuda Dieticians Association, awar e1142 13 March 20 17 Official Hansard Report

Bermuda House of Assembly ness of the Eat Well Plate is growing and increased
from 55 per cent last year. In case you are unaware,
the guidelines in a nutshell are that half your plate is
to be vegetables, one- quarter meat or protein, and
one-quarter grains or starches.
Mr. Chairman, the $aver the Flavour initiative
is a collaboration with grocers and wholesalers i ntended to assure access to healthy food options via supermarket promotions and healthy eating demon-strations. Look for the $aver the Flavour logo on food
specials —and Mr. Chairman, I cannot help but just
reinforce this. If you go to these grocery stores . . . we
keep talking about the supermarkets and the fact that
you know, what are they doing to help us, but if you
go to them you will see the $aver the Flavour, you will
see the logos, you see the information that not only tells you what that particular food is good for —
whether it is protein, whether it is a starch—but it also gives you some indication of whether it is on special,
and it is designed to help people stretch their dollars.
So look for the $aver the Flavour logo on food specials in your local supermarket and also the prom otions where they turn around and show you how to cook some of these things and make healthy meals
for busy homeow ners.
Mr. Chairman, the Community Heath team
provides health care in the community and they assist
with client’ s dressing and activities of daily living , i.e.,
bathing and eating so that persons can remain in their
own homes with a high quality of life. The idea is not
to create a cycle of dependency but to raise the c apacity of families and informed caregivers so that
44 per cent of new cases can eventually be di scharged. And that is such a good idea in terms of
caregivers that can stay at home so that new cases
can be discharged.
Mr. Chairman, the 2017/18 budget estimate
for Community Health and Community Health Administration are listed as cost centres 32240 and 32265
on page B -137, and the 2017/18 combined budget
estimate is $2.9 million.
Mr. Chairman, the Community Health team
provides not only primary nursing care, including risk assessment, interventions , and monitoring, but it also
provides community care, support services, and per-sonal care to seniors and disabled. This is done in coordination with Ageing and Disability Services,
which provides case management for vulnerable and
at-risk persons. This is an important role and one that
assures that residents with long- term care needs can
remain in their homes rather than being institutional-ised at a far greater cost. Every time I come across
individuals I keep promoting this.
Community Health staff provides individual
assessment of clients and their families, home as-sessment , and monitoring of high- risk clients and case
management , and coordination of client services i ncluding referrals. Functional assessment of cognitively impaired seniors for institutional placement is also
performed.
Mr. Chairman, therapy services are provided
to maximise the functional ability of individuals and to
increase awareness of health prevention for seniors.
Increased awareness of key strategies and skills to promote optimal functioning and quality of life are
needed for an ageing population such as ours.
Health prevention education and home assessment for clients and caregiv ers on adaptive
equipment, fall prevention advice, and education on
helping older adults remain mobile are interventions
provided by the OT/PT team. And Mr. Chairman, if
any of you have had your seniors and ageing you r ealise that fall prevention and advice on how to prevent
falls is so important because you see so many people that when they have to go from home to institutiona lised it is usually because of a fall. And Mr. Chairman, I cannot highlight the fact that sometimes we have to
say to our seniors, It isn’t about the fact that you don’t
want that walker or you don’t want that stick, but you
just have to say that it is important because we don’t
want them to fall. So sometimes we have to be a little
stricter with them.
Mr. Chairman, the Community Health team
provides not only primary nursing care, including risk assessment, interventions , and monitoring—just a
minute, sorry, I just flipped over the page. I just talked about the OT/PT team.
The Speech and Language Programme pr ovides in- service trainings on communication disorders
and swallowing difficulties primarily to staff at the Lefroy House and Sylvia Richardson Senior Care F acilities. And Mr. Chairman, for persons out there . . .
because it was something that I did not realise, until you have senior you do not realise that swallowing
difficulties are something that increases with age and
that you are not going to be discharged from the hos-pital unless you can swallow properly at home and that is where the Speech and Language therapists come in there and make sure. And that difficulty i ncreases with age, so it is not only the communication, because we tend to think about the communication, but it is also the swallowing difficulties. So they pr ovide the in- service training to the staff at Lefroy House
and Sylvia Richardson and it is very important.
The Environmental Health team ordinarily performs inspections of Residential Care Facilities on behalf of the Aged and Disabilities Services Section (ADS) to ensure that elders are being cared for in safe
and quality environments. Nutrition Services acts as a
resourc e for rest homes and assures elders’ nutrition,
by monitoring and advising on institutional meal plans.
And that was something, Mr. Chairman, it was nice to be able to go around and look at the care homes and see the fact that the nutritional plans were up there so that we know what the residents were supposed to be getting and that they had plans which had been as-sessed by Nutrition Services.


Bermuda House of Assembly Mr. Chairman, the Department of Health operates two long-t erm care facilities. Sylvia Richardson
Care Facility (SRCF) provides care, promotes ind ependence and optimal health in persons aged 65
years and over, who have significant unmet nursing and care needs requiring 24 hour, facility -based care.
Last year was a challenge because of faulty
elevators and the difficulties encountered in remed ying them, and I want to recognise the staff that went the extra mile and endured great inconveniences to assure the safety of the residents during a challenging time. The good news is that the faults have been remedied in the medium term and the elevators have
passed inspection. A long -term solution is also at
hand and infrastructure investments are being made
by my colleagues in Public Works that will prevent recurrences.
Mr. Chairman, the 2017/18 budget estimate
for Sylvia Richardson Care Facility is listed as cost
centre 32015 on page B- 136 and the 2017/18 budget
estimate is $5.2 million which is a 4 percent reduction
on 2016/17.
Mr. Chairman, the Lefroy House Care Community (LHCC) in Sandy’s Parish provides multi -level
care, including supportive care, nursing care, skilled care, respite care, day care, physician services, reh abilitation services, nutrition services , and services of
engagement for caregivers and their clients who r eside in our community. LHCC strives to maintain the elders’ dignity, independence, and right to choice, and
to provide care and services to meet the individual’s needs. The team at Lefroy House is to be commended for their dedicated and fruitful efforts to overcome challenges due to storm damage and other re pairs.
Indeed, during storms staff at both homes forfeit car-ing for their own families to ensure residents are safe
and cared for.
Mr. Chairman, t he 2017/18 budget estimate
for Lefroy Care Community is listed as cost centre
32000 on page B -136 and the 2017/18 budget est imate is $4.77 million.
Mr. Chairman, the Department of Health r eceives support services from its l aboratories. The Cli nical Laboratory is situated at the Hamilton Health Centre. There, the bulk of the clinical testing work is performed for child health, school clinics, oral health, the communicable disease clinic, and the maternal health
and family planning clinic. Special work was per-formed for Norovirus and Flu testing as well as Zi ka
testing; helping obtain samples and sending them overseas to specialist public health affiliated labs ar e
also part of their services.
The 2017/18 budget estimate for the Clinical
Laboratory under cost centre 32090 is listed on page B-136 and the 2017/18 budget estimate is $276,000.
Mr. Chairman, the Central Laboratory pr ovides a range of analytical services to a number of Government and non- Government agencies. It ope rates three programmes: Water and Food Analysis; Urine Drug Testing; and Forensic Analy sis. The
2017/18 budget estimate for Central Laboratory is listed on page B- 137 and the 2017/18 budget estimate
is $1.2 million.
The Water and Food programme provides a
laboratory service for the analysis of water and food to assist in reducing environmental threats to health, i mproving drinking water quality and food quality, and maintaining a low incidence of waterborne and food-borne diseases.
Sampling and bacterial testing of seawater
from the most highly used beaches verify that 100 per
cent of beaches met the requirements of the 2012 US
EPA Recreational Water Quality Criteria. Important Fats, Oils, and Grease [FOG] controlling legislation is
under Island -wide implementation to improve the way
that food establishments manage the FOG that they generate an d to reduce the risk of the recurrence of
grease balls.
Mr. Chairman, the urine testing programme
provides a laboratory service for drugs of abuse tes ting of urine specimens to agencies such as drug treatment programs, the Department of Corrections, the Department of Court Services, doctor’s offices,
workplace, and sports drug programmes. These
agencies receive accurate test results on which to
base their treatment or disciplinary proceedings, con-firmatory testing being provided when there are any legal or disciplinary implications.
Mr. Chairman, the Forensic programme pr ovides accurate and impartial information, training, and
analytical services to the Criminal Justice System, Road Traffic and Transport Services and the Health Care community. Policy advice was also offered on medical marijuana options and decriminalisation of marijuana.
Technically skilled and knowledgeable scie ntists are authorised under the Misuse of Drugs Act 1972 and the Road Traffic Act 1947, while also wor king from the Pharmacy and Poisons Act 1979; Ev idence Act 1905; Police and Criminal Evidence Act
2005; and the Liquor Licenc e Act 1974 to assist the
aforementioned service entities. The laboratory continues its unwavering collaboration with the Bermuda Police Service, Coroner, Pathologist , and the Justice
System.
Mr. Chairman, the Department of Health
through its Administrative Section has adopted an overarching strategic theme which is “To halt the rise in obesity and diabetes.” All business units within the department are tasked with ensuring that services that
have relevance to the NCD preventative factor and risk factors are strengthened and emphasised. The
department is currently consulting stakeholders in the
health system and other important sectors on the
framework for a National Obesity and Diabetes pr evention strategy. And Mr. Chairman, I think it is also good to note . . . and I just make a plug here because
I saw that it was advertised that on the 17
th of March
1144 13 March 20 17 Official Hansard Report

Bermuda House of Assembly there is going to be the Diabetes Association’s Annual
General Meeting and there is going to be a doctor
there that is going to talk about reversing your diabe-tes. And this was something that people would not have been aware of , and now we have so many other
things that are coming up that tell us concerning diabetes –– which is obesity, whether it be type 1 or type
2 diabetes –– that there is some hope for certain types
of diabetes.
So, Mr. Chairman, I just want to say that we
obviously, this Ministry, is working, as I said, with con-sulting with stakeholders in the health system on the framework for a National Obesity and Diabetes pr evention strategy.
Mr. Chairman, the 2017/18 budget estimate
for Administration is listed as cost centre 32230 on page B -137 and the 2017/18 budget estimate is
$946,000 which is increased over 2016/17. And this is because additional funds have been earmarked for
staffing for the America’s Cup and the associated ce lebrations with the bulk of the funds —$400,000—
intended for the new Port Health Unit salaries and
implementation of the Quarantine Act 2017.
Mr. Chairman, this concludes Head 22.
Sorry, Mr. Chairman, I am just trying to make
sure where I am with respect to—

Proceed, Minister.
Hon. Jeanne J. Atherden: Yes, I am trying to make
sure that I leave time for questions because I know that lots of people are interested in this Ministry , and
well they should be.
Thank you, Mr. Chairman.

HEAD 24 —HOSPITALS (PATIENT SUBSIDIES)

Hon. Jeanne J. Atherden: Mr. Chairman, the current
account estimates for Head 24, Hospitals , can be
found on page B-148 of the Estimates Book. These
estimates reflect grants and subsidies paid to the
Bermuda Hospitals Board (BHB):
• For medical care delivered to patients at the
King Edward VII Memorial Hospital (KEMH) at
various rates of subsidy as follows: 100 per
cent for children and the indigent, 70 per cent
for seniors aged 65- 75, and 80 per cent for
seniors aged over 75 years; and • To fund the net cost of operating the MidAtlantic Wellness Institute (MWI).

2017/18 Estimates

Hon. Jeanne J. Atherden: The estimates for 2017/18
are shown on pages B- 148 and B -149, and amount to
a figure of $120.2 million, a reduction of 17 per cent
from the $143.674 million that was allocated in the
fiscal year 2016/17.
Patient subsidies amounting to $82.856 mi llion have been allocated to pay for the billed acute care services of the young, aged, and indigent at the
King Edward VII Memorial Hospital. This represents a 24 per cent reduction from the prior year.
The Mid- Atlantic Wellness Institute is provided
with a grant of $37.344 million, which is unchanged from the prior fiscal year.
Mr. Chairman, the hospital subsidy is the
amount Government budgets to cover the care for youth, aged, and indigent residents who require hospital services over the fiscal year. The budget also i ncludes the geriatric subsidy, paid towards the care of
long-term care patients, and the drug/clinic subsidy,
which contributes costs towards HIV drugs.
Bills for patients covered by subsidy were adjudicated and are forecasted by the Ministry to be a pproximatel y $116 million for 2016/17. Based on how
much more the community is using hospital services year on year, BHB is expecting to experience a further increase in service use utilisation of 7 per cent in the
next fiscal year 2017/18.
Mr. Chairman, Government’s budget for subsidy in 2016/17 was $108.33 million, prior to a subs equent mid- year cut of $2 million. No supplemental
payments are being requested to cover the shortfall for this year, which BHB will cover. The hospital sub-sidy will be reduced by a further $25.5 million or 24 per cent to $82.856 million in 2017/18.
This is a one- off budget cut being made to assist the country as it navigates its way through to a more financially stable position.
Government’s view is that the hospital’s cash
position is strong enough to pay for this one year cut, as it has saved $100 million through extensive cost -
control and efficiency measures over the last four years, in addition to periodic fee increases and the recent provision of a transfer from the Mutual Rei nsurance Fund. Alongside efficiency, BHB delayed
capital investment in critical projects such as the electronic medical record, and the MWI and General Wing
facilities to ensure that savings were appropriately
used against a clear investment plan that supported the new Strategic Plan 2016 –2021. BHB has r esponded to capital requirements on an as -needed b asis in the interim. This has helped build a stronger
cash position.
These savings were in preparation for an i nvestment in facilities and IT improvements. This inBermuda House of Assembly cludes extensive facilities improvements and repairs
for the ageing Mid- Atlantic Wellness Institute and the
General Wing at King Edward as well critical clinical IT
systems upgrades for near failing systems, and i nvesting in an Electronic Health Record. Although $100
million is a large sum, the combined IT and facilities costs, which relate to projects that would be completed over many years, exceed the amount saved.
Mr. Chairman, BHB will postpone some of its
planned work in this year, but has stated that as long
as the budget returns to parity next fiscal year —
meaning BHB is paid fair and reasonable fees for services used by patients covered by subsidy —that it will
start saving for and planning work in the following fis-cal year.
BHB estimates the loss in revenue from this
cut in subsidy will be material, particularly taking into consideration that the $25.5 million cut is on a budget that was already short of current claims for services
used by subsidy patients.
Mr. Chairman, also impacting BHB revenue,
but helping reduce costs pressuring the hospital subsidy and Standard Premium Rate in the coming fiscal year, will be the proposed reductions in BHB’s diagnostic imaging and dialysis fees to bring them in line
with fees charged by private providers.
The higher fees previously charged for hospital fees recognised that BHB is the only diagnostic service expected to run 24/7 and that BHB operated with a built -in capacity to respond to potential national
disasters. The Ministry has directed that hospital fees in these areas should now align with community fees. Additionally, fees that relate to people who no longer need acute care services but are in hospital will be reduced based on new categories of patients in hospi-tal. These reductions will help control costs for all of
Bermuda.
BHB has calculated that the impact of the fee
reduction for Diagnostic Imaging is expected to trans-late in $15 million lost revenue for BHB. The reduction in dialysis fees will translate into about $8 million of
lost revenue. In addition, the Mutual Reinsurance
Fund transfer will reduce by $1.7 million. This trans-lates into an expected loss of $24.7 million compared to this year.
Mr. Chairman, taking all these changes into
account, BHB expects to experience a total revenue
reduction of about $60 million in 2017/18 based on
these changes. It will use its cash reserves to cover the cost of delivering its current services.
BHB’s 1,800 staff have worked extremely
hard to stabilise BHB financially over the last four years and accepted vacancy and wage freezes alongside major efficiency programmes to help BHB move
into a more stable position. This means that BHB now has reserves it can fall back on. When the subsidy budget moves to fairly represent the value of services delivered the following fiscal year (2018/19) BHB will be able maintain current services and allow for major IT and facility work to ensure the stability and safety of
services over the long term.

The Triple Aim

Hon. Jeanne J. Atherden: Mr. Chairman, BHB effort s
to improve patient experience, improve population health, and cut the per capita cost of care:
The hospital subsidy aims to cover the hospital fees for the most vulnerable in our community —our
youth, indigent , and seniors. However, the increasing
incidence of diseases such as diabetes, hypertension,
kidney disease, cancer , and heart disease and an i ncreasing number of seniors with one or more chronic
health issues is translating into more hospital bills that
the country cannot afford to pay.
Mr. Chairman, while we all feel the financial
pressure, these diseases can also leave an indelible mark on families in our community. People on dialysis
spend hours every week in treatment, impacting ability
to work and the well -being of the individual. Blindness,
amputations, strokes , and heart disease are all poss ible complications of diabetes that leave individuals debilitated and families struggling.
BHB adopted the Triple Aim this year as part
of its new Strategic Plan. This has the goal of improv-ing patient experience, improving population health, and improving the per capita cost of care. Progress
towards these three goals will assist in the pressure on Government patient subsidy and the MWI grant.
The three aims are tightly connected— quality outcomes in hospital and healthier people throughout the
community will reduce the per capita cost of care.
Mr. Chairman, BHB has taken out $40 million
of recurring costs since 2013, and in 2016 [it] cost $2
million less to run than it did in 2012. This decrease in
cost was achieved even though it has shouldered about $40 million additional costs with the Acute Care Wing [ACW] opening since 2014—comprising $27
million for the annual payment and about $13 million in annual operational costs for running additional
space—such as utilities and cleaning costs.
This decrease has meant it has absorbed i nflationary increases as well. In the last four years, fees
have only gone up by 2 per cent, with Bermuda infl ation running now above 2 per cent per year and international medical inflation rising annually at around
6 per cent.
Despite continued pressures on subsidy
budgets, BHB continues to ensure our most vulner able members of society —youth, seniors , and ind igent—are never turned away even as the country
works through its economic challenges. Mr. Chairman,
in addition, there are individuals who are not covered
by subsidy, but cannot or will not pay their bills. In 2014, there was also about $6.5 million of outstanding bills. This has risen by 25.5 per cent over the last
three years , and this fiscal year the figure was $8.1
million.
1146 13 March 20 17 Official Hansard Report

Bermuda House of Assembly It cannot be said that BHB is not shouldering
its fair share in controlling healthcare costs. It is a
non-profit and all its surplus is invested back into care.
While we are asking more of our hospitals this year than ever before, we must also look to the healthcare system itself to continue cooperating and collaborating to control costs as we have seen in recent years.
Mr. Chairman, the National Health Accounts
report shows that total health spending has stabilised since 2011 and last year saw a 1 per cent decline,
proving that the combined efforts across the health system are making a positive difference and, together, we are finally bending the cost curve.
As today’s budget highlights, the hospital is
regulated through legislation which structures its gov-ernance, requires it to run 24/7, and be financially r esponsible. A legislative process approves what it can pay for and the amount it can charge, and BHB is not allowed to charge a co- pay. It is accountable to the
country through a Minister -appointed Board as well as
this annual review of finance and activity. BHB is the only healthcare provider required to table its financial statements in the House. It lists its utilisation statistics, is open to PATI requests and, this year, provided details on salaries of all its staff back to 2013. But it is only a portion of the healthcare market and as we move forward, we need the private sector to be sim ilarly accountable to the Bermudian public for its quali-ty and cost.
We need all our services—public and pr ivate—focused on building services around patients,
working together to raise the bar on patient exper ience, improving population health, and reducing
costs.

Launch of BHB Strategic Plan

Hon. Jeanne J. Atherden: Mr. Chairman, BHB completed and made public its BHB Strategic Plan 2016–
2021, which not only directed it to work towards achieving the triple aim I just outlined, but aimed to
give a solid direction in which services at the Mid -
Atlantic Wellness Institute, King Edward VII Mem orial
Hospital , and the Lamb Foggo Urgent Care Centre will
evolve. Its new vision is: Exceptional Care, Strong
Partnerships, Healthy Community.
To successfully achieve this vision will help
ensure a more efficient and effective service that will help control costs for all Bermuda. In support of the strategy, BHB staff worked to identify a number of pr ojects that would help make healthcare more affordable and relieve suffering in some of our most vulnerable groups —many of whom are high users of emergency
and hospital services.

Patient -Centred Medical Home

Hon. Jeanne J. Atherden: Mr. Chairman, in October
of 2016 BHB opened a pilot service aimed to care for people with chronic diseases who do not have insur-ance or are under -insured. It used the term “ PatientCentred Medical Home” to align it with similar services
in the US, where such services have helped reduce
the cost of care by helping vulnerable people better manage their chronic illnesses. This pilot has been entirely funded by BHB in its first year wi th a $1.7 mi llion investment of its revenue from other services.
It is very much in line with the Health Insurance Department’s Enhanced Care pilot, and the P atient-Centred Medical Home [PCMH] is likely to join
this Government initiative as a participant.
The goal is to reduce hospitalisations and
Emergency Department visits in vulnerable groups who are not seeing a GP, by improving the manage-ment of their chronic illness, whether it is diabetes, hypertension, cardiac disease, or kidney disease. R educing hospitalisations and Emergency Department visits reduces the cost burden for Bermuda and the
hospital subsidy budget.
Mr. Chairman, this is not the Medical Clinic reopened, which served the indigent population without
the need for referral or diagnosis. The Patient -Centred
Medical Home has strict criteria and is based on referrals. Individuals must have a chronic disease and be
non- or under -insured. The goal is to help them better
manage their chronic illness, maintain improved well-ness , and reduce the use of medical services.
The Patient -Centred Medical Home team i ncludes a physician, nurses , and support staff, and
longer term, if successful, the service could include social workers and mental health professionals. The team recognises the holistic needs of the individual.
This service will reduce suffering for individuals who are often left to fend for themselves in the healthcare system. The impact will be improved wellbeing, fewer hospital stays that interrupt daily life, and
a reduced likelihood of amputations or dialysis. This makes lives better and can improve family situations.
Mr. Chairman, financially, the hope is this service will br ing cost savings to the system. Bermuda
has many of the same issues the US has when it comes to population health. In the US, 5 per cent of
the population uses 50 per cent of the services. This
5 per cent group are usually non- or under -insured
individuals with chronic illnesses that are not being managed. This project meets all three of the triple
aims —it improves population health, patient exper ience, and reduces the per capita cost of care.
In the US, the “ Patient -Centred Medical
Home” is well known and there is significant research
that it improves health and controls costs. It is with a progressive eye on the future that BHB has taken on
investing in a pilot that will carefully follow patients to
see if similar benefits can be gained here in Bermuda. About 50 patients, so far, have been referred to this service.

Enhanced Antimicrobial Stewardship Plan


Bermuda House of Assembly
Hon. Jeanne J. Atherden: Mr. Chairman, BHB took
the lead role in an antimicrobial stewardship pr ogramme this fiscal year. The goal is to improve t he
use of antibiotics to optimis e clinical outcomes while
minimis ing the unintended consequence of antimicr obial use —namely an increased prevalence of antibiotic-resistant infections which can kill or maim, and be
costly to treat.
During the year , an antibiogram was developed and circulated to all local doctors by BHB. This
is an important clinical document that shares the ant ibiotic susceptibilities of the most common pathogens
that our patients are treated for locally ensuring targeted, effective treatments.
Research was also published by a team co mprising of BHB and Ministry of Health and Seniors staff about antibiotic -resista nt microbes in Bermuda.
Globally the rise of antibiotic -resistant infections is a
major concern. While, so far in Bermuda, we have not followed this trend, having an antimicrobial stewar dship plan will help us to fight against these lifethreatening infect ions. Given that travel for vacation
and medical treatments exposes many Bermudians to
these microbes, we continue to follow global developments closely and do everything possible to monitor the hospital population, especially those with long hospital stays or transfers from overseas.

Forensic Mental Health Solution

Hon. Jeanne J. Atherden: Mr. Chairman, Bermuda
has struggled for many years with establishing a vi able forensic mental health solution. We do not have a
forensic mental health service at this point. BHB welcomed Dr . Sebastian Henagulph, a Bermudian forensic psychiatrist, in this fiscal year , and he is working
on a joint initiative with the Ministry of Health and Seniors, Ministry of National Security, Ministry of Legal
Affairs, Department of Court Services , and Depar tment of Corrections to establish an appropriate place
for prisoners with mental illnesses to receive care.
We all recognise that inmates with severe
mental health issues are not adequately treated at this
time. The Mid- Atlantic Well ness Institute does not
have the level of security required for safe treatment. This means that individuals do not have the best
chance of recovery or successful management of their mental illnesses. The worst -case scenarios can be
tragic.
Mr. Chairman, only a small handful of people
in Bermuda require this type of specialised care, which can make solutions costly. In a 2015 report,
nine prisoners were identified as in need of medium
secure forensic services , and recent needs analysis
sugges ts Bermuda needs a forensic mental health
service for between 12 to 14 individuals. Despite the relatively small numbers, the impact on individuals being in an appropriate environment is huge. An ap-propriate mental health service for prisoners who have
psychiatric illnesses can give them a pathway to r ecovery, or better success to manage their illness.
While the mental health court has shown what a pos itive impact can be made before people with mental
health issues are tried and convicted, the next step is to have a viable solution of care for this population if
they end up in jail.
Numerous potential long- term solutions both
here in Bermuda and overseas have been discussed.
As an interim measure, a transparent procurement process was conducted to partner with an overseas provider to provide appropriate services for these
priso ners and protect public safety. A multi- agency
Steering Committee is working together to oversee the process.

Clinical Services Planning

Hon. Jeanne J. Atherden: Mr. Chairman, one of the
largest pieces of work that BHB has been preparing
for this year, is clinical services planning. This is a critical project in the Strategic Plan. It will be the most important and impactful project BHB has taken on
since the construction of the ACW. It will, effectiv ely,
look at local health needs, the economic situation, and
the health system and determine how all BHB ser-vices can be developed to most meet needs, in the most effective and efficient way. It will consider where
services are best provided for patients and will remain
true to the triple aim of structuring services that i mprove patient experience, improve population health,
and reduce the per capita cost of care.
The Clinical Services Planning process will
require extensive outreach to multiple stakeholder s
within the healthcare profession, government, insurers, and the community , as well as detailed information and projections on healthcare need.

Clinical Affiliations

Hon. Jeanne J. Atherden: Mr. Chairman, as a clinical
services plan is developed, BHB will then seek formal
clinical affiliations with one or more hospitals through a robust competi tive process. Currently, such agre ements tend to be ad hoc, based on requirements at both MWI and King Edward. While this often meets
the need of an individual department or service, there
is a benefit to having formalised agreements that are coordinated and support the requirements of Bermuda and the achievement of the BHB strategy. Going
through an RFP process will, BHB believes, also bring better value to these agreements for Bermuda.

