June 26, 2024

Madam President, I
move that the Bill do now pass.

The President: Is there any objection to that motion?
No objection.
The Bill is passed.

[Motion carried: The Computer Misuse Act 2024 was
read a third time and passed.]

The President: Thank you, Senator Dill, and thank
you, all Senators, for agreeing to this matter.
Yes, that is done.
And we will now move on.

NOTICE S OF MOTION S
The President: There are none. PETITIONS

The President: There are none.

STATEMENTS

The President: There is one Statement. And that is in
the name of the Honourable Owen Darrell, Minister of
Tourism, Culture and Sport, as well as the Government Leader in the Senate.
Minister Darrell, you have the floor, sir.
Sen. the Hon. Owen Darrell: Thank you. Good morning, Madam President.
The President: Good morning.

SUMMER DAY CAMP
Sen. the Hon. Owen Darrell: Madam President, as the
2023/24 school year concludes today for many stu-dents across the Island, the Department of Sport and
Recreation is prepared to welcome participants to this
year’s Camp Connect initiative. For over 50 years , the
department has served as a reliable option for parents
seeking safe, enjoyable and affordable summer camps
for their children. We are committed to continuing this
tradition of excellence this summer.
Madam President, on Monday, July 1, 2024,
over 1,000 children across the Island will embark on a
summer of fun and learning at our Summer Day
Camps. This year the department of Sport and Recreation, in collaboration with our partner organisations,
has introduced several exciting enhancements to the
camps:
• Increased capacity . We have added [850] additional spots, allowing more children to partic-ipate during the summer break .
• We have extended camp duration. Various
camps are now available from July 1 to September 6, 2024, offering extended engagement opportunities.
• Expanded variety . We have broadened the selection of camp types available, ensuring a diverse and dynamic array of experiences for attendees.
Madam President, I would like to express my
gratitude to the 27 partner camps for their invaluable
collaboration and for providing their specialised programmes to our students. Their involvement has been
a significant factor in reducing the waitlist numbers for
our programme.
These camps offer diverse specialised programmes including archery, futsal, cricket, dance, educational, STEM, robotics and art. We are also excited to reintroduce the White’s Island swimming camp this
summer. Additionally, Raleigh [Bermuda] and Outward
Bound Bermuda host programmes for those interested


Bermuda Senate in survival skills. The variety and diversity of these
camps significantly enhance our offerings.
Madam President, the Government’s annual
Summer Day Camp programme not only enjoys widespread popularity with parents, but also provides summer employment for approximately 140 individuals this
year. It is imperative to not e that all staff members are
required to have valid CPR and First Aid, as well as
SCARS certification. These work opportunities are also
offered to students studying in education or humanities,
enabling them to acquire hands -on experience in their
chosen fi elds. We are committed to uphol ding this
proud and valuable tradition.
Madam President, our government camps are
led by Mr. Kenneth Bartram, with the assistance of
Crystal Richardson, Melanie Seymore and Elicia Hollis.
The camp names, locations, as well as the supervisors are as follows:

Boys to Men Victor Scott Primary Crenstant Williams
Camp Bermudez W. Pembroke Prim ary Kennita Phipps
Camp Chameleon Gilbert Institute Judith Welch
Camp Hibiscus Elliot Primary Eulannae Douglas
Camp Kiskadee Dalton E. Tucker Shay -la Gilbert
Camp Palmetto Harrington Sound Shayla Morton
Camp Paw Paw W. Pembroke Prim ary Malisa Butterfield
Camp Pontoon Prospect Primary Jade Spencer
Girls to Ladies Victor Scott Primary Miesha Greaves

Madam President, I extend my best wishes to
all participants in our summer programme s—from the
supervisors, counsellors and specialists, as well as the
custodians and, most importantly, Madam President, the campers , for a fun- filled and safe summer.
Thank you, Madam President.
The President: Thank you, Minister Darrell.
Moving on with our Orders of the Day.

INTRODUCTION OF BILLS

The President: There are none.

FIRST READING OF PUBLIC BILLS

FINANCIAL ASSISTANCE (SHORT -TERM RELIEF
BENEFIT) ACT 2024
The President: The following public Bill has been received from the Honourable House of Assembly and is
now read for the first time. Its title is Financial Assistance (Short -Term Relief Benefit) Act 2024. And that is
in the name of Senator Lindsay Simmons, the Junior
Minist er for Youth, Social Development and Seniors.

FIRST READING OF PRIVATE BILLS

The President: There are none.
QUESTION PERIOD

The President: Senators, we will entertain questions
on the Statement that was read by Minister Darrell.
Yes, Senator De Couto. You have the floor.

QUESTION 1: SUMMER DAY CAMP

Thank you, Madam President, and thank you to the Minister for that Statement
about the Summer Day Camps.
Definitely we recognise the importance of this
important care and assistance for families. I was particularly pleased to hear about White’s Island swimming
camp. I know that that has been a valuable resource for
a lot of people. And perhaps the Minister would be able
to comment on if we might see this as an ongoing camp
in future years as well .
Thank you, Madam President.
The President: Thank you, Senator De Couto.
Would any other Senator care to ask questions
on this Statement?
Hearing none, we will wait for a response from
the Minister.

Sen. the Hon. Owen Darrell: Thank you, Madam President.
I was a camper many years ago, and I have
fond memories of going to White’s Island and not only doing swimming, but also doing sailing. And White’s Island back in the day, similar to how the registration is
now, was one of those camps that the department put on. And you used to have to go u p to the old Hamilton
Seventh- day Adventist Church, and you had to get in
line and you grabbed a ticket. And I remember it was
one of the most popular camps. So, you know, that is
just a testament that these camps that t he Bermuda
Government has been putting on have been popular for
many, many years.
So to answer Senator De Couto’s question,
this is a collaboration, again, with the Bermuda Swimming Association. And as we talked about the collaborations with camps that we have done with the 27 that
I mentioned earlier and in a previous Statement that I
have done, if they come back to us next year and say,
This collaboration worked and we wish to continue it, it
is definitely something that we will consider and we
wish to have, because parents have been asking for it
for years.
And I would just like to give them some credit.
We know a former Senator ( now an MP who sits in another place), MP Ben Smith, is the National Swim
Coach. And that association is sponsoring this White’s Island swim programme, and they are leading the initi-ative. However, you know White’s Island is one of our
properties. So it is a collaboration. So if they wish to
continue it and take us back to the good old days when
swimming at White’s Island was fun—we used to go
496 26 June 2024 Official Hansard Report

Bermuda Senate over on the Friendship, and other people used to do
sailing over there —we will definitely have it again next
year if they wish.
Thank you, Madam President.

The President: Thank you, Minister Darrell.
With no further questions on the Statement, we
will move on.

ORDERS OF THE DAY

The President: Senators, we will reverse the order,
and we will now introduce the second reading of the
Financial Assistance (Short -Term Relief Benefit) Act
2024. And that is in the name of Senator Lindsay Sim-mons, the Junior Minister for Youth, Social Develop-ment and Seniors.
Senator Simmons, you have the floor.

STANDING ORDER 25

Sen. Lindsay Simmons: Thank you, Madam President.
Madam President, I move that provisions of
Standing Order 25 be granted so that the Senate may now proceed with the second reading of the Bill entitled
the Financial Assistance (Short -Term Relief Benefit)
Act 2024.
The President: Is there any objection to that motion?
No objection.
[Motion carried: Leave granted for the Financial Assis-tance (Short -Term Relief Benefit) Act 2024 to be read
a second time on the same day as its first reading.]
The President: Carry on, Senator Simmons.
Sen. Lindsay Simmons: Madam President, I move
that the Bill entitled the Financial Assistance (Short -
Term Relief Benefit) Act 2024 be now read a second
time.
The President: Is there any objection to the second
reading?
No objection.

BILL

SECOND READING

FINANCIAL ASSISTANCE (SHORT -TERM RELIEF
BENEFIT) ACT 2024
Sen. Lindsay Simmons: Thank you.
Madam President, the purpose of this Bill before the Senate today is to establish a framework to provide immediate financial support on a short -term basis for persons who qualify in the event of experiencing financial hardship due to unforeseen circumstances.
Madam President, the former President of the
United States, President Barack Obama, said, “If the people cannot trust their government to do the job for
which it exists —to protect them and to promote their
common welfare —all else is lost.” Therefore, Madam
President, one of the essential roles of this Government
is to ensure the well -being of its citizens, especially
those who face financial hardship due to various reasons that are outside of their control. Providing financial
support can help them overcome their difficulties, maintain their living conditions and continue to contribute to
society.
Madam President, I want to reiterate that this
short -term relief benefit provides financial assistance
which is apart from any of the financial assistance programmes currently offered by the Department of Financial Assistance. It is not intended to be long -term financial support. The title of the Bill clearly underscores its
intent: to provide short -term relief.
Madam President, Bermudians’ experiencing
financial hardship due to unforeseen circumstances has always existed but was heightened in 2020 due to
the global pandemic. Although at that time the temporary unemployment benefit was initially introduced from
March to September 2020, then the supplemental unemployment benefit was put in place and extended on
several occasions until it ended in November 2022.
Since then there were still no provisions in legislation to deal with the sudden financial hardship challenge that
some of our citizens experience.
Madam President, jurisdictional reviews were
undertaken for Australia, Canada, the United Kingdom
and the United States seeking to identify a similar benefit outside of social security and unemployment insur-ance. The jurisdictional review ascertained what benefits each country provided to assist persons faced with an unexpected crisis. The findings from this jurisdictional review, combined with Bermuda’s experience
with the supplemental unemployment benefit during the
COVID -19 pandemic, informed the development of a
solution for Bermuda, the short -term relief benefit.
Madam President, the overarching objective of
this Bill is to financially support persons who qualify for
the short -term relief benefit by providing $1,500 per
month for a maximum period of three months in any
given financial year, which totals $4,500 per financial
year. The payment to successful recipients could be
continuous for three consecutive months or an aggregate period made up of two to three awards. The Department of Financial Assistance has established a
framework in which detailed checks will be made to ensure that no one person is paid more than a total of
$4,500 during a financial year. It will be the responsibil-ity of the Director of the Department to make a report to
the Minister at the end of each financial year of monies


Bermuda Senate awarded as a short -term relief benefit to only those persons who qualify for the benefit.
Madam President, applicants who are qualified
to apply for the short -term relief benefit must first and
foremost be 18 years of age or older and either possess
Bermudian status, be a spouse of a person who possesses Bermudian status, or an applicant for t he short -
term relief benefit could be the guardian of a dependent
who possesses Bermudian status. For example, a nonBermudian could be a custodial parent of a Bermudian
child. The eligibility criteria found in clause 8 require an individual to have lived in Bermuda for at least one year
and also requires that the applicant’s investments and
assets, other than real property, like owning land or a
house, must not exceed $5,000.
Madam President, the Department of Financial
Assistance has conducted the necessary operational readiness for rolling out the short -term relief programme. A dedicated resource is already in place to
manage the short -term relief programme. This financial
assistance coordinator is responsible for the intake of
applications, processing, administration, payment and reporting requirements related to the programme. This
will involve the screening of case information and advising applicants of documents needed to support their
applications, and the timely processing and payment of
the benefit.
The coordinator will also perform and manage
audit and financial reporting requirements for effective
monitoring and tracking of the distribution of benefits to
recipients. The Department of Financial Assistance will have a team of four full -time resources assigned to
carry out the due diligence for all applications. This is inclusive of the director and the deputy director.
Madam President, when applying for the short -
term relief benefit, two application forms will be made available— one for walk -in requests, and the others can
be completed online. Both application forms will contain
the same information. Also, a household monthly expense form will be included in the application package.
The information requested on this form will be used during the pre- screening and interview process to assist
with and determine the authenticity of eligibility of the applicant and their financial hardship.
The successful applicant will in turn be sent a
letter from the Director of the Department of Financial
Assistance, notifying them of their approval to receive
the short -term relief benefit. The letter will also outline
the timeline for payment of the benefit, the conditions under which the short -term relief benefit is given as per
clause 11 of the Bill, and consequences of applicants’
making false statements or providing false information
in their application as per clause 19(1) and 19(2).
Madam President, this Bill stipulates that individuals who apply for the short -term relief benefit and
who claim that they have or are experiencing financial
hardship must provide evidence attesting to the same.
The evidence must be a direct result of var ying hardship circumstances resulting from a natural disaster, a public health emergency declared by the Minister re-sponsible for Health, one’s employment being terminated, the death of a household member or domestic
violence. The Director of Financial Ass istance considers all applications and decides whether to refuse or
approve the application. The Director may also request
additional information from applicants to support their
application. Should there be any other type of evidence
found causing financi al hardship, the Minister may
amend the list of evidence in the Bill by negative reso-lution.
Madam President, if an applicant has been terminated from their job, the Department of Financial Assistance will require proof from their employer for the
reason for termination. The application must be submitted within three months of the termination. The reasons
given by the employer will be reviewed and assessed. A short -term relief benefit will not be awarded to persons terminated from their jobs because of misconduct
or gross misconduct behaviours. Additionally, to restrain the flood of applications, persons who simply quit
their jobs and who knowingly think that for three months every financial year they could just receive $1,500 will
not be considered. The reasons given for termination
will be heavily scrutinised by the department when exercising its due diligence.
Madam President, the number of reported domestic violence cases has ranged from 170 in 2020 to 133 cases in 2023. While this decline in number of
cases reported may reflect a decrease in incidences of
domestic violence, the reality is that there remain people in our community who are experiencing violence in
their interpersonal relationships. In instances of abu-sive relationships, persons might have to be removed
from their homes at a moment’s notice. Additionally,
there have been instances where persons w ho choose
to leave are forced to leave and have access to their
joint back accounts blocked, leaving them without access to money to support themselves. When evidence
of these occurrences is provided to the Director of Financial Assistance, either by a hel ping agency or the
police, the applicant for a short -term relief benefit, after
meeting the eligibility and criteria as stated in this Bill,
could receive financial support for alternative accommodation, food and other basic needs until they get back on their feet.
Madam President, the Bill also states that an
applicant who knowingly submits false information or makes false statements in their application commits an offence and is liable to a fine of $1,500 or imprisonment
for six months or both. These consequences were the
same for successful applicants who received the supplemental unemployment benefits under the Public
Treasury (Administration and Payments) (Supplemental Unemployment Benefit) Regulations 2020,
Regulation 14.
Madam President, there are pros and cons to
establishing this legislation. These considerations are
no different to those identified when the supplemental
498 26 June 2024 Official Hansard Report