Peer Review

Hon. Jeanne J. Atherden: Similar to clinical affiliations, BHB undertakes ad hoc peer reviews for clinical
services as required. As clinical affiliation agreements
1148 13 March 20 17 Official Hansard Report

Bermuda House of Assembly are drawn up, BHB is seeking to formalise peer review
across departments building on good work that has
been undertaken, often with overseas hospitals as advisors, in many areas such as Emergency and D iagnostic Imaging, as has taken place this year. This
helps improve quality and patient experience.

Mental H ealth Services Plan

Hon. Jeanne J. Atherden: Mr. Chairman, it is seven
years since the Mental Health Plan launched. Back in
2010 there were about 300 service users being seen at the MWI Acute Care Clinic for adults, which is the
main referral site to MWI programmes. Today, there
are over 700. Services are still under pressure and the
ageing MWI facility —much like the older General
Wing of King Edward —needs significant infrastructure
upgrades and functional improvements to maintain it as a safe environment to provide care.
Clinical services across BHB —whether phys ical health services based at King Edward or mental health, learning disability , and substance abuse services based at MWI —will undergo a strategic planning
process in the coming fiscal year. This is part of the
BHB’s Strategic Plan as it recognises the need to r eshape for the future needs of Bermuda and adjust to
the economic realities we live in.
BHB’s mental health service change, however, started this year as the final piece of the senior managem ent restructure took place. Announced in
2014, when BHB’s senior management was restruc-tured, BHB moved from two to one Chief Operating Officers, or COO s, in February 2017. Previously MWI
and KEMH had separate COOs. There is no change in the clinical directors and managers of the MWI ser-vices, but they now come under the BHB COO.
Mr. Chairman, I would at this point like to pay
tribute to Ms. Patrice Dill who had been the COO at MWI. With over 40 years championing mental health services, she had been at the helm of MWI for 19
years. We are grateful not only for her decades of
dedicated service, but also for achievements such as
the 2010 strategy, which are strong legacies for Ber-muda on which we can build.
A steering committee comprising of MWI -
based staff, board members, union and senior leader-ship are working to oversee both the leadership trans ition and the strategic process of planning for the f uture.
Mr. Chairman, while the strategy will identify
how services can evolve, we know there are key piec-es of work that need to be addressed as identified by the strategic planning process itself. These include
updating the Mental Health Act, which dates back to
1963. It is antiquated, does not reflect the needs of modern Bermuda, and is not consistent with the H uman Rights Act. This has consequences beyond mental illness, for example, there is currently no legislation to protect individuals who lack capacity to make dec isions, such as individuals with dementia.
National Contribution from BHB

Hon. Jeanne J. Ather den: Mr. Chairman, like the rest
of Bermuda, BHB had to cope with another major storm this year, when Hurricane Nicole blew over us.
Unlike most of the Island, however, BHB and other emergency response and residential services provi ders had to stay on duty to protect the public. Many
BHB staff members do not get to go home and hunker down with their families when a storm hits; two shifts
of staff from clinical frontline nurses, doctors , and ot her healthcare professionals to support staff such as
cleaners, m aintenance crew, dietary staff , and admi nistrators, volunteer to stay at MWI, KEMH and the UCC to ensure inpatients and emergency patients get the services and care they need.
The additional cost of having two shifts of staff
in to ensure round the clock services for inpatient and emergency patients costs BHB about half a million dollars ($500,000) each time, then there are extra food and supplies costs as well as repair costs.
Thankfully, Hurricane Nicole did not signif icantly damage any BHB properties, although the older buildings —the General Wing at King Edward and
MWI—suffered leaks and minor damage.
This requirement of running a 24/7, no- matter -
what -happens hospital service is unique to BHB and
providers of residential care and emergency r esponse. Community clinics, diagnostic labs , and doctor’s offices are not expected to operate non- stop.
BHB does not receive dedicated funds to support its disaster response duties. Like other residential and emergency services, it pays for supplies and staffing
from it s general revenues.
Mr. Chairman, this year in particular, BHB is
planning for expected higher -than- usual numbers of
people in Bermuda over America’s Cup. This will r esult in increased staffing costs just to run day -in and
day-out, and to prepare in the event there is a mass
casualty event at one of the many races or social
events planned over the May and June period. An extra ambulance has been ordered as well as mass casualty clinical care tents.
There is no additional grant being paid to BHB
to cover the costs. BHB will be required to dig into its savings, which will help Bermuda not increase its debt burden. We remain grateful to the BHB staff for their hard work in disaster response and the commitment BHB shows to working with I sland -wide emergency
services to ensure life- saving responses for all who
live and travel to Bermuda.

Modernisation Project and Other Cost- Saving
Measures


Berm uda House of Assembly Hon. Jeanne J. Atherden: Mr. Chairman, BHB’s
Modernisation Project was initiated in 2013 with the
goal of making significant recurrent cost savings. Started at a time when BHB’s financial forecasts were grim, the Modernisation Project comprised multiple projects from contract reviews and restructures to maximise efficiency. A key goal was to ensure BHB
could afford the new Acute Care Wing payments
which commenced in 2014, without driving up costs through fee increases.
Initially, BHB had been promised five 1 per
cent annual fee increases over inflation to pay for the new ACW, and BHB promised to make 5 per cent eff iciency savings over the same five- year period. While
internal efficiencies well beyond 5 per cent have been
achieved, the 1 per cent fee increases above inflation
over five years was not delivered for the full five years, due to the Island’s worsening financial situation, so BHB sought additional cost savings as a way of affording the new wing.
In 2016/17, completed projects included the
demolition of the Continuing Care Unit and the Queen
Elizabeth Nurses Residence. Though vacated for
safety reasons, maintaining these empty buildings
cost BHB about $2 million per year. Though there is a one-off demolition cost, going forward this project r eflects annual savings. A fleet optimisation project has
also saved money this year, with a reduced fleet being maintained representing annual savings, and the sale of second- hand vehicles adding a small amount of
one-off revenue to the year.
Alongside several smaller projects, the Modernisation Project is expected to have achieved ann ualised savings of $12.1 million recurrent costs by the
end of this current fiscal year (31
st March 2017), with a
further $6.1 million expected to materialise next fiscal
year. Mr. Chairman, in total this means over $18 mi llion in recurrent savings will be made by the Modernisation Project and, along with other budget reduc-tions, BHB has saved over $40 million in recurrent savings compared to 2012. In 2016, BHB cost less to
run than it did in 2012— despite having the ACW costs
to pay.
Enh
anced Pharmacy Strategic Sourcing
Through PAHO
Hon
. Jeanne J. Atherden: Mr. Chairman, BHB this
year has worked with the Ministry of Health and Seniors on an initiative that is focused on various cost -
effectiveness strategies with respect to the procur ement and consumption of various pharmaceuticals. This included collaborating with the Pan American
Health Organisation (PAHO) to generate cost savings
in the procurement of high cost drugs, primarily relat-ed to HIV and oncology. The first order arrived in au-tumn 2016 with gross savings of $654,759 to subsidy funds. The intent is to expand this to cover hyperte nsion and diabetes drugs in the future. It is expected that there could be cost savings of up to 50 per cent
on the current spend, and the first order and delivery
of these drugs is to be completed by summer 2017.
This dir ectly supports the aim of reducing the per capita cost of care.
Facil
ities Capital Investment
Hon
. Jeanne J. Atherden: Mr. Chairman, BHB this
year sought to develop a plan to fund, design , and
maintain the infrastructure and plant equipment assets at BHB. BHB’s General Wing at the King Edward and the entire plant at the Mid -Atlantic Wellness Institute
are age ing. While every effort is made to keep the
facilities safe, there are infrastructure issues —as was
seen when a ceiling tile fell down in a Maternity Room
due to a leak in another area that was not visible. Thankfully no one was injured, but this highlights the need to strategically manage and improve these r esources.
The reduction in the hospital subsidy budget
will require BHB to use more of its own resources to cover more than usual unpaid bills for patients cov-ered by subsidy. This limits the funds being immediately available for infrastructure work and certain work
will have to be postponed if it is not a critical safety issue.
Imp
roving Diagnostic Imaging Systems
Hon
. Jeanne J. Atherden: Mr. Chairman, upgrades
to the Diagnostic Imaging and Cardiac Diagnostic Unit systems are needed in order to maintain services to the community. This year the clinical need for these upgrades was highlighted when diagnostic imaging turn-around time started to increase leading up to the
summer. BHB put in actions to address issues in the short t erm, including administrative overtime, but recognised a deeper review was needed in order to bet-ter understanding longer term improvements that could be made for a faster and more reliable service,
with future capability for physician and even patient
portals.
Improvements included systems upgrades to
streamline how reports were being posted by the overseas radiologist service that reads BHB diagnos-tic tests out of hours. Process improvements within
the hospital were also reviewed to reduce inefficiency ,
and a staffing review was undertaken. A business
case for systems improvements was approved at the end of 2016.
Diagnostic i maging is a key part of diagnosis.
However, there is such as a thing as over -testing and
it has very real impacts on our health. BHB has been a voluntary implementer on having guidelines to en-sure only clinically necessary testing takes place. This does help control costs for the Island —but it also
saves lives.
1150 13 March 20 17 Official Hansard Report
Berm uda House of Assembly New tests and technology allow doctors to
see an amazing amount of detail inside us and this
can be critical in diagnosing sometimes life-threatening illnesses or identifying conditions that al-low ap propriate treatment plans to be developed. But
X-rays and CT scans are exposing us to radiation and
MRI scans often require contrasts that can cause side
effects in rare instances. These scans are not risk free
to the patients.
Mr. Chairman, recent research in the US indicates that about one- third of CT scans in the US serve
little if any medical purpose—and Bermuda’s rate of being tested is higher than the US. Researchers also
estimate that at least 2 per cent of all future cancers in
the US —about 29,000 cases and 15,000 deaths a
year—will be the result of CT scans alone.
You should not avoid a CT or other imaging
test if you need it —the risk posed by one scan is
small. But talk through your options with your doctor and carefully consider what is appropriate, because
every time you are exposed that risk increases. Ca ncers from medical radiation can take anywhere from five to 60 years to develop and the risk also depends on age and lifestyle. Younger people, especially chi ldren, have higher risks from exposur e.
In Bermuda, where diagnostic imaging pr oviders —including BHB —are paid by the scan, there is
a natural incentive to grow revenue for owners or shareholders. If you are providing imaging services, the only way to grow revenue is to scan more. Bermuda is, however, already over -served and over -
scanned. The concern is that down the road this will result in more cancer, as well as higher costs for pr emiums due to unnecessarily high rates of scanning. To counter this, BHB introduced voluntary guidelines to focus on clinically appropriate tests a few years ago
to help control costs.
Mr. Chairman, the result has been that at BHB
the number of scans for every modality is lower except for CT. Comparing 2011/12 to 2015/16, ultr asound at BHB is 24 per cent lower, CT is 15 per cent
higher, MRI scans are 41 per cent lower, and X- rays
are down 9 per cent. Nuclear medicine scans are
down 16 per cent over this same period. Increases in CT numbers are related not just to volume, but to new tests such as CT angiogram that came online with new technology.
Unlike other providers, King Edward is not e ntirely incented to volume, as payment of subsidies to the hospital —which is directly linked to services used
by the youth, indigent and seniors —has been restric ted since 2012. As noted earlier, the hospital is often covering usage costs with revenue from other services. Additionally, unlike smaller providers, BHB is
the second largest employer in Bermuda. Increases to healthcare premiums directly impacts its bottom line as it pays half the cost of premiums for its 1,800—so simply earning more has a significant down side for BHB. Improving Communication w ith Physician Offices
Hon. Jeanne J. Atherden: Mr. Chairman, BHB has
worked on a project that would make secure BHB e-mails availa ble to physicians to improve the efficiency
and reliability of sharing patient diagnostic tests.
For many years, fax has been the preferred
communications device for local physician offices. Many do not have secure e- mails, but all have fax
machines. BHB wanted to offer a more reliable com-munications delivery method and has therefore of-fered its e- mail service to physician offices. By using a
BHB e -mail, doctors have access to an e- mail service
housed in a highly secure environment. Essentially patient information sent via BHB e- mail will not have
left the hospital’s highly secure server.
The e- mails can be accessed and printed by
office staff, just as they currently manage fax messages, but the potential for a missing fax or a paper
jam to interfere with an urgent communication is
avoided. BHB is making this service available for free
to all doctors’ offices in Bermuda, in an effort to i mprove communication and work cooperatively for the
benefit of patient care. It is, however, a voluntary service and doctors can elect to continue with fax com-munication if that is their preference.
Longer term, although much of BHB’s clinical
laboratory and medical record services are already in electronic format, it is uncoordinated and piecemeal,
and BHB recognises that it is essential to have a un ified national Electronic Health System that all Berm uda healthcare providers use. Mr. Chairman, BHB b elieves that this will bring great improvements to patient
care and they support closer cooperation between
healthcare providers as patients move through the
system. This is, however, an expensive and resourceintensive project that will require unprecedented col-laboration between multiple on-I sland healthcare pr oviders and diagnostic services so likely to be some years away.
Lab
oratory System Upgrades
Hon
. Jeanne J. Atherden: A Laboratory Systems
upgrade project was started this year, which will in-clude software for a patient and physician portal, that
will let them review their diagnostic test results direc tly. This will improve communication and timely r esponses in the support of timely patient care, while
decreasing the calls and paper reports that have to be answered and administered within the Lab to help run an efficient service.
Imp
roving Access to L ong-Term Care Beds
Hon
. Jeanne J. Atherden: Mr. Chairman, there are
too few long- term care nursing and residential care
beds in Bermuda. This impacts both King Edward and


Bermuda House of Assembly the Mid- Atlantic Wellness Institute as people seek s olutions for their parents and senior loved ones who are
unwell physically or suffer from dementia or Al zheimer’s related disorders. The problem is only going
to get worse. The number of seniors in Bermuda is
expected to double in the next 20 years. By 2030, one in four residents will be 65 or over.
At King Edw ard, this is causing patient flow
delays and Emergency Department staff members are finding they have to spend more time with seniors as they are more likely to have multiple issues and medi-cations. This year, during an unexpected surge in flu and respiratory illnesses that impacted our community, it caused a critical situation in bed capacity.
Mr. Chairman, this is not a failure of the hosp ital, nor of the number of acute care beds in the ACW.
The hospital did not want to build an over -sized hospital, wher e it would be maintaining unused space. It
would cost a lot more to build and to operate. The c apacity in the ACW can cope, with exceptional overflow space in the General Wing— if the community pr ovides more beds for seniors.
BHB prepared a proposal for long- term care
for the Ministry of Health and Seniors this fiscal year.
The amount it costs BHB to provide long- term care
services each year is $29.2 million, including staffing,
food, facility, infrastructure, cleaning, laundry , and s ecurity requirements. Government currently provides a $10 million grant towards the care of individuals in the Continuing Care Unit Wards.
BHB and the Ministry of Health and Seniors
agreed new categories of care that identify the skill level and numbers of staffing [were] requir ed. Furthermore, BHB agreed to decrease the fee it charged per subsidy bed per month based on the needs of each category. This assisted the Ministry of Health
and Seniors in the cost of care at BHB, but does not address the chronic shortage of long- term beds outside of BHB which leaves BHB funding a shortfall in revenue but without the ability to move people to more appropriate community placements that are less cos tly to run. The costs at BHB are higher because nurse skills are higher and services are housed in a facility originally built for most costly acute care, rather than residential care seniors.
Mr. Chairman, there are no simple solutions
ahead of us, but the Ministry will continue to work with
BHB as well as other private partners and gover nment -run facilities to establish a viable strategy going
forward.
Strong partnerships improve local services
and reduce overseas health costs. And Mr. Chairman,
I would be remiss if I did not remind everyone that in
the Speech from the Throne this November we ind icated that promoting investment in institutional care beds is important, but just as important were the steps to have seniors own their own homes and stay in there as long as possible. So that we are actually g oing to turn around and look at incentives to have more investment in long- term care and, at the same time,
some incentives for seniors to afford appropriate home renovations. Because seniors can be di scharged from the hospital into their own homes just as easily as they can be discharged into long-t erm care
facilities. So we obviously recognise that this is som ething that has to happen and as we indicate, strong
partnerships improve local services, and reduce overseas health costs. And that leads me into the next item.
BHB is partnering with Bermuda Cancer and
Health to support the provision of radiation therapy in Bermuda. This, again, supports the triple aim even
though it is not a direct BHB service. BHB agreed to
share its oncologist, Dr Chris Fosker, with Bermuda Cancer and Health and this year upgraded its CT equipment in order to provide the diagnostic services to support the therapy. The result will be an improved patient experience as people can stay in the comfort
of their homes supported by friends and families. It will
also help reduce costs, as individuals will not need accommodation and travel costs associated with rad iation therapy overseas.
And Mr. Chairman, as we keep discussing all
of these things, I mean the theme we have to keep harping on is the fact that as we start to do things away from BHB or in conjunction with BHB in terms of
different cost services, we are mindful of the fact that the aim is to get the patients in the right facilities with the right care because that results in the right cost.
And, therefore, if we reduce overutilisation, that drives
the cost down and ultimately the premiums and, ther efore, that is what Bermuda wants. So I just want to remind us that these are things that we are highlight-ing and I am sure we will talk about them more.

Tripartite Union Negotiations

Hon. Jeanne J. Atherden: Mr. Chairman, staff at
BHB worked extremely hard to make $40 million worth
of savings —the benefit of which is a more efficient
hospital service for Bermuda. In 2013, when BHB’s financial stability was most at risk, staff accepted v acancy freezes —so shouldered more work —and wage
freezes, which means they did not get a cost of living wage increase for three years. In 2016, with financial stability more assured, a wage increase was agreed
with both unions: a 2.75 per cent increase backdated
to 1
st April 2015, a 0 .0 per cent increase in 2016 and a
2.25 per cent wage increase starting 1st April 2017.
This averages out to 1.6 per cent over three years.
While wage increases do contribute to i ncreasing costs of care, these agreements show both respect for the work BHB staff undertake [and] do,
their contribution to a 24/7 service in all eventualities, and helps keep BHB competitive so it can have ad equate staff numbers to deliver services to the comm unity.

1152 13 March 20 17 Official Hansard Report

Bermuda House of Assembly Conclusion

Hon. Jeanne J. A therden: Mr. Chairman, I would like
to end by once more extending my thanks to the staff
and management of the Bermuda Hospitals Board, for their efforts in reducing the costs of care and the shouldering of additional cuts this year.
Moving the country to a more financially st able position is a team effort for us all. We value our hospital services, the dedication and commitment of the staff , and the efforts that are going into more collaborative, efficient , and effective ways of working.
I also would like to pay special tribute to the
Chairman and Board. They have overseen a major financial turnaround at BHB over the last four years —
from near collapse in 2013 to having a reserve of cash that can be reinvested into healthcare and contribute to the country’s gradual recovery.
Mr. Chairman, this concludes my remarks on
Head 24.

HEAD 91 —HEALTH INSURANCE

Hon. Jeanne J. Atherden: Health Insurance. The
current estimate books —

And the Head? Sorry.
Hon. Jeanne J. Atherden: I am sorry, Head 21—
sorry —Head 91, Health Insurance.
The current account estimates for Head 91,
Health Insurance begin on page B -157 of the est imates book. A total of $3.995 million has been all ocated for this h ead for fiscal year 2017/18, which is
the same as the approved 2016/17 budget.
Mr. Chairman, the Health Insurance Depar tment’s (HID) mandate is to provide access to affordable health insurance to all residents of Bermuda. This continues to prove to be a challenge in light of Ber-muda’s high cost healthcare system. The rising t rend
of multiple chronic health conditions, which largely
accounts for the increased healthcare costs system
wide, is a major factor in getting healthcare costs to a sustainable level.
Mr. Chairman, in spite of the rising costs of
healthcare, HID was able to maintain monthly prem iums for HIP and FutureCare policyholders at the
same rates as they were in the prior year (2015/16).
Staying healthy is one of the best ways to
save healthcare dollars. To that end, HID introduced a
wellness promotion benefit to encourage healthier
habits and lifestyles. For those with a chronic disease, this benefit covers various programmes to help, i ncluding support for asthma, nutrition, diabetes, lif estyle counselling, fall prevention, and counselling for smoking cessation. HID recognis es the importance of
policyholders taking an active role in their healthcare, and what that means to overall healthcare and its costs. And Mr. Chairman, I guess I really want to
turn around and just highlight that because I know in . . . and I am not going to talk back to a previous debate, but I think it is important to recognise that there was concern about promoting wellness, promoting things that can help the individuals. And as we say, HID introduced this so it is important for the public to
know that it is already out there. That we are doing
this and over time we will talk about the benefits because, like everything else, you do not see the results immediately, you see the results over time.
So just to reiterate, for those with a chronic
disease, this benefit covers various programmes to
help, including support for asthma, nutrition, diabetes, lifestyle counselling, fall prevention, and counselling for smoking cessation.
Mr. Chairman, the Personal Home Care ben efit intro duced in 2015/16 has proved popular with our
policyholders, with over 200 active cases receiving
care in their own home. With this benefit, HID is pr omoting ageing in place, dignified quality of life, and
person- centred care. We are saving health system
costs. For example, there were 15 persons with functional impairments in their daily living that were ready
for discharge from KEMH. These persons were able to go home as a result of the advantage of this bene-fit. Actual claims paid over 90 days in their own homes
totalled approx imately $67,000. The comparison of
care in the home versus staying in KEMH long- term
care has a savings of approximately $1.9 million over
the course of 90 days.
Mr. Chairman, if you recall, the Enhanced
Care Pilot (ECP) program me was part of the 2015/16
legislated redesign of the Standard Hospital Benefits
(SHB). The ECP program me’s goal is to meet some of
the needs of the underinsured and uninsured popul ation with chronic non- communicable diseases. It was
designed to change the way care is provided to ind ividuals with chronic diseases, and change how pr oviders are re imbursed. HID designed the ECP pr ogram around the Medical Home model of:
• Patient centered orientation;
• Cohesive communicating healthcare team;
• Superb access to care that meets patients’ needs and preferences, including after hours;
• Care coordination across all elements of the
healthcare system;
• Systematic evidence- based approach to qual ity and safety that includes gathering and r esponding to patient experience data; and
• Commitment to ongoing quality improvement.
The chronic diseases targeted by the ECP
program include:
• Obesity or overweight;
• Hypertension;
• Diabetes;
• Asthma and COPD; and


Bermuda House of Assembly • Coronary vascular disease (hyperlipidemia),
along with the often associated co- morbidities
of chronic pain or arthritis and depression/anxiety or other chronic mental ill ness.
A clinical nurse case manager is dedicated to
servicing the ECP program me.
Mr. Chairman, HID will be performing various
activities as it administers the ECP program, includ-ing:
• Identifying high risk/ over users within the
healthcare system;
• Enrolling participants from the participating
Primary Care practices, in collaboration with
the p roviders;
• Providing case management support to the
participants and providers;
• Providing transportation support to the partic ipants;
• Collecting clinical outcome measures anon ymously for future analytical use; and
• Identifying gaps in care for chronic disease management, allowing for better informed decisions to develop new initiatives.
Our goal is to increase access to care, shift to
proactive care, improve the uptake of evidence based practice, improve patient experience of care, and r educe unnecessary hospitalisations and emergency depart ment and urgent care use. HID is optimistic that
this pilot will prove to reduce costs and improve care efficiencies. Our soft launch has generated much interest in the program me and provided considerable
collaboration with the p roviders in the initial phase of
set up.
Mr. Chairman, to date 40 patients have been
enrolled in the ECP , and in fiscal year 2017/18 HID
will be ramping up the ECP programme. HID antic ipates enrolling hundreds of participants who will have
access to a team of healthcare professionals to monitor and treat their chronic diseases. Those participants
who are insured will have all the benefits associated with their health insurance coupled with the additiona l
benefits of the ECP programme. The uninsured will become eligible for the standard health benefit and a
limited pharmacy benefit to help bear the cost of the
medications needed to manage their chronic diseas-es.
Head 91 is the partial source of funding b ehind the d epartment, which is responsible for developing and administering the Government’s social health
insurance products offered to the public, including:
• Health Insurance Plan (HIP) ;
• FutureCare Plan (FutureCare) ;
• Mutual Reinsurance Fund (MRF) ; and
• Government Subsidy Programme (Subsidy), which provides relief to the vulnerable popul ations in Bermuda. The Health Insurance Department is delegated the operational responsibility for the various pr ogrammes.
Mr. Chairman, I will now summarise the operating results of the various f unds under HID’s admi nistration, followed by a discussion of the Performance
Indicators for the d epartment over the period.

PART 1: OPER ATING RESULTS

HIP Operating Results

Hon. Jeanne J. Atherden: The department is committed to providing affordable health insurance to res idents. The HIP premium remains low due to the f inancial support provided by the Government and the
MRF, despite increases in headcount, utilis ation, and
claims costs.
At March 31, 2016 there were approximately
3,201 persons insured on HIP as compared to the previous year’s figure of 3,010. This is an increase of
191 persons, or roughly 6.3 per cent. This is the third consecutive year in which the HIP headcount has i ncreased (194 persons, or 6.7 per cent increase in fi scal year 2015).
• HIP premiums earned for fiscal year 2015/16
were $16.9 m illion, an increase of $2.1 million.
• Claims incurred in 2015/16 totalled $28.3 m illion.
• HIP wa s allocated approximately $1.1 m illion
in administrative expenses in fiscal year 2015/16.

FutureCare Operating Results

Hon. Jeanne J. Atherden: FutureCare’s insured
headcount was approximately 3,786 at March 31,
2016, which was an increase of 146 persons, or
roughly 4 per cent, when compared to the headcount
of 3,640 reported at March 31, 2015. It is expected
that FutureCare’s headcount will continue to grow as
new retirees seek affordable health coverage.
Premiums earned for FutureCare for fiscal
year 2015/16 were $21.9 million, an increase of $2.6
million, or approximately 13.5 per cent, from the pr evious year. For the current year, it is estimated that
premiums will be just under $24 million, due primarily
to increases in the headcount.
Futur eCare claims for fis cal year 2015/16
were up only 1 per cent to $22.5 m illion, which was an
incre ase of approximately $200,000. For eight months
in fiscal yea r 2016/17, claims paid are $18 m illion ve rsus $15.1 m illion f or the same period in 2015/16. This
represents a 19.2 per cent increase in claims paid
year on year for the eight -month period.
FutureCare absorbed administrative expenses
of appr
oximately $1.1 m illion for the fiscal year
2015/16.