Bermuda Senate unemployment benefit was implemented. Providing financial short -term relief to individuals and households
in need of temporary financial assistance can meet their basic short -term needs with less mental anguish.
It also provides an uplift while not creatin g dependency.
On the other hand, there is the risk of dependency if
persons cannot find employment quickly within the
three- month period, or if a public health emergency or
impacts of a natural disaster extend beyond three months.
Madam President, there were lessons learned
for the Department of Financial Assistance after the implementation of the supplemental unemployment benefit. These lessons have caused strict monitoring and
controls to be implemented at the front end of the short -
term relief benefit application process. These include the following:
• maintaining the established timelines that apply to other Financial Assistance programmes;
• a thorough vetting process;
• assigned dedicated resources; and
• the stipulation for third- party confirmation.
The Department of Financial Assistance will do
its utmost to protect the government’s funds that have
been budgeted for this short -term relief programme.
The benefits awarded will be in alignment with this legislation.
Madam President, in closing, financial assistance reform calls for change. In October of 2023, legislation was amended to increase allowable expenses
for several items provided to Financial Assistance cli-ents because of increased and valid needs. The Government assessed, researched and measured, recognising that some of the allowable expenses awarded to
clients were not sufficient to cover some basic needs.
Consequently, changes were made to bring the ex-pense allowances in alignment with needs and costs.
Madam President, far too often we can find
ourselves resistant to change, particularly if it means
providing more funds for social welfare. Currently, the
majority of Financial Assistance clients are our seniors,
pensioners and persons with disabilities. A dditionally,
there is the minority of clients who are able- bodied unemployed and persons with low earnings. The Depart-ment of Financial Assistance is committed to ensuring
that these latter two client groups are supported in find-ing employment by working i n unison with the Department of Workforce Development, mitigating any ten-dency to become dependent on social welfare.
Similarly, Madam President, in establishing
this short -term relief benefit programme, the structured
framework will allow for a stringent process to be fol-lowed by the department staff to ensure the right persons receive the benefit and then are supported as
much as possible in finding employment or getting back
on their feet within a short period of time.
Madam President, today we stand at the cusp
of enhancing the social protection programme for per-sons experiencing financial hardship, which is long overdue for Bermuda. This Government continues to
work through the Financial Reform Working Group’s
recommendations step by step to improve and
strengthen Bermuda’s social safety net. The establishment of the short -term relief benefit will help maintain
the resilience of our people while they are pressing
through situations of unforeseen financial hardship.
This short -term relief benefit will support our people
and help them continue their contribution to the Ber-muda economy without stress, without a loss of hope
and without fear of the unknown.
Madam President, it is with those remarks I
now present the Bill entitled Financial Assistance
(Short -Term Relief Benefit) Act 2024 and welcome
comments from other Senate Members. Thank you, Madam President.

The President: Thank you, Senator Lindsay Simmons.

ANNOUNCEMENT BY THE PRESIDENT

SENATE VISITORS

The President: And, Senators, before I open the floor
for your participation and questions, I would just like to
acknowledge the presence of the following persons in
the Senate Chamber: That is, the Permanent Secretary for Youth, Social Development and Seniors, and that is
Permanent Secretary Valerie Robinson- James; and
also the Policy Analyst, Ms. Kleita Pitcher.
Welcome to both of you ladies.
[Debate on the Financial Assistance (Short -Term Relief
Benefit) Act 2024, continuing]

The President: Would any Senator care to speak on
this Bill?
Senator Robinson, you have the floor.

Sen. Dwayne Robinson: Thank you, Madam President.
And just right off the top I want to signal that
the One Bermuda Alliance will be supporting this legis-lation. We support anything that is helping Bermudians
in their time of need, especially during these current
challenges we are facing, which are increas ingly putting more and more financial burden on Bermudians and their families.
I just have a few clarifying questions to put to
the Junior Minister just for my clarity and that of the lis-tening public. One of my main concerns is how a person who is currently a victim of domestic violence or in
a domestic abuse relationship is able to qualify, or what
do they have to show in order to qualify for this particu-lar benefit? And the reason why I bring it up is because it can be very challenging and very hard for a person
who is in a violent situation or in a domestically abusive


Bermuda Senate situation and a victim of that to come forward and actually report or actually take legal action against their
abuser.
So in this case if they are looking to get a benefit because their funds have been frozen or they are currently being abused, if they have to show a court order, what happens to a person who simply wants to
claim the benefit to rebuild their family and be able to
start anew or start fresh or get the help that they re-quire, but does not want to go through actually reporting? What is the recourse for that particular victim if the requirement is that they must show proof or something
that is legally binding that they are indeed a victim of
domestic abuse?
So I just wanted to get a bit of clarity. Is there a
path for a person to be able to get that benefit without
necessarily putting themselves in more harm’s way by reporting particularly a violent offender?
And also, just now questioning whether or not
government has a duty of care in those situations where someone is not reporting and government does make way for them to claim that benefit. Now that it is
clear that they have proven that they are indeed a vi ctim of domestic violence and are suffering, is there now
a duty of care for government granting that benefit to also now say, We need to take steps to ensure that this
abuser is punished or brought to justice for what they are doing? So I just wanted to p ut that forward.
And also a few other questions around the eligibility of claiming this benefit. I notice that anyone over 18 is able to claim it with the other stipulations. I was just wondering how someone who is homeless fits into
that particular bracket. If they do not have a bank account or any way to receive said funds, are they going
to be ineligible? Will government pay in cash? Are there
other ways for folks who may have other barriers of en-try, but are our most vulnerable citizens, to receive? And will it be a poi nt where they include registered charities like HOME or others to stipulate this sort of benefit for folks who may not have a way to receive it —that is,
legal and trackable by a government?
Also will the government consider folks who
are involved in serious accidents? You know, there are countless members of our communities who have to put up GoFundMe and various things because they
have had a serious accident and they have had to go
overseas and get care, and their medical and health insurance bills are skyrocketing. So I just wanted to know
whether they would be able to fit into the eligibility,
those two particularly vulnerable and sudden things,? because, folks who are at risk of homelessness, it could
happen very quickly as well. So those two particular
persons within our community who are suffering from
that and sudden accidents, the eligibility there, I would
like to get a bit of clarity from the Junior Minister as well.
Also regarding the death of a household member. Now, in the legislation it does not really define the relationship to said household member. It says just a member of the house. So if you do have multiple members within the household who have lost the household
member, can each individual member of that household who is over 18 claim their own individual benefit?
Or will government stipulate that it is per household? I think that this is very important because each and every
person will qualify under this le gislation if their household member passes away. If they are [at least] 18,
each of them qualifies for that benefit. So if you have a
household of five, if you have a household of six and
four, you know, they are all eligible for this particular benefit for losing their household member.
So just wondering whether or not we could get
a bit of clarity as to whether Government has factored in this. We know that it is a finite amount budgeted for
this, $630,000. So if we have households that are particularly large, it could fall into a point w here you are
paying out a large sum to one individual household for
the death of one household member. So just something
to consider there as well.
Also, when we talk about households, we also
have folks who stay in shared living situations. We have
folks, seniors, who are in rest homes, you know, who
technically, if somebody wanted to [could] say, That
was my household member who passed, I could qualify. So just to take into account various things that may
lead to multiple or larger payments that Government may have not budgeted for.
And also leading into that relationship aspect,
if I am dating somebody and I am cohabiting with that person, you know. So I feel like that relationship piece
to that household member should be quantified a bit
more just to make sure that you are supporting family members through their loss, you are supporting people
who are impacted deeply by the household member
through their loss and not necessarily folks who are just
residing with them for a time, or residing with them at a
time when they pass.
So a few other technical points with that is, if it
is an urgent benefit, I just was looking in the legislation
hoping to get turnaround times for the director’s decision on whether or not somebody is approved or not.
And basically I just think we should have a bit of a
timeframe there. If it is an urgent benefit and the director is inundated with approvals, will this person have to wait for the approval? In other words, making it not so
urgent because if I need the support immediately because something has happened that has rendered me
in need of it, long turnaround times for a decision can
cause undue issues and undue stress. So I would have
liked to have seen some stipulated turnaround [times].
And I am hoping that that comes out in the regulations
when t hey do come out so that folks know when to expect an approval for something that is so urgent.
My final technical question is around the clause
of investigation. I just want to get a bit of clarity as to
how these investigations will verify whether or not
somebody is indeed . . . Let us take domestic violence,
for example. How are these investigations going to be
500 26 June 2024 Official Hansard Report

Bermuda Senate carried out? Is it budgeted enough for proper investigations? Because each investigation could be long, short
and more in- depth than the next. So I just wanted to get
a bit of clarity as to, you know . . . And how much of the
person’s personal data and how much of the person’s
personal business will have to be looked into per se in
order to qualify for this urgent benefit? So just a bit of
clarity around that.
And with that, those are my comments. I look
forward to hearing the Junior Minister’s response. And
I thank her for her brief and also for her advocacy for those who are suffering domestic violence and our domestic violence victims.
I respect your consistent advocacy on their behalf. So I just wanted to say that to you as well.

Sen. Lindsay Simmons: Thank you.

The President: Thank you, Senator Robinson.

Sen. Lindsay Simmons: Thank you, Madam President.

The President: Thank you.
We have Senator John Wight who has indicated he will speak.
You have the floor, Senator Wight.

Sen. John Wight: Thank you, Madam President.
Conceptually, I support assisting our residents
during difficult financial times brought on by sudden
and unforeseen circumstances. Practically speaking, I
just see a few issues I would like to raise that concern
me a little bit. I guess this Bill is meant to assist people, as was mentioned by the Junior Minis ter, with immediate financial assistance. And I see the due diligence for many of these eligibility items requiring quite a bit of time to assist. So for example—and again, it was raised
previously —domestic violence, for somebody in Financial Assistance to determine whether a person or a family qualifies for what we know is a very concerning issue
in our community. I do not think that is an easy one for
somebody in Financial Assistance to determine themselves. So I am just a bit concerned about the due dili-gence process that may result in payments being prolonged because of the due diligence time required.
And just a couple of other minor items. One is,
the eligibility criteria under clause 8(b) says, “the value of the individual’s investments and assets . . . does not
exceed $5,000.” Well, just a strict interpretation of this,
anybody who has a private pension plan, working one
year and earning $50,000, they would have assets of
at least $5,000 because 10 per cent of everybody’s salary must go into a pension plan. So if the intention was
to exclude an individual’s private assets, I think that
should have been clarified because, as I say, virtually every person in the workforce or in retirement would
have assets exceeding $5,000, in which case they would not be eligible for this short -term relief. So that is
my second point.
The third point is using the example of a natural
disaster. I am not sure exactly . . . it is sort of very
broad. In its interpretation that could be any number of
things. But if I use the example, say, of a hurricane and
if somebody has, say, $1,000 of uninsured damage to
their home, then as I read the Bill they could be entitled
to $4,500. But I would have thought it would be capped
to the out -of-pocket expenses. So under that scenario,
if somebody has $1,000 of natural [disaster] damage,
why are we payi ng them $4,500? I would have thought,
again, there would be a cap so that the person receives
the out -of-pocket expenses, but does not receive a
benefit above and beyond what it cost them.
So those are my main comments, Madam
President. I support the Bill. I just think the practicality
of it may be a bit more difficult to manage. But certainly
the intention of assisting people during difficult financial
times brought on by sudden and unfores een circumstances I am fully supportive of.
Thank you, Madam President.

The President: Thank you, Senator Wight.
Would any other Senator —
Vice President Kiernan Bell, you have the floor.