1154 13 March 20 17 Official Hansard Report

Bermuda House of Assembly MRF Operating Results

Hon. Jeanne J. Atherden: The Mutual Re- insurance
Fund premium in 2015/16 was $63.74 per month as of
July 2015.
The premiums received by the MRF for the
year ended March 31, 2016 totalled $31.5 million. This
represented a $15 million increase, or 91 per cent
compared to fiscal year 2015, due to a change in all ocations which supported the HID funds.
The MRF premiums for the current fiscal year
are expected to be approximately $40.5 m illion, $9
million more than 2015/16, or 29 per cent. This increase will provide funding for the Enhanced Care
Pilot as well as additional financial support for HIP,
and the Consolidated Fund. Administrative expenses
of $1.1 million were allocated to the MRF for the 2015/16 fiscal period. Projected expenses for the current fiscal year 2016/17 are expected to remain t he
same.

Subsidy Operating Results

Hon. Jeanne J. Atherden: For the year ended
March 31, 2016, the department paid claims under the
aged, youth, and i ndigent subsidy programmes totalling approximately $106.3 million. This amount was a
1 per cent decrease from the previous year’s $108
million. There is $1.1 million budgeted in the Consol idated Fund for fiscal year 2016/17 which contributes towards the administration of the aged, youth, and
indigent programmes.

PART 2: PERFORMANCE MEASURES
(QUALITATIVE SE RVICE PERFORMANCE)

Hon. Jeanne J. Atherden: Mr. Chairman, we will now
consider the department’s Qualitative Service Performance found on pages B- 159 and B -160 of the Bud get Book. HID is heavily subsidis ed due to the nonexistence of underwriting criteria; therefore, some of
our performance results will vary significantly from the
traditional insurance industry standards. I will now
highlight several service performance indicators in-cluding:
• m edical loss ratios;
• actual claims expenses incurred (in dollars)
along with a comparison with the previous
years (expressed as a percentage);
• claims turnaround times; and
• procedural and financial accuracy of key functions .

Loss Ratios

Hon. Jeanne J. Atherden: The department’s projec ted medical loss ratio for fis cal ye ar 2016/17 is 170 per
cent for HIP and 122 per cent for FutureCare. HIP’s
medical loss ratio was 178 per cent in fiscal year 2015/16. FutureCare’s loss ratio was 105 per cent;
however, it must be remembered that FutureCare
benefits from a capital injection from Government, as
well as benefiting from the Aged Subsidy. The combined effect results in a lower loss ratio for the F utureCare Fund, which would look very different without these financial supports.
Mr. Chairman, these plans take on a high le vel of risk that private plans never face as a result of the absence of medical underwriting. A significant proportion of HIP clients have more intensive health needs resulting in a higher loss ratio than in FutureCare. The HID Plan requires significant financi al
support from the Government. Providing affordable
health insurance to Bermuda residents is the com-mitment of the Bermuda Government, and is in ac-cordance with the World Health Organisation’s princ iple of access to universal healthcare.

Claims Paid

Hon. J eanne J. Atherden: The Health Insurance D epartment paid out approximately $158 million in total
claims incurred in fiscal year 2015/16. We forecast
incurring $162 million for all the funds for fiscal year 2016/17, an increase of approxi mately $4 million. T his
may be due to the burden of chronic disease in the community and growth in the ageing population.

Turn around Times

Hon. Jeanne J. Atherden: Mr. Chairman, HID has
maintained its high standard of claims processing with
a consistent 14- day turnaround time and a 99 per cent
accu racy rate. The number represents the statistical
average time for all claims processed. The department’s turnaround t imes are independently veri fied.
Mr. Chairman, HID has worked in collabor ation with key strategic partners Sutherland Healthcare Solutions, Argus Insurance, ProServe, and Europ A ssistance/Global Medical Management, Inc. I apprec iate the valuable support provided by each of these organisations. Finally, I would like to thank the Health
Insurance Department and the members of the Health Insurance Committee for their hard work and dedic ation.
Mr. Chairman, th
is ends my presentation on
Head 91, Health Insurance and this ends my prese ntation on the Ministry’s budget and I turn it over for debate.

Thank you , Honourable Minister, that
is a refreshing change from last year.
Is there any other Member who wishes to
speak on these heads?
The Chair will recognise the Honourable and
Learned Member from constituency 24 [sic], the Ho nourable Kim Wilson. You have the f loor.



Bermuda House of Assembly Ms. Kim N. Wilson: Thirty -four, Mr. Chairman, thank
you.

Twenty -four.
Good evening, Mr. Chairman, and I thank the
Honourable Minister for allowing sufficient time for us
to participate in this debate. I know that there are a few of my colleagues that also want to share some submissions as well.
Let me start off, Mr. Chairman. I would like to
go straight to Head 21, Ministry of Health and Seniors
Headquarters, which can be found at page B -130.
When you look at the Department Objectives it indicates, “Access: All residents have affordable health
insurance that enables access to essential health ser-vices.” And then it also describes “Efficiency: The health system operates efficiently to improve its financial sustainability and population health.”
Mr. Chairman, let me start off with respect to
the Department Objective of Efficiency. Now, we all
recognise that health care costs in Bermuda, unfort unately, are very, very high, that they are unsustainable, and that we need to address it on a more urgent
basis. In fact, it is a crisis that has to be looked at b ecause it is far too expensive, the cost of premiums are
unsustainable and, regrettably, we have all heard of stories, particularly as we are canvassing and speak-ing to seniors, about the fact that they cannot afford
. . . their health insurance premiums are far too high.
And stories that are heart -wrenching where they are
effectively trying to decide as to whether or not they
should get medication as opposed to pay for other expenses that they may need to live. So needless to say, we realise that we have to do something about
these unsustainable health care costs. We saw last
year the Government increased the HIP by 11.1 per
cent. We also saw that the FutureCare increases were $54 per month. So that affected largely our senior population and those persons that are either . . . they
are struggling to make ends meet with respect to i nsurance.

Hon. Jeanne J. Atherden: Point of order, Mr. Chai rman.

The Cha irman: Your point of order, yes?

POINT OF ORDER

Hon. Jeanne J. Atherden: We did not increase HIP
or FutureCare last year.

Sorry, 2015. Sorry, it was 2015. I
apologise. I retract that. It was 2015.
Continue? Thank you . I apologise. Mr. Chairman, again, I have to emphasise the
issue concerning wellness, and kudos to the Minister
and her team who have taken tremendous steps to ensure that wellness is an integral part of their health plan. We have all heard our grandmothers and ever yone else speaking about prevention being cheaper than a cure, and I would like to offer to the Minister,
perhaps, a couple of suggestions that a PLP Gover nment would implement, or certainly consider for implementation as it relates to reducing the cost of health care, and in particular, as it relates to preven-tion, the motto, prevention being cheaper than a cure.
First of which I would like to speak about, real
quickly Mr. Chairman, is the continued use, as we see
worldwide, of established complementary and altern ative medical services. We know in the United States, in particular, almost 40 per cent of the population
chooses alternative and complementary health r egimes first and foremost before actually going to a
physician. And one thing that we would like to consi der, and perhaps the Government would also consider
is to explore the option of insurance companies offer-ing insurance, extending the insurance coverage for established complementary and alternative medical
services such as traditional Chinese medicine, Hom eopathic, Kinesiology, Neuropathology . . . those type
of things that we are seeing an increase in use of
worldwide. And I am sure the statistics also would show here in Bermuda that we are also seeing quite an increase of use. So I would think that, perhaps,
consideration ought to be given to exploring with the
insurance companies the requirement for them to ex-tend their coverage so that these types of alternative and complementary medical services can be insured.
We know that doctors are in the business of
treating sick people. You only go to the doctor when
you are sick and oftentimes their remedy is medic ation or surgery. What we are trying to do, which is in
keeping, I suspect, with what the Minister has been speaking about all along, is to try to keep people well. And there are statistics that show that some of the
complementary and homeopathic medicines and remedies out there and the teas and the things that we have grown up with—Match- Me-if-you-Can leaves
and Father John—a nd those type of things. You can
turn up your nose, but I am sure you know exactly what I am speaking about, Mr. Chairman. Father
John—

Thank you.
Father John and certain remedies like that
which we know that we grew up on, these are homeo1156 13 March 20 17 Official Hansard Report

Bermuda House of Assembly pathic and natural remedies that are aiding in our
wellness and prevention and so, perhaps, the G overnment can consider looking at those things.
Mr. Chairman, when we look at what the doctors . . . and I mean no disregard to the physicians
because they obviously participate and provide a very valuable service here in Bermuda and worldwide. But
oftent imes when we go to the doctor, we have an ai lment and they put together a sickness plan, right?
They are generally used to treating people that are sick. I am saying let us try to put more emphasis on prevention and in that element of prevention and wel lness let us look at alternative and complementary —
and I am talking about recognised complementary and alternative—medical treatments.
Mr. Chairman, again, I would like to now move
quickly to the issue concerning lifestyle and enviro nmental factors. And we heard the Honourable Minister speak about this earlier today insofar as we need to
try to shift . . . in addition to adopting healthier lif estyles and some of the programmes that the Minister
spoke about, I think it was the programmes in the gr ocery stores and the like, we need to try to shift our emphasis, shift our focus, from relying on the doctors
to treat us to taking better care of ourselves and being
well and making our own personal efforts to ensure that we do what is necessary for ourselves, whether it
is exercise, whether it is to stop smoking, whether it is watching what we eat, et cetera, so that we can take care of our own wellness plan. And I think that by e ducating the public and continuing the education efforts of that then, perhaps, we can at least get people to
realise that they are their own worst enemy in some cases, unfortunately, with respect to their health and that we all —all of us —end up paying the cost for that.
So, Mr. Chairman, let us put more of an emphasis on
wellness.
Mr. Chairm an, I would also like to look at
ways in which we can reduce health care costs, which is something that . . . I think it has been floated around
before, I know certainly it is an option that the PLP
has spoken about before, and I think in some quarters
they refer to it as the “public option.” And what do I
mean by that? Why do we not explore options in which we can have either FutureCare or HIP—a go vernment entity, a government insurance— extended to
other individuals that may not necessarily be old
enough to qualify for FutureCare or they may want
some other type of benefit from HIP?
First of all, let me back up a minute. We need
to get to the point where we decide what are the standard hospital benefits —is it A, B, and C? Once we
have decided these are what standard benefits should
be—these are what every individual in this society
should have, these are the minimum basic standard benefits —once we decide that, then why can we not
explore options similar to a public option where the Government is offering that particular type of standard benefit to everyone? So it does not matter your age, it does not matter under any of the other type of criteria
that exists. For example, for FutureCare, they are offering this as an alternative to private insurance. They are not in the business to compete with private insurance companies; it is an alternative to private insur-ance. So individuals can pay into that.
Surely if more individuals are paying into it , it
will keep the premiums low. It would not be for profit, it would simply . . . they would generate enough money
to pay the expenses and the administration of it, but it certainly would not be for the same benefit of profit as many of these other insurance companies are doing locally. Why can we not explore something like that so
that we can make sure that those people that are uninsured and underinsured can have quality health care? But I think the starting point is for us to establish what our standard hospital benefit is going to be.
We heard a little bit also today about diabetes.
And again, I am talking about the issues surrounding
Access, at page B -120 under the Department Objectives. Unfortunately, we have an alarming rate of
type 2 diabetes in Bermuda. And it is probably, I think,
leading in the world and, of course, there are all kinds of chronic illnesses that are attached to that, such as
obesity. And I appreciate that the Bermuda Diabetic
Association as well as the Ministry have been doing a lot of education to get people more familiar with how healthy diets and lifestyles can actually change [one’s
health]. I was encouraged to hear the Minister this morning speak about an individual that will be in Bermuda soon to talk about how we can reverse the trend
of diabetes. These are things that are very, very i mportant and I applaud the Minister for doing this.
However, because we know that a lot of the
causes of type 2 diabetes are directly attributable to diet, high sugar content, processed foods, things like
that, again, and I have called on this before and the
PLP has spoken about this, why can we not look into
the implementation of a sugar tax? It has worked in other jurisdictions. The reality is that any money that is generated from this particular tax goes right back into
educating the public about the importance of a healthy
diet, the importance of drinking water, the things that the Minister spoke about earlier. But at the same time it has been successful in various jurisdictions where it has curbed the demand for high sugar content things, such as Coca- Cola, soda, et cetera. So, again, I am
calling on the Government to explore the implement ation of a sugar tax.
Again, another thing that I think that we could
consider, Mr. Chairman, that would help to address
the issues of increasing health care costs is to i ncrease our community health education. What we are
seeing is that part of prevention means you have to educate people. So we have to . . . if it means being
bold in their face saying, This is what happens if you
don’t exercise, this is what happens if you c onsume
too much food— bold initiatives —bold in your face.


Bermuda House of Assembly You may remember, Mr. Chairman, a few
years ago, I think it was CADA and the Road Safety
Council produced this in -your-face marketing tool
about trying to get people to . . . dissuade them from
drink ing and driving, and you saw smashed cars on
East Broadway down at Barnes Corner, strategically situated throughout the Island to get people to slow
down and to think about driving whilst intoxicated—
drinking and driving. And from what I understand, those marketing tools were very, very effective. Perhaps we can consider with respect to our education, doing something like that, really, really boldly letting people know that this is what the actual effects are—
put it in your face. If you call it a scare tact ic, whate ver, but I just think that perhaps maybe the softy -softy
approach might not be getting it. It is just a suggestion.
Again, one of the things that the PLP has pr oposed is that we require that all nutrition information
be publicised in local restaurants. I heard the Minister
speak about the STAR . . . I cannot remember what it
is called, but an initiative where restaurants would be graded for how clean they are. But likewise can we make consideration for requiring all restaurants to
publicise the ingredients and the fat content in those
French fries that you are consuming or the ingredients that are contained in these particular items because you might think twice about it. How many of us have ever walked into a McDonald’s and really wanted that Big M ac and then when we see 675 calories we think,
All right, maybe I’ll get the chicken. It is in your face,
again, it is part of marketing . . . it is part of marketing
and, again, these are things that can very well be paid for by the implementation of a sugar tax.
Another thing, Mr. Chairman, real quickly is let
us look into incentivising employers who provide wel lness programmes. So if they are allowing their staff members to have a gym membership or they are e ncouraging water for drinking and they have got plenty of water throughout the facilities —things that they are
doing to promote health and wellness —then, perhaps,
we can look at some type of concessions or incentives for those employers who are providing that to their staff members. And likewise the employees that are taking advantage of that then, perhaps, could also be incentivised. It is a shame that we are looking at it in 2017 having to provide incentives for people to be
healthy but, unfortunately, that is the reality of the
times that we are living in.
Mr. Chairman, I would like to quite quickly
speak about Head 21 . . . I still am on that, but I would like to address the issue concerning the rising cost of health care. And I am still at page B -130, Mr. Chai rman. Again, we need to find steps to try to drive down
the cost of health care. All right? We have vulnerable people living within our community —seniors, underi nsured, and uninsured persons —who have a need for
medical attention. One of the things that I think that we should consider to help to drive down the cost, in addition to the one that I spoke about regarding the
public health option, is to open up insurance companies to competition. All right, we know that competition drives down costs. What is it that would prevent us from allowing a Blue Cross Blue Shield or some other internationally recognised insurance company from overseas to come to Bermuda and offer premiums to
Bermudians and their policies to Bermudians? All
right, we are talking about trying to contain the costs and one of the highest costs that we know is the cost for insurance.
I have already spoken about requiring insurance companies to cover alternative and complementary medicines. Another thing I think that we should
consider with respect to driving down health care costs i s to improve the synergy between KEMH and
the Department of Health. Now we have . . . and better utilise our clinics. We have the Somerset Clinic that, I do not even know, I think it is only open a co uple of days a week and we have got the Clinic . . . we
have got the Urgent Care facility down at the Lamb Foggo, why can we not better utilise these clinics and these urgent care facilities, using the community nurses? I know that they go out into the community
and we have heard that they help to change dressi ngs
and the like, but better utilise these types of facilities
that are already there and use those to help to steer away people from going down to the hospital for non-emergency types of matters. How many of us have ever met people who may have something that is relatively simple but they do not know how to deal with it,
they do not know how to address it, so they end up in the emergency department. Let us look at ways that we can utilise some of the services that we already have and expand upon them.
I am certain, and I do not know whether this is
taking place, but perhaps if it has, maybe the Minister can show me where I can perhaps read through this, but has there ever been a survey that has been done to show the instances of non- emergency types of
conditions that present themselves at the hospital?
And based on that information can we not offer that
type of service? Let us say —and I am just using this
as an example—bruising, right? It is not necessarily intense, but somebody falls and they may have a bruise. I am just using that as an example. But if there
have been any statistics that have been done— a survey, excuse me—that says that these are the types of episodes of conditions that are non- emergency, that
could really be more geared towards urgent care as opposed to ER care that are showing up at the hosp ital? And if we have that information then, perhaps, that will help better utilise the existing urgent care unit
as well as perhaps the clinics.
Now, I was in the States a few months ago
and they have like . . . when you go down to the hospital they have got a list . . . and it is an education
thing, and I think, perhaps, that is something we can
consider here because I think that a lot of Bermudi1158 13 March 20 17 Official Hansard Report

Bermuda House of Assembly ans, unfortunately, think that the hospital . . . they
have this entitlement and that is where they go, I’m
sick, I’m going to the hospital, notwithstanding that it
may not be an actual emergency. Now I am not expecting somebody to self -diagnose themselves. All
right? But there are certain conditions that I am sure
people end up at the hospital when they could perhaps either be at an urgent care centre or an exte nsion of, let us say, the Somerset Clinic.
For example, somebody has a minor cut or
abrasion . . . and I do not know whether this . . . I
suspect that there are statistics that confirm this, but
things like minor sprains, minor cuts and abrasions, an earache, minor infections, sore throat, cough, ur inary tract infections . . . I am sure, people are showing
up at the hospital for these type of things, and these are not emergency things. You know, severe chest discomfort or a really bad asthma attack, or severe shock or unconsciousness, temporary unconsciousness are things that you show up at the emergency
room for. And maybe we need to start promoting edu-cation more and letting people know that, yes, the hospital is there for us and everybody in Bermuda—resident and Bermudians alike— will go to the hospital
at some point.
However, I think that we perhaps need to put
more emphasis on educating people as to what the purpose of the emergency department is, why you would go to the emergency department, as opposed to perhaps going to a clinic or to the urgent care unit
or your own doctor if you have the insurance. And we
know of issues where people have their insurance, and rather than go to the doctor to pay the co- pay,
they end up at the hospital, all right? That has to be . . . we have to look at that. We have to address that.
Okay, now the vexing issue, and the Minister
did speak about this and this is with respect to longterm care, which we know is something that has to be addressed. And I am still referring to page B- 130 under Efficiency. We have an ageing population, as the Minister indicated, and we know that the last census
indicated that the average age was 42 to 44. So in
another 20 years we are going to have half of our population knocking on 65, and that is continuing. The baby boomers are almost there, and our generation, Mr. Chairman, we are almost there as well. And at the end of the day, we have to do something to address
that ageing population.
The suggestions that I had spoken about just
a few moments ago, in terms of linking KEMH and the community health to support that population and the uninsured or underinsured, I think, are things that we
can consider that may help steer people away from
going unnecessarily to the ER Department for things
that are non- urgent matters.
In the United States (and I have spoken about
this before and I think that it is time for Bermuda to consider this) in 14 states, I think it is, they have what is called filial legislation. And these are laws that i m-pose a duty upon third parties, normally the child of
those parents, of the adults, to support their impoverished parents or their relatives. In other words, a per-son that is at the hospital or they are in the . . . I think
it is called the AC . . . what is it called?

[Inaudible interjection]

Yes, the Continuing Care Unit.
So you have a patient that is in the Continuing
Care Unit and you have family members that can afford to pay for that person to either be at home or to be in community nursing. And I am . . . let me qualify
this, I am not talking about the people that cannot afford to pay because of their own financial status. I am
referring specifically to the people that can afford to
pay and that their family members are sitting over at the Continuing Care Unit and these family members can afford to pay.
In 13 states in the United States the state or
the institution can actually sue the child and say, You
need to go ahead and pay for this person’s care be-cause you can afford to pay for the care. And they
have got a number of judgments in various states and Puerto Rico where this has been successful, and the parents’ bills are having to be paid for by the children.
Perhaps that is something that we need to look at
here because we know of situations where, for what-ever reasons, a myriad of reasons, the family might
say, Oh well, I have to renovate my house. I’m going
away for six months on a cruise so when I come back
then I will look into it. I can’t do it now; mother is too
difficult for me to look after. There are a number of
reasons. And meanwhile the patient is sitting up cos ting (what is it?) $20,000- and-something a month at
CCU— which we are paying for when the family can
properly pay for that person. All right?
We have heard of situations where the medical social workers will say, We have a place open for
you at XYZ home in the community . The family does
not want it because they want it somewhere in St.
George’s or they want to be in Somerset. So the pa-tient stays there because they do not collect the patient.

[Inaudible interjection]

Yes. So we have those scenar ios.
So we should look at the legislation— it is
working in the United States —some may say it is dr aconian, but it is certainly something that is worthy of
exploring.
Mr. Chairman, another thing that may be controversial, but is something that I think we should also


Bermuda House of Assembly consider exploring is long- term care insurance coverage. It is certainly something that I think probably in
my own personal circumstances I just started looking at things. I mean, not looking at things, but it is som ething that as you get older you start thinking, What will
be my long- term care? (Well, we should do.) I do not
want to be a burden on my family. I do not want this
. . . and you start looking at these things.
I know in some jurisdictions they do offer i nsuranc e. And I do not know whether or not that is
something that we should explore, whether it should
be compulsory, whether or not 2 per cent of your
wage goes into that, just like we implemented the
compulsory health insurance. It is something that we
perhaps need to explore and see whether or not we
need to start looking at some type of mandatory long -
term insurance coverage.
In closing prior to a couple of questions that I
do have, but I have to thank the Minister for her brief
because she did provide me with the brief, so I have a
number of questions that have already been an-swered, but I do have a couple of questions.
I want to turn real quickly to Head 24, and that
is at page B -148, KEMH. If I read the mission stat ement: “To provide free hospital care for the young and the indigent and subsidised hospital care for the elder-ly.”
Now, as we have heard already from the Minister that this is a service that is provided by KEMH and it is paid for by the Government providing these
services to this population. And you have heard me
previously speak about the whole aspect about Youth
subsidy, and notwithstanding that we do provide 100 per cent for Youth subsidy and it looks like prev iously under the 2016/17 —I am at page B -149 now —
for Youth subsidy the original estimate was $34 million
revised to $33 million. That was for inpatient, and then
for outpatient it was $8 million and $7 million, revised. So we are paying quite a substantive amount of mon-ey on an annual basis for Youth subsidy.
I wonder if we could explore the options of
looking at the situations where parents that are gain-fully employed, that have medical insurance them-selves, whose medical insurance covers their children should be able to, I guess, kind of opt -out. I am not
quite sure how it would work, but I am saying let us explore this so that we are not paying Youth subsidy
for their children because they already have major
medical insurance that is covering them. It is almost like you are having two insurance policies. And I know I pay for my children to be on my major insurance, but I also know that because they are under 18, if they have any hospital treatment, then it is free.
So what I am saying is why can we not explore the provision of Youth subsidy insofar as if a parent has major medical insurance, so their children are already covered and they are paying for it in any event, then whether or not that could be a cost sav-ings. It is just a suggestion. I do not know how it would work, but needless to say I think it is something that
we need to explore. I wonder how many people are
actually on major medical insurance and their children are insured, and yet Government is still effectively paying for those children under Youth subsidy.
Back to the subsidies, so with respect to, in
particular, the Indigent subsidy and the Aged subsidy,
we know that depending on . . . year over year is
what increases or affects how much subsidy is paid. It
depends on a number of things such as the eligibility criteria, increases of the numbers in the groups. Right? We have got about 400- and-some- odd children
being born every year, so those would be Youth. And
then as people age out then they may be in the Senior
subsidy, et cetera. And then we know there is a class of people that are the indigents, those persons that are living amongst us that for various circumstances
they are living in extreme poverty, perhaps, or maybe have certain psychological or drug addiction issues.
There are a number of issues. But there are a number
of people that are indigent and I . . . walkin g from my
office here this morning there were a number of peo-ple that I know are deemed indigent, and we are hel ping to pay for the medical treatment that they have.
And that is what we are supposed to do. That is what
a Government should do, help those that are less for-tunate than ourselves. And we have an obligation to do that.
And I do not have an issue with that, and I
hope none of us have an issue with that , but we do
have an obligation to ensure that we provide for those that are less fortunate. And I am talking specifically about our vulnerable members in our community, the indigent and our seniors.
So the population does need a type of subs idy, a health insurance subsidy. However, when I look
at the Budget and I see that we have this line item
3400 0 on page B -148, the subsidy for Aged, Indigent
and Geriatric has been reduced by $25 million. So I started off from the premise that we have an oblig ation to make sure that we protect our vulnerable persons, but we look at the Budget Book and we see that
there has been a reduction of $25 million of subsidies that heretofore would have been utilised for our vul-nerable persons. And then when I look at the Mini ster’s Statement which indicates that . . . let me just
read from her statement, “This one- off Budget cut being made to assist the country as it navigates its way through to a more financially stable position.” This is what the Statement is saying as to why the $25 million has been [cut] from the Indigent subsidy.
Yet, in our Budget [Statement], that we r eceived two weeks ago, it indicates at page 40, “ the
total Government budget for America’s Cup- related
direct and indirect current expenses during the 2017/18 fiscal year is estimated at $31.8 million. ” This
is excluding the $70- some- odd million that has a lready been paid. And then it goes on to speak about, “the above increases and others were partially offset
1160 13 March 20 17 Official Hansard Report

Bermuda House of Assembly by reductions in other expenditures, with the most notable being a one- off $25 million reduction in the Government’s annual funding to the Bermuda Hospital
Board (BHB). ”
Now, Mr. Chairman, I just said that that money is for our subsidy, for our indigent, for our aged, for our youth, for our vulnerable persons in our community. So here we have a Government who is taking $25
million from the subsidy , effectively, because they
need $31 million to pay for the America’s Cup. Mr.
Chairman, it seems to me that we have a situation where our priorities are a little skewed, because when we have vulnerable persons in need and an obligation
to ensure that their needs are met, particularly their
health needs, but yet we are prepared to take $25 million from that subsidy to pay for what some people
call a rich man’s sport , boggles the mind. It absolutely
boggles the mind.
We are taking money that is needed for pe rsons that are vulnerable to help to pay for a sport that
not everybody is going to participate in, not even ev erybody is going to even watch. Everybody will go to the hospital. Everybody knows somebody that is on Age subsidy. Everybody has a child under 18 or
knows a child under 18 that is going to get Youth subsidy. And we all see the persons that are walking down the street that are indigent. Therein lies the challenge because, at the end of the day, if we look —

Hon. Jeanne J. Atherden: Point of order, Mr. Chai rman.