Sen. Kiernan Bell: Thank you, Madam President.
First of all, I am very much in support of this
Bill. I think this is filling a gap that we have in the juris-diction which was, I think, laid very bare by the COVID -
19 experience that we had. So I welcome the provision of short -term and targeted assistanc e. This is an important safety net for our people, and hopefully we will
get people back on their feet quickly.
I will not mirror the questions that have been
raised by others save to say that I had similar types of questions. One of the questions I have for the Junior
Minister is whether or not at the end of the year there
will be a report from Financial Assistanc e not just on
how much has gone out, which of course naturally I would expect to see, but also what the impact has been
positively. So in other words, Is it enough? Is this long
enough? Does this get people back on their feet and
back to being in a stable environment with housing and
so on? Appreciating that, for example, the natural disaster, I am sure the intention is for somebody who loses
their home for a period of time who does not have insurance, they have got an ability to put a roof over their head.
So I think we will be learning as this legislation
is enacted and we are living with it. But I think it is going
to be very important to have that reporting annually so
that we see how the safety net is working.
And then I think my colleague in the Senate
also asked a question around the criteria. And I too
noted that personal injury and specific health- related issues were not there. And I was just concerned whether
or not the sudden financial catastrophe that mi ght befall


Bermuda Senate somebody was too specifically delineated in those sections, so that there was a lack of discretion. Sometimes
it is hard to know what will cause a particular financial
impact on a family. And for example, it might not be a
loss of employment per se; people who are self -employed may suffer a personal injury and have a decrease in their level of earning ability because of their
lack of mobility and lack of ability to stay on their feet
for a period of time or whatever it may be.
So I just flag the fact that I thought that there
was a little less discretion in that section as to what would amount to . . . what criteria leads to a financial
catastrophe than I would expect to see. But those are
very much comments at this stage rather than any opposition to the Bill.
And my last notation, having criticised other
legislation for being too draconian (if I can put it that way) in terms of the punishment, I would say that I will
give praise where praise is due. I thought that this Bill
was proportionate and appropriate in terms of the potential for summary offences and imprisonment, which
is if you commit essentially a fraud on the public purse
and you do not tell the truth in your application, that to
me seemed entirely proportionate and appropriate. So
I did want to make comment on that, having made other
comments so many other times on other legislation.
So, many thanks.
The President: Thank you, Senator Kiernan Bell.
Senator De Couto, you have the floor.

Thank you, Madam President.
I echo my colleagues’ and the other Senators’
support for this Bill. I really will not get into any of the
details about this Bill other than to say conceptually this Bill is an example of the kinds of things that the One
Bermuda Alliance is always happy to support the Government on and which we have in the past, often. I want
to make this clear for the record: [We] often support the
Government on help for people where help is needed.
And if you would allow me to expand on what I
mean by that, Madam President. We heard about some
of the ins and outs of the Bill. And we appreciate that what we like about this Bill is it has targeted the people
in need in meeting a specific need. And tha t is the kind
of thing, Madam President, the One Bermuda Alliance
can really support versus blanket giveaways or blanket
discounts that perhaps give people who do not need it
something they do not need. Let us use those funds where they are needed like how this Bill does it.
We heard from my colleague and some of the
other Senators. But when you do that it does get com-plicated. There will probably be a learning process, and
perhaps next year there may be some tweaks to this
Bill. But we are really happy to see the Government do-ing the work to put the money where it will have the
most impact. And that is the kind of thing . . . again, I
want to state this for the record, because sometimes the Government says, The OBA doesn’t care about people! The OBA doesn’t support the Govern ment’s initiatives to help people! And I just want to be super -
clear, Madam President, along with my colleagues that
we are here to support the Government when it pro-vides targeted, impactful relief like this Bill does.
Thank you, Madam President.
The President: Thank you, Senator De Couto.
Would any other Senator care to speak on the
Bill?
Senator Dill, you have the floor.

Thank you, Madam
President.
I would like to commend the Junior Minister
and the Progressive Labour Party Government for the
presentation of this Bill and the deep sensitisation that
we have to the needs of individuals in this community.
This is an example of an understanding that while in
many ways these are the best of times for many in our
community, yet there are others who are still experiencing challenges in terms of their ability to function from
day to day and meeting unexpected challenges along
the way. So I certainly want to commend the Junior
Minister and certainly commend the team at the Department of Financial Services for the work that they do on a day -to-day basis and the ways in which they work
with individuals in this community to understand what
their needs are and to certainly put stop- gaps in place
to ensure that they do not fall between the cracks.
So once again I say thank you and continued
prayers and support for the entire team as they endeavour to meet the needs of the individuals in our community.
Thank you.
The President: Thank you, Senator Dill.
Would any other Senator care to speak on the
Bill?
Hearing none, then it is over to you, Senator
Lindsay Simmons.
Sen. Lindsay Simmons: Thank you, Madam President.
Madam President, first I would like to thank all
of the Senators for their support of this Bill. I think this is a very important Bill that we are passing today. And
I just want to reiterate and thank you guys for the sup-port.
I also want to remind colleagues that there is
legislation for domestic violence, the Domestic Violence (Protection Orders) Act 1997. The purpose of the
Act is to prevent domestic violence by making legal protections available for persons who have suffered such
violence, or are threatened by it. So to answer your
question, Senator Robinson, about domestic violence,
the objective is to provide short -term relief to an individual who has experienced domestic violence and which
502 26 June 2024 Official Hansard Report

Bermuda Senate resulted in material changes to their living conditions
and financial means of support. Domestic violence [as
a criterion] was included to assist persons who might
have to be removed from their homes at a moment’s
notice and were financially dependent on t he other person involved.
The applicant must satisfy conditions as outlined in clauses 7 to 9 of the Bill. The applicant must interview with the Financial Assistance Coordinator.
They must complete individual monthly expense forms.
The Department of Financial Assistance will conduct a financial institution’s controlled check to determine financial independence. Any other supporting evidence
deemed to be relevant for proof would include written
information from third sector agencies advising them of
the reported incidents, a police report, et cetera.
To answer another question, only the main
bread earner would apply. The relevant checks in addition to the interview process will make the final determination of eligibility.
How long will it take for clients to be paid for
the benefit? The Department of Financial Assistance follows established timelines to ensure the efficient process is managed from the point of receiving an application to pre- screening, and then the final p ayment. This
process also ensures that the department does its due
diligence when considering applications. Upon receipt
of an application, pre- screening will immediately commence for completeness and eligibility, and then payment to recipients will be made within the first week of
the following month once all is in order. This timeline ensures all documentation is complete in accordance
with legislation requirements and that the final interviews have been conducted and third- party verifications are received. The department aims to ensure all
audit requirements are always satisfied.
To answer about the timelines, the most important is the application package is vetted, screened
and aligned with what is required. So, depending on
what has been provided by the applicant will determine
the time taken, because if the department has to keep
going back and asking for documentation, of course
that would extend the period of time. So the department
has to take each application case- by-case individually.
The part of the vetting process that will take the
longest time to get completed will be when the department has to check in with the financial instructions to
verify the information provided by the applicant to the
department. For example, if the applicant provides the
funds they have in their bank account, the department normally has to verify that the information being provided is accurate with regard to the different banks. The
banks usually take a little while to get back to the department. But the good thing is that the department already has an established relationship with every single
bank in Bermuda. They are very much aware of who the Department of Financial Assistance is. That is what
the department currently does with all existing clients,
meani ng we do financial checks on every single client as well. The department is hoping the synergy and the
relationship the department has developed thus far will
not prolong or prevent any applicant from being processed in a quick and efficient time.
The biggest challenge the department has with
Financial Assistance clients is that information is not
being presented to the department in a timely manner
by the applicants. That is the department’s largest challenge presently.
To answer the question about accident victims
who fall under the benefit, we did not look at the cer-tainty of . . . if any of us just got in an accident we would
have insurance to cover for that. For persons who do
not have insurance, we will consider that and see if they
meet the qualifications. If someone has gotten into an
accident and their employment has been terminated,
that would be sudden hardship. But if long- term, the
other mechanism is to apply for financial assistance.
The legislation specifica lly states what hardship is for.
Public health measures, natural disasters, recent unemployment, death of a loved one and domestic violence. If it is related to short -term hardship or financial
hardship due to recent unemployment, and injury has
resulted i n recent unemployment or termination, that
would be under consideration.
To answer the question about false information. If a situation like that unfolds, it all starts with
the department investigation officers and evidence they
normally uncover in terms of their investigation. Depending on the level of evidence that has been uncovered, they will normally communicate directly with the
Attorney General’s Chambers to determine if the particular offence is criminal or civil. At that point in time, the matter is usually referred to the Magistrates’ Court,
and then it is taken to a different level. What sentences
are given out is not for the department to decide. That
would be done by the courts. Whether it is $1,500 or imprisonment, that is determined by them. The offence
may fall within civil or criminal. It is what the Attorney
General’s Chamber determines.
I also want to remind colleagues that the Financial Assistance Act and the regulations still exist for
cases that exceed beyond the remit of this short -term
financial benefit.
I hope that answered all of your questions.
Also, I just want to reiterate. Persons with no
fixed abode can come into the Department of Financial
Assistance where support can be provided in determining whether the person should qualify for financial as-sistance or the short -term relief benefit.
Thank you, Madam President.

The President: Thank you.
Senator Simmons, you can now move your Bill.

Sen. Lindsay Simmons: Madam President, I move
that the Bill entitled the Financial Assistance (Short -
Term Relief Benefit) Act 2024 be now read a third time.



Bermuda Senate The President: Sorry. You need to do your second
reading again. Do it the second time.

Sen. Lindsay Simmons: I just said that. Say it again?

The President: You said “a third time.”

Sen. Lindsay Simmons: Oh, I am sorry.
Madam President, I move that the Bill entitled
the Financial Assistance (Short -Term Relief Benefit)
Act 2024 be now read a second time.

The President: Is there any objection to the second
reading?
No objection.

SUSPENSION OF STANDING ORDER 26
Sen. Lindsay Simmons: Madam President, I move
that Standing Order 26 be suspended in respect of this
Bill.

The President: Is there any objection to that motion?
No objection.

[Motion carried: Standing Order 26 suspended.]
Sen. Lindsay Simmons: Madam President, I move
that the Bill entitled the Financial Assistance (Short -
Term Relief Benefit) Act 2024 be now read a third time.
The President: Is there any objection to the third reading?
No objection.

BILL

THIRD READING

FINANCIAL ASSISTANCE (SHORT -TERM RELIEF
BENEFIT) ACT 2024
Sen. Lindsay Simmons: Madam President, I move
that the Bill do now pass.

The President: Is there any objection to the passage
of the Bill?
No objection.
The Bill is passed.

[Motion carried: The Financial Assistance (Short -Term
Relief Benefit) Act 2024 was read a third time and passed.]
The President: Thank you, Senator Lindsay Simmons.
And thank you, all Senators who participated.

Sen. Lindsay Simmons: Thank you.
The President: Senators, thank you, and thank you ladies for being present.
We will now move on to item number 1 on the
Orders of the Day, and that is the Bermuda Health Council Amendment Act 2024, and that is in the name
of Senator Arianna Hodgson, the Junior Minister for
Health.
Senator Hodgson, you have the floor.

Sen. Arianna Hodgson: Thank you, Madam President, and good morning to you.

The President: Good morning.

[Laughter]
Sen. Arianna Hodgson: Madam President, I move
that the Bill entitled the Bermuda Health Council
Amendment Act 2024 be now read a second time.

The President: Is there any objection to the second
reading?
No objection.

BILL

SECOND READING

BERMUDA HEALTH COUNCIL
AMENDMENT ACT 2024
Sen. Arianna Hodgson: Madam President, I stand today to introduce the Bill entitled the Bermuda Health
Council Amendment Act 2024. One of the principal objectives of the Bill is to allow for the collection of data necessary for improving health care outcomes and ensuring equitable access to services.
Madam President, the Bermuda Health Council Act 2004 [the Act] gives the Bermuda Health Council
[the Council] authority to ensure the provision of essential health services and to promote and maintain the good health of the residents of Bermuda under sect ion
15(1)(a). Section 7 of the Act also provides [that] the
Minister, “after consultation with the Council, may give
general directions as to the policy to be followed by the
Council in the performance of its functions as appear to
the Minister to be neces sary in the public interest. And
the Council shall give effect to any such directions.”
Madam President, the Government relies on
the Council in fulfilling its purposes to regulate, coordinate and enhance the delivery of health services in Bermuda to make evidence -based recommendations.
However, the Council does not have all of the legislative authority required to fulfil its role. Health system
transformation and the implementation of universal health coverage specifically requires an expansion of
the functions of the Council.
Madam President, the Bermuda Health Council Amendment Act 2024 will give effect to the Council’s
504 26 June 2024 Official Hansard Report

Bermuda Senate authority to ensure the provision of essential health services and to promote and maintain the good health of
the residents of Bermuda by establishing that the Minister may direct the Council to collect certain data from
health service providers, licensed insurers and approved schemes, and require the provision of such
data. The Bermuda Health Council Amendment Act
2024 makes provisions to govern this collection of data
and information by the Health Council.
Madam President, the 2023 Throne Speech
proposed legislation “to support data collection to con-trol medical ‘co -pays.’” This follows a 2022 Throne
Speech initiative to understand the drivers of medical
co-payments. More correctly the term is “patient -responsible portion,” or “balance billing.” Although not
stated in the Throne Speech, the initiative is focused on
vulnerable populations only. The Government is com-mitted to controlling the patient -responsible portion for
the vulnerable population.
Madam President, the patient -responsible portion of health care service fees represents the delta be-tween the fee, or the price set and charged by the provider, and the portion covered by the patient’s health
insurance policy. For many, there is a lack of clarity with
respect to both the provider’s charge and the level of
insurance coverage. And the result is an uncertainty
that can lead to patients’ avoiding treatment due to the
actual or anticipated out -of-pocket expense.
Madam President, the Council currently lacks
the required data and information needed to assess the factors determining the payment and thereafter making appropriate recommendations. Targeted data collection from health service providers is a necessary fi rst
step to reveal the drivers of health care costs for providers which contribute to the fees, or the prices set by
those health service providers. Similarly, targeted data collection from health insurers and approved schemes would assist in understanding the reimbursement decisions of insurers. From there, a strategy and action plan for government intervention that is specific and progressive can be sought.
Madam President, two stakeholder engagement sessions on health business licensing were held
on the 14
th of October and the 28th of November of last
year. Invitations were extended to over 520 health businesses and members of the Universal Health Coverage
clinical senate. The November session included a focus on the collection of data to inform the drivers of co -
payments. Coming out of that session is an acknowledgement that the correct term to use is not “co- pay,”
but rather “balance billing” or “the patient responsible portion.” There was wide acceptance that better health
system data was needed to inform decisions that would
ultimately improve health outcomes and better manage
health care costs.
Madam President, while the Throne Speech initiative is specific to the patient -responsible portion of
the health service provider’s fees, there are additional
areas of the health sector where the Council requires the ability to collect necessary data. For example, the
collection of data regarding diagnostic order rates
would support the Council’s efforts to identify any over -
utilisation of health services. While anecdotal evidence suggests that there is an over -supply, an overuse of
some health services on the Island, possibly driven by
financially invested referrals and self -referrals which
contribute to increased health costs, the actual data to inform policy decisions are not available. Monitoring diagnostic ordering rates through legislation better ensures clinically appropriate testing and imaging without
impeding patient access to necessary and appropriate
care.
Madam President, section 5 of the Act lays out
the Council’s functions. The amendments through this
Bill clarify and confirm the functions of the Council as
the entity responsible for collecting and evaluating in-formation in aggregate and anonymising forms to support objective decision- making with respect to population health, health care service delivery, and health
care costs and payments. The Council’s data collection is directed by the Minister pursuant to section 7 to ensure that data collection is targeted and authorised, and
to avoid a data sweep.
Madam President, though ministerial direction
is provided for in the amendment, it is subject to the
overarching goal of supporting objective decision- making in health care. The Minister’s role is to ensure that necessary information is collected to facil itate evidence- based policy formulation rather than to advance
political agendas.
A justification that is grounded in evidence will
be required to progress each new data collection. It will
be up to the Health Council to do the legwork of re-search to propose a plan for new data to be collected.
For example, if we wanted to know the bre akdown by
race of those insured by public or private payer to better
understand health disparities, there must be accompanying research that already links race to disparities in
access to care that is being used to ground the effort.
The Minister may also delegate the review process if
appropriate.
Further, ministerial direction will be guided by
the overarching goal of supporting evidence- based decision -making in health care. The Minister will work
closely with the Council to ensure that directives are targeted and aligned with the Council’s mandate. Additionally, there are provisions for transparency and accountability in the direction process, including the ability
to challenge directives through appropriate channels if necessary. The Bill is drafted so as to specifically avoid
data sweeps.
Madam President, accountability and transparency are fundamental principles guiding the Council’s operation. The amendment reinforces this by clearly
defining the Council’s responsibilities and the purposes for which data will be collected. Additionally, the Council will engage in regular reporting to stakeholders and
the public, providing updates on its activities and the


Bermuda Senate use of the collective data. Feedback mechanisms such
as public consultations and stakeholder forums will be
established to ensure that diverse perspectives are
considered in decision- making. This commitment to
openness and responsiveness will help maintain trust
in the Council’s actions and decisions.
Madam President, turning now to international
best practices relating to data collection and security.
This amendment aligns with international best practices in health care data collection and analysis. The
Council has conducted thorough research on interna-tional best practices in health care data collection and
analysis to inform the development of this amendment.
Lessons learned from other jurisdictions including successful approaches to data anonymisation, secure
data- sharing protocols and effective ut ilisation of health
care data for policy decision- making have been incorporated into the amendment’s provisions. By drawing
on global experience and expertise, the Council aims
to implement world- class standards for health care data
governance and utilisat ion in Bermuda.
In keeping with international best practices, the
amendment outlines the types of information required
including data related to health care service delivery,
utilisation, cost, and payment for health products and services. This information will support objective decision-making particularly in the context of implementing
universal health coverage. The Council will operate
with transparency and accountability, ensuring that
data are used solely for their intended purposes and
that decision- making processes are subject to appropriate oversight.
Madam President, with respect to the specific
measures that will be put in place to ensure the security and integrity of the data collection by the Council, data
security is a top priority and the Council will implement stringent protocols to safeguard information. This in-cludes encryption measures, access control and regular audits to ensure compliance with data protection
standards. Anonymisation techniques will be carefully
vetted to minimise the risk of re- identification, and the
Council will stay abre ast of advancements in data privacy technology to continually strengthen its practices.
Data security also includes patient privacy matters surrounding the data collected. Patient privacy is
of utmost importance, and this amendment includes
provision for anonymising patient names and other
identifying information. This ensures that while nec essary data are collected for objective decision- making,
individual privacy is respected. Additionally, the Council will adhere to strict data protection protocols to safeguard patient information.
Madam President, privacy and data security
are paramount. The Health Council is committed to ad-hering to the Personal Information Protection Act
[PIPA] and ensuring that all data collected are anony-mised and [that] commercially sensitive information is
protected. Along with this, the Health Council Board,
made up of health professionals, corporate leaders and concerned residents, hold the team accountable to the
standards that it espouses through governance, reviews and audits. The Health Council has been t he primary collector of health system data since its inception and has never once been accused of breaching confi-dentiality or using its current access to sensitive health
system data in ways that would compromise the integrity of businesses or persons.
On average, the Health Council collects data
related to 2 million health system transactions each
year. Understanding the importance of that slice of health system data and the responsibility to keep it private, the Health Council is clear that it is not a bove the
law when it comes to adherence to PIPA or general corporate and professional standards. According to PIPA,
a person or organisation who commits an offence under PIPA may be liable on summary conviction in the case of an individual to a fine of up to $25,000 and up
to two years imprisonment. And in the case of conviction of an entity on indictment, to a fine not exceeding
$250,000.
The Health Council has had discussions over
the last few years with the Privacy Commissioner and
is committed to being an accountable, transparent and
reasonable actor within the health system and is a responsible corporate citizen in general.
Madam President, the natural question some
might ask is, How does the data collection initiative out-lined in the legislation contribute to universal health
coverage? And will improved data help the health system save money? The data collection initiative is integral to advancing universal health coverage by provid-ing the necessary evidence base to inform policy deci-sions aimed at expanding access to essential health
care services for all residents of Bermuda.

The President: Senator Hodgson, I would just ask you
to keep the microphone closer to you.

Sen. Arianna Hodgson: Apologies, Madam President.
The President: All right. No problem.

ANNOUNCEMENT BY THE PRESIDENT

SENATE VISITOR
The President: I am sorry. Can I just acknowledge the
presence of the Town Crier for Hamilton, Mr. Edward
Christopher, and the overseas visitors.
Welcome to you, and enjoy your stay.
They are about to leave. I just want to
acknowledge them.
[Bermuda Health Council Amendment Act 2024, second reading debate, continuing]

Sen. Arianna Hodgson: By systematically collecting
data on health care service delivery, utilisation, cost
506 26 June 2024 Official Hansard Report

Bermuda Senate and payment mechanisms, the Health Council can
identify gaps in coverage, assess the effectiveness of
existing health care programmes and tailor interventions to address specific needs within the population.
This targeted approach to decision- making enables
policymakers to design and implement initiatives that
promote equitable access to health care services,
which is a key tenet of universal health coverage. Furthermore, improved data quality and analysis capabilities can lead to more efficient resource al location and
cost-saving measures within the health system. By
identifying areas of inefficiency, redundancy or over -utilisation, policymakers can implement targeted interven-tions to optimise health care delivery and reduce unnecessary costs. For example, better data on health
care utilisation patterns can help identify opportunities
for preventative care interventions or interventions to reduce hospital re- admissions, leading to cost savings
from the overall health system.
Overall, leveraging improved data to inform decision -making processes has the potential to make the
health system more financially sustainable while advancing the goal of universal health coverage.
Madam President, turning now to what may be
of concern to licensed health service providers, insurers and schemes regarding what may be seen as additional administrative burden, especially for smaller providers. How will they cope with the costs and resources required for compliance? While it is understandable to
be concerned about administrative burdens, the
amendment emphasises the importance of streamlined reporting and data collection. The Council will collaborate with stakeholders to develop efficient mechanisms
for submitting information, minimising the burden on
providers, insurers and schemes. Additionally, the benefits of having access to comprehensive data for deci-sion-making such as improving health care delivery
and ensuring equitable access to services outweighs
the initial investment in compliance.
The Council recognises the potential impact on
health care providers and is committed to minimising any undue burdens. Technical assistance and support
will be provided to help providers navigate the data collection process, including guidance on data anony-misation and reporting requirements. Additionally, the
Council will engage in ongoing dialogue with stakeholders to address concerns and streamline compliance
procedures where possible.
Madam President, public awareness and engagement are integral to the success of the data collection initiative. The Council will launch targeted public
education campaigns to inform residents about the importance of data collection for improving health care
outcomes and ensuring equitable access to services.
Additionally, opportunities for public consultation and
feedback will be provided to solicit input on data collec-tion priorities and to address any concerns or misconceptions. This proactive engagement will help build
trust and transparency in the data collection process. Madam President, these amendments would
be futile without ensuring the Council’s ability to enforce
them. Therefore, failure of a health service provider, insurer, or an approved scheme, to provide the information or data requested by the Council is an of fence
and could result in a fine of $20,000, imprisonment or
both. This serves as a strong deterrent and ensures
that providers, insurers and schemes understand the
importance of fulfilling their obligations. The standard
penalty via legislation serves the purpose of enforcement, which is customary.
However, the penalties outlined in the recently
enacted Bill are consistent with those already estab-lished in the existing Act. In all cases brought before
the magistrate, it falls within their discretion to decide
the penalty whether it be a fine or term of imprisonment
based on the circumstances and severity of the specific case. The magistrate exercises their discretion to deliver a proportional sentence that aligns with the gravity
of the offence for those who face challenges meeting
this requirement.
The Ministry of Health and Bermuda Health
Council will assist health businesses in collecting and
submitting the required data. Additionally, the Council
will collaborate with stakeholders to streamline the reporting process and address any concerns they m ay
have.
Madam President, allow me to end where I
started. This Bill before Senators today seeks to provide for the collection of data necessary for improving
health care outcomes and ensuring equitable access to
the services for all Bermuda residents.
Madam President, we will be going into Committee to handle the amending motion that has been provided. So, Madam President, with these remarks I
am pleased to introduce this Bill today, and I look forward to a wholesome debate.
Thank you, Madam President.

The President: Thank you, Senator Arianna Hodgson.
And, Senators, I would just like to remind you
that we will be going into Committee as there is an
amendment to the Bill. However, we will entertain the
comments from the floor at this time.
Senator De Couto.

[Pause]

The President: I cannot hear you, Senator De Couto.
Can you speak to the microphone?