Honourable Member, have a seat.
Honourable Minister, your point of order?

POINT OF ORDER
[Misleading]

Hon. Jeanne J. Atherden: I believe the Honourable
Member is inadvertently misleading the House in the
sense that while this Budget might have been r educed, we have made it very clear that the services
would still be provided to these individuals. And so these individuals will still be cared for and we made that absolutely clear and that this was a budget reduc-tion.

The Chai rman: Thank you, Minister.
Honourable and Learned Member.

Thank you, thank you.
I do not doubt for a moment, looking at the
people that I see around here that represent the E xecutive and the Board of BHB, that they are going to
do everything in their power to ensure that there is no change of service. I do not doubt that for a moment. But the $25 million has got to come from somewhere, and at the end of the day . . . and I am not an ac-countant (I say this all the time). I studied law f or a reason— because math is not one of my areas of forte
at all. But the way I look at it is, if I make $100 a month and then I get $25 cut from that month, I have to find the $25 from somewhere. It does not neces-sarily mean I am not going to have bread ev ery day,
but the $25 million has to come from somewhere. So the hospital is going to have to find that money. It was
in the brief, the hospital is going to have to find that
money.

Hon. Jeanne J. Atherden: Point of order, Mr. Chai rman.

Thank you.
Let me go back to my scenario. I have $100 a
month, I spent $25. I have $10 in my savings. That $10 was earmarked for my children’s university. If I
now need to use that $10 because I have just got a reduction in salary, then my bottom line has been af-fected, has it not? Absolutely.
So the reality is, yes, we know that the hosp ital has reserves, we also know that those reserves
are earmarked for very vital critical operations and
obligations that the hospital has. So the money has
got to come from somewhere, it is not manna from heaven, it is coming from somewhere, and that is the point that I am trying to make. I am not in any way
attempting to mislead this Honourable House, but at the end of the day, $25 million has been cut from the grant that the hospital normally gets, a grant for sub-sidies.
In closing, before I get to my questions, and
you as an academic may appreciate this, this whole
scenario that I am speaking about reminds me of in
the 16
th century, prior to the Reformation, you will r ecall that the Church of . . . what is the Pope, is he
Catholic?

Yes, I know. How they got it matters not . . . well, no, it does matter; but that is a story
for a different conversation.
However, one way they did get it was by taxes. Right? So all of the other churches throughout [the land] had to pay taxes to St. Peter’s [Basilica] in
Rome, notwithstanding [St. Peter’s] wealth already. So, St. Pa ul’s [Cathedral] in London was getting a nnoyed because they were saying, Well, hang on a minute, we need the money so that we can use the money to help our Londoners, our own people, so that
we can . . . you know, the churches have historically
helped the indigents and the homeless and the wi dows and so forth.
So London was upset because they were sa ying, Well, hang on a minute, we need the money, our
taxes, to stay here so that we can help and do our community outreach as a church. However, St. P eter’s w as not going to have any of it. They said No
(and, again, this was prior to the Reformation), everybody has to pay the taxes over to Rome. And the expression that came from that, though it is a 16
th century expression, which to me epitomises what we have
just spoken about over the last five minutes about this
$25 million reduction in the hospital’s grant for Ind igent is that what the Government is doing is they are
taking from one to another, they are robbing Peter to
pay Paul . And by doing that they are, I respectfully
submit, notwithstanding that I do not believe the services are going to be impacted, but the money has got to come from somewhere. And they have already told us what the money is going to—they need $31.8 mi llion for the America’s Cup.
Thank you, Mr. Chairman.

Thank you, Honourable Member .
The Chair will now recognise the Honourable
Member from constituency 5, the Honourable Derrick
Burgess.
You have the floor.
Hon. Derrick V. Burgess, Sr.: Thank you, Mr. Chai rman.
First of all, Mr. Chairman, I would like to thank
the staff for the services at the hospital and the Ministry for the work that they do because I think that they
are doing a good job, led by the young lady from St. George’s. They are doing what they can and I am very happy about that, and even in the Ministry they have some very good staff.
I think that the Minister (and, Minister, correct
me if I got it wrong) is the right person from that crowd over there to handle that Ministry. And I think when it goes wrong it is not because of anybody from the
hospital or the Ministry, it is political interference. So, I really believe . . . and I sincerely say that and I do not normally say things like that, but I really believe Mini ster Atherden is the right person for that Ministry.
What I get a little uptight about is that you
have not mentioned dementia or Alzheimer’s in the Budget. I do not see anything there.

Thank you.
Hon. Derrick V. Burgess, Sr.: Yes.
As you know, dementia is one of the biggest
health challenges and social challenges in the world
right now. In fact, there are over 46 million people liv-ing with dementia. And, as we understand it, by the
year 2050 that total will go up to at least 131 million.
And the cost —to mention the cost —it is quite high,
very high, Mr. Chairman. In fact, in the year 2015, 9.9 million people were diagnosed with dementia.
Now, you know in Bermuda there is a stigma
attached to that and some people with dementia are kept in isolation. Not a good thing. Not a good thing at all. It concerns us.
Mr. Chairman, if you do not mind, can I read
some excerpts from European Charter of rights of older people, i f you do not mind?

As long as you site the proper reference and the date.
Hon. Derrick V. Burgess, Sr.: This is the European
Charter of rights and responsibilities of older people in need of long- term care and assistance. And I am just
saying this because I think it is something that the
Ministry must bring to this House— a charter of rights
for older people —because, Mr. Chairman, if you live
long enough you are going to be one of them.
Now, “The European Union recognises and
respects the rights of older people who are more likely
to come to depend on others for care, to lead a life of dignity and independence and to participate in social and cultural life.”
Mr. Chairman, it also says, “that advancing in
age does not involve any reduction of a person’s
rights, duties, and responsibilities.” And I will end on this little line, it says, “Health and long term care, i ncluding prevention and early intervention, should be considered not as a cost but as an investment that benefits all age groups.”
And I really do not think that the Government
is investing any money, particularly with dementia. You know, this topic really . . . it is really close to me,
and we are not doing what we should here because we are going to wait until it gets out of hand, just like
1162 13 March 20 17 Official Hansard Report

Bermuda House of Assembly we have on the streets with some other folks that I am
going to talk about later.
In fact, I think it was last year we had som eone come down here to head a seminar for family
carers and professionals and I understand they will be coming, if they can get some rooms, they are coming
again in either May or June. This will be, in fact,
thanks to Miss Carol Everson in arranging for this to
happen. And so this is much needed. We need to have a special centre for people with dementia.
Madam Chai rman, le t me clear up something
first about the America’s Cup. I want the America’s Cup to be successful. I am a hotel person; I want it to
be successful. But they get a rep because they are
finding money —easy money —for the America’s Cup
and other things we are not finding any money for, like
dementia care. It is so easy to . . . you know you are
getting what? Over $70 million for the America’s Cup and all the other money, $39 million to reclaim land up
there. That is a lot of money to find just like that and
we have got people here with dementia that need some care and they are not getting it.
Mr. Chairman, on Health, still on [Head] 21,
sometimes I get annoyed when I hear people going to
the doctor and, for example, they have got high cholesterol and some doctors will prescribe drugs instead of . . . I guess it depends on the numbers, some
probably need drugs right away. But you know with some numbers you can have an alternative diet and you can buy supplements like Red Rice Yeast, niacin,
garlic . . . you experiment with them because they
may not work for you, but they work for some people.
I think the other thing is our bad diet, Berm udians in particular, black Bermudians in particular.
When we go to a function and we will put peas and rice on the plate, macaroni and cheese, and potato
salad. That is all going to turn to sugar in you. And so
that is why we have the highest amputation rate in Bermuda because of our crazy diet that we have. And I would venture to say (and if I have got it wrong I would apologise in advance) that we are not doing
enough in the schools to educate our children on the
proper way to eat and what you should eat and what you should not eat.
Now, let us look at our rest homes. We have
some of our dementia people in rest homes and, as I understand, some people are drugged or even tied
because there are certain forms of dementia and
some are very aggressive. Now, you cannot use
drugs or tie them down, that is against their human rights. You cannot use that. These anti -psychotic
drugs . . . y ou should not be injecting these people
with those drugs. I would tend to think that a lot of
those homes are not sufficiently staffed to take care of
these people.
Also, when you see the increase in falls and
errors in the rest homes, again, I think that those
homes are not sufficiently staffed. And I think we need to do what is necessary —the Ministry needs to do what is necessary —to make sure those places are
staffed and there is a ratio in the Act, but that Act was done some time ago, and it needs to be revisited. B ecause when you still have the number of falls as out-lined in the Budget Book it concerns me. And the er-rors . . . senior abuse . . . well, senior abuse, not necessarily at the homes but it happens there too also I
understand.
Just let me get that one on the falls. In fact, if
you look at business unit 32000, you will see at Lefroy
House the number of falls sustained by elders d ecreased from 30 to 25. Twenty -five is still too many.

[Inaudible interjection]

Hon. Derrick V. Burgess, Sr.: Page B-140. And the
number of incidents (not fall related) and errors inclu ding resulting in harm or injury to the elder is three at
Lefroy House. Certainly it is more at Sylvia Richar dson, it is eight down there. And then the number of falls by elders at Sylvia Richardson went from 30 to 24. Too many, 24 is too many, much too many, too much. The only thing that I can put it down to is shor tage of staff.
Now, you have increased some grants to
some rest homes and then the rest home, the AME, you have not increased that at all. I do not know. You probably did not increase it because it is AME, I do not know what it is. But they are a non- profit organis ation. And Minister you are shaking your head and that
is fine, but you doubled the grant for Packwood Home,
you w ent from 150 to 300, and you are only giving us
. . . you have not increased ours at Matilda Smith. I do
not know about the others.

Minister, Minister, what is your point
of order?
Hon. Jeanne J. Atherden: [Microphone turned off]
The Chai rman: You might want to turn your micr ophone on though.

POINT OF ORDER
[Misleading]

Hon. Jeanne J. Atherden: The Honourable Member
is misleading the House because what ended up happening is you have one facility that only showed the six months when the grant moved over to us, not what the grant actually got through the year. And I want to say that because I am sure you did not intend to mis-lead the House.

Thank you, Minister.
Honourable Member .
Hon. Derrick V. Burgess, Sr.: I would never intend to
mislead this House, Minister, but I accept what you


Bermuda House of Assembly are saying. But the thing is I think they need even
more than you are giving them because as the Go vernment has said that they are not going to be inves ting in any . . . building any rest homes , they will leave
it to the private sector.
Okay, fine, if they are not going to do that,
then give us some money. You know, give those rest homes some money to improve their infrastructure because people think, Well, let’s put Aunt Mary down
at this home and we can park her there and we go
see her once a month, and that is fine. That is not the
way we should be thinking of anybody that has life in them. I think rest homes should be spic and span,
they should be top- notch. You know, all of us think we
are going to be healthy until we reach 100 and we are
not going to need any type of care. But, unfortunately for some, that will (fortunately or unfortunately) ha ppen and it will happen the other way for the others. But whoever has to go to these rest homes, they
should have the best.
We should not spare a dollar in taking care of
our seniors because our seniors have done what is
necessary to build this country and now we are short -
changing them. You know we should not have seniors
that have to decide whether they are going to pay for
their lights or medicine or food. None of our seniors should be in that position —never, ever —we should
never cut money to senior care. No government should do that. It is a crime and a sin to do that.
Senior abuse: I think we have to strengthen
the law on senior abuse.

And the Head for that?
Hon. Derrick V. Burgess, Sr.: You want a Head for
that? Look on page B- 134, cost centre 31135. Do you
have it? You are not even looking at it.
But anyhow it is there, Mr. Chair man. We
have to strengthen that legislation where any form of
abuse on seniors . . . that person should end up in
that court as quick as possible and be dealt with in
accordance with the law. Right now I am not satisfied
that it is done. And you are the Government, we ex-pect you to bring it because when we bring Bills you want to . . . that other crowd wants to play with it
sometimes. But if you bring a Bill to make sure that our seniors are protected in law, then you will certainly
get our support on this side of the House.
Now, the other thing, Madam —not Madam —
Mr. Chairman, I am sorry, I always see a lady there,
but you are not there . . . the Mental Health. Even
though you addressed some of it in your brief it is real-ly not addressed here as far as any of the reports.
You know you have Head 24, Hospitals. I get a little
concerned about that because we have a lot of these people on the streets that need care and they are not getting it and so they end up begging around town when they need care. Now, I wou ld venture to say that they are not
equipped down at MAWI to deal with them. And I can tell you of a case I was dealing with at MAWI. They have still got a fellow down there and they were giving him some drugs and they had serious side effects on him. And we went down there and met the doctor —
they are good people down there—and they said,
Well, we tried all the drugs that we can try for this particular individual and they all have the same side ef-fects. But they wanted to release him on the streets.
And I said, Well, you can’t release him on the
streets because he could be a danger, and then what is going to happen? He goes and does something in
the streets and ends up in jail. Too many of our folks
with those mental problems end up in jail. They cannot deal with them up there because they are not equipped. And the places that are equipped for them, that should be equipped for them, we do not take them down there. And that is something that we must
deal with . . . take serious, serious, [we] must take it
very serious and we must come up with some answers or some resolutions in order to help these pe ople. We are not helping them enough. You know, you
see them in town everyday begging.
And then again, I am not saying that the Government or anybody in this Parliament or the workers are responsible for them. We really do not know what a lot of these children have come from. In fact, one of my friends was a counsellor and he was counselling this young man in his 20s, but he would not say an ything. He was an introvert; he would not say anything. Then one day he took him to lunch and he started get-ting him to talk —the boy was about 25 I guess. And
the young fellow opened up and the problem that was happening with him was that he said his mother sold him for drugs. Now, how do you come out of that? I do
not know if MAWI is the place for that. I do not know.
Certainly not King Edward, but some serious therapy is needed. But that is just one of them.
There are a lot of young folks out there and
we tend to judge them, and when I say “we” I am tal king in general terms, really not even thinking, What has this child come from? What was the home life like? And we do not have anywhere they can really
deal with these situations that they have. How does a person go through life— all their life —with these types
of problems created from home? And that is what the
mental health, the Department of Health, the Ministry
of Health is there to do.
I am not saying you can fix everything. No
government can fix everything. But some things w e
have to do, things like that because, as you know, 10 years ago we did not have that many on the streets as
we have today. Ten years ago we did not have that
many people with dementia. Ten years ago we did not have that many seniors in homes , but they ar e increasing. And what I do not see from the Government
is . . . they are not doing anything to address any one
of those issues —Mental Health. And I am talking
1164 13 March 20 17 Official Hansard Report

Bermuda House of Assembly about the folks that are on the streets, nothing; they
are not addressing dementia . . . nothing to do with
. . . you know, they are not doing that. And I do not
think we are doing enough for seniors.
Seniors are not put in rest homes to wither
away. Seniors are put in rest homes to live the rest of
their life as comfortably as they can. So, Minister , I
really think you are the best one, again I repeat, of that crowd over there for this Ministry, and I just hope the Premier, after hearing this, does not try to move you because it would get worse. So, I am depending on you to try to address these issues.
I am not looking for the answer overnight; it is
not going to happen, even if we were there. But cer-tainly we are looking for some . . . some things we can
address right away because the situations in the rest homes —the falls . . . and I am glad to see one rest
home does not have any pressure sores. But I see one has some. Now, to me those things can be a ddressed and addressed easily by doing what they have to do. So we should not have that anymore. I would like to see that next time it goes to zero als o.
But the falls, I would urge you and ask you to find out why people are having these falls. And again, I would
venture to say it is because there is a shortage of
staff.
But, again, I certainly want to thank the staff at
the hospital, the staff in the Mi nistry, and the Minister
for doing the best that they are able to do without po-litical interference.
Thank you.

Thank you. Thank you, Mr.
Chairman. I sat down and failed to ask the few questions
that I did have. So thank you, Member from constituency 6, for letting me stand up real quick.
The few questions I do have Minister, the first
one relates to page C -4, item number 75021, MidAtlantic Wellness, the Minor Works for $120,000, this is under Capital Accounts —
[Inaudible interjection]

I am sorry, page B -131 and then
underneath Expenditure of the Analysis of the Current
Account Estimates there is a 40 per cent increase on
the line item Repair and Maintenance for the Ministr y
of Health and Seniors Headquarters; however, I note
that at the back at page C -32 [sic] it indicates that the
Headquarters are in Continental Building as well as Building 332 –Southside. So I wonder if you could just
explain what the repair and maintenance are for buil dings that, I guess, presumably, are not owned . . .
does Government own the Continental Building?
Okay. So if you can explain what the maintenance is for those buildings.
Thank you, Minister, and just two more real
quickly. [Page] B -136, li ne item 32130, Adult Health, it
is a 31 per cent increase and I wondered what that
represented, please.
And my last question is [page] B- 137, line
item 32160, Oral Health Prevention and there is a r eduction by 5 per cent which leads me to my question abou t the status of the dentists in Bermuda. I know
that there was an issue concerning shortages of de ntists. And then when we look at page B- 143—and I
am not sure if you can answer this —but I noticed under the business unit 32130, which may tie to the question I just asked about Adult Health, it is indicat-ing that the Department of Corrections was unable to provide this information because of staff shortages, does that mean that there are no physician consult ations, or were they unable to provide the statistic s?
And that is it. Thank you, Mr. Chairman.

Thank you, Honourable Member .
The Chair recognises the Honourable Member from constituency 6, the Honourable Wayne
Furbert.
You have the floor.
Hon. Wayne L. Furbert: Mr. Chairman, there is no
doubt health care costs —and I am speaking to Head
21, the Ministry of Health and Seniors —is probably
one of the most important issues that we have to face,
gracious, from the time I remember. I think the biggest problem that we have always gotten wrong is that
everybody has an answer and nobody has the sol ution. And our biggest problem is because we do not work together on this thing. And I think it is time for us
on both sides, although I am going to be coming at the
Minister in a few minutes, but I think it is time for us to . . . like Education, Tourism, it is time for us to—

Okay.

Hon. Wayne L. Furbert: Yes. It is time for us to kind
of put down our shields and swords and find a solution
working together. And I think we can do some things. And I heard my honourable colleague mention some
things to the Minister that the Progressive Labour Par-ty will do when they form the next government. And I hoping the Minister . . . although the time is running
out, Mr. Chairman, for them to do certain things, as
my honourable colleague has said, I hope that there
are some things that can be done between now and
the time the Minister crosses the floor.
The whole idea of health care costs . . . and
let me just give . . . I was 23 years old when I was
Chairman of the Finance Committee at the Hospital .
At a very young age John Swan threw me in there. And I was there for 10 or 11 years and we saw a lot of
changes take place. And the way the hospital used to calculate their costs in those days was probably a little different from now as far as the subsidy. I remember like it was something like the amount of hotel beds times some rate and then . . . and I am speaking to
the cost, I am talking about subsidy —

Member this is a real stretch.
Hon. Wayne L. Furbert: Yes, I know. I am speaking
to 2401, line item 34000, King Edward Memorial Hospital and how it was calculated.
You know there is a method of them getting
that number, although the Minister for years has been
getting this consistently. And I am getting to my point that all of a sudden Dr. David Saul (who was Minister
of Finance at that time) found that we were calculating
that way . . . and of course the hospital got more
money. And the reason why it worked and the Minister who was the CFO at the time, I was Chairman of the Finance Committee, she remembered how it was cal-culated. The hospital was able to build up cash r eserves to pay for such things as the kitchen (at the time), we did the Emergency Department, we did the parking lot out the back, and some other things.
In other words, we did not have to rely on
Government. That is very important. We did not have to rely on the Government. We did not have to go
knock on the door and say let us go borrow some
money . . . extend security or whatever it is. So the
implication that what Dr. Saul did in . . . I cannot r emember when it was . . . it was probably 1989 or 1990, had an impact on the hospital for years. If you look back at the financials, they had losses around that same time. Before it was all this nice reserve being built up so they could take care of things because
the hospital is a very expensive place to run . . .
equipment that is needed, things . . . and they did not
have to go running to the Minister every five minutes
to say, Look, I need this. I have got the money . The
Board is going to have to make a decision. I see the
Chairman sitting in the Gallery.
So what has happened now is that the Government, instead of putting themselves in such a pr ecarious situation, they have put the hospital in a situation. They are taking away $25 million from a $106 million subsidy down to $82 million. And I heard the
Minister say that the individuals who were billed for
this are not going to be impacted. So who does the hospital bill now? I would like to ask the Minister, who will the hospital bill assuming all things are equal? I
know they did some reconciliations sometime down the road and they are working some things.
So a senior comes in . . . now let us say it is
nine months and all the money has been used up, the last quarter. Who does the hospital bill? The Gover nment? Or do they bill the senior? If they bill the Go vernment, they are not going to get the money. I would
like the Minister to answer that question. Or you say, Okay, bill me, no you are not getting the money because you will w rite it off. The hospital already writes
off between $7 million and $10 million a year for people who are not paying their bills.
I remember the first time, again, when I was
on the Board, Quenton Edness was the Minister of
Health, we went to him and said, Minister, you know
we have got this debt here—and it was small co mpared to what it is nowadays. And he said, Just write it
off. Just write it off. That is how the Minister . . . just
write it off. And the Minister knows because, as I say, she was the CFO at the time; she remembers those
amounts we used to write off every year from King Edward. So it has an impact. And I am surprised . . . I
know it was not the Minister’s fault. I know it was the Minister of Finance who locked her in a corner and
said, Listen, this is what you’re going to do, this type
of thing because I know the Minister would not agree
with that because she is familiar with the numbers.
So, if you look at . . . well, you do not look at it
Minister. I have to refer to . . . people may not understand it, but I am looking at the King Edward Memorial
. . . the Bermuda Hospitals Board financials because
at the end of the day it shows the impact of what is
going to take place. In 2015 their net income after provisional [was] $44 million. But they had an extraor-dinary income that year, which was probably unusual. Extraordinary means something unusual. So som ething took place, I do not know what it was, I have not read the financials to tell what actually took place be-cause these are not . . . as a matter of fact . . . because these are not audited. Oh, yes it is. Hold on. No, no . . . it is not.
1166 13 March 20 17 Official Hansard Report

Bermuda House of Assembly And then in March 2016 they had a profit, net
income of $14 million. That is because this subsidy
was in there. What happens in . . . well, 2017 will be
fine, but 2017/18, assuming all things are equal and
you do not see it here, but the medical revenue had dropped for those two years. I do not know whether it has dropped from 2016 to 2017, again, because we
do not have the financials for that period. So it has an
impact. So the hospital will suffer a loss in . . . the year
end is March, t hey will suffer a loss in 2018. They will
suffer a loss.
And we just think, W ell, that is fine, we were
taking care of America’s Cup. Why could the Gover nment not go and borrow their own money instead of allowing . . . basically what they are doing is borrowing
the money from the hospital and saying, You are on
your own. Make your own suffering. Y ou can suffer on
your own. And, as I have said before, they are just
trying to balance the books and make it look better
because at the end of the day they would have borrowed, instead of $130 million, they would have bor-rowed $160, 170 million. What sounds better?
I cannot believe that the Government at the
end of the day will just make the hospital try to . . .
now let me just make it clear. They said that they had $100 million reserve. Well, I looked at the financials for 2015. They had $100 million there, but they also had some, what they call, current liabilities. Current liabilities means they have got to be paid within the first year —$50 million. So if they had taken that cash
that they had in March 2016 and paid everything off, the current liabilities, they would only have $50 million left in the reserve, Minister.
So they do not have, really, the $100 million. It
is like someone collecting money and I am paying the
bills, Oh, I’ve got $50,000 in my account, but I owed
$30,000 around town. That is what you are telling me
and telling the hospital. And the long- term liability of
$320, well, you could have turned around and paid
that 30 on the long- term liability, reduced that liability,
but what you have done is extracted it.
And so you are saying well . . . and as my
good friend said, It is Peter paying Paul . Oh yeah, so
this yea r . . . so what is going to happen next year?
Oh, sorry, you will not be there. I am sorry. We will make sure the numbers are straight by then.
But it puts an impact because we do not know
. . . and I looked at it . . . let me just show you this one.
I read the statement by the former Chairman, he says—this is Bermuda Hospitals first quarter 2015/16
update—“We have spoken about” —do you mind if I
read this, Mr. Chairman? I think it is very important.

Just provide the proper reference.

Hon. Wayne L. Furbert: Yes. I am talking about the
Hospital subsidies, this is line item 34000, King E dward Memorial Hospital and Mid- Atlantic because I
think these are the consolidated financials. “We have spoken about BHB’s financial pos ition for some time. There is an evolving situation as
hard work by the BHB staff” (and I congratulate the staff for pulling us out of the hole) “has successfully cut costs from the organisation already. Two years ago we expected to run out of cash.” They expected to run out of cash by the end of 2013. “By controlling
costs through budget cuts, various vacancy freezes,
and contract reviews we have extended that deadline well into the fiscal year.”
Now, I was not sure what they meant that they
extended the . . . they run out of cash deadline the last
. . . the following fiscal year. “But 18 per cent was
saved on operational costs, including for example, $1 million saved through a review of the billing system” —
makes sense —“$4 million saved on new equipment.”
Okay, now, in other words, they put it off.
Somewhere along the line if they needed it, they have got to find it —unless they have already got it; unless
they already bought it.
“Around $6 million saved through supplier
contractor reviews” (which makes sense, go down and negotia te it and get some better deals.) “And $3 mi llion saved in support and administration services. At
the same time revenues for inpatient” (and I am getting to the point) “and outpatient support and admi nistration services” (sorry) “at the same time inpatient and outpatient services declined, outpatient revenue decreased 5 per cent due to BHB’s voluntary introduc-tion of diagnostic clinical guidelines.”
I am trying to get to the point. In other words,
they said this was a small surplus. The surplus that year was, I think it was $15 million, around that time.
So this was a small surplus for a hospital. “This is not a profit, but money that is used to reinvest in care and services. Without it, if we cannot afford to maintain our
ageing facilities and equipment, we cannot invest in
new treatment.” That is my point. Technology and
equipment, and we cannot invest in staff from basic cost of living increases to ensure a safe staffing level.
My point is that what the Government has
done is put the hospital on the back foot. And so now they have got to be concerned because you are . . .
well, I know someone said . . . I think the Minister said
they were expecting a 7 per cent increase in revenue this year. Okay? Well, suppose something strange goes on . . . I do not know, but something strange
happens and the hospital needs that cash. Will the Minister at the end of the day come back to this House with a supplementary and tell us that you will make sure the hospital . . . I mean at the worst, Mini ster, what the Governm ent should have done is let
them break even . . . at the worst, but not let them go
in the hole for some America’s Cup. That cannot be right, Mr. Chairman. That just cannot be right.
And so I am hoping that the Minister will say
during her wrap- up that we are not going to allow the
hospital to go in a hole, that somewhere along the line we will make sure that they break even. Zero is better


Bermuda House of Assembly than a minus $10 million at the end of the day in my
books.
I think what the decision by the Government
overall . . . and, as I said, I do not believe it was the
Minister of Health (knowing that she was a former CFO) that would allow the hospital to head in this di-rection. And they have come a long way and I co ngratulate all the Board members and the hospital staff for what they have done to make the situation better.
But at the end of the day it has an impact.
The questions I asked the Minister on the
hospital are: Who does the hospital charge for the reduction in indigent, aged, youth, geriatric, this total
outpatient subsidy . . . as a matter of fact, it was $7
million for the aged, for our seniors, indigent
$700,000; aged was $8 million in total outpatient su bsidy. These are significant and we have . . . and with
our ageing population I would have thought that even probably more seniors would probably be heading to
the hospital.
I want to know, Minister, who will pay for
those charges, the hospital? Or will they just let them
come in and say, Well, you’re coming in . . . you know,
somebody has got to account for something, it has got to be recorded somewhere. Now the question was,
will you come back and at least allow the hospital to break even?
Mr. Chairman, my honourable colleague
spoke about the Government had promised when they first were elected in 2012, a reduction in health care
costs. Well, clearly that has not happened. Health
care costs . . . and, yes, the hospital has done some
reduction. But overall people are still paying significant premiums, and the most vulnerable people are our seniors. With an ageing population, a shrinkage in our
overall people working in Bermuda, these insurance
companies still want to make $90 million a year in
profit . . . $100 million in profit, total. It could be a little
more.
And so we have got to find a way to bring it
down. And I think I mentioned this before that . . . and
I am speaking to line item . . . I know the Chairman is
looking at me like, What line item are you talking
about? I am talking about the overall cost of health
care, Mr. Chairman.