Earlier today I talked
about how the OBA supports targeted, impactful Bills
that achieve specific outcomes that are important and
necessary. I will come back to that theme a little bit later, but just to give you a heads -up, this is not a Bill
that we see in that category.
But I want to stipulate, Madam President, that
the One Bermuda Alliance urgently, urgently observes
and sees the need for improvement in health care in Bermuda, both in the actual outcomes —we need a
health care population— and in terms of the resources
needed to improve those outcomes —dollars and cents,
the costs. I think everyone understands th ose pressures. And, Madam President, we stipulate the need for
information and informed decision- making to improve
those outcomes and reduce those costs. So in terms of
the Bill’s objectives, Madam President, we are supportive of those objectives. But, Madam President, we cannot support this Bill.
From where we sit, Madam President, this Bill
does not support those objectives. It is too broad. It is not appropriately tailored. And even if, Madam President, this last -minute amendment —which we are having delivered to our desks this instant —was to be
passed, which, by the way, we would support passing
that specific amendment. Even if that amendment was
to be passed, we still could not support the Bill, because there are numerous, numerous other issues with
the Bill, which I want to get into right now, M adam President.
You know, Madam President, the Government
talked about some consultation. And I have to say that
we are going to have to disagree on that one because
in the past two years I cannot recall a piece of legisla-tion that has engendered such a spirited, such an emo-tional outpouring of response to us from the stakeholders. In fact, since the Bill was originally passed in the
other place, the One Bermuda Alliance has had numerous consultations with medical professio nals. And we
have had the opportunity to learn about the many,
many issues with this Bill that, frankly, while I appreciate the Junior Minister’s brief, I would say she did not
adequately address. And I am going to try and talk
about some of those issues. And again, Madam President, you will find that we are going to have to agree to
disagree on some of the statements that she made.
Madam President, it is very hard because this
Bill is very open -ended about the amount of data that
can be collected, and we are imagined to trust future
rules and regulations that have not appeared yet. And
from the perspective of many of the stakeholders, med-ical professionals, they are worried about arbitrary data
sweeps, overly broad discretion. We heard about the
costs. And again, many of the small operators, despite
the Junior Minister’s comments, are concerned about
the costs. Will they have to hire staff to prepare this information?
Let me talk about, for example, handling of private data. This Bill only mandates that patient names
be hidden. It leaves the rest up to the discretion of the
Health Council. And it has been reported to us by the
professionals, those who know, that this c an open the
door to people being able to determine personal information. So, for example, birth dates, gender, addresses, race, family medical information—those are
all pieces of information that can easily be used to correlate sensitive medical information back to individuals across data sets.
We remain concerned that this Bill is not consistent with PIPA. And it raises very much a lot of con-cerns there, as the medical professionals have raised
that concern to us. We remain incredibly concerned
about the Health Council having the appropriate da ta
retention policies for these data —data access policies,
Madam President. None of which are specified through
this legislation.
Who will have access? With whom shall this
important information be shared? And how long will this
data collection go on, Madam President? Will the Gov-ernment still be sweeping medical professionals for
data 10 years from now? If universal health care shou ld
be achieved and put into place, will this Bill still empower the Health Council to continue to seek sensitive data on patients?
And I am going to provide, Madam President,
a disturbing example that was supplied to me. An employee of the Bermuda Health Council had in fact sent
an email to all of the pharmacies on the Island naming
specific individuals, including some specific sensi tive
medical data about those [individuals] in this blast email to all of the Island’s pharmacies, requesting specific
and detailed personal and private prescription information from those pharmacies.
508 26 June 2024 Official Hansard Report

Bermuda Senate So that gives you an idea of the kind of controls, or lack of controls, and the mishandling of patient
information that . . . And look. I do not want to paint the
Health Council with a broad brush, Madam President. But when you see an example like this, you have to ask what else could go on when the Health Council might
have this information.
So I would suggest, Madam President, that despite the Junior Minister’s statement that international
best practices and securities have been considered, in
practice what this Bill contains is in fact not consistent with any of those international best prac tices.
And going back to the consultation, Madam
President, like I said, when this Bill was passed in the other place, we in the One Bermuda Alliance in fact had
an opportunity to continue further consultation. And because of the numerous problems with this Bill, they feel
that—

Sen. the Hon. Owen Darrell: Madam President, I have
heard quite a bit. But the Senator is misleading the [Senate].

Madam President —
The President: I will take a point of order.

Sen. the Hon. Owen Darrell: A point of order, yes.

POINT OF ORDER
[Misleading]

Sen. the Hon. Owen Darrell: The Senator is misleading the [Senate]. What he will not say is that in another place the One Bermuda Alliance voted to support this
Bill, Madam President. Thank you.

The President: Senator De Couto, you can continue.

Madam President, like I
said, we have had numerous consultations. And the
message that we have received in the medical community is that the Government has not listened to them, that things that showed up in this Bill were not adequately conveyed to them. The key —
Sen. the Hon. Owen Darrell: Madam President, point
of order.

The President: What is your point of order, Minister
Darrell?

POINT OF ORDER
[Misleading]

Sen. the Hon. Owen Darrell: The Senator is again
misleading the [Senate] when he says that the Govern-ment has not listened to the medical professionals. I
can tell you without a shadow of a doubt, Madam President, that the Minister of Health has met with the
Health Council and many stakeholders in this area many, many times. So, Madam President, I would ask
that the Senator please stop misleading the [Senate]
repeatedly.

Madam President, as I
said, numerous medical professionals have directly
said to us . . . numerous medical professionals have directly said to us that they were not adequately con-sulted on this Bill. They were surprised by the contents
of this Bill. And these numerous issues with this Bill that
I am relaying to you, Madam President, here have been
relayed to us from them.
So you are going to have to . . . If there are
people here who are saying that I am lying about what
has been said to us, I would urge them to perhaps restrain themselves, Madam President.

Sen. the Hon. Owen Darrell: Madam President, point
of order. Point of order.

This is what we have
heard directly.

Sen. the Hon. Owen Darrell: Point of order, Madam
President.

POINT OF ORDER
[Unparliamentary language]

Sen. the Hon. Owen Darrell: The Senator is using language that is non- parliamentary in here, Madam President. I [ask that] he retract that comment about people
in the Senate lying. That is very out of order and disrespectful, Madam President.

The President: Senator De Couto, you are required to
withdraw.


Bermuda Senate Sen. Dr. Douglas De Couto: Well, I do retract that. But
if there are people here saying that what we are saying
did not happen —
Sen. the Hon. Owen Darrell: Madam President, again
point of order!

The President: Minister Darrell.

POINT OF ORDER
[Unparliamentary language]

Sen. the Hon. Owen Darrell: Point of order, Madam
President.

Yes, Madam President.
So let me repeat my point, Madam President,
because it keeps being interrupted.
We have been directly informed by numerous
medical professionals that they do not feel they were
appropriately consulted on this Bill. They are not happy
with many of the provisions of this Bill —not just the imprisonment provision but numerous provisions. They
have major concerns about patient privacy. They have major concerns about commercial sensitivity. They pro-vided numerous examples, such as, the pharmacy example that I gave where, despite what is written on paper they have, frankly, based on reality, some reasons
to be unsure that the sensitive personal data will be ap-propriately handled.
And from their perspective, this Bill has coloured the whole collaboration that is required to suc-cessfully achieve the important health outcomes that
we need, which should have become a mutually constructive and collaborative process between the medical professionals, the Government, insurers and so
forth. [This Bill] has now turned into a carrot -and-stick
exercise which seems to have a little more stick than carrot. And, Madam President, you know in human relationships, you do sometimes have to have the stick
and you do sometimes have to have the carrot. And
when those things become out of balance, you do not
get very good results. And that is where we are with this
Bill, Madam President.
And then of course we have the hacks. So
again that is a reinforcement of the concern that people
have with more sensitive data being collected by the Health Council. How will this information be shared securely with the Health Council? How will it be made
safe?
So those are some of the concerns that we
have, Madam President.
And then let me conclude with two final comments. This Bill has a feature that we have seen recently in some of these Government Bills that generally
we feel should be uncommon. And this is the Henry VIII
clause, a sort of back -door [provision] that allows the
Executive to modify other Bills through negative resolution. I have had an opportunity since being notified of
this to do some research, Madam President. And they
are generally considered in the parli amentary systems
to be very uncommon, very overreaching and, where they are used, subject to great, great scrutiny, Madam
President. And again, I feel that this Bill does not re-quire that clause. The Government, if it felt the need to
make various changes, could always bring them (as we
like to say here) in the usual manner. And we in the
OBA will be happy to support on those objectives. We will review them appropriately tailored and appropriately narrowed.
So, with that said, Madam President, we do not
support this Bill. Even should this amendment that I believe we will discuss later pass (which we do support
that specific amendment because we do not believe
medical professionals should be locked up around data
collection), the outstanding problems with the Bill —the
consultation, the privacy, the overreaching—still remain, Madam President.
Thank you for allowing me to make those comments.

The President: Thank you, Senator De Couto.
Senator John Wight, you have the floor.
Sen. John Wight: Thank you, Madam President.
Several weeks ago the Senators were invited
to meet with the Bermuda Health Council, which I found
very helpful. And I assume the other Senators found it
helpful as well. And we were able to ask questions and
get some further insight as to the objectives behind this
amendment.
I think it is this type of collaboration that is necessary to ensure a full understanding of the ramifications of important legislation such as this for the many
stakeholders who will be impacted by the legislation
should it go through, being principally the hundreds of
licensed health care providers, licensed insurers, approved health schemes and even the Bermuda Hospitals Board. We all, I believe, share the same objective
of wanting improved health care services, efficient and
value- driven. Moving from t he current health model to
universal health care is a monumental shift for an island our size. It is complex and not without great risks.
While I can appreciate the need for the Health
Council to require information from the parties I just
listed, I am opposed to both the process that has gotten
510 26 June 2024 Official Hansard Report

Bermuda Senate us to where we are today and also certain wording in
this 2024 amendment. To emphasise my first point relating to the process, the very fact that there has been
such strong opposition to the amendment Bill at the
eleventh hour by the medical profession fol lowing its
recent passing in the House tells me that the collaboration required did not adequately take place.
My second concern about the amendment relates to its wording. The current Bermuda Health Council Act 2004 states that the regulations [at section
15(1)(e) of the Act] require “licensed health service pro-viders to supply such returns, statistics or other i nformation as the Council may, by notice in writing, require
. . . .” This wording has been in existence for almost 20
years. I am not aware of any material complaints from the application of this wording over that long period.
Fast-forward to 2024, and draft wording becomes broader and requested data more open- ended.
While we understand the need for the Health Council to obtain information to achieve its goals, health care
practitioners’ practices are staffed to prioritise pati ent
care, as they should be. We do not want patient care
outcomes to be adversely impacted by a sudden need
to provide administrative services relating to this
amendment.
As the wording stands now, the message is,
Pass this legislation, and the rules, as determined by the Health Council, will be unilaterally determined and enforced at a later time. In my view, this is not the correct path to success. Real collaboration needs to take place between the Health Council and the impacted stakeholders so that all parties understand and can see
the line of sight to success that achieves the goals that
we al l want to see—a more effective and efficient health
system for Bermudians and its residents.
Until this happens, Madam President, I am not
supportive of this legislation.
Thank you, Madam President.
The President: Thank you, Senator John Wight.
Would any other Senator care to speak?
Senator Vice President Kiernan Bell, you have
the floor.
Sen. Kiernan Bell: Thank you, Madam President. And
I will try not to be repetitive, as some of my concerns
are mirrored by other Senators.
So, I would like to provide some context if I
may. I have reviewed this amending Bill, which is a very
small amending Bill. I think, given the amount of time that we are taking debating this, the listening public
might be interested to know that we are debating a Bill
which is really in substance two paragraphs. And that
is because those two paragraphs and the impact of
those two paragraphs are important.
So when I reviewed this amending Bill, I reviewed it with the important public policy goal of assist-ing the Ministry of Health and the Health Council in
achieving their stated policy goal of taking Bermuda on the journey to accessible universal health care and enabling the Health Council to achieve its statutory purpose of regulating, coordinating and enhancing the delivery of health services in Bermuda. That is what this
amending Bill is intended to assist. It is intended to assist the Health Council in gathering data from health
service providers, health insurers and employers who
operate improved schemes in gathering those data.
And I will come back to that.
Secondly, I reviewed this Bill with the public
policy consideration of safeguarding highly sensitive and personal health information. And I have that firmly
in mind. This Bill is not concerned with the data that
belong to health insurers, doctors, nutriti onists or occupational therapists or any other licensed health service provider once they become licensed. It is concerned
with my data and your data and your family’s data and the data of every single person living in Bermuda today.
I also reviewed this Bill in connection with the
sentence of 12 months imprisonment. In other words, what are the punishments for failing to provide the
data? And I was particularly concerned with the sentence of 12 months imprisonment, which I know is going to be the subject of an amendment. I did raise in the
technical briefing my concern with this, and I viewed it
as disproportionate and not consistent with the very important public policy consideration of ensuring that we have a fair system of law in t his country that prevents
abuse of power, protects individual liberty and maintains the public trust. And for that, at least, I am grateful
that there is, it appears, an amendment which will be
getting rid of that provision, which we shall deal with
subsequently.
While I am pleased of course to see that this
has been addressed, I still do not support this Bill in its
current form for two principal reasons. First, the Bermuda Health Council Act in section 15 already provides
the Minister, in conjunction with the Health Council, to
make regulations to collect precisely the sort of information it is seeking by this amendment from licensed
health service providers. Those regulations, as Senator
John Wight already mentioned, have not even been
drafted or passed. The Hea lth Council technical officers
have confirmed to Senators in the technical briefing, for which I am very grateful, that they intend to pass those regulations. And this amendment, to my mind, is therefore unnecessary and possibly, and quite probably, unhelpful in assisting the Health Council in its important
work, and appears to go beyond the scope of the prin-cipal Act.
But one of the ways it goes beyond the scope
of the principal Act is by reference to the fact that the
amendment seeks to apply to health insurers as well as
employers, like the government and the Bank of Butterfield, who operate approved schemes. These are all
entities that are already regulated by the Health Council
under entirely different legislation and already provide
data to the Ministry of Health under this legislation. In
short, Madam President, in my view I do not understand