Do you wa nt to tell me you are still on
that same line item?

Hon. Wayne L. Furbert: Yes, yes, I am.
And so if we are going to bring our health care
costs . . . because the Minister mentioned about the
cost of health care, so I am also responding to her.
FutureCare, we have got GHI out there, we
have got the private insurers . We have got GHI and, I
think, HIP. And I think I have mentioned it over and
over again to the Minister , if we can find a way to
combine FutureCare and HIP . . . and I was almost
going to say GHI, but I am not sure there yet . . . but allow other individuals , younger members , to pay into
that plan who do not use it. My son has probably been
to the doctor twice in his whole life and he is 33 years old. Right? Where I go to the doctor . . . every time I
get a pain in my finger I am running to the doctor. That is because . . . not because —

[Inaudible interjection]

Hon. Wayne L. Furbert: — not because . . . and I do . I
go to my doctor . But my point is that as we get older
people go to the hospital , go to the doctor much more,
particularly if they are comfortable with the doctor. But if you can find a way to bring our . . . why are we the
most expensive . . . probably one of the most expensive jurisdictions in the world? You have been to C uba, Mr. Chairman, for medical reasons . Their costs
down there are extraordinary.

[Inaudible interjection]

Hon. Wayne L. Furbert: I said for medical reasons.

The Dominican Republic.
Hon. Wayne L. Furbert: Dominican Republic. I knew
it was somewhere down in the south . But the cost is
cheaper. And so I do not understand, although we are
60,000, 70,000, 65,000 people, w e have got to find a
way because this is going . . . with the continuing ageing of our population it has an impact on us. And then my colleague said that people have the right to try to decide whether they pay the hospital bill . . . not the
hospital bill , pay their health insurance or whether
they go get some food.
I told the Minister over there ( I am not going to
call her name) . . . but I went to the Minister and she is helping me on this particular one. B ut I have a lady in
my district that collects $40 0 a month from her pension and she pays $500 out on FutureCare.
You know , somewhere along the line it is g oing to be like the hospital . Somewhere along the line it
is just going to be . . . her reserves keep on shrinking
and shrinking and shrinking because she pays . . . she
is taking some more . . . and I have spoken to the Minister and I appreciate the Minister is going to look into this for me.
That is a decision . . . an
d that is just one lady
in my area. I know where she lives and there are
probably some more. I just have not . . . someone just
brought it to my attention. T here must be other seniors
throughout Bermuda that are in the same situation.
1168 13 March 20 17 Official Hansard Report

Bermuda House of Assembly And so we have got to find a way to get that cost
down.
So now let me get back to the line item that I
was speaking about, Mr. Chairman. What time do we
finish by the way?

We have about one hour and eight
minutes.
Hon. Wayne L. Furbert: Okay. So I know my co lleague on my right here wants to speak.
I see these performance measures and . . .
no, I am not going to speak on that. So my main beef today, Mr. Chairman, is two things : the hospital, the
impact on the hospital financials , and the cost of
health care. We have got to find a way . I think the only
way we are going to do this is both sides getting a
room, beating each other up, and finding a solution for
the good of Bermuda.
Thank you, Mr. Chairman.

Thank you, Mr. Chairman, and
good evening everyone. Age deferred to beauty that
time. You were expecting another speaker , I think.
But let me first of all congratulate the Minister
and all the executive members of the Ministry of Health for the job that they do for that section of the population. It is certainly not a job that I think I would be cut out for, so I certainly appreciate what they do. And I do thank them.
Mr. Chairman, let me say that I am going to
refer my remarks to Head 22 [on page] B -136. I had
intended, as my honourable learned colleague did ask, for [programme] 2201, [cost centre] 32130. I was
kind of curious myself, Minister, as to what that sum of
money is for. So I am going to be interested to hear
your response to that.
[Inaudible interjection]

Head 22, [page] B -136 under
[programme] 2201, [cost centre] 32130. Okay?
But while I am there, under that same column,
General Summary, I want to refer to cost centre
32020. It may not be exactly what I am about to say,
but it is entitled Health Education. So I am going to use that as my “in” and say that in my former working
life, almost 15 years ago, I used to give presentations
on pensions and talk about the age ing population.
And the reason why I am raising it here now and spe-cifically mentioning health education is because there are two subjects that are dear to my heart. One is persons with dementia; and the second one is a title that I do not particularly like, it is called “granny dum ping,” but it is really persons leaving their senior me mbers in the hospital when they probably could take them home and look after them. My learned colleague I think gave the Minister a suggestion of how maybe
she ( the Honourable Member ) could look at rectifying
that.
But the reason I say Health Education is b ecause we need to educate our people on those two
subjects particularly because they happen to elderly people. We have not, I do not think, educated the general population that we are all going to get old. W e
are all going to need some sort of health services as
we get older , and someone is going to have to do it for
us because we are not going to be able to do it [ourselves] . And I really think . . . and I do not know if it
comes out of that line item, but I think there needs to
be an education portion upped within the Ministry to educate the general population and certainly on those
two items.
As I said, dementia is something that . . . we
used to call it something else I think, when I was a
young kid, but we are now recognising that it is hap-pening to a lot of people. I can certainly speak from
personal experience within my family , and it is really
something that . . . I think it takes a special person to
have to look after these people. I certainly visit one of
the rest homes that is across the road from my boundary in Warwick , and I really glorify in the staff
there, how they are able to cope there with those persons. Not all of them there have dementia. Some of
them have other circumstances, medical circumstances. But the ones that have dementia there, I do not
really believe the staff have that level of training to
actually deal with them effectively. And again, maybe I want to make an appeal there as well that the Minis try
could probably be looking at it.
And certainly on the subject of, as I said, what
is titled “granny dumping” . . . this is serious . That is
really something serious that the general population —
the younger population— needs to be aware of as to
how to deal with it. I would say that it is a multitude of things, maybe, as to why it happens, as to why we would leave our loved ones like that . But it is also, I
think, a lack of education as well. So, again, Minister I am imploring . . . I certainly implore your Ministry to
look at those two areas in a little more detail. You may
come back to me and say what you are doing that I do not know about, but certainly I need to raise it b ecause those are things that I am certainly aware of myself.
Thank you, Mr. —

[Ms. Susan E. Jackson, Chairman]

Thank you, Honourable Member.
Anyone else like to—
[Inaudible interjection]


Bermuda House of Assembly The Chairman: That is okay.
The Chair recognises the Member from constituency 29.

Hon. Zane J. S. De Silva: Thank you, Madam Chai rman.
Madam Chairman, I guess I have to start by
congratulating all the staff at the hospital, led by their
CEO , Mrs. Venetta Symonds. Because one of the hot
topics in health over these last two weeks has been
the $25 million cut that the hospital has made or has
been told to make. So, I can only assume . . . and certainly if there is a surplus of funds at the hospital,
which is always a goal of any hospital, I would think,
to have a surplus of funds, obviously , this is the case
and the hospital and the staf f have done a phenom enal job.
And I am not forgetting about all the staff because, you know, Madam Chairman, those staff that
may be doing some of the more challenging jobs, like cleaning toilets, mopping floors and whatnot, they have to make sacrifices too. So sacrifices have been made from top to bottom , I know . And by the sounds
of it the efficiencies that the hospital has implemented
. . . and obviously they are taking effect. So my hat
goes off to the hospital staff. That is number one.
Now, the other thing that you will be happy to
hear, Madam Chairman, is your mother , rest her soul .
. . I will never forget the picture we had taken on Valentine’s Day. A lot of people could not believe it . But
we were on the front page (you might remember that
yourse lf), because we were always scrapping up here
in the House. But one thing she always used to say ,
and the first thing she would say when I was the Mi nister was you know , Head 24, Hospitals , there are no
details . There are no details.
So I wonder now if my dear friend, the Honourable Member Louise Jackson, were still alive if she
would have put some heat on the Minister and maybe the Ministers to give more detail to Head 24. Because she certainly made that point , as did the Honourable
Member from constituency 22, Dr. Gibbons, certainly
made a point about that for a couple of years when I
was Health Minister.
But maybe now . . . what, I think, the current
Health Minister is finding is that, you know, to give that kind of detail . . . and I always remember us ing . . . my
reply was , You will see all the details when the Hospitals Board produces their financials. So that was always my answer , and I am sure that the current
Health Minister will say the same thing, Well, I am not
going to fill up the B udget Book with all sorts of details. Even though when I was Health Minister and
they were over here, they used to say all the time,
Look, we need more details on the hospital. So here
we are.
Now, I think it is worth pointing out, Madam
Chairman, that when the OBA took over one of the
things that the Progressive Labour Party was really chastised for was the cost of the new wing at the hos-pital and what the yearly cost would be thereafter. And
there was . . . I remember , it might even have been
the Finance Minister who has just come in, I am glad because maybe he can clarify it if I am not saying . . .
not giving the correct information. B ut I remember ,
and, certainly, I think my colleague the Honourable
Member Wayne Furbert just confirmed, that one of the things that we got thrown at us quite, quite regularly
was that the hospital and the OBA Government were not going to have enough money, they were going to struggle to make those payments for the new wing at the hospital. They were going to struggle to make it —
$27 mil lion a year was the maintenance agreement.
Now, not only are we paying that $27 million,
but somehow this year we managed to take away a nother $25 million from the hospital. So, I mean, the
staff must be doing really, really well . Or maybe the
OBA Ministe rs that were making those statements just
had not done their homework, maybe they did not talk to the Hospitals Board or the CEO or any of the exec-utive staff. So, all of a sudden, we caught hell for the
amount of money that would be paid out every year to
now we are making a $25 million cut. Hmm .

[Inaudible interjection]
Hon. Zane J. S. De Silva: Okay.
Now, Madam Chairman, if you look at page B -
149, which is Head 24 , if you look at the reduction
across the board . . . now, of course, we know there
are only two lines [cost centre 2401] for the hospital,
just like when I was Minister. But the good thing is if
you look at page B- 149, it gives you a little breakdown
of that reduction of $25 million. And if you look at it ,
the Indigent is $700,000 less; the Aged is $7 million
less—and these are just approximate numbers —the
Youth $1.7 million less; Geriatrics $2.5 million less;
Indigent $600,000 less; Aged $8 million less; and the Youth $1.7 million less; the Clinics $600,000 less; for a total of around $24 . . . $25.5 million.
Now, one would say, W ell, look all these costs
have been reduced. T his is good, right? And the Ho nourable Member MP Commissiong certainly knows because his mother , who is a very good friend of mine
(I call her my aunt , right?), she is getting up in age. So
we might say this is good that this $25 million has
been cut . But look where it has been cut from. You
have one, two, three, four, five, six, seven line items
where it has been taken from. One is Youth, the rest is all our seniors.
Now,
we are taking $25 million . . . well, let us
deduct the children from it, which is $1.7 million, let us
round it off to $24 [million] ,say $23.5 million away from
our seniors. Now, we have an age ing population, and
we seem to be taking it away from those that are going to need it most. Why are we doing that?
Now, I could understand it if we took $25 mi llion away from a couple of ambulances and maybe
1170 13 March 20 17 Official Hansard Report

Bermuda House of Assembly some other things that the Minister mentioned for the
America’s Cup. And I will talk about that in a minute
too. But it seems like . . . and maybe the Minister . . . I
am sure she will have some time to answer . And I will
certainly make sure I try and leave her a little time because we finish at, I think, ten to eight?

[Inaudible interjection]

Hon. Zane J. S . De Silva: Oh, 8:08, so I will definitely
leave the Minister some time to answer.
But certainly, to me it seems like we are taking away from the people that really need it most. And that is not a good thing. A good thing that we have a
cut, it is a good thing that . . . unless the Minister of
Finance told his Minister of Health, like I was told, I remember when I was Minister of Health my Finance
Minister , Everybody’s got to cut their budget by 15 per
cent. I remember I came back the next week, mine
had actually increased by 5 [per cent]. And she said, I
want everybody decreased by 15 [per cent] Y ou have
to come back. And I will get to the supplementaries in
a minute. And I remember sitting down with my PS . . .
and it is funny because the number this year for the
hospital , or the subsidy . . . I believe the subsidy is
around $82 million. It is a funny number because I
remember sitting down with my PS and we were looking at the budget and it was about $80– 85 million,
something like that. And I said, Well, w ait a minute,
we had a supplementary of $20 million last year —a
supplementary of $20 [million].
So to me, I would say, Why do we not budget
for a $100 million? [And I was told,] No, it does not
work like that, Minister. It does not work like that .
I said, Well, it would work like that to me. If I
am running a business and my fuel bill was . . . well, my fuel bill is about $50,000 a month. I can tell you, I
budget for $55,000 a month because my fuel bill is $48– 50,000 a month, so I always budget $55,000.
So why would you budget $20 million less
than your past expenses? And this has been going on
for years, I was told. I said, Well, I don’t work like that,
I’m putting it in effect .
The honourable . . . my friend [who] used to
be Chairman of the Health Counci l is now the PS of
Health. I remember us sitting down and going through
a lot of different numbers and I said, Listen, you know
. . . because we were developing the Bermuda N ational Health Plan (you will remember that quite clearly). I am sure the current Minister remembers that too, which I think that it was a very good thing that we lost, it was a lot of work by a lot of good people, a lot of good people. But anyway, one of the things that I was
told by the Health Council and re- emphasised by my
PS, and t he statistics showed it, was that health costs
in Bermuda were rising 8 per cent to 10 per cent a year. So why would I say that, Okay, I’m gonna go
ahead with this budget of $82 million— when I know that I had a $20 million supplementary and health
costs ar e rising 8 per cent to 10 per cent a year?
Really, what I should have done was to take
the $80 [million], added $20 [million], give me my
$100 million, add another $10 million for 10 per cent
and put it in for $110 [million]. In fact, I think, to give credit to my team, I think we put it in for about
$106 [million] or $108 million that year. So what I am
saying to you, Madam Chairman, is this . . . is that . . .
now, I am hopeful. Trust me, I am hopeful that we can bring this in at $82 million. That would be fantastic. But you know what? We are not living in cloud cuckoo land. I am not. I am not. I would like to think that we
could, but with our population ageing I do not see it
happening.
And we know that the hospital does not turn
anyone away —we cannot turn people away. And I will
be the first to put my hand up, and I will give the Mi nister apologies and kudos come next year if this
budget stays at $82 million. In fact, I will give you con-gratulations if you can bring it in under $100 [million] because I just . . . I just . . . you know, history just
does not tell me that. Even though, I think, last year health costs for the first time in a long time, we did
actually drop a little bit.
Now, the Devil is in the details . So did it drop
or did it not drop? I will let the Minister . . . I want to
give the Minister time because I would really like to
hear what she has to say about that.
Now, the Minister mentioned briefly in her
brief some of the challenges that she had at Lefroy House. I know the Minister was not here when I was
Minister, but I can tell you that she would . . . som ething that she should be aware of is that prior to the last election, the now current Premier (former Shadow [Minister] of Health, Premier Dunkley) said that if he
was the Health Minister he would shut down Lefroy
House because it would not be operational anywhere else in the United States. It was not fit. It was not fit. In fact, his colleague and OBA candidate, Ray Charlton, went out and took pictures. He took the press up
there, and he said the place should be razed . . .
should be razed.
Now, we are four years into an OBA Gover nment. Where is the money for Lefroy House improv ement? Well maybe now folks have been up to Lefroy
House and found that it is not so bad up there. Now,
they still may have that section (I have not been up
there for a while) but they still may have the section
that was damaged . . . gee, almost a decade ago, and
we stopped using that building. That is where they were taking pictures. A building we had not us ed for
10 years. But let us not get away from the fact that
you had the now Premier (former Shadow Minister)
saying that the place should be shut down. So I ex-pected one of two things to happen . . . because if it
was [in] that bad a shape, you had the candidate that ran up in Dockyard saying that it should be demol-ished, you had a Premier saying that, you know, it


Bermuda House of Assembly should not even be operating . . . where is the money
to fix it up?
Now, they will say that, Oh, you guys spent it
all and we haven’t got any left. But we will talk about
that in a minute, too. Yes, we will. We can find money
all of a sudden for an ambulance for the America’s Cup, but people up in the West End have been calling
for an ambulance for . . . since I was a child. Not to
mention the folks down at East End. But it seems like
money is found for certain things under this OBA Government. Certain things are found . . . they find
money for certain things. So my thing is, what are we going to do about Lefroy House?
And whilst I am at it, Madam Chairman, let me
congratulate the staff at Lefroy House, once again. They do a phenomenal job up there— a phenomenal
job. They really do. They really do. And what is the lady’s name, I think it is Rosheena Masters. Rosheena Masters deserves a medal; she re ally
should get a medal. She lives, eats, and sleeps her job. She is really . . . she really is a charm, she and all
the other staff up there certainly are.
Now, Madam Chairman, I do not know how
much the Minister . . . if she spent any time at all, but I
know that certainly, I think, my honourable colleague Wayne Furbert, and I know my colleague, the Honourable Member Mr. Tyrrell, mentioned dementia and
Alzheimer’s. And I do not know . . . and I know that
. . . I am fairly certain that . . . if I remember correctly,
Dr. Jennifer Attride- Stirling, that is close to her heart.
And if I remember correctly, I know that Liz
Stewart, it is close to her heart, too. And I do not know if what we have done in terms of dementia and Al zheimer’s, but we should certainly make . . .if it is not
already in train (and the Minister can tell us) to really try and make some inroads with those two diseases.
Because my stepmother who passed recently had a
touch, I think, before she died. And it is a really tough thing when you have your mother or father that, all of
a sudden, they are saying, Well, who are you? Or they
are talking to you about something that happened 20 years ago and you are talking about something that
happened yesterday. It is really, really a tough one, and I do not know what we are doing in that regard, but there has to be . . . I know of one particular person, but I know there must be many that have this challenge with their parents.
And the more we could do in that area, I think,
it will be great to help our people because, you know,
when you have a parent that gets to that stage, they need attention. And they need a lot of attention. When you get a parent that starts going on a walk and you do not know where they are (it is like your dog getting
loose) and they do not know where they are going,
you do not know where they are, and then one of your
friends calls up and says, Listen, I just saw your
mother walking down the railway trail and I know that
she doesn’t go walking . . . so it is a challenge. And I see a note being passed to the Minister, so hopefully
we will get some information on that.
Now, another thing I would like to talk about,
Madam Chairman, and I did not hear the Minister talk
too much about . . . and I will put my hand up, I have been in and out, but Agape House. And, of course, I tend to be in Agape House a little bit more often than
most, I guess. But I would like to see us . . . and certainly . . . I do not know if the CEO is still in the House,
but . . . yes, I saw her hand come up. And she knows
that whether I am a Minister or not I have a passion for Agape House.
Now we are going to . . . Minister, we really
need to put some concerted effort into Agape House in terms of . . . let us do something with it. I am happy
to talk about that offline. All I wanted to say is, I do not want to make a big issue about Agape House, b ecause, again, the staff does a fantastic job. They have some really good volunteers, and the CEO certainly
knows that my goal would be to knock Agape House
down —it is a big enough site —we could knock it
down, we could build up a really nice facility. You have space out to the north which would lend [itself] to a nice little garden setting and, of course, you have
the Botanical Gardens which are on the other side.
So we could take that up two or three stories
and it would be a fantastic place for our loved ones —
all of our loved ones. So, I would really like to see us
do something a lot better for Agape House.
Now, the Minister said in her brief that there
will be no supplementaries this year. That is what she said, that there will be no supplementaries. And the question I have for the Minister is this —

Miracles can happen.

Hon. Zane J. S. De Silva: Yes, and you are right,
Honourable Member. I believe if that happens, I would
look at it as divine intervention. As a former Health
Minister, certainly MP Roban knows that it would be divine intervention. Now, what I did hear the Minister
say is that if there is a need, if there is a shortfall, the BHB will cover it. And Minister you can just nod your head, but did I hear you say that they have surplus of about $100 million? Is that correct?

[Inaudible interjection]

Hon. Zane J. S. De Silva: BHB. Is that correct or not?
[Inaudible interjection]
Hon. Zane J. S. D e Silva: Okay, the Minister is —
[Inaudible interjection]
Hon. Zane J. S. De Silva: Pardon?
[Inaudible interjection]
1172 13 March 20 17 Official Hansard Report

Bermuda House of Assembly Hon. Zane J. S. De Silva: A hundred million on hand,
the Finance Minister says.

[Inaudible interjection]
Hon. Zane J. S. De Silva: No, I did not say . . . I did
not say it was; I was asking if it was a surplus.
[Inaudible interjections]
Hon. Zane J. S. De Silva: Okay. Well, I will tell you
what I would like, because that is what the Minister
said in her brief. So I would like to know if the BHB are
going to cover any supplementaries that they needed. I need a little bit more explanation to that.

[Inaudible interjection]
Hon. Zane J. S. De Silva: Oh, did you? You asked
that same question. All right, so you have had that
question twice, Minister, maybe we will get the an-swer.
Now, the other thing that I think I heard the
Minister say is that this $25 million cut will be for one
year only. Now, I found that interesting. And the Mini ster then went on to say in her brief that the BHB would
be dropping its diagnostic fees so that they (and I
think your (the Minister’s) words were) should align
with the community’s fees. So, my question is, why
did the Minister single out the reduction in diagnostic fees dropping to match the community fees?
[Inaudible interjection]
Hon. Zane J. S. De Silva: Well, I would not dare say
that, Honourable Member , but, yes.
So my thing is, I know that there are some
health providers out there that have been complaining
that the hospital fees are a lot higher than their fees. So is it a good thing that the Board is dropping diag-nostic fees, or is it a bad thing that they are not sta ying the same and the local health providers are not given that increase? And I am hoping that the Minister . . . she is making notes. I am hoping she has an a nswer for that.
Now I do believe she also said that with this
drop in diagnostic fees . . . there were two things she
said: there would be an $8 million loss for dialysis and a $15 million loss under the diagnostics. So, that just happens to amount to $23 million. Is that the $25 [mi llion] or is the $25 [million] coming out of the seniors I talked about on page B- 148 earlier?

[Inaudible interjection]

Hon. Zane J. S. De Silva: But this is my question.
Now, if we are going to lose $25,474,000 which is outlined on page B -148, cost centre 34000, is this $8 million loss in dialysis and the $15 million loss in diag-nostics additional to that? So are we looking at a $56
million loss just in those three items? And the Ho nourable Finance Minister said just now that they have $50 million on hand, the hospital does. So maybe—
[Inaudible interjection]

Hon. Zane J. S. De Silva: No, no, he said $50 [mi llion]. The Minister said, I think she said, $100 million
surplus, but the . . . you do not see a point of order, do
you? The Finance Minister said no, they had $50 mi llion on hand. Right?
So he has $50 million on hand. My question
is, with that $25.474 [million] and this $23 [million], are we looking at this $56 million loss? So I would like the Minister to answer that question.

[Inaudible interjection]

Hon. Zane J. S. De Silva: Now, I do want to give the
Minister time, you know. I really do.
Now, the other question I had was on page B -
136, Head 22, [cost centre] 32020. It was Health Ed ucation, $5,000.
Minister, can you just explain what that $5,000
is for Health Education? And maybe it is somewhere
else, but I would like to see and, of course, again, those that . . . some of those folks, I think, most of
them are still there at the Health Depart ment who . . .
I think, another department that deserves a lot of
praise are the folks at the Health Department. And
Madam Chair man, if I could just take a second to d igress a bit, but let me say something about the folks in the Health Department. One year when I was in the Health Department, I will never forget it because it was February 14
th—

Well, just —
Hon. Zane J. S. De Silva: Because you know there
are a lot of our people, Madam Chairman, who are
quick to say that our civil servants do not work. Well,

Berm uda House of Assembly let me just tell you a little story in case you . . . because I have said it here several times, but let me say
it one more time.
In the Department of Health, it was February
14th, Valentine’s Day, and it was about 6:30 at night.
Kevin Monkman, the former PS, came in and said,
Minister, take a little walk around the office and notice how many women are still working. Well, Madam
Chairman, I took a walk around that office and there
were no less than eight women—Valentine’s night,
almost 6:30—still working. And I remember walking
around telling each and every one of them, Thank you
so much for your dedication. And I know a couple of
them were married and a couple of them sure had sweethearts. So, let me say that . . . and I think most
of the staff are still there. Those girls work hard and they l ove their jobs with a passion. So, I thought I
would just throw that in there.
Now, getting back to this $5,000 for educ ation. I hope that number has to be not what I think it is for, because I know that the current PS and the former PS (who is now doing some consultant work for the Health Department, as I understand it; he is a good man to have back on deck, to be honest), those two in
particular, know how important it is . . . and I am sure
everyone in this House knows that certainly when I
was . . . and the current Minister . . . and I would like
to congratulate her too, because she has been beat-ing that drum a lot lately too.
I have not seen her skipping yet in any . . . but
have you done a little skipping, Minister Atherden? But let me say this, we can never stop— never stop —
trying to educate our people with regard to exercise and eating correctly. And you, Madam Chairman,
have got yourself in really good shape in the last year and a half. That is right. I am surprised you are not
Health Minister, to be honest —not to take anything
away from the current Minister. But you certainly
make a good candidate, and you can speak to people like I used to all the time about your experiences.
And I am sure that you got yourself in shape
by eating correctly, maybe changing some of your eating habits and exercising. And I know you do that because I see you. In fact, you have gone from walk-ing to running. So, I know you know exactly what I am saying.
So my thing is we can never put enough
money into bringing about awareness to our people and listen, I will tell you, when we were talking about the Finance Minister’s tax increases, you will know because I have said it a hundred times, chocolates and sweets and all that stuff, you can make the duty 500 per cent for all I care. Cigarettes, make them $50
a pack, all right? Because it does nothing for our peo-ple. We have one of the highest rates of diabetes in the world. We have the most amputations . . . I think,
second in the world.
[Inau
dible interjection] Hon. Zane J. S . De Silva: Yes, we do. And we have
bad eating habits. We all know that. It is in our DNA —
we want chicken, we want macaroni and cheese, we want potato salad full of mayonnaise.
[Laughter]
Hon. Zane J. S. De Silva: You go over to Island Cu isine on a Sunda y and these guys are putting big
spoonsful, big spoonsful of mayonnaise on top of their codfish and potatoes, you know?
[Inaudible interjections]
Hon
. Zane J. S. De Silva: I am telling you, but it is
true.
[Inau
dible interjection]
[Gav
el]
Hon
. Zane J. S. De Silva: But it is true. Our people
love to eat junk. Look, my momma, bless her soul,
used to cook . . . when she used to cook bread she
cooked what they call massa . Member Jeff Sousa
probably knows what massa is, right? Massa, sweet
breads, donuts, but . . . pies out the ying- yang. I am
telling you, my momma used to cook, and it was good!
But it was so bad for us, so bad for us.
[Laught
er]

You survived.
Hon
. Zane J. S. De Silva: I have survived. I have
survived. I have survived. Now, see, that is a double-edged sword right there. You know how to stick it to me, don’t you? Yes, you do.
Bless my momma, she meant well. So, with
regard to the Health Education I have got to believe
that that is something else and it does not include
mark eting, because if I had my way . . . in fact, I may
get my way very soon when we take over. And cer-tainly, if I am not Health Minister, I will certainly have the Minister’s ear and I will certainly be telling her,
Look, we need to put some money in adverti sing. Drill
it, constantly drill it. You have all seen the GEICO
commercials? The GEICO commercials are ever ywhere, right? I have got to give it to Warren Buffet, but
he keeps drilling. Everywhere you look it is GEICO —
everywhere. You know, Try GEICO and you get 15 per cent. So we cannot . . . we cannot advertise
enough in my humble opinion on eating right and ex-ercise.
Now, Madam Chairman, I just want to finish
on this note, and I touched on it earlier. We know that things are tight. But the Minister when she talked about getting a new ambulance because of the Amer1174 13 March 20 17 Official Hansard Report

Bermuda House of Assembly ica’s Cup, it hit a nerve with me. Now, I live up in the
West End and so do you. We have cruise ships coming to Bermuda more and more. We have (what?) 8,000 visitors per week up in Dockyard. I thi nk we
even had a death up in Dockyard last year or the year before. Right? And we have been calling for an ambu-lance up in the West [End].
I know down in the East End, my honourable
colleague over there from the East [End] will probably tell you that she has been hollering for an ambulance as well. But let me say this: If we can find money for that ambulance for America’s Cup, it should have long been found. It should have long been found because
not only do we have to worry about . . . we know that
30 seconds in terms of saving someone’s life is a
long, long time.
So if we can get the ambulance for the Amer ica’s Cup, I do not know where the Minister is going to put it, but I would think it has got to be up in the West
End, okay? We need to find out from the Minister if
the plan now is to keep it up in the West End. Now, I am probably going to fight with my Honourable Member from down in the East [End], the Honourable
Member Roberts -Holshouser, she will probably want
one down in the East End.
But let me just say that, Minister, I would rea lly like to know what the plan is for the ambulance dur-ing and after the America’s Cup. I hope, I hope that, you know, one of the other ambulances down at King Edward are not on their last legs and they say that this
will last them until July and then we will take that one,
we will trash it, and we will bring the new one in and
that is going to be the end of it. Let us keep that am-bulance up in the West End after America’s Cup.
Thank you.

Thank you, Member.
W ould anyone else like to speak to the
Heads?
Minister, you have the floor.
Hon. Jeanne J. Atherden: I must admit, I must say
that I have enjoyed sitting here. I have enjoyed it because I appreciate it when people have concerns about health because health is important. And so I
recognise . . . I think that I left the Opposition, I think,
almost two hours, and in my response I think they
have left me 25 . . . 20 minutes. Maybe 20 minutes?
[Inaudible interjection]
Hon. Jeanne J. Atherden: No, no, that is fine b ecause you have chosen to ask all your questions and then you have given me the 20 minutes in which to
respond to all of the questions.
And so it gives me the opportunity to look at
the things which I think the general public would want to know about and try and make sure that I get that
information out. So, I am going to start with something that I
said in my brief, but maybe it did not come across quite so well. This was when I was talking about the fact of the . . . finally that the care was starting to
bend, that finally the cost per person was starting to
go down. And someone raised the concern about if
we don’t start doing things whether the cost was just going to keep going up, et cetera. And because I mentioned this, and because it had come up in something
else, I am just going to refer you back to . . . I talked
about improving diagnostic imaging systems. And in
the course of discussing that I reminded everyone that the diagnostic imaging system that we have seen . . .
that in Bermuda it says . . . I said about this that CT
scans in Bermuda that are . . . we have a rate of being
tested higher than even in the US. So it said that in Bermuda we are tested more and, therefore, obvious-ly if you are tested more, that means you are spen ding more mone y on CT scans. And that means that if
you are going to talk about reducing costs, that you need to be turning around and . . . that is one of the
first things that you should be looking at.
And it also talked about the other concern,
which is that it is n ot just about the testing; it is about
the impact on you of the radiation and whatever. And I am saying that because later on at some point in time we are going to talk about which things you need to try and do if you are going to reduce the cost of health
care in Bermuda. So just remember, I am not going to discuss this any further, but just remember that if you
are going to bring the cost down, bringing it down
means that you have to stop using some things and you have to start doing something, which the Honourable Member talked about earlier, we have to now
start making . . . we have to change. Remember I said
about the Man in the Mirror ? Bermudians are some of
the people that have the biggest waists, we are obese, we have diabetes, and we have —

Hon. Zan e J. S. De Silva: Point of order, Madam
Chairman.
I think the Honourable Member is maybe mi stakenly misleading the House when she says that we
have to cut down on CT scans because, you know, we are using them too much. I totally disagree with that. I have a lot of faith in the doctors that we have in
Bermuda— whether it is CT, MRIs, labs, bloods, whatever—I have a lot of faith in the doctors that we have.
And you know what? There was once upon a time where our people did not have that available to them, it was only the wealthy. So now everybody can get to
use it. Anybody’s doctor can—

Okay, Member you can take your
seat. That is not a point of order.
Minister, you may proceed.

Hon. Jeanne J. Atherden: [Microphone turned off]



Bermuda House of Assembly The Chairman: Minister, could you turn your micr ophone on, please?

Hon. Jeanne J. Atherden: Pardon me.
There was some concern about the dementia
and Alzheimer’s. And I do not know whether people
remember because I did mention it when we were
talking about the Throne Speech. I did mention the
fact that we understood that it was important for us to start to address that, and that in the long- term care we
actually have some persons looking at that because we know that it is very important. And also, if I can look amongst all of these things that are here, we actually had some training, et cetera, that was done on
people for the Alzheimer’s. And yes, we very much appreciate what Carol Everson brought to Bermuda. And we are looking forward to, I think it is going to be in April or May, when we are going to have some more. So we have that.
And we are also, obviously, working on the
whole thing of ageing well in Bermuda. There is a long-term plan because it is very important for us to
address that. Leaving aside the fact that we are all getting there, we have friends, we have family, we
ourselves do not know whether we are going to be
one of those persons who are going to suffer from it and at the time it happens we probably still will not know. But we are working on that. So I just want to say to you that this is very high on our agenda and, therefore, it is being worked on with the long- term
plan.
I am going to now try and just quickly go
through some of the things that came up because I know that all of you, as I say, I know all of you are
very interested in all of this and I am just going to talk about the ambulance because that was the last thing.
And I do not know whether any of you remember
when we came and we amalgamated the ambulance cover with King Edward and the Fire Serv ices, so we
actually have something that, even without having to get the ambulances, we have somebody that is at the
East End, West End. So what I am trying to say to you
is we are trying to do more with less. Okay? So I am not going to get into the ambulance, et cetera. All I can say to you is that obviously as we go forward we are trying to make sure that we cover the areas and I would think that this is the important thing, to make
sure that we cover the areas.
With respect to Agape House, we can talk
about that afterwards.
In terms of the healthy eating, there was a
question about health promotions. And if you went to
[cost centre] 32240, Health Promotion, that is where
all of the education is in terms of telling people about
why you should eat healthily, telling people about what should happen with respect to . . . things that we
put out because, obviously, we have things like we have booklets that we put out, we have things on our website where people can go, we have fact sheets that come out. All of this stuff is being done, but the
budget is in the [cost centre] 32240, Health Prom otion.
With respect to . . . there was a question
about Alzheimer’s; I have dealt with that.

[Inaudible interjection]

Hon. Jeanne J. Atherden: There was a question
about health care expenditure . . . Well, we just talked
about it. I told you that this had started to . . . it is star ting to tail off. And as I just mentioned, obviously, the
costs are being driven by utilisation and so that is why
we are working on the areas in terms of trying to deal
with the utilisation, trying to deal with persons . . . and
the Shadow Minister raised something which I think I
will just quickly go to.
You talked about alternative types of medicine, et cetera. Some insurers do actually have that
covered and we are actually trying to make sure that
as we do the Allied Health, we are trying to get all of those individuals to be covered under that so at some point in time all of those alternate health professionals will be covered. When I say “covered,” they will be
regulated and then you can start talking about whet her the services that they offer are then covered. So
nobody is turning around and saying that these things are not useful. We are trying to turn around and in a systematic way trying to make sure that it is actually
addressed.
In terms of the mental health, it is very i mportant. We know that there are obviously concerns about the mental health. And when I mentioned this in terms of the forensic health and what we are doing, it is all des igned working with the Bermuda Hospitals (I
am trying to see them down there), working with them.
They have been taking the lead with us in terms of
trying to deal with the prisoners who . . . we were not
able to give them the proper care and we are trying to
take the lead on that. But they are also working with us in terms of how we make sure that, from the mental
health perspective, we start to deal with them more
effectively.
And I want to just remind everybody, reme mber the Mental Health Court? That was put together because there was the recognition that people are out there and if we are not trying . . . we do not want to
incarcerate them when sometimes we just need to turn around and help them get better. So all of these things are being addressed in a systematic way with
the hospital, with the Health Department, and I just want to say to you it is not like we do not understand the need. We are trying to make sure that need is a ddressed.
There was talk about competition with insurance companies. All I can say is when we start to have this whole discussion about that, the indications that we have are that to get . . . to be viable . . . you
start . . . you need mass . . . that you need something
1176 13 March 20 17 Official Hansard Report

Bermuda House of Assembly on the order of 100,000 people. Now, I always take
the position that if something has been raised, I am
prepared to look at it. And I know before I have had conversations with the current insurers because I do not believe that, with respect to the premiums that people make and the profits, we want . . . I do not
have . . . people have to have profits, but I have to
make sure that the profit is reasonable. So all I can say to you is that this is something that I believe that I will look at because, as I say, we obviously do not have 100,000 people in Bermuda.
And th e difficulty is that at one stage when we
had more people, when we had a workforce that had
more people in Bermuda and healthier people, we
actually had loss ratios which were better and we ac-tually had the distribution in terms of the cost per per-son . . . it was better. Now we have had all these
healthy people who used to not claim a lot on their insurance leave, so we have to now hope that we can
get . . . as the new people come to Bermuda and as
the jobs come, we can turn around and do something
along t hose lines.
But having said that, we are not just turning
around and not starting to do something with the people in Bermuda, so we are saying that we have to
make people healthier, which is why we are putting so much emphasis on wellness. We are putting empha-sis on people starting to change. I look around and I see . . . when I thought about that change thing, I am
in that category. I am in that category of people who
are those . . . I have my special person’s card. So I
am part of that population that is ageing.
I am part of that population that has medic ation. I am part of that population that has to look at my
plate and make sure that I eat less. I am part of that population that needs to turn around and look at ev erything that it says from the point of view of hypertension, diabetes, heart attacks. And I am saying to all of us in this room that it is not just about the education; it is about people doing things —people doing things.
And if we want to do something with this money, we
have to do things with our families, we have to do
things at the hospital.
So that transitions me to this thing about the
ageing. I have brought people on; we are looking at this whole question of what we can do with respect to the facilities. You do not want Government to go and
build any more facilities because if Government is paying for it, it is going to result in more taxes and everything to cover it. So as we said in our Throne Speech, we are now trying to look at what we can do to make it more financially viable for the private sector
to build some of these things. But in order for them to
build them we have to make sure that they know what
needs to be built. So that is why the long- term care
plan is out there looking at how many people are age-ing, what types of people are . . . needing [help because of] dementia, what is the percentage? And on top of that, as I said in my brief, we
have been working with the hospital to say, Okay, hospital, if you’ve got people in the ACW this is an appropriate amount for you to charge. But if you have
people that do not need the extensive intensive care, let us come up with another amount that you should charge for something stepped down. They are wor king with us because that means that we can then r educe the cost of the care.
We are also looking at going back to what I
call . . . I view care as like the five stages: ACW, which
is really intensive; the next level down, which is sort of intermediate; staying at home is the really minimum
care; and in between is something else which is
something on the order of the rest homes and the
nursing homes; and then something that is assisted living. And if we can go ahead and start to get that where people can see that insurance can cover it, and we are definitely looking at that, then it means it becomes sustainable because you want people to be able to turn around and make it sustainable.
I said two things in here and I do not know
whether it was lost in my reading. We talked about the Enhanced Care Pilot and we talked about the Patient -
Centred Home. Those are two things which are de-signed to take people away from going to the Emer-gency Department. They are designed to sort of, on
the one hand to say to people, You don’t need to go to
the Emergency if you have issues, you can go down here and you can have somebody look at . . . you
know, whether you are feeling faint, you can have someone dealing with your blood pressure and what-ever else. So that is the hospital’s way of trying to do
something.
The Health Department is also . . . and the
other thin g, which is the Enhanced Care Pilot which
says, You will then be able to go to your doctor and
have your chronic diseases case managed. Because
if you have . . . if you go there and you stay on top of
your meds and do whatever else, you do not suddenly turn around and end up in the Emergency because
you have not taken your medicine and you have not done whatever . . . these things. So we are pulling all
of these levers because we know that . . . we hear
you, we hear the people out there, and we are trying to turn around and roll it back and try and dial this
back down.
So, all I am saying to you —and, as I said, I
appreciate all the Members across the aisle. I know you are asking these questions because you believe that it is important for us to do something. So, let me
just see in terms of the community care that was asked—
[Inaudible interjections]
Hon. Jeanne J. Atherden: There was also, with r espect to talking about the hospital, as we go forward
we obviously are working with the hospital to make


Bermuda House of Assembly sure that services are rendered down there and make
sure that no one is turned away. So, that is something
continues to be . . . so, the hospital will continue to
render the services. We will continue to keep track of who comes there because it is very important for us to know who comes there and to be able to turn around and determine the level of services.
With respect to . . . as I said, the hospital, we
will—there was also a concern about maintenance with respect to buildings. We obviously, you know, we have . . . the Health Department, by and large, other
than Syl via Richardson and Lefroy House, are in rented premises so we have some small monies in there
that will take care of repairs and maintenance.
Let us see, okay, that was day care. I n terms
of the regulations, obviously, we have things that are
with our drafters, as I told you, we have things that we are looking at with respect to the nursing homes and the rest homes and also with respect to the abuse
because we recognise that the legislation, the leg islation is not allowing us to do the things that we want.
So, that is why we have persons helping us draft the legislation changes with respect to the office of the public guardian and I think there was a suggestion
about persons . . . the Shadow Minister talked about,
you know, if someone did not take care of their senior
what could be done now. These types of things are being looked at in terms of anything that we can do because we know that seniors sometimes have r esources whether they be property , homes, or whatever else, we are going to obviously do something to make sure that there can be renovations done to that, that if a senior can get some money but at the same time make sure that it is done in a way so that it is not abused . Those things are actually in train.
The mental health service . . . the technical
people . . . when I talked about the budget for BHB,
they indicated that they are working on things with respect to the clinical services for the persons that have mental health illnesses because BHB has to lead for us and we work with them. And I do not know,
and I have to say this because we have to recognise
that it is sort of a triumvirate in the sense that you have the Ministry, you have BHB , and you have the
Health Council , and we all try and make sure that they
lead on something and we work along with them. So BHB is obviously doing a lot of the clinical side, the
Department of Health is obviously doing lots of things
with respect to community , and you have the Health
Council trying to make sure that from the point of view of regulations and how everything is supposed to work and making sure that we keep track of the money that was spent and have the comparisons with other places because that is the best way for us to understand
whether we are getting the value for money . . . what
we have to dial back.
I am just trying to think . . . I will then make
sure if there was anything else. Okay, let us see, oh,
yes, the health education. This is used for free birth clinics [sic]. Remember there was $5,000 . . . it was a
question of health education, what is it for? This is for
free birth clinics [sic]—free birth classes, sorry, free
birth classes. I am trying to read this . . . okay we have
talked about dementia.
I n terms of dementia, also, BHB has a gerontologist, Dr. Myint, and she works with the psychiatrist in looking at appropriate care for the long- term. But
that gets back to what I said about this long- term care
plan. We have this dynamic team which is made of
people from the hospital, people from outside, people from age concern, and they have established these long-term care goals which I would invite persons , and
maybe I will distribute some of these things later on in terms of showing the long- term clear action plan. We
had a symposium just in November, December where people got together and talked about what we are d oing. It is all there and I appreciate you asking the questions and I do not mind you continuing to ask
more questions.
In the meantime, all I can say to you is that we
have tried to look at all of the areas —and I think there
was a suggestion about whether we should say to
people, in terms of the youth, whether we should turn
around and say do not have Youth subsidy cover that.
I must say to you I thought about that. And when I
thought about doing that , the answer is to me . . . well,
if you do that then the public will have to reach into
their pocket s and that means the cost of their prem iums go up because right now anything that Gover nment pays for as a subsidy is actually a reduction in
the claims experience for the private sector. So, all I am saying is that we continue to look at ways , but I
think the most important thing that we have in train is what I call the “ health system financing reform. ” We
are looking at —that is something which is being actively discussed in terms of everybody’s money going into the pot so that you do not have insurance, (a) making a profit like a loss ratio of 90 percent and
somebody a 100 [per cent] and then the Government
having a loss ratio of over 100 [per cent] which means
that we are taking the loss. So that is something—the
health system financing reform is actively under r eview and I am pressing them to say that I need that as soon as I can because I know that this is part of ma king sure that if we can eve r get towards the universal
coverage then that is what we want.
I will try and make sure that periodically I bring
forward s ome more statements because that is the
way to make sure that not only the House but the people of Bermuda stay informed, and I know that it is
important to you. Very shortly you will see me coming to this House to talk about the premiums and we have
some good news. But I have to make sure that I bring
them here appropriately and, so, I just want to say to you that w ith respect to this budget I have understood—the Minster and I have worked together to make sure that, you know, we have been able to do something with the budget and to make sure that the
1178 13 March 20 17 Official Hansard Report

Bermuda House of Assembly funds that I have available to me have been utilised in
a way to make sure that the people of Bermuda, the
seniors and the staff . . . and I am very appreciative of
BHB because they have worked together with us and made sure that some of the changes —and I would be
remiss without saying that some of the changes have been . . . some of the accumulation has been because
they have gone back and looked internally and, sorry, the Shadow, sorry, the Member here who unfortunat ely pops in and then he does not . . . he is not around
to hear, he would remember, he would remember, and we talked about —

[Inaudible interjection]

Hon. Jeanne J. Atherden: No, no, I am —

It has been moved that the Commi ttee rise, report progress and ask for leave to sit again. Is there any objection to that motion?
No objection.
Agreed to.

[Gavel]
[Motion carried: The Committee of Supply agreed to
rise and report progress, and sought leave to sit
again.]

House resumed at 8:11 pm

[Hon. K. H. Randolph Horton, Speaker, in the Chair]

REPORT OF COMMITTEE

ESTIMATES OF REVENUE AND EXPENDITURE
FOR THE YEAR 2017/18

Thank you, Mr.
Speaker.
I am pleased to introduce the Bill entitled the
Registrar of Companies (Compliance Measures) Act


Bermuda House of Assembly 2017 which seeks to increase the Registrar of Companies monitoring and enforcement powers in respect
of registered entities that operate in and from within Bermuda in order to protect Bermuda’s overall OECD (and that is, as Honourable Members would know, the Organisation for Economic Cooperation and Development), the OECD rating which is currently a favourable “ largely compliant ”.
Mr. Speaker, as Honourable Members will be
aware, the OECD is a monitoring group whose stated
goals include fostering economic development and cooperation. The OECD maintains a blacklist of coun-tries it considers uncooperative in the drive for transparency in tax affairs and the effective exchange of
information.
Mr. Speaker, by way of background, members
of the OECD assessment team visited Bermuda in
early December of 2016 and conducted what is known as a peer review of Bermuda’s legal and tax system,
financial sector, as well as legislation governing legal
entities and legal arrangements regarding exchange of information requests. The assessm ent team made
several recommendations, one of which was to en-hance the powers of the Registrar of Companies to
allow him to conduct proactive inspection of Berm uda’s registered entities in order to ensure that such
entities are fully compliant with the requirements of their governing legislation. Mr. Speaker, Bermuda is globally respected
for its leadership and proven record for compliance
and transparency. Until now, the Registrar of Companies has been primarily a depository for Bermuda reg-istered entities. However, its role must evolve to be-come more of a regulatory body to keep in step with an ever -changing global regulatory environment.
So, accordingly, this Bill seeks to confer powers on the Registrar of Companies to monitor, inspect, enforce, and otherwise regulate Bermuda registered
entities to ensure compliance with their governing leg-islation. At present, Bermuda registered entities are required to maintain books and papers which include
financial statements, accounts, records of account,
deeds , and minutes. However, with the proposed
amendments in the Bill, they will now be required to produce such documents at the request of the Regis-trar. The Registrar will be able to enter and inspect the premises of a registered entity as well as inspect, take
copies of or make extracts of any recorded information found on those premises. The Registrar will also be able to ask for an explanation of any recorded information or where requested documents may be found.
Mr. Speaker, these powers are accompanied
by compliance measures. Registered entities that are
in default will be subject to a minimum default fine per day of $100 that will not exceed $500 for every day that the default continues. Failure to comply with any requirements or contravention of any proh ibition by or under this Bill or the Act that governs the registered
entity may result in a penalty of up to $250,000.
Mr. Speaker, natural justice rights are embedded in this Bill as the Registrar must give notice to a
registered entity or other person affiliated with a regi stered entity to comply and also afford them the oppor-tunity to be heard. Likewise, if the Registrar decides to
impose a penalty on a registered entity or person, n otice must be given along with the opportunity for the
registered entity or person to make representations. The Registrar must give reasons for his decisions fol-lowing any representation made to him. There is a right of appeal to the Supreme Court of the Registrar’s
decision regarding default fines and civil penalties.
Mr. Speaker, other protections in this Bill i nclude offences for disclosing information that is gat hered in the course of the Registrar’s inspection. These
protections strike a balance in Bermuda’s ability to maintain its favourable rating with the OECD and the
interest of the registered entities.
In closing, Mr. Speaker, I would like to thank
the Registrar of Companies, the Attorney General’s
Chambers, the Treaty’s Unit of the Ministry of F inance, the Bermuda Monetary Authority , and the N ational Anti- Money Laundering Committee for their i nvaluable assistance in the formulation of policy and the speedy drafting of this legislation.
Thank you, Mr. Speaker.

—MP Wayne Furbert.

Hon. Wayne L. Furbert: Mr. Speaker, I would like to
thank the Minister first of all for giving me his brief ,
and as far as we are concerned this is straight forward.
The compliance, again, are some steps that have to
be taken. We understand we live in a world nowadays
where certain entities around the world require us, particularly as a small jurisdiction, to put these in place, and the OECD is one of them. And so we are
here to basically put this compliance in place and we
support the Bill.
Thank you.

Thank you, Mr.
Speaker.
Mr. Speaker, I thank the Honourable Member
for his support. He is right, it is quite straight forward
1180 13 March 20 17 Official Hansard Report

Bermuda House of Assembly and it is simply a matter of Bermuda making sure it is
in compliance with what is seen to be required of us
by sup ranational regulators like the OECD and others.
Mr. Speaker, I move that the Bill be commi tted.

Thank you, Madam
Chairman.
Clause 1 provides that this Bill shall be cited
as the Registrar of Companies (Compliance
Measures) Act 2017.
Clause 2 provides definition of terms that appear within the legislation to aid in the interpretation of
the provisions of the Act.
Clauses 3 through 9 of the Bill set out the
scope of the Registrar’s powers and function as follows:
The Registrar has the power to regulate and
inspect registered entities for purposes of ensuring that such entities comply with the provisions of this Act and the relevant statute pursuant to which they are registered. Registered entities to which this Bill applies are in the Schedule at the end of the clauses, in Schedule 1. The functions of the Registrar with respect to
inspection of registered entities are spelled out. They include encouraging and ensuring compliance with the Bill, the power to inspect registered entities, powers of inves tigation and enforcement to ensure compliance.
The Registrar also has the ability to delegate
his functions.
The Registrar has the power to require information and documents for purposes of the perfor-mance of his functions as well as requiring assistance from the registered entity in respect of obtaining the requested information and documents.
The Registrar also has the power to conduct
inspections by way of site visits and in the case of failure to comply with an obligation under this Bill or the relevant Act, the Registrar may give written notice to a registered entity to remedy the noncompliance failing which the Registrar may exercise his enforc ement powers which includes imposing a civil penalty.
Part 3, which are clauses 10 through 13, pr ovide for compliance measures. So, where a registered
entity is in default, a minimum daily fine of $100 up to a maximum of $500 can be levied. Failure to comply with any requirement or contravention of a prohibition
under this or relevant Act can result in a civil penalty
not exceeding $250,000 as the Registrar considers
appropriate by having regard to the procedures laid out in respect of civil penalties. In the case of a con-viction, neither the default fine nor the civil penalty provisions I just mentioned may be invoked.
Clauses 14 through 21 are essentially miscellaneous and commencement. They provide that the Bill creates offences relating to making false or mi sleading statements, as well as obstructing the Regi strar in the performance of his duties under this or a
relevant Act. There is a right of appeal to the Supreme
Court against the Registrar’s decision regarding default fines or civil penalties. The Bill also allows for regulations to be made in respect of fees for any func-tion performed by the Registrar under this Bill or by the Minister under a relevant Act unless a fee with
respect to that function is already prescribed.
The Bill also protects the confidentiality of information which may come to the Registrar in the performance of his duties, and the Registrar and others acting on his behalf, providing such persons are ac ting in good faith in the performance of their duties, are
immune from local and foreign lawsuits.
There is a provision for consequential
amendments as well as a savings and transiti onal
matters provision. The Bill will come into operation on
being gazetted.
Thank you, Madam Chairman.