Bermuda Senate this legislation to be the appropriate legislation to be
regulating these entities with these amendments.
And if for some reason it is deemed important
to provide for additional data- collecting powers or to
force compliance with health insurers or employees or
executives of the government, or one of Bermuda’s major banks, then there should be full consultation with
those stakeholders and a full debate in the House of
Parliament under the Health Insurance Act and amendments to that particular Act.
Secondly, I do not support this Bill because,
despite the statements that were made by the Junior
Minister, there is no language in this amending Bill
which is consistent with international best practices on
protecting data. The amendment deals with data and
anonymising data in clear recognition of the sensitivity
of the data, and yet is not consistent with the statutory language of the Bermuda PIPA legislation shortly to
come into effect. The amending Bill does not cross -refer or incorporate PIPA by refer ence. Put bluntly, the
proposed Bill in its current form makes insufficient provision to safeguard our personal health information.
I would support an amendment to this Act
which expressly mandates the Health Council to collect health data in accordance with PIPA and expect that any regulations which are ultimately drafted by the
Health Council for the Minister to review will be in accordance with PIPA. And I thank the technical officers of the Health Council who briefed the Senate for confirming that this is indeed their intention. But the Bill as
it is currently formed does not in fact cross -refer or refer
to PIPA.
And at this point I would note, Madam President, that section 5 of the Act, which deals with the functions of the Health Council, actually contains no
provision whereby they shall collect sensitive personal information, as defined under the Personal Inform ation
Protection Act, or make any other provision surrounding how they should functionally collect personal data.
And that, I think, is an oversight, particularly given that
this is entirely focused on collecting data.
So, I do have some questions. Those are my
overarching in- principle concerns. But I do actually
have some questions about this legislation. So, appreciating that the 2004 Bermuda Health Council Act has
two primary statutory purposes: (1) to create the Heal th
Council and to provide for its function; and (2) to provide for the regulation of health service providers, and acknowledging there are not any currently licensed
health service providers under the Act, are there going to be regulations passed under sec tion 15, and when?
And what state are those regulations in in terms of
drafting? I made reference to those regulations before.
Secondly, turning to the actual language of the
proposed amendment itself and the inclusion of an “approved scheme,” could the Junior Minister confirm what
the term “approved scheme” refers to? I have extrapolated that “ approved scheme” is intended to refer to that
term as it is defined in a completely different Act. But that is an assumption on my part; it is not in fact a term
which is defined in this particular legislation. So could
the Junior Minister confirm what an approved scheme
is? And is it intend ed to refer to an approved scheme
as defined in the Health Insurance Act?
The follow -on question from that, Madam President, is if an approved scheme is an approved scheme under the Health Insurance Act, that is not a body corporate or a person. It cannot provide information; it cannot pay a fine. So how is an approved scheme supposed to fall within this particular section?
As a follow -on question, Given that the only
bodies that operate approved schemes are the government and the Bank of Butterfield, can the Junior Minister answer whether or not the government or the bank
have been failing to provide requested information to
the Health Council?
(I am skipping over some of the questions
which have been addressed by others.)
Madam President, I would ask the following
question: Has there been any consideration to includ-ing a provision in the principal Act which includes that
the function and duty of the Health Council is also to
ensure the safe and secure collection, analysis and dissemination of health care data? There is no such provision in this amending Bill or in the principal Act.
So, there was a concern raised about the punitive provisions for failing to provide data. And I have made reference to section 15 [Part III] of the principal
Act, which is the section providing for regulations. That
section specifically provides that offences for breaches
of regulations, including any regulations which may be
made for the provision of such return of statistics, et cetera, are to be subject to a fine not exceeding
$50,000. The current provision, of course, is different
than that. The fine is $20,000, and currently provides
for a sentence of imprisonment. Why the difference?
There is a clear conflict there.
In terms of the sensitivity of data, because it is
clear from the provision of the section that the Health
Council (if this Bill is passed) can require return of statistics or other information and shall require such in the
form that anonymises patient nam es . . . But that is the
only provision that is in there on anonymisation that mandates it. Can the Junior Minister confirm whether
there is anyone currently employed by the Health
Council as a data protection officer, a privacy officer, a
chief information security officer or their equivalent? I
have looked on the website [to see] if it exists, and I do not see anyone with those designations or any equivalent job title identified. But I think it is important to know.
If no such persons are currently identi fied or are employed, is there an intention to recruit people?
At this point I would observe, Madam President, that in the United Kingdom as a matter of law, at least a data protection officer must be employed by
NHS [National Health Service] England, which is the
equivalent of the Health Council. In fact, they employ
512 26 June 2024 Official Hansard Report

Bermuda Senate four different people, all of whom have the role of ensuring that they do not request data that goes too far,
and they protect patient confidentiality and protect sensitive health data.
Can the Junior Minister confirm whether the
Bermuda Health Council will adopt regulations or principles or guidance and publish them so far as their data
collection practices? And while there was reference in
the brief given by the Junior Minister to the H ealth
Council following best practices, there are well -published best practices in the United Kingdom called the Caldicott Principles, which are used by NHS England.
There is nothing currently published in the Health
Council’s website today. And there is no mention of it
in their PATI [Public Access to Information] statement.
And there is of course no mention of any of this in the
amending Bill itself.
I have already made reference, Madam President, to clause 2(3) of the amending Bill, which provides that the Health Council can require returns or statistics in such a form that anonymises patient names, which indicates clearly that this is sensitive personal information as that would be defined under PIPA. So my
question concerns the discretionary language in that
clause. There is no language that requires that this be provided in accordance with PIPA [Personal Information Protection Act]. So can the Junior Minister answer why this provision does not expressly incorporate the provisions of PIPA such that the Health Council will
only collect data in accordance with PIPA when it
comes into force in 2025, which includes of course the principles of proportional ity provided in section 11 of
PIPA, which is that the Council would only request per-sonal information that is “adequate, relevant and not excessive in relation to the purposes for which it is
used”?
Then finally, Madam President, can the Junior
Minister confirm whether or not the Health Council has
created a data protection impact assessment template
or equivalent to help to identify and mitigate potential
data protection risks to an acceptable level before requesting in formation from insurers, medical professionals and others, and certainly before using, sharing or processing data that identify or could identify individu-als? And if such a document exists, Madam President,
can the Junior Minister confirm, as in other juri sdictions
which have enacted similar protections to health data,
that this will be published on the website?
Thank you, Madam President.

The President: Thank you, Vice President Kiernan
Bell.
Would any other Senator care to speak on this
Bill?
Senator Robinson, you have the floor.
Sen. Leslie Robinson: Thank you, Madam President.
The President: Sorry. Senator Leslie Robinson I
should say.

Sen. Leslie Robinson: Thank you, Madam President.
I appreciate comments that have been made
thus far. I think, though, that we are losing sight of the
ultimate goal of this Government, which is to one day
provide universal health care to the citizens and residents of this Island. And as another Senator s aid, it is
a complex task. It is not going to be easy. But we are beginning that process because this is one of the things that we as a government have said that we will do, and
we know that it is necessary for our people.
I think we, as I said, are losing sight. We have
this one piece of legislation which is allowing us to be
able to —or the Health Council to be able to—collect
needed data, and in particular needed data for the patient-responsible portion of the fee. Now, I am going to
sit here and say, yes. You know, I have family members
who own health care facilities. I have friends who own
health care facilities. And they have discussed and
raised concerns with me and many others, even as has
been said today.
Madam President, at the end of the day we are
still looking out for our people— our people. We have to
remember there are so many people who cannot afford health care. And we want to be able to have all people on this Island have access to adequate health c are. We
have, for example, seniors. And we all know the plight
of our seniors. So many of them, because of the cost of
living on our Island, they are not able to always pay for
health insurance. They cannot always get FutureCare
each month. I know with my mother, whom I was deal-ing with some years ago, was having to pay out $1,600
a month to one of the health insurers. And then we
moved to FutureCare, but it was still having to pay out.
And then also we have young people, and
many of our young people when they come back to the
Island have already aged out and they cannot be part
of their parents’ health insurance. So while they are
looking for jobs, permanent jobs, it is difficult sometimes in some cases to get health insurance and to be
able to get the needed health care because their in-come does not allow. And then we have self -employed
people. A lot of them, again because of the cost of doing business, are not able to access the necessary or
have means to be able to access the necessary health
care.
And at the end of the day, all segments of the
population who are not able to access health care have problems. Many of them have problems as they get
older because things that they could have been able to
fix they are not able to fix because they are not able to
get the necessary care.
Madam President, I was in a health care facility
that I only go to once a year. And just the other day,
you know, a lady was having to pay an extra $40. I am
just going to say, you know, $40 for a particular procedure. And I felt bad for her because she was being


Bermuda Senate called in a second time. The first time she had got the
procedure done there was no fee. The second time she
is being called back, and now she is worried about what
the results are going to say, and she now finds out she
has to pay a $40 fee. And she was l ike, Oh, my gosh.
You didn’t tell me. And they could not give her any
breakdown or reason as to why she had to pay this $40
fee even though she had come there a few weeks before and she did not have to pay a fee.
I felt very sorry for her because in midst of her
whole health care situation, not knowing what the re-sults were going to be, she was worried about, Oh, my
gosh! I can’t pay this $40 fee. And it was almost like,
Well, you can’t get this second procedure until you pay
the $40.
So, all we are saying here with this piece of legislation is being able to collect data so that we can un-derstand what the patient -responsible portion of the fee
is. How does it get made up? What does it comprise?
Because at the end of the day, we are tryi ng as a Government to bring forth universal health care.
I do also understand the concerns about PIPA.
Some of us call it PIP- A . . . or PI -PA. But when that Act
is enforced, when that date of January 2025 comes,
everybody is going to have to be in compliance with PIPA— everybody. So it is not necessary at this moment in time to be putting specifics about PIPA in this because at the end of the day everybody is going to
have to comply with PIPA.
So, Madam President, I wanted to understand
that at the end of the day it is about universal health care for our citizens. This is just a step to be able to get
there. But this is the end goal. And as a former Berkleyite, I always say, r espice finem— Keep the end in
view.
Thank you, Madam President.

The President: Thank you, Senator Robinson.
Would any other Senator care to speak?

[Inaudible interjections]

The President: No, no.
Senator Kiernan Bell, you —

She has already spoken.

The President: No, I know she has already spoken.
She asked the question.
Sen. Kiernan Bell: I have one question. It flows from
something which Senator Robinson said. Am I able to
just ask a question on section 17?
No?

[No audible response]

Sen. Kiernan Bell: I am not clear. Sorry.
The President: You can ask your question.

Sen. Kiernan Bell: Thank you so much, Madam President.
I just understood it to be suggested that there
would be no issue in terms of the Health Council complying with PIPA, for which of course I am grateful. I
wanted to understand section 17 of the Bermuda
Health Council Act 2004 [which] provides for statutor y
immunity to the Council “any member of the Council or any person acting on the direction of the Council for an-ything done in good faith in the exercise of their functions under this Act.” Does that include if they breach
PIPA?
Thank you.

The President: Senators, the floor is still open. Which
Senator would like to speak at this time?
Senator Robinson, Dwayne Robinson, you
have the floor.

Sen. Dwayne Robinson: Thank you, Madam President.
A lot of my concerns have been stated by my
fellow Senate colleagues. My main goal for speaking today is to kind of highlight the fact that we have once
again been told that when this Bill was brought forward
in another place that consultation and thoroug h consultation was done and that the stakeholders were buying
into this. And the One Bermuda Alliance in another
place signalled its opposition to this Bill by one Member
calling it “draconian” and another mentioning that it was
a “heavy hand.” And an amendment was brought for-ward.
Now, this amendment was to remove the imprisonment from this particular Bill. And that was voted down by 18 PLP Members in another place. And now
we see that same amendment brought before us today.
So not to pre- empt that, but it is very pressing because
we are also now seeing medical professionals, who
have lobbied all of us, who have sent emails to Sena-tors who have come out into the press and mentioned that they have an amendment, they have concerns after the passing of that Bill in another place that let us
know that the consultation is being somewhat disputed
and that it has been signalled that the [Bermuda Medical] Doctors Association would be willing to work collaboratively with the Government to ensure that this
legislation is passed in a way and a manner that is equitable and supported by those particular stakeholders.
And I would like to also put forward that the Opposition is willing to make itself available should the
Government choose to take up that offer and actually
collaborate with the stakeholders and produce a piece
of legislation that has the unilateral, or at least majority, support of those medical professionals and also address the very serious and egregious allegations of lack
of security for people’s persona l information that I think
should not be dismissed.
514 26 June 2024 Official Hansard Report