Thank you. Are there any Members
that would like to speak to clauses 1 through 21? The
Chair recognises the Member from constituency 6.



Bermuda House of Assembly Hon. Wayne L. Furbert: Thank you, Madam Chai rman.
Again, these clauses are straightforward. I
want to ask the Minister a few questions. Will the Re gistrar require further staffing to make sure that this Act is complied with?
Also, are we sure that nothi ng in this Act co nflicts with the Companies Act of 1981 (I think it is)? And, also, I saw the fines . . . at first I thought the fines
were kind of low. But I saw where it is charged every day provided . . . as long as the default is there. This
is Part 3, [clause] 10, Default Fines.
Again, is that something . . . how did we come
up with these fines? Is it something we just pulled out of the hat or is this something that we can refer to that other jurisdictions —and also have we compared this
with other jur isdictions . . . and what other jurisdiction
would that be?
Thank you.

Thank you, Madam
Chairman.
Let me work through the questions from the
Honourable Member. First of all, with respect to staf fing, the answer is yes. The Registrar will require add itional staff in order to be able to create a compliance function. Right now it looks like that will start with
three but up to five additional bodies may be required
to be able to do that, and if we had debated the Regi strar of Companies Head on Friday, that is actually
budgeted in this particular year’s, 2017/18, budget.
In regard to conflict with the Companies Act,
no, this works hand in glove with the Companies Act
and this provides additional authorisation for the Registrar to proactively go in and make sure that compa-nies are essentially abiding by their requirements un-der the Companies Act to keep books and papers, to have financial statements and et cet era, et cetera. So,
that is in there as well, and I think the Honourable Member will be aware that there are already prov isions in the Companies Act for default fines. They tend to be a little lower because they are historical. But when this particular inspection Compliance Measures Act is invoked then the fines that are in this
particular Bill, this Act, take place. So, these will occur
if there is an onsite inspection or if the Registrar needs to do an inspection of some sort where it r equires information and someone is in default, then this
Act will apply once it is, obviously, approved.
With respect to the degree of default fines, I
think because the default fines are here, once a pro blem has been identified on the basis of an inspection or request for information, then they are slightly higher than those in the Companies Act, and I think we are not going to be out of sync with other jurisdictions be-cause everybody is sort of required to do this. The issue I think the OECD has recognised—
or I should say has imposed upon us —is the issue —
not only do you have provisions in your Companies Act and other legislation to require companies to keep records and that sort of thing, but the question is, is it effective, and the only way to know if it is effective is,
if it is actually —there is somebody who is actively out
there inspecting it and that is the purpose of this Compliance Measures Act to make sure that people are doing what they are required to do under the Act and therefore the Act is effective because somebody is keeping an eye out for it.
I hope that answers the questions.

Thank you. Are there any other
Members that would like to speak to clauses 1
through 21?
The Chair recognises the Member from constituency 6.

Hon. Wayne L. Furbert: Yes, thank you, Madam
Chairman, again. I had asked the Minister whether
does our Act follow any particular jurisdiction that we
may be familiar with. But you also mentioned and
caught my attention when you mentioned that there is
an increase of staff of about five. But in the budget, there is no increase in staff. And I think you should look at B -336, it says 18 last year and 18 this year —
unless it is somewhere else in another department of which I am not aware of —Registrar of Companies.
Thank you.

The C hairman: Thank you. The Chair recognises the
Minister.

Thank you, Madam
Chairman.
I am pretty sure that the money is actually
budgeted in there. I cannot tell you exactly where it is
off the top of my head, but since this is a relatively
recent provision because of the legislation it may not
have slipped in from a numbers perspective. It may also be, and sometimes this happens . . . there are
essentially staff which are unfilled so they may be working it out that way. But I do not know off the top of my head.

It has been moved that the Bill be
reported to the House as printed.
Any objections to that motion?
No objections.
Agreed to.
[Gavel]
[Motion carried: The Registrar of Companies (Compl iance Measures) Act 2017 was considered by a Committee of the whole House and passed without
amendment.]

House resumed at 8:31 pm

[Hon. K. H. Randolph Horton, Speaker, in the Chair]

REPORT OF COMMITTEE

REGISTRAR OF COMPANI ES (COMPLIANCE
MEASURES) ACT 2017

Honour able Members, the second
reading of the Registrar of Companies (Compliance
Measures) Act 2017 has been approved.
We move now to Order No. 6 which is the
Miscellaneous Taxes Amendment Act 2017 in the
name of the Minister of Finance. So the Chair will rec-ognise the Minister of Finance.

Hon. E. T. (Bob) Richards: Thank you, Mr. Speaker.
Mr. Speaker, I move that the Bill entitled the
Miscellaneous Taxes Amendment Act 2017 which has
been recommended by the Governor be now read a second time.



Bermuda House of Assembly The Speaker: Thank you. Are there any objections to
that?
Please carry on.

BILL

SECOND READING

MISCELLANEOUS TAXES AMENDMENT ACT 2017

Hon. E. T. (Bob) Richards: Thank you, Mr. Speaker.
Mr. Speaker, the Bill before the Honourable
House this evening seeks to amend the Miscellan eous Taxes Act 1978[sic] to extend the relief of passenger cabin tax in respect of smaller passenger
ships docking in the City of Hamilton and the Town of St. George from 31 March 2015 until 31 March 2023.
Mr. Speaker, the Ministry of Tourism,
Transport and Municipalities has been diligently wor king with the Bermuda Tourism Authority to increase the number of cruise ship calls to Hamilton and St. George’s by attracting smaller luxury cruise ships. Historically, the key incentive for enticing the smaller
cruise ships has been the waiving of the passenger cabin tax in respect of any date.
Mr. Speaker, extending the date to 2023 is
important to make good the intent made by the Minis-try responsible for Transport to attract and secure these smaller, premium brand cruise ships. Due to the
contract with the Norwegian Cruise Lines [NCL], Bermuda will see a minimum of twelve NCL branded cruise ship calls each year to the Town of St. George’s between 2017 and 2022. This is NCL’s commitment to help revitalise the old town.
Mr. Speaker, in 2017, Bermuda will enjoy a
total of 26 cruise calls to the City of Hamilton and 16 calls to the Town of St. George’s to include Holland
America Lines Veendam, Fred Olsen lines Boudicca ,
Norwegian Cruise Lines Seven Seas Navigator , the
Sirena and the Insignia . These ships would not ord inarily have made this commitment to Hamilton and St.
George’s without this incentive for passenger cabin tax relief. Thank you, Mr. Speaker. With that, I will invite
Honourable Members to comment and debate.
Thank you.

Members, we are now in Committee—sorry about the voice —we are now in Committee
of the whole [House] for further consideration of the
Bill entitled Miscellaneous Taxes Amendment Act
2017 .
I call on the Minister in charge to proceed.
Minister, you have the floor.

Hon. E. T. (B ob) Richards: Thank you, Madam
Chairman.
Madam Chairman, I think we have three
clauses ; I move all three clauses.

Are there any objections to the m otion to move clauses 1 through 3?
No? Minister, please proceed.

Hon. E. T. (Bob) Richards: Thank you, Madam
Chairman.
Clause 1 of this Act is the citation of the Bill.
Clause 2 amends section 32A of the Miscell aneous Taxes Act 1976 to extend the exemption from
passenger cabin tax in respect of passenger ships
docking at the City of Hamilton or at the Town of St.
George’s . The exemption was first introduced in 2009
for three years, and was continued into 2012 for a fur-ther three years until 31 March 2015. The amendment at hand extends the exemption by deleting 31 March
2015 and substituting 31 March 2023.
Clause 3 is the retrospective commencement
to come into effect on the 31
st of March 2015.
Those are all the clauses, Madam Chairman.

Thank you. Are there any Members
that would like to speak to c lauses 1 through 3?
The Chair recognises the Opposition Leader.
You have the floor.
Hon. E. David Burt: I will keep it very quick as this is
something that has been carried on by the previous Government. We have no objection.
1184 13 March 20 17 Official Hansard Report

Bermuda House of Assembly The Chairman: Thank you, Member.
The Chair now recognises the Minister.

Hon. E. T. (Bob) Richards: Thank you, Madam
Chairman.
In that respect, I would like to move all three
clauses.

It has been moved that the Bill be
reported to the House as printed. Any objection to that
motion? No objecti ons.
Agreed to.

[Gavel]
[Motion carried: The Miscellaneous Taxes Amend-ment Act 2017 was considered by a Committee of the
whole House and passed without amendment.]

House resumed at 8:38 pm

[Hon. K. H. Randolph Horton, Speaker, in the Chair]

REPORT OF COMMITTEE

MISCELLANEOUS TAXES AMENDMENT ACT 2017

Thank you, Members. The second
reading of the Miscellaneous Taxes Amendment Act
2017 has been approved as printed.
Order No. 7 I believe is carried over. And we
move now to Order No. 8 in the name of the Minister
of Finance.
REGULATION S

GOVERNMENT FEES AMENDMENT
REGULATIONS 2017

Hon. E. T. (Bob) Richards: Thank you, Mr. Speaker.
Mr. Speaker, I would like to move the Government Fees Amendment Regulations 2017 with the
Governor’s recommendation in accordance with section 36(3) of the Bermuda Constitution. I would like to move that consideration be given to draft regulations entitled the Government Fees Amendment Regulations 2017 proposed to be made by the Minister r esponsible for Finance under the provision of section 2
of the Government Fees Act 1965.

Thank you. Any objections?
Carry on, pl ease.
Hon. E. T. (Bob) Richards: Mr. Speaker, so I move
that these regulations be now read a second time.
Mr. Speaker, by way of standing policy, Go vernment reviews the fees on a regular basis to ensure
that there is a reasonable cost recovery for provisi on
of various services offered by a range of Government departments. Accordingly, a biennial review of Government fees is conducted with the last review being 2016. On occasions, there is a need to amend fees based on justifying situations in between the r eview
period. The Government Fees Amendment Regul ations 2017 represents an amendment in these respec-tive fees. The fee increases are as follows:

HEAD 6 —BERMUDA IMMIGRATION AND PROTECTION ACT 1956

Hon. E. T. (Bob) Richards: There are two new fees
being introduced under Head 6.
1. Paragraph (6)(c) provides for not -for-profit
organisations to pay a lesser fee of $104 for a work permit where the services are being provided free of
charge and for the direct benefit of the Government.
Paragraph (6)(b) limits the payment for the lesser fee by not -for-profit organisations to coaches, teachers of
sports and recreation, clergy, speakers, and mus icians. However, where the not -for-profit organisation
is bringing in other categories of specialists to perform
a function that will directly benefit the Bermuda Government and the general public, then the organisation must pay the full work permit. Paragraph (6)(c) pr ovides the option in such cases to pay the lesser fee of $104. One example of this type of scenario relates to
the work to upgrade the Bermuda Railway Trail. The
registered charity, Friends of the Bermuda Railway Trail, have partnered with the Ministry of Public Works to open the Bailey’s Bay walkway bridge and are working on upgrading other segments of the Railway
Trail. This charity would benefit from the introduction


Bermuda House of Assembly of this fee to bring technical persons to assist with this
project. So that was one, Mr. Speaker .
2. Paragraph (6)(a) provides for an employer
to submit a request for a fee of $14 to obtain a refund
if the employee does not arrive in Bermuda or if satisfactory evidence is provided that the employee never commenced employment. Currently refunds are only
granted if: (1) the work permit is refused or the appl ication is returned because it is incomplete; or, (2) a
lesser period is granted by the department than was
requested; or (3) the work permit is cancelled prior to
a decision being made. This new request will now al-low the employer to obtain a refund if the work permit
is never used.

HEAD 35A —LIMITED LI ABILITY COMPANY
ACT 2016
Hon. E. T. (Bob) Richards: Mr. Speaker, several
amendments are being made to Head 35A in order to
provide clarity and to make minor corrections to the schedule.
Head 35A includes the fees which are appl icable to limited liability companies, otherwise knows
and LLCs. Honourable Member s will recall that this
new structure was introduced into law in Bermuda
pursuant to the Limited Liability Company Act 2016. There are no increases in any fees with this amend-ment, just clarifications and minor corrections to a few
errors in the text of the fee schedule.
So, Mr. Speaker, as there is no Committee
with regulations, I will just go through these in a bit more detail.
Mr. Speaker, clause 3 makes amendments to
Head 35A which relates to fees for limited liability companies. Specifically, paragraphs 1 and 2 of Head
35 are being amended. Firstly, to clarify that the $305
currently shown in paragraph 2 is the applicable fee for an application for the consent of the Bermuda Monetary Authority to form an LLC and, secondly, to
clarify that the $90 fee currently shown in paragraph 1
is applicable for filing an initial certificate of formation with the Registrar as well as to reserve or change the name of the LLC.
Paragraph (4)(h) is being amended to correct
a typographical error so that the reference to “fee” now reads “a fee.”
Paragraph 21 is being amended to delete the
reference to any consent to the Authority and to in-stead make the fee more broadly applicable to doc uments filed with the Registrar and for which a fee is not specifically prescribed.
And, finally, paragraph 28 is being revised to
clarify that the fee is only applicable to maintaining and updating the Register of Managers in accordance with section 59 of the LLC Act.
Those are all the matters that relate to this
Bill, Mr. Speaker .

All right, thank you, Minister. Any other
Honourable Member care to speak?
The Chair will recognise the Leader of the
Opposition, the Shadow Minister of Finance.

Hon. E. David Burt: Thank you very much, Mr.
Speaker, and I thank the Minister for his brief. Unlike
the Honourable Minister of Economic Development,
he did not share it, but it is no big deal because it is relatively simple and straightforward.

[Inaudible interjection]

Hon. E. David Burt: No, I got that one. I am okay.
Long story short, Mr. Speaker, that there are
no objections to these minor changes. We support the
revisions for the reduction of fees for the charitable purposes, without question, and the typos to amend the Limited Liability Companies Act —which I guess a
few things missed us in Committee and, more i mportantly, seems to have missed a certain Independ-ent Senator in another place who seems to pick up every typo.
So, with that, Mr. Speaker, there are no objections.

The Chair will now recognise the Minister for Finance, Minister Richards.

SUSPENSION OF STANDING ORDER 21
Hon. E. T. (Bob) Richards: Thank you, Mr. Speaker.
Mr. Speaker, I move that Standing Order 21
be suspended to enable me to move that the Bill [ent itled] the Miscellaneous Taxes Amendment Act 2017 be now read the third time by its title only.

Mr. Speaker, I rise on a point of
some concern . . . concern for the House and respect
for the House, and what should perhaps happen, in
our view on this side, when it comes to important matters pertaining to this country.
Today we have obviously had the Budget D ebate and some other matters dealt with . . . all are i mportant, but earlier today . . . and I am not looking to delve into the area of going back to a previous debate, but today we had an announcement of some serious significance (during a previous debate) and it had to
do with the public release of an inquiry report.
Now, for us this was puzzling, Mr. Speaker .
Normally, matters of this significance, we would have
thought, would have been presented to the public or certainly to the Legislature by a Ministerial Statement or a statement from the Minister responsible, who just
happens to be the Premier. But we did not get pr esented with that today. It was almost as if by a flipping
of the tongue we heard about the announcement of an
important inquiry report. And we raise this because of a couple of reasons, Mr. Speaker. One, those are very
serious matters when you have inquiries, when a
commission is conven ed to review a particular matter.
These are not things that happen very often in either the history of a country of our size or when it comes to matters concerning Government. The very ability for this inquiry to even be
called, Mr. Speaker, is because of amendments pr esented in this Legislature, in an Act that actually pre-exists the democracy of this country. The Act that ac-tually governs inquiries goes back before 1968. So, not only that but this was an inquiry of some serious political significance. O ne, it was convened by the
Premier which is, perhaps, the first of that type to be
done. Two, Mr. Speaker, it was pertaining to matters
of the Government coming out of an auditor’s report and certainly it raised certain attention to key figures who were in volved with the governance of this cou nBermuda House of Assembly try—not only civil servants, but former Ministers, senior civil servants.
Persons were called in front of this inquiry and
it was a public inquiry. So, the public got to see the
deliberations. All very unique and his torical occu rrences . . . but this House was not given the courtesy
of receiving the report. We were told it was online on
www.gov.bm . That is how this House received the
public pronouncement of this very important inquiry
report —a very historical report, a very important report
to the governance of this country.
Implications on individuals will come out of
this report. Perhaps changes to how we govern will
come out of this report. But it does not seem to have
been treated with respect to this Legislature. And I
cannot help, Mr. Speaker, but wonder . . . and this is a
question, Was the Premier afraid to bring this as part of a Ministerial Statement to be presented with ques-tions possibly from Members of this House around it ?
It clearly was a very controversial inquiry. But why was the House not (in our view) respected with it being presented to this House officially? We ask the ques-tion, Is there some fear in doing so?
But, Mr. Speaker, I say again because it
seems as if this is a pattern that we have been con-fronted with when it comes to Parliamentary Ques-tions —answers not given satisfactorily, even when it
comes to requests from committees of this Legisl ature—a seeming unwillingness to disclose or to act on requests from committees of this Legislature which
are enshrined in legislation, efforts to bob and weave
. . . statements that are often seen as having misled
the House. This is some of the history we have seen over the past four years. So we have to wonder, Is there some fear in the Government, by the Premier, why that did not happen and why we were only confronted with an Internet address for perhaps one of
the most historic inquiry reports this country has had? We have to wonder. It does not seem as if there is a respect for the processes of this Legislature.
And I put it as a question. I am not going to
accuse the Government of not respecting because they should have opportunity to answer the question. Presenting an accusation, I think, would be perhaps a bit much. But I present the question. Is there fear in this Government with being transparent, with open, with an inquiry they seem to take glee in calling and
putting the report on this Table? Are there things in
that report that perhaps they are not happy with or are not proud of? So, we think this Legislature deserves an a nswer, Mr. Speaker , on this very important point. The
continuous pattern of misleading, the continuous pattern of unwillingness to answer questions properly, the
unwillingness to be open or to respect the Legislature in all different w ays from this Government. That is the
question we ask and we hope that an answer can be given of some sort, Mr. Speaker.
REPORTED ABUSE OF WORKERS BY DIGICEL

Mr. Speaker, the other matter I
will raise only briefly is that in the last couple of days
we have heard reports concerning a local company
that has employed overseas workers bringing them to Bermuda to do certain work in the area of telecomm unications. Digicel is the company, I believe. And over the last 24 hours there have been reports about a pparently unwillingness to pay workers —not just once
but twice. These are workers from a country called Guatemala in Central America brought here to do work, presumably that they had the skills to c omplete,
and it appears to be work that is extremely important to the operation of that company in this country.
But there is one thing that the Progressive
Labour Party does not tolerate or like, Mr. Speaker,
and that is the abuse of workers —whether they be
local workers, Mr. Speaker, or whether they are wor kers who have been invited here to carry out work by any firm. We believe that such behaviour should not be tolerated, that companies that are found to have been abusing workers —whether they be local or nonBermudian workers —should face the full extent of the
law.
These reports are disturbing to us. I am sure
they are disturbing to many members of the public and I do not doubt that they are disturbing to Members of the Government. We hope that the Gover nment
takes swift action to discover what the truth is and to
act in the best interest of those workers who may potentially have found themselves abused by this com-pany, if the reports in the media are true. Any compa-ny that abuses workers in this country should not be treated as a company of good favour or a good corpo-rate citizen, if it is discovered to be true. No worker
should be abused in any way —denied benefits, denied payment, to working conditions that are not safe
or to not be provided with the appropriate obligations
that they have been contracted to be provided to by their respective employer. Intolerable! And we hope
that the Government acts swiftly to address what has
been reported, Mr. Speaker . I do not doubt that the
Government is as concerned about this as we are by
those reports. So, we look forward to hearing about reports about the actions taken against Digicel, Mr. Speaker .
It has also been reported to us, Mr. Speaker,
that Bermudian workers are not being paid at the air-port, L. F. Wade International. Again, a lot of change is happening with the airport, Mr. Speaker . We just
hope that in light of what has already been done t owards the airport that we are not going down a road of
serious misadventure any more than this side believes
we have already gone, and that Bermudian workers at
L. F. Wade are now finding themselves in a serious position of disadvantage in whatever way. Again, we call on the Government to investigate these issues and to swiftly act to protect the interests of workers
1188 13 March 20 17 Official Hansard Report
Berm uda House of Assembly whether they are Bermudian workers or nonBermudian workers.
Thank you, Mr. Speaker .

Fifteen.
COMMISSION OF INQUIRY REPORT
Hon
. Wayne L. Furbert: Constituency 15, reminds
me of what I wanted to say earlier. I was shocked this morning while sitting there in the back room and hear-ing about the situation in regard to having to go to the website and look for the Commission of Inquiry . . . I
mean that is an insult on this Parliament and, of
course you, Mr. Speaker , because at the end of the
day, it was this Honourable House that passed the
amendment. It was this Honourable House that gave
the funding for it, and then the Honourable Premier asked us to go back and read this commission [report] online.
A lot of Members on this side, I am not sure
all of them, but some of them, like hard copies as you are probably aware. But it is absolutely wrong. It is absolutely wrong and the Premier needs to give an answer why he decided to just float it over the air like that instead of bringing it and possibly even having a
debate on the Commission’s report itself to ask some
questions. But it is wrong, and so I will ask the Pre mier to give us an answer for that.
But I would also to ask . . . and the Minister,
the Attorney General (who is out of these Chambers)
said earlier, as we are aware, that they spent some
$400,000 on this case in Boston. And we are aware also that they are floating civil actions around here in Bermuda, particular on some colleagues from this side. And I will ask the Attorney General is he plan-ning to also do a civil case against the Senator Victor
Ball who was also included in the Commission of I nquiry —similar situations? I have not heard whether
the Minister or the Premier is going to take such action, but it is clear that based on the report that there were some clear conflicts by the Senator Vic Ball.
As a matter of fact, they have asked that the
police to look at this. So, I am just asking whether now that everything is out in the open whether the Attorney
General and the Premier . . . well, the Premier or the
Attorney General, are they going to take such actions against the Senator that sits in another place.
Thank you. The Speaker: Thank you, Honourab le Member .
The Chair will recognise the Honourable
Member from constituency 21, MP Rolfe Commi ssiong.
JOB MARKET AND ECONOMY

If you see an erosion of the
protection of workers by this Government and those who support them within the business sector, that is an example of the consequences that elections can
bring.
I hope that Bermudians are paying attention.
That even in this late date in their tenure, Mr. Speaker, they are continuing to exact real pain on those who
are most vulnerable in this society. Yet, by way of
contrast, $60 million is expended by this Government
on the America’s Cup and the airport. But we must not focus, as we often do, on those foreign workers. We must place the onus for these abuses, for this degree of exploitation of not only the foreign workers but Bermudians as well, on their employers.
This Government does not get it. I heard earlier the debate on health care, without indulging in too
much reflection, I was wondering if I was still in the real world. Certainly, the demographics indicate that our ageing population will be exploding. The key ques tion should be, Can we afford a market -based,
for-profit system not just 20 years from now, but within
the next five to seven years, Mr. Speaker?
I gave these statistics the other day from the
Government of Bermuda’s own Department of Stati stics. The Bermuda population projection 2010 to 2020 produce d in 2014 . . . it goes on two things. Berm uda’s mid -year population was 64,129 in 2010, and it is
projected to decrease to 61,566 by 2020, a decline of 4 percent. I think we are held to that projection. But
what does that say for the cost of healthcare? F or
health insurance? We are already at this point. This is not something that we can continue to kick the ball
down the road.
For example, Mr. Speaker, there are a number of bullet points here with respect to these stats.
The proportion of seniors 65 year s and older will climb
from 14 percent in 2010 to 20 percent by 2020. I suspect we are already there now —two, maybe three

Berm uda House of Assembly years ahead of schedule. Why? Because that trend
would have been accelerated by the outward migr ation of Bermudians over the last four, five or six years,
mostly to the UK. These projections are conserv ative—bear that in mind, bearing in mind the devast ation, dislocation caused by the Great Recession.
You know, I heard the Premier the other day
talk about the jobs that were lost under t he PLP Go vernment at a time when we were experiencing the greatest boom in Bermuda’s history. At a time when the Gibbons Group of Companies, at a time when the Dunkley’s Dairy or Dunkley’s whatever it is called nowadays, Butterfield & Vallis made the great est
number or the highest level of profits that they ever made, historically —

But the major shareholders
at the Bank of Bermuda, Butterfield Bank, Argus . . .
and they took those profits that they were generating in this overheated domestic economy and invested them overseas .
But we saw what happened the time the Great
Recession hit. It hit them, too. Look what happened to Argus, XL and all the rest of them. But, yet, yet . . . it
is the PLP’s fault that this economy cratered and the revenue stream shrunk.
But getting back to the issue of those jobs that
were lost throughout that period, Mr. Speaker. I guess the Premier must have forgot the presentation I made here before you, the take note motion, and the Members of the House in 2015 where I cited the work, the
studies undertaken by people like Doug Soares who highlighted the fact that most of those jobs were gone, to some degree through outsourcing, but also a large number of them went by way of the growth of autom ation in this economy, Mr. Speaker .
Take for example those same banks, put
them all together. Circa 1998, let us say 2000, those banks may have had about, all four of them, 3,000 employees. Seven, eight years later, they are down to half that number. The Bank of Bermuda itself had 1,200 employees or so before that sale was consummated with HSBC. Today they might be struggling to find 600. Most of those jobs, not just outsourcing, but automation.
Look at today, the great vaunted OBA, the
great engine of wealth creation. The great engine of
job creation. Where are the jobs? Although, they are
still caught up in their false narrative pre- election, i nstead of dealing with the harsh realities of the struc-tural changes that hit this economy, and began under the PLP during that great boom . . . that is when they really get crystallised. Where are the jobs?
Mr. Speaker, ILS, insurance linked securities,
catastrophe bonds, one of the most . . . how can I put
it? A new and exciting feature within the overall global insurance market. Bermuda has developed almost as its epice ntre. This is a market in the billions of dollars,
globally, and again Bermuda is, if not the number one
or two global centre for that economic activity, then it
is close to it. But where are the jobs, Mr. Speaker ?
It has exploded in the last five, six years largely because of the work undertaken by the same PLP Government that they routinely disparage. Back in the
early 2000s or late 2000s, to lay the regulatory
framework to make that market work in Bermuda—but it is not bringing jobs to Bermuda. That is the new normal.
But no, what we are hearing is at times you
would think, like I said, with some of the discussions
going around with healthcare as if we are still in the
1990s. Maybe part of the problem is because they tend to represent such entrenched economic interests that they cannot look beyond their own noses to grasp this future that we still see before us.
I heard the Honourable Opposition Leader the
other night on Kim Swan’s show —was it last night? It
seems like a long time ago. And he talked about the danger which a concentration of economic power has in a country, in an economy. It is not healthy. It is healthy for some. We see massive growth of income inequality when it is like that.
1190 13 March 20 17 Official Hansard Report