Bermuda Senate And I find it to be very concerning. Because
when a guardrail was placed on this particular [legislation] before in another place, they voted against it, only
to now come back and bring it.
So this is a moment now for the Progressive
Labour Party to show the public and to show everyone
that they are indeed the type of Government that listens, that they are indeed the type of Government that
they campaign to be and listen to the outcries of the
medical professionals. Because we know letters have
been sent, we know emails have been sent that have been read, or hopefully read, by [Senators] before they
came into this place to debate it accurately. This is a
moment now that would define whether or not we will
be looking down months in the future to see yet again another amendment brought forward because, Oh, we
got a lawyer who is now going through the Bill and has presented legal ramifications, and now Government will
have to U -turn.
If this is the journey that this Progressive Labour Party is taking Bermuda on the road to universal
health care, which is one of their pledges, we cannot
start that road alienating those who are administering
that care. That is not looking out for the best interest of
Bermudians if you are alienating those who are going to be providing care in the hopeful universal health care
system that is going to be coming down the line. So we
have to be careful to safeguard not only people’s health, but we have to sa feguard those who are administering that health [care] to our people and safeguard their data.
And I believe that as it stands right now with
this particular Bill, that is not the case. And I do not see a defeat for the Government to listen to those health care professionals and do what is in the best interest of
Bermuda and make sure that they com e back with a Bill
that takes into account the criticisms and complaints of these particular medical professionals that will be
passed. Because I feel as though it is no fault to change
a stance when presented with new information, when
presented with plausible and very critical concerns for
people’s health care safety and the security of their information.
So, I am not going to retread too much ground
that has been said by fellow Senators. But I cannot sup-port this Bill in its current form even with the amendment that was suggested in another place by colleagues in the One Bermuda Alliance. I do support that
amendment, but I also support fulsome, collaborative
governance. And I think that this is a defining moment for the Progressive Labour Party, if they also support
fulsome, collaborative governance, because it is not a
vote no here that equals a vote agai nst universal health
care. Voting down this particular legislation does not
signal that universal health care or the help and betterment of our people is not supported. A vote down here signals that you are willing to listen to people who will
be on the ti p of the spear, providing that and are willing to reorganise and bring forward legislation in the best interests of the people.
So before the framing starts, which we know is
going to occur, where it will be framed in a way in which
this is a vote against the betterment of health care for Bermudians and a vote against . . . We all know the
spiel. We know the techniques. We know the greatest
hits that are going to be played. I encourage [Senators]
to step back and realise that they have a duty to country
first, and to not go partisan or misquote or misrepresent
what is being brought forward and the concerns that are being brought forward. Because at the end of the day,
as appointed and/or elected Members in both Chambers, that is our responsibility, to listen.
So, I urge my Government colleagues to listen
to what has been brought forward, the concerns, and to
take that on board, to extend their hand to the [Ber-muda] Medical Doctors Association and the medical
professionals to have a fulsome, collaborative approach, and they will get the support that they are looking for when it comes to their road to reforming the
health care system.
So with those comments, I yield. Thank you,

Thank you, Madam
President.
I certainly want to thank my fellow Senators for
this very robust conversation regarding this very important legislation that provides the foundation for the
advancement of accessibility of health care for all Bermudians and the framework for the development of universal health care.
It has been interesting to hear some of the concerns that were initially expressed. And like most of the
Senators who are present here today, we attended a
session with the Bermuda Health Council, and we have
certainly heard concerns that have been raised. And
like the Senator said, there were many individuals who
reached out to him concerning this Bill. Likewise there were many who reached out to me. And certainly as we
have discussed it and they have expressed the concerns, in most instances they have understood what we
are trying to accomplish. They have been satisfied as they understand PIPA more closely. They understand
that the privacy of individuals and organisations will be
protected because we will all be bound by PIPA, which
will come into effect soon. And the data will be anonymised and every person and organisation will be protected.
We can continue to sit here today and talk
about what could happen. But I am confident that as we
go forward and we continue to develop as a country,


Bermuda Senate this is moving us in the right direction, that the individuals and organisations will be responsible. And certainly
they will be bound by the legislation that has been put
in place, that as we continue to evolve as a country we
will begin to see everyone. Because right now with regard to health care, it has been very disheartening to
see that there are many individuals who just do not
have access to great health care. That if you are not
able to provide for the Rolls Royce of insurance coverage, that possibly in many instances your lifespan will
be limited and your quality of life will be impacted by the fact that you just do not have access to health care.
So, I commend the Junior Minister and the Minister of Health and all of the individuals who have worked so hard to put this legislation together. And I am
hopeful that as we move forward we can pass this legislation and get on with the business of doing every-thing that is necessary to develop our universal health
care so that all Bermudians can have the quality of
health and health care that they all deserve.
Thank you, Madam President.
The President: Thank you, Senator Dill.
Would any other Senator care to speak on this
Bill?
Sen. the Hon. Owen Darrell: Madam President.

The President: Minister Darrell, you have the floor.
Sen. the Hon. Owen Darrell: Madam President, thank
you. I will not be long because my colleagues who have
spoken behind me for the Progressive Labour Party
have painted a very clear picture as to why we are
bringing this Bill to this place this morning.
But I do wish to push back on a couple of points
that were made from the other side, and actually a cou-ple of points that were made in an earlier debate. And
as I have mentioned many times and I have been able
to point out many times, the One Bermuda Alli ance are
more concerned with playing politics than they are with actually serving the people of Bermuda. And that is my
humble opinion, Madam President.
You would have recalled in an earlier debate
when we were passing a Bill regarding financial assis-tance and relieve some benefits —

POINT OF ORDER

Point of order, Madam
President. This is not relevant to the Bill that we are
discussing.

Sen. the Hon. Owen Darrell: But I am just saying earlier, Madam President.
The President: Minister Darrell, carry on.
Sen. the Hon. Owen Darrell: We spoke about another
Bill earlier. And I particularly remember a Senator from the other side making a clear point to the listening public that they were supporting that because it was the
right thing to do and the support of people in Bermuda, and they have the people’s interests at heart. I am paraphrasing, Madam President.

The President: Minister Darrell, are you speaking to
the Bill in question?
Sen. the Hon. Owen Darrell: Not at all. I am speaking
to—
The President: I want to—
Sen. the Hon. Owen Darrell: I am speaking to the examples of which I have seen over time, Madam President, of the One Bermuda Alliance instead of putting
solutions forward, they play politics.
In this particular Bill, Madam President, in another place, although yes, they put an amendment forward, they actually supported this Bill. And they started
by saying that and it is on record. So once again, there
is another example of the One Bermuda All iance —

I addressed this in my
comments here with respect to the immense consulta-tion that we have had since that time, which has allowed us to gather information to adjust our views
based on feedback from the medical community —

Sen. the Hon. Owen Darrell: Point of order, Madam
President.

The President: Senator De Couto, the Minister is
speaking and that was not a point of order.

Sen. the Hon. Owen Darrell: Thank you, Madam President.
Madam President, I would like to raise a story
of an interaction I had with a young Bermudian man at one point, maybe about a year ago, Madam President,
a year and a half ago. And in the interaction with this young man, he felt it appropriate to refer to me as a
yes-man. Something that I took to heart, Madam President, I took very personally. But in a display of unity, I
had a discussion with this young man after the interaction. And I said, Hey, you know, I’d like to get some
context. I’d like to explain a few things, because I didn’t
appreciate being referred to as a yes -man. Much to my
chagrin, Madam President, this young man discarded my viewpoint, doubled down on his assessment of my
character and—
516 26 June 2024 Official Hansard Report

Bermuda Senate Sen. Dwayne Robinson: Point of order, Madam President. Point of order.

POINT OF ORDER
[Misleading]

Sen. Dwayne Robinson: The (quote/unquote) “young
man” is in the Chamber. And I will dispute . . . I will dispute that I dismissed his attempt and his discussion.

The President: Senator Robinson.

Sen. Dwayne Robinson: He is misleading the Chamber.

Sen. the Hon. Owen Darrell: Madam President, I will
stay on my line of individuals who have called me a yes -
man.
The President: Minister Darrell, we are debating the
Bill—
Sen. the Hon. Owen Darrell: I am getting there,

And I would like to focus on the Bill.
[Crosstalk]

Sen. the Hon. Owen Darrell: Madam President, and
after reflecting on that for some time, I thought maybe
it would be effective to speak to how the Progressive
Labour Party says yes to the people whom they serve.
And in this case, Madam President, the Progressive Labour Party is sayi ng yes, that they wish to progress
its policy goals of providing accessible universal health care for all.
So, Madam President, the Progressive Labour
Party, as I have said many times before, are continuing to say yes to putting the people of this country first and
saying yes to supporting and servicing the people who
have entrusted us to be the Government.
Madam President, the stories of which you
have heard earlier today, especially the detailed stories shared by Senator Leslie Robinson about individuals
young and old standing at doctors’ offices not knowing
what the cost is and how they are going to pay i t, and
having to make a choice between feeding themselves
or taking care of themselves are ones that are real,
Madam President. Far too often, believe it or not at the age that I am at, I have conversations with my peers
about the financial struggles that they find themselves
in because other family members, whether it be parents, siblings or others, have not and do not have access to affordable universal health care coverage.
There are stories of individuals who have lost life sav-ings, lost assets due to t he inability to have accessible
and affordable health care. So, in order to get us to this place, Madam
President, and as said before by my colleague, Junior Minister Hodgson, the collection of data is important to
see where we are at. And I am sorry, but we must say
yes to fixing this issue that is plaguing so many Bermudians in this country. We cannot continue to kick this
down the road.
I am sure those from the other side who actually canvassed, if they were being honest with themselves, Madam President, would say that one of the
number -one issues on the doorstep was one of affordability and living in Bermuda. And this is directly connected to health care costs. When we debate many debates in this place, Madam President, and I have used
this term before, the One Bermuda Alliance gloats and
loves to throw shade and talk about all the things that
are wrong in this country, and all the strugg les that they
see. And they lay all of these at the feet of the Government. Yet here we have a chance in front of us to move
further down the line of accessible universal health care
and we see the One Bermuda Alliance playing politics.
Madam President, there is much said about
collaboration. The party that wears red would like to
take credit for going out and speaking to the public and
beating their chests and [saying] they are the people’s
champions. Is that really true, Madam President? Or
are they saying yes to the individuals of whom they
serve? Which, dare I say, may be owners of these insurance companies.

POINT OF ORDER
[Imputing improper motive]

Sen. Dwayn e Robinson : Point of order. The Minister
is [imputing] improper motive. He should retract those
statements, please, Madam President.
Thank you.

Sen. the Hon. Owen Darrell: Madam President, I think
the Register of Interests would show otherwise, but I
will go on.

POINT OF ORDER
[Imputing improper motive]

Madam President, I cannot let this stand. The Minister has implied that we
come here with improper motives and are voting on


Bermuda Senate personal interests, and I will not abide, and I will
strongly request him to retract that statement, Madam
President.
The President: Minister Darrell.

Sen. the Hon. Owen Darrell: Madam President, in the
Senator’s speech he talked about who the PLP should
be representing and no one objected —
Sen. Dwayne Robinson: Point of order.

Sen. the Hon. Owen Darrell: —to that.

POINT OF ORDER

Sen. Dwayne Robinson: In my speech I spoke about
the people of —

The President: Senators.

Sen. Dwayne Robinson: —Bermuda. He needs to retract that —
The President: Senators.

Sen. Dwayne Robinson: —before he continues.

The President: Senators, I am in charge of this Senate. And I will make the decision as to any regard of anyone not adhering to the rules of the Senate.
Minister, I am asking you to respond to the Bill
in question.
Sen. the Hon. Owen Darrell: Madam President, thank
you.
And when we speak to collaboration, the Progressive Labour Party, as has been stated by another
Senator, has listened to many of the individuals. I can
tell you without a shadow of a doubt that we have gotten letters. Doctors have met with the Minister of
Health.

The President: Mm-hmm.

Sen. the Hon. Owen Darrell: They have met with the
Bermuda Health Council. And as you will see in a few
moments, there is an amendment that we will be bringing forward which will show that we have met and listened to individuals.
So Madam President, I am going to go back
and finish where I started. The Progressive Labour
Party refers in almost every document you have seen
over the last few years, whether it be the opening of
Parliament, whether it be a Budget Statement, to the
people.
Madam President, one thing that the Progressive Labour Party has fought for for years is that of
equality. And in this situation, Madam President, we are seeking equitable access to services for all people that
will lead to accessible universal health care coverage
for all.
Thank you, Madam President.
The President: Thank you, Minister Darrell.
Senators, I would just like to speak at this time.
And I should declare my interests because I have been a trained nurse and worked in the London teaching hospitals for so many years in areas of health care and
general nursing, midwifery, psychiatry, admi nistration—you name it. And then I returned home. I too continued in health care.
I want to also inform you that I was a member
of the Alf Oughton Health Care Review Taskforce in
1996 which highly recommended the creation of the
Health Council. And so I have been extremely inter-ested in the rules and the laws of the Health Council
and I have followed it and talked with people. I am also
interested i n the state of health care in Bermuda. And I
am sure that most of you would agree, that we have some profound issues in health care in Bermuda, not
the least of which is obesity and also we have kidney
diseases. We have many illnesses and issues. Some
of it is due to lifestyle.
I am saying all this because I am very, very interested in improving the health care coverage in this Island. I have met and talked with the doctors. I have
talked with the Minister of Health. I have talked with
several people, whether it is at the hospita l or wherever
it is they work. And I was interested in this Bill when it
came. And I have spoken to quite a number of people
with respect to this Bill.
And I too am interested in universal health care
because, as has been stated, there are many people
here who do not have health coverage. There are many
people here who cannot afford to go to a doctor so they
go to the emergency department. The emergency department is their first call because they do not have
health care or they do not have the money to go and
see a general practitioner. So we have a lot of things to
fix here. I was very pleased that the Health Council Executive Director made a presentation to the Senate and
answered many of our questions.
I also follow what is happening in other jurisdictions when it comes to how much does a country spend
on health care? And I can tell you, the United States
spends $16,000 per capita on health care. We spend
$11.6. That is still high for this small Island. So anything that will draw down the cost of health care and would
ensure that this Island can take care of its own, can
take care and people can . . . they do not have to be
concerned about whether or not they can afford to go to a doctor or whether or not they have an illness that
cannot be treated. We are in a very, very serious situation at this time.
So when it came to this Bill, I have talked to a
number of doctors. I have talked to the Health Minister
herself. And I have reviewed the discussion that took
518 26 June 2024 Official Hansard Report

Bermuda Senate place last year where doctors did attend. So for me, this
is a critical Bill. And the other thing that I have done also
is I have looked at and I follow what happens in the
OECD countries and how much is spent on health care.
And so I know that for our siz e, we do spend quite a lot.
So I have read the Bill. I know there are some
issues regarding PIPA [Personal Information Protection
Act]. I also know that the Health Council, their role, in
effect is to regulate, coordinate and enhance the delivery of health care to people in Bermuda. I know that
there are concerns about PIPA, and also the information that is being required by the Health Council. But
they need that information to plan for care for Bermuda’s population.
Like each one of you, I have received several
telephone calls [and] emails that we should not support
the Bill or that there are questions about the Bill. The PIPA issue certainly is one that has been frequently
brought up. But we also know that it is pos sible to provide information without it being accessed by individuals. We are a small jurisdiction, yes. But I am of the firm belief that the Health Council, in order for them to plan
for the care on this Island that they need the information
from not only the doctors but any health care practitioner who is providing services on the Island.
So I will say to you that I support the Bill. And it
is based on the original rationale for the creation of the
Council which is to regulate, as I said, coordinate and enhance the provision of health services in Bermuda.
Thank you.
Senator Arianna Hodgson, it is your Bill and
you can proceed.