Bermuda House of Assembly Our grandparents lived in that sort of economy. You know wha t I am talking about. It is not an
economy we want to go back to, but that is what is
happening. That is why we are talking about income inequality not just here but globally, and we have to address it. Bermuda has a ruinous cost of living. Number one . . . we finally made it! Rah, rah, rah! We
are number one in something! It is the cost of living! And imagine that cost of living on the most vulnerable in our society, the growing number of persons living in poverty. What Bill Clinton and the Democrats woul d
characterise back in the 1990s as the “working poor.” Those on low incomes.
The other night we got a report in the paper
about the forum they had on clubs, and they are speaking about all the symptoms, Mr. Speaker . And I
am tired of it. Let us deal with the causes! And I imagine that there was one little skinny little nerdy guy with
his finger up who said to the organisers, Excuse me, do you think there is any correlation between the fact
that most of these clubs are situated in communities with the high number of low income households and
single parent households where there is rising poverty in these communities?
Do you think that maybe we are seeing some
of these negative outcomes because of that? Because certainly in those more affluent households and com-munities in Bermuda we are not seeing these out-comes. Come on now. Let us talk about that elephant in the room. It means we also must talk about the
maldistribution of income in this country and how it is
aligned almost perfectly with Bermuda’s racial dispar ities.
So, they said that term limits were destroying
the economy. They removed term limits. Where are the jobs?
I will say this here: Just as I talked about earlier, about the rise of ILS precipitated by the great work done by the previous PLP administration along with the TIEAs and the whole nine yards . . . at one
time you would have thought that the PLP was the
international business party in that final two, three,
four years before 2012 with the amount of legislation that we brought to enhance their interest and to facil itate their growth—not only in Bermuda but globally.
Look at . . . for example, Mr. Speaker, I was at
a forum the other night on technology. Actually, it was
about three or four weeks ago. And we had an insurance executive who has been here about 20 years,
one of the largest global insurers, who said, If not for
Solvency II equivalence, the insurance international
business insurance sector that we have known over the last 25 years may not have existed anymore.
That is what he said. And then he went on to
say that the Solvency II agreement has been one of
the few bright spots in attracting new companies to our shores . Again, who brought that to the table? Who
started that groundwork? Who had the vision for that? It was the PLP G overnment. So, they may bemoan and bewail when I say
that during that five- or six -year, seven- year period
that the companies and the financial interest they had had the greatest success that they probably ever had during a similar period in our history . . . but I think the
facts speak for themselves, and it happened under a PLP Government.
But we have to look forward. And I am going
to close, Mr. Speaker, by saying, and I ask Bermudians to remember what I have been saying for the last couple of weeks, that we could not win every battle because elections do have consequences and we lost. But we have won some battles. But the most decisive battle is still to come, and that is the next ge neral election. Let us not make the same mistake we
made.
I had a conversation, in closing, Mr. Speaker,
again, with a brother from your end of the country. I forget his name but you know him. He is a little older
than me. and he was saying, Rolfe, I do not think we
can take another three or four years of an OBA Government because of where their priorities are. He said,
Our people cannot take another three or four years .
I said to him, Brother, I am going to tell you
something. With some exaggeration, if we see the OBA Government win another election and continue to replicate what they have been replicating, the only black people left around here will be a few high level civil servants (with some exaggeration) and a few of
our people in the corporate and international business
sector . I say that with some exaggeration. But I say
that because we have already seen the people flowing
out of here, the great migration, and it has been hap-pening because of the seminal failures of this Go vernment to look beyond their own self interests.
Thank you, Mr. Speaker .

Thank y ou, Honourable Member .
The Chair will now recognise the Learned
Member from constituency 36, MP Michael Scott.
You have the floor.

COMMISSION OF INQUIRY REPORT

Hon. Michael J. Scott: Mr. Speaker, thank you.
May I follow on from the Member from constituency 6 who raised the follow -up question to the
Member for constituency 15 on this Commission of Inquiry.
I stand on a point of justice in light of the actions by our Bermuda Attorney General, the Member who sits in this House, the Honourable Attorney Ge neral, who has found it okay to issue civil actions in the
Port Royal elements of the Commission of Inquiry
against at least two members of the Progressive La-bour Party and other members of the Port Royal Trus-tee complement —a member of the private sector,
business sector and one of the trustees of the Port Royal.

Berm uda House of Assembly And I am talking about disparities now, Mr.
Speaker . I am talking about disparities when we know
that the Attorney General probably has had an inkling
or direct information about what this Commission of Inquiry’s findings have been for a number of weeks, possibly months . . . well, weeks because it has been recently sorted and completed.
So, his initial actions that I question, and by
questioning the Attorney General, I question the Premier and the entire Government because of collective responsibility . . . and we were always concerned, and I have made this pronouncement that the Com-mission of Inquiry seems to have drifted into the unfortunate area of being politicised. There were the unfortunate pronouncements in the middle of the Inquiry by
its chairman making pronouncements that indicated a lack of impartiality when he described a straightfor-ward fraud—the elements of the Inquiry at Port Royal. That was unfortunate because it took away from the
independence of that chairman himself.
We have had enough statements in the public
space from Dr. Ewart Brown, former Progressive Labour Party Premier, and all of the carryings on that have been going on in relation to his private practice
that point to the politicising of the Commission of I nquiry’s proceedings . . . it being a spearhead for use,
politically, and not a genuine inquiry into matters of
public concern.
So now, we add to my list the failure . . . first,
the laying of civil actions against members of the Pr ogressive Labour Party, certainly, and others in the pr ivate sector, and I know, I suspect, that the Attorney General and the Premier have been aware of the find-ings against their own sitting Senator, Senator Vic Ball, in relation to the asphalt matter that has been found.
So the question I put as the Shadow Attorney
General is, Does the Attorney General of this country intend to issue civil proceedings against Senator Ball? Why did he issue proceedings against two members of the PLP and not issue proceedings against Senator
Ball when he must have known . . . he must have
known at the same time that he issued civil procee dings against our members of the involvement and findings with reference to Senator Ball? And so for an ybody wishing to make an argument that this entire platform . . . I saw the media asking the Opposition
Leader today about his response to the Commission
of Inquiry. It is getting mired deeper and deeper and more deeply into having a political agenda.
So I have very little confidence in it. I have
very little confidence in it and I say this as the Shadow Justice spokesman for the Party. It is increasingly being demonstrated that it is being used as a political
tool and not as an inquiry tool into matters of public import. It undermines the Commission of Inquiry’s
recommendations and findings, and given that we spent money on it and sought to produce it as an im-portant inquiry of national import . . . if it is increasingly coming to the reality that it is over -politicised and b eing used politically, then it loses all of its functionality and all of its purpose and I think we are past that stage. It is already has this reputation and it is a shame. It is worse than a shame. It is deeply, deeply troubling that this should be taking place in this I nquiry.
So, I want to go on record that I am not troubled by the findings of an Inquiry that has the reput ation of being political. It completely discredits it and its findings and its recommendation for criminal invest igation, further police and criminal investigations are all
put under a deep cloud and I want this to be noted
coming from myself as the Shadow spokesman for
Justice in this country. Justice must be fair and even-handed and the point I am making this evening is that the Attorney General’s actions have not been fair, even -handed, or impartial, and it is disgraceful that he
is undermining the 400 —no, millions of dollars, at
least that was spent on this Inquiry to unearth what we thought were going to be important matters of pr obity
in our country, and it is being discredited and not de-serving any kind of value because of this misman-agement of the entire process. And, so, I want to go
on record in that regard.
Thank you.

Good evening.
INCREASES IN OCCASIONAL LICENCES
Hon
. E. David Burt: Mr. Speaker, I will be the last
person from my side to speak and, hopefully, we will hear from the Premier because there are certainly
some questions that need to be answered.
Before I get to what other Members have
raised, which are without question, Mr. S peaker, the
disrespect of this Parliament and the failure to abide
by simple items such as common courtesy to Parli ament and the Ministerial Code of Conduct. I will just
raise an issue which has come to my attention by a
number of young entrepreneurs in this country and it
has to deal with the challenges now that young entr epreneurs have in getting liquor licences or occasional
liquor licences for their events. And the financial costs
to these young entrepreneurs in this country for occ asional licences has gone up—f or some, by as much
as 525 p er cent, Mr. Speaker.
Now
, we know and we understand that this
particular budget has a whole number of tax increases
that are inside of this budget, Mr. Speaker, and we do
1192 13 March 20 17 Official Hansard Report
Berm uda House of Assembly not know the exact tax increases for alcohol because
those Bills have not yet been tabled. But when we
were in Government, we held back on the increases in some “sin taxes”, specifically in alcohol understanding the impact it would have on tourism, Mr. Speaker .
I am sure, Mr. Speaker, that many peopl e will
know that you worked in tourism for a number of years
and the fact is that as a jurisdiction we need to make
sure that we are competitive and when we raise taxes on certain things that can impact that competitiveness we have to understand that it has an impact.
A lot of entrepreneurs right now are asking,
because they are uncertain as to what exactly the increases will be on alcohol as they are looking to plan
their events for the summer, as they are looking to plan their events around the America’s Cup and, you
know, because they get taxed unlike certain people down there at the America’s Cup, but they get taxed. So, there is a question as to what that will bring.
It is a challenge when the Government is taxing things in the tourism industry more but it is also a challenge when the entrepreneurs that put on these events that are supposed to bring the fun into Berm uda and make sure that our tourists are entertained
while they are here are now having an issue doing
that, Mr. Speaker, and it has come t o my attention by
a number of entrepreneurs —three as a matter of
fact—over the past 48 hours different ones have said
they are having an issue with this and this is som ething that I think the Government should look at.
I would ask them to please stop puni shing the
little guy. Just please —understand that there are pe ople in this country that are trying to make ends meet. As the Honourable Member from constituency 21
said, Bermuda is number one— number one most expensive place to on the planet in which to liv e. Stop
making it a little bit more challenging for the little guy.
COMMISSION OF INQUIRY REPORT
Hon
. E. David Burt: Now, Mr. Speaker, my Deputy
spoke earlier about the disrespect to Parliament. And in my opinion, Mr. Speaker, there is no better way to
put it than the disrespect of Parliament, Mr. Speaker .
And if you will allow me, Mr. Speaker, I will quote from
the Ministerial Code of Conduct
which the Honourable
Premi er himself updated in 2015. And in this, Mr.
Speaker, I will read from section 7.1 of the Ministerial
Code of Conduct which says, and I quote: “ Parliamentary Statements and other Government A nnouncements .”
It goes on to say, Mr. Speaker, “When Parli ament is in session, Ministers will want to bear in mind
the desire of Parliament that the most important an-nouncements of Government policy should, in the first instance, be made in Parliament. Even when Go vernment announcements are not of major importance, their timing may require careful thought in order to avoid clashes with other Government publications, statements, or announcements or with planned Parliamentary business.”
Now, Mr. Speaker, what that speaks to is the
premise of the primacy of Parliament. And what we
experienced earlier today, Mr. Speaker, was using the
pretext of a budget debate and taking up the time i nside of a budget debate to make a, in some ways,
press or political statement which would have better
been reserved for a Ministerial Statement when speaking about the Commission of Inquiry, Mr.
Speaker .
Now, as you would understand, and I am sure
as you would probably expect, or as most persons
would expect, that such a publication would have
been done under Ministerial Statements, would hav e
been tabled under Papers and Communications to the House, just like the SAGE Commission report, just like other reports, and the Premier would have possibly opened himself up to questions. But as we have seen,
Mr. Speaker, that this Premier and this Government
does not like scrutiny. That is the reason why when
we ask Parliamentary questions it is sometimes very difficult to get answers. That is the reason why, Mr.
Speaker, that when the Honourable Premier will give
a statement and we ask him for his brief and he will refuse to share his brief with the Opposition Leader, but then he will send his brief to members of the m edia. That, Mr. Speaker, talks about the disrespect to
the people’s representatives. Their refusal to answer questions makes it seem as though they do not work
for the people.
Now, Mr. Speaker, we were elected under different parties but the fact of the matter is that each
one of us here represents voters of this country. We represent citizens of Bermuda and therefore when we speak and when we ask questions the responsibility of
which we have been given is to ensure that we are
asking questions on their behalf.
So, it begs the question as to why the Premier
would choose to do that and I would hope that he would take this opportunity to close out this debate
and provide the answers because I think it was rather
extraordinary, Mr. Speaker, and in that case to put it
inside of a budget debate with limited time when we were supposed to be speaking specifically to issues of heads and trying to actually drill down on particular matters, that I think it was a disservice to the process
itself. So, I would hope that the Premier would clarify
his actions there.
COMMISSIONER OF EDUCATION
Hon
. E. David Burt: But, in confining it during that
debate time, Mr. Speaker, and some of the other actions of which we have seen of late from this Gover nment —refusing to make statements here in Parliament. I mean, we appointed a new Education Com-missioner, Mr. Speaker . For the first time since 2013,
Bermuda has an Education Commissioner, and the


Bermuda House of Assembly Government did not feel that it was necessary to bring
a statement to this House when the Ministerial Code
of Conduct is very clear that major announcements of Government policy when Parliament is in session should be made her e. Why, Mr. Speaker ? Is it b ecause they are afraid of scrutiny? Is it because they do not want to answer the people’s questions? It just
seems as though what we see daily, Mr. Speaker, are
the actions of a tired and desperate Government with
priorities that are misplaced.
[Inaudible interjections]

LAHEY CLINIC, ATTORNEY GENERAL’S
CIVIL ACTION
Hon. E. David Burt: Oh, we hear the noise, Mr.
Speaker, but the thing is . . . what is interesting is,
when they are given the opportunity to speak, Mr. Speaker, they do not. They could get up and defend
the actions of spending $426,000 on a lawsuit when
we do not have Wi -Fi in schools. They can get up and
defend those actions, Mr. Speaker, but they choose
not to. They choose to remain silent. So, they can
chirp as much as they wish, but just like we, Mr.
Speaker, they have the opportunity to speak on the
motion to adjourn.
So, when we talk about a tired and desperate
Government with misplaced priorities, Mr. Speaker,
we ask ourselves what type of country do we liv e in
when there is $426,000 to be spent on suing a reputable international hospital but we do not have the money to put Wi -Fi in our kid’s schools. People must
ask the question, Mr. Speaker, what type of country
do we live in when we have a political Attor ney Ge neral—not the DPP, Mr. Speaker, a political Attorney
General —who has no criminal investigative powers
whatsoever, would use information which has clearly been gleaned from a criminal investigation and put it in a civil suit prior to a criminal invest igation being
complete.
It is a very, very dangerous line, Mr. Speaker,
when we begin to break down any constitutional pr otections of which may exist inside of a country. It is a very dangerous situation because we understand that the roles of the DPP and the Attorney General were
split and they were split for a reason.
So, we have to ask, What possible investigative power would the Honourable Attorney General have to have access to information that could only come from criminal investigators? Looking into peo-ple’s and disclosing information of people’s private bank accounts, Mr. Speaker, communications that
were not on Government servers, between private parties . . . how on earth does the Attorney General
come across that type of information, Mr. Speaker , in
a civil matter?
And these questions have been asked and all
we hear is, the new excuse is, O h, no they came from local sources . And you know why they say it comes
from local sources, Mr. Speaker? Because they know full well that if they say they came from the place
where we know they came from, the international sources, they will be admitting that they violated an international treaty, Mr. Speaker .
You will note that they have never denied it.
You will note that they have never said whether or not they have been contacted by the US Department of
Justice. All we hear is the Premier say is, Oh, I co ntacted the US Consul General and everything is okay .
Why did you contact them in the first place, Mr. Speaker ? Why did you?
At the end of the day, Mr. Spe aker, the report
that was published today with the Commission of I nquiry contains a lot of things inside of it. But, Mr. Speaker, most of those things we already know. The
fact is that there are criminal investigations that are ongoing and a Government that believes in the rule of
law should let the rule of law rule the land and should
not try to engage in situations where they take the law into their own hands, Mr. Speaker .
Thank you.

Thank you, Honourable Leader.
The Chair will now recognise the Honourable
Premier.

COMMISSION OF INQUIRY REPORT
Hon. Michael H. Dunkley: Thank you, Mr. Speaker .
Mr. Speaker, much to the disappointment of
the few Opposition Members who remain over there, I
will not remain silent. What type of Opposition do we
have? In their tired and desperate attempt they just smear information from all quarters. What type of
country do we live in when we have a former Junior
Minister of Finance silent as a church mouse when the former Government spent over $40 million on Grand Atlantic and could only sell one unit —$40 mi llion-plus and they could only sell one unit?
What type of Government did we have before
when there were overruns on projects galore from Heritage Wharf to the Dame Lois Browne- Evans
Building to the senior school? What type of Gover nment did we have at that time and the Junior Minister of Finance was silent?
Now, Mr. Speaker, we hear the talking points
that have been handed out to honourable colleagues on that side about disrespecting of Parliament. I an-nounced the PDF was posted online in Parliament in the Budget Debate. Mr. Speaker, it should also be
noted, in spite of what some Members on that side
have said, I take no glee— in his comments the Member from constituency 21 who has talked and left. I
take no glee in announcing that Commission. Said it all along. That was announced, it was incorporated to deal with significant challenges that we must clear up,
and Honourable Member s now say they know what
1194 13 March 20 17 Official Hansard Report

Bermuda House of Assembly happened. Oh, interesting. They know what happened
and did nothing about it to clear it up.
It was an independent Commission as I explained in my brief, and Honourable Member s on that
side had opportunity in the debate, in this House of
Assembly, to ask questions and I will never duck any questions from Honour able Members on that side because there are no reasons to duck any questions.
Unfortunately, Mr. Speaker, as we have all
seen many times in this Chamber, they do not like the answers because truth can hurt. Truth can hurt when it comes back against misinformation and prevaric ation and spin that takes place—
Hon. E. David Burt: Point of order, Mr. Speaker .

Yes, thank you. If you can stay away
from that line, Premier.
Hon. Michael H. Dunkley: Well, Mr. Speaker, you are
putting another word out there and I will bide myself accordingly. But misinformation or alternative facts —
how about that —and it will not be long before they
complain that they want to put those in the book of
words that we cannot use. But, many of the words coming from the other side are certainly not appropr iate language from this place.
So, this Government is never averse to any
type of scrutiny from Honourable Members on that
side. I hope with the veracity that they have tried to debate the way the report was handled and made public will be the same veracity that they will look for
the entirety of the report as we go through because
what the Auditor said in that report, on those three financial years, and what has been repeated over and over again is something that we need to clear up whether it is with the police investigation, whether it is with civil action by Chambers, whether it is in changes
to financial instructions or changes to legislation we
need to tighten things up. We have to do it.
What I find deeply disappointing here this
evening, Mr. Speaker, is Honourable Member s want
to forget big parts of the report that show serious chal-lenges and focus in on certain small areas, and so that leads me to believe that through this whole situ ation and into the future —and the Honourable Member
from constituency 36 said, and the Shadow spokes-person for Justice— I am not troubled by the report.
Well, well . . . if he is not troubled, then certainly there
is a problem on that side. And the Honourable Oppo-sition Leader might need to think about a new r eplacement for somebody in Justice to start thinking about it because the report outlines serious concerns that this Government intends to deal with in the appropriate way. We are not going to let it slide underneath the
carpet. This independent report was given to me over
the weekend. At the first instance, I came to the
House today during the Budget Debate and a nnounced that I received a PDF copy of it. It is posted online. They all —Honourable Member s sit over there
with their computers. They could tune into it right away. Tune into it right away and I know some of
them did because I saw them scrambling to do it. So
do not give me any hogwash about disrespect. Disr espect in this regard is to the people of Bermuda for trying to gloss over an important piece that we need to deal with. That is what disrespect is. And try to spin it
in another way so that people of the community could
get confused by all the talk back and forth by Oppos ition and Government. That is what people do not like.
They are tired of politicians talking to each
other, spinning things, putting misinformation out there, putting facts that just do not hold up under the
scrutiny of any sunshine, Mr. Speaker. And I will get to
that. So, I make no apologies for the approach that I took today. Never refused to answer any questions. Never ducked from any scrutiny and will stand the test of time and answer those questions to them at all time, Mr. Speaker .

COMMISSIONER OF EDUCATION

Hon. Michael H. Dunkley: Now, in regard to the Ed ucation Commissioner, the Honourable Opposition
Leader knows full well that is an appointment by the
Public Service Commission. We have been through all that. That is pure political attempts to score some weak points. We have been very clear. All Members on this side have supported a Bermudian Education Commissioner as I have heard it said by Members on
that side. I remember the Shadow spokesperson sa ying a decision has already been made months ago
when it had not even gone to the PSC. What type of misinformation and spin is that because as soon as I heard it, I believe on the floor of this House, I asked questions. They had not even considered the case
and if somebody on that side wants to jump up and shout “point of order” I will take it. But they are quiet because they are incorrect.

Hon. E. David Burt: Point of order, Mr. Speaker .



Bermuda House of Assembly Hon. Michael H. Dunkley: I checked and they are
wrong.

All right. Thank you, thank you.
[Inaudible interjections]
Hon. Michael H. Dunkley: That is a good spin. That
is a good —a recommendation—

[Inaudible interjections]

Hon. Micha el H. Dunkley: If the Honourable Members would listen, the Board of Education make a recommendation and the PSC makes the decision . . .
makes the decision, and that recommendation, the Honourable Member s will not say that, that there was
more than one person that was initially recommended.
Oh, yes, they will not say that. They want to
spin. Try to rearrange the mirrors so you can see from different angles and get a different decision and I get it
. . . but, you know, that does not help them. Because
peopl e cannot add up what is going on. And, so, we
stayed out of the process because lo and behold if we got involved the next thing they would be saying, Well,
the Minister of Education was interfering. The Premier was interfering. You cannot have it both ways . We
abide by the proper course of action and we follow it. So we are pleased that Dr. Freddie Evans was ap-pointed. Very pleased that he was appointed.
Now, talking about alternative facts and the
Honourable Member from constituency 29 who runs in
and speaks and then runs out real quick, I do not know why he does not stay in the Chamber long, cer-tainly he makes stuff up with the best of them. And let me clear up a couple of situations here tonight.

MISINFORMATION

Hon. Michael H. Dunkley: Earlier in the debate today
he made the comment that I had said that I would, if I had the opportunity, close down Lefroy House. I recall saying nothing of the sort. I researched through rec-ords and found nothing of the sort, Mr. Speaker . It is
absolutely ludicrous that the Honourable Member can
come up here and just float things out. And it is not the first time he has done it. It is not the second time he has done it. It is not the third time he has done it. He has done it so many times I cannot count with the fingers on my hands. I will list a few of them, Mr. Speaker , I brought
something up to you a couple of weeks ago and it is in Hansard. The Honourable Member stood up during a
debate and said myself and the Honourable Minister of Finance had gone into a correctional institute and tried to persuade an inmate to implicate himself and other Members. What an outright lie! Because it never
happened. And if that language is too strong, Mr.
Speaker, I will take it back, but that is the truth. It ne ver happened.
And that Honourable Member should be
ashamed that he would come up here with privilege
and continue to spout misinformation at the best —
because it all is lies. To say we would go in and impl icate—implicate —people. I have never been in a correctional institute with t he Minister of Finance, for one
thing. And, secondly, whenever I have gone in as the Minister of National Security, I have always had a member of staff there with me. I have talked to pri soners. I never bring up the subject of politics and co lleagues.
The Honourable Member needs to get on the
straight and narrow. Perhaps that is why he is facing some of the challenges that he faces. The Honourable
Member used to love to pontificate, Oh, remember,
CEO Bill Hanbury made $400,000 or $600,000 or a
million dol lars a year . With no shame! He would just . .
. it is like he gets up, he gets so excited and he just spouts out numbers that do not stand the test of time. And I guess, the real crux was last week when we
found some blank piece of paper dropped on the table
right there about alleged comments on Facebook by Minister Richards. And you know the sad thing about it, the disrespect and the blatant personal attacks which are wrong and mischievous and bold- faced L-IE-S are starting to spread throughout those benc hes.
But, Mr. Speaker, I could tell you very clearly that this
Government will not be deterred.

JOB MARKET AND ECONOMY

Hon. Michael H. Dunkley: So, as I close, let me say
a few more things. The Honourable Member from
constituency 21, who has gone home because he
probably has an early day tomorrow like we all do, said that the economy doubled under the former Gov-ernment. Well, Mr. Speaker, if that economy doubled
in those years, why did Bermudian jobs decrease? They do not answer that. They duck that and t hey try
to rearrange those mirrors to get them to look in an-other direction. So if the economy doubled, why did Bermudian jobs decrease?
And, Mr. Speaker, the Honourable Member
talks about people leaving Bermuda to go to other countries. How have they forgotten the migration that took place in the years from 2008– 2012? Oh, it is
called amnesia or running from your own record. And as President Obama said on a number of occasions, if you do not have a record you run from it and you try to
1196 13 March 20 17 Official Hansard Report

Bermuda House of Assembly critique somebody else’s record, and that is exactly
what the Opposition try to do on a regular basis.
Now, Mr. Speaker, we realise that we have a
significant amount of work still to be done. We realise
that when we took over we had tremendous challen ges in every sector of our economy and in Government
finances. This is not the first time I have said this on
the floor of the House, and it is not the last time I will
say this on the floor of the House. But we will not stop. We will not stop until progress reaches into every single household across the Island and that hope is ac-tually seen by the people that we serve, Mr. Speaker,
because we serve everyone and we are not going to
be part of a divide and conquer politics that Members
of the Opposition seem to have as the only book that they can read. The road is long. The struggles are real and we will not stop in spite of the headwinds we face in making sure progress and hope get to every Ber-mudian household, Mr. Speaker .
And, with that, I will say we will rise together.
Good night, sir.