Sen. Arianna Hodgson: Thank you, Madam President. I do want to thank my colleagues as well as yourself for your contributions this morning.
The President: The question is, Minister and all Senators, whether or not we should break for lunch.

[No audible response]

The President: No. The response is that we will . . . I
am asking the question because it has been put to me
that there might be . . . so we will continue.
Senator Hodgson.
Sen. Arianna Hodgson: Yes.
The President: It’s over to you to continue with the
passage of your Bill.

Sen. Arianna Hodgson: Thank you, Madam President.
Before we move forward in this session, I do of
course want to respond to some of the questions that
have been posed through the dialogue this morning as
well as to correct (I guess) some of the misinformation
that may have been unintentionally shared. So bear with me as I go through the questions that have been
posed.
To begin, there was a question about who
would have access to the data being collected. And I
can confirm that access is currently and will continue to only be provided to those who need it to fulfil their job
duties. The Health Council has a ringfenced d ata analytics team who are the only individuals who have access to restricted data files.
There was a question about safeguarding data.
And again, the Health Council has encrypted photos
and partition drives that hold its relevant data. Users
also use two- factor authentication to log in to their accounts so that the data analytics team members ’ accounts are also protected on top of the individual file
protections that exist.
There were some questions about the Act and
whether or not it complies or aligns with PIPA. And I
can say that the Health Council’s data collection processes do comply with PIPA and such has actually
been discussed with the privacy commissioner. For
comparison, a health survey collects data from individuals. The identifiers are scrubbed and data is analysed
in aggregate without identifiers and reported in summary to answer high- level questions. And of course this
is ethically the process of research methods.
There was a question that referred to our consultation and what we have learned. And I can say that
the consultation from last year in particular, indicates
that we need to make sure that we do not overburden
health service providers in the process of gat hering this
data and moving to licensing. And so much more con-sultation is to come as we actually move forward with the implementation.
Establishing a robust reporting culture will undoubtedly be a challenge, but it is an essential step toward universal health coverage. Change is challenging. But unless we have robust health data, we cannot
make the evidence- based decisions that would be
needed to facilitate such change in the health system.
There was a question about whether or not we
are collecting individual or family data. The Ministry of Health as well as the Bermuda Health Council, tend to
focus on population. Well, they do actually focus on
population health issues. And they actually c ollect data
at a population level. And so this means that we do not
collect or store (for that matter) any information that
would identify specific individuals or their families. And
of course I want to reiterate that this amendment is not about collecting personal health data. The data will absolutely not include any identifiable individual’s per-sonal data relating to the physical or mental health of
an individual. And as is noted in clause 2, the Bill does
require the anonymised collection of patient data that is
not specific to a name.
There were some questions about, How do
know that the additional data collecting powers are nec-essary? And of course we have seen that there have
been challenges with the health data submitted from


Bermuda Senate various stakeholders as there are data gaps. This was
evident when we were seeking health data for the Joint
Strategic Needs Assessment. And in the Chief Medical
Officer’s introduction to the report, he actually said that
robust information is the key to understanding popula-tion health. The Joint Strategic Needs Assessment unapologetically focuses on the strengths and limitations
of current data availability and the need to focus our
efforts and resources on improving our data quality. I
hope that the Joint Strategic Needs Assessment reinforces that comprehensive and accurate data is a prerequisite of any well -performing system of universal
health coverage and not a luxury add- on.
And I can also note that, you know, the system,
our health system actually relies heavily on data from
other jurisdictions. And while it is helpful, we should
also have adequate data about our own health system so that we can rely less on anecdotal evidence and
more on empirical evidence.
There was a question about why an amendment to the Act was required, given that the same data
could be collected through powers and regulations. I
just want to provide some clarity in that regulations actually get their power from the Act, and so the authority
in order to make the regulations. We must then estab-lish them in the Act.
There was a question posed regarding what an
approved scheme actually refers to and whether it re-fers to the Health Insurance Act. Yes, an approved
scheme is one where an employer provides the Health
Insurance Plan itself. And so it is an employer -sponsored plan which has actually been approved by the
Health Council under the Health Insurance Act via the
Health Insurance (Approved Scheme) Regulations 1971. And so the Health Council actually is responsible
for reviewing these applications.
I do also want to note that the legislation itself
speaks to renewal of existing approvals only as opposed to new schemes being approved.
There was a question about what are the intentions to pass regulations under section 15 of this Act
and when they would be passed. And I can confirm that
they are currently being drafted. The intention is to hold
additional consultation over the summer to actually discuss the intention of the regulations.
There was a question about whether the Government or the bank had refused to provide information to the Health Council as an approved scheme. And I
can say that at one time or another the Council has
been unable to obtain data necessary to support in-formed decision -making. There is a challenge with all
entities currently regulated under licensure. And so that
would be a response in that aspect.
There was a question about whether the
Health Council has a privacy officer or intends to recruit
one. I can confirm that the Health Council has a desig-nated privacy officer in the same way they have designated a PATI officer. So the Health Council team ac tually participates in training as an organisation in privacy rules. So that is something they keep abreast of as an organisation.
Will the Health Council adopt regulations or
guidance on data collection principles? And again, we
will abide by all PIPA provisions, data privacy, data security, all relevant policies. They will all be available and
published and validated with any changes in data requests.
There was some reference to data protection
and risk assessments and whether or not this information will be published. Risk assessments will actually be done prior to any particular data request. And the
reviewed request will then be published. Any risks will
be vetted with the stakeholders. The Bill is drafted to
require data collection only when directed to do so by
the Minister.

[Pause]

Sen. Arianna Hodgson: There was some conversation around PIPA and data collection, and I would say that from my understanding PIPA is a cross -cutting requirement for all data collection activities by any entity.
So it is a requirement for all without exclusion. I can say
that the Bill enables the Council to anonymise more
than just the patient names, and I do want to drive
home that key point there.
I can also say that the Health Council has designated a privacy officer to ensure compliance with
PIPA in particular. That we are not above the law and
that we would never seek immunity if determined to
have done something wrong, especially when taken on
advisement from the privacy commissioner.
I think it is also worth sharing, Madam President, 12 things that the Health Council will not request
from a health business as part of this legislation. So I
will go through those 12 items quickly.
• Individual patient records. The Council will not
be collecting any information that identifies individual patients or their medical history. I want
all persons to know that their personal health
information will remain private and confidential.
• Medical diagnosis without consent. We will not
collect any information (“we,” being the Council) about your medical diagnosis or conditions without your explicit consent and that your
medical decisions or health status are yours to
share as you see fit.
• Another of those items is doctor/patient conversations. The legislation will not require the
Council to listen in or to record any conversations between you or your doctor.
• Personal identifiers. Again, we will not be collecting your social insurance number, the
driver’s licence number or any other personal
identifiers that could be used to trace back to
an individual.
520 26 June 2024 Official Hansard Report

Bermuda Senate • It is important to highlight that your religion,
your sexual orientation or other sensitive demographic information will not be collected under this legislation and that your privacy and
dignity will be protected.
• It is important to share that we will not be asking for sensitive financial information such as
your bank account numbers or income details.
And that your financial privacy will be re-spected.
• In terms of religious practices, again, information about your religious beliefs, practices or
affiliations will not be included in the data and
your privacy will be honoured.
• As it pertains to genetic information, we will not
be collecting any genetic data or information
about your DNA. Your genetic privacy will be
safeguarded.
• Any non- medical personal information [will not
be shared.]
• Any work -related information [will not be
shared.]
• Any of your activities on social media [will not be shared.]
• Political affiliations [will not be shared.]
It is important that persons understand that
their privacy will be maintained.
When I think about the journey and the months
and weeks leading up until today, I think it is important
that we recognise that Bermuda has actually been
working on achieving universal health coverage for
several years. And I think some of our earliest efforts
actually date back to the early 2000s.
So now, Madam President, we have gotten to
2024, and while we have gotten to a place where we
understand the broader steps that need to be taken,
without comprehensive and reliable data it is actually
challenging to assess the current state of our health
care system and to identify areas for improvement and
to ultimately measure the impacts of reforms that are
needed. So, all the politics can make for interesting
conversations about the potential impact of bad actors,
there is not one person in this room th at would disagree
that data is the cornerstone of informed decision- making in health care reform.
Madam President, I recognise that one of the
primary concerns was the privacy and confidentiality of
patient information. Along privacy concerns, there were
worries about the accuracy and reliability of the data being reported as well as the security of t he data being
reported. There were also some elements of provider
assistance and reluctance. And you know, we recognise that there were some health care providers who perceived this amendment as an imposition on their autonomy, or an additional regulatory burden in some instances.
I know that we are going to move into Committee shortly and I am sure there will be a lot that will be said in the media tomorrow. But if there is anything reported I want it to be that this amendment was not
about clinical data or arbitrary data collection. The patient provider privacy is of utmost importance and any
data collection involving identifiable information will re-quire explicit justification and will be subject to rigorous
oversight to protect commercially sensitive information.
I hope that it would be reported that extensive
stakeholder engagement has been a priority throughout this process and that it will continue to be a priority
for us as a Government. I hope that it will be reported that the intention behind section 52 is to actually enable
the Council to collect the necessary data to enhance
health care delivery and oversight. And that it was designed with safeguards to prevent misuse. And that, ultimately, data collection will be guided by clear, written
directions from the Minister ensuring that it is reasonable, proportionate and necessary. And finally, that this
amendment is a crucial step toward enhancing the delivery of health services promoting better population
health outcomes and improving the management of
health care expenses.
And so as I wrap up, I want to say that looking
at other jurisdictions . . . you know, we all have seen
that countries have had to implement various laws and
regulations to mandate health care providers to share
data with relevant entities, and it is for a simple reason. We need the data. And so we have all heard the saying,
If you can’t manage it, you can’t measure it. And we
have been unable to measure for far too long.
I read something that said that there are no solutions to complex population health problems within
our community without data. And you in particular would know that we cannot intervene on such issues
as wait times, disease prevalence, obesity, the cost of
health care, the impact on vulnerable persons, our ability to access healthy food and all of the rest unless we can measure how big these issues actually are.
Health care delivery is a process that can only
be improved if you can identify where the problems lie
and that, Madam President, is where the data comes
in. I want you to know that we remain committed to continuous dialogue and we encourage further feedback to
refine the implementation We all know that open dialogue and collaboration will be key as we strive to build a stronger, more resilient health care system that ensures access to essential care for everyone and benefits all residents of Bermuda.
Thank you, Madam President.
The President: Thank you, Senator Arianna Hodgson.
And now, as you have indicated, we will be going into Committee for the amendment so I will get you
to ask . . . that you move—
Sen. Arianna Hodgson: Well, I will first move that I . . .
yes. I will do the second reading and so I do —

The President: Second reading and then move.


Bermuda Senate Sen. Arianna Hodgson: —now move that the Bermuda Health Council Amendment Act 2024 be now
read a second time.
The President: Is there any objection to the second
reading?
No objection.
Sen. Arianna Hodgson: Perfect. Madam President,
then I move that the Senate do now resolve itself into Committee of the whole for further consideration of the Bill entitled the Bermuda Health Council Amendment
Act 2024.

The President: Thank you.
Senator Kiernan Bell . . . I will now ask Vice
President Kiernan Bell to take the Chair. Thank you.

Senate in Committee at 12:59 pm

[Sen. Kiernan Bell, Chairman]

COMMITTEE ON BILL

BERMUDA HEALTH COUNCIL
AMENDMENT ACT 2024

Good afternoon. We are now in the
Committee of the whole for further consideration of the
Bill entitled the Bermuda Health Council Amendment
Act 2024.
Junior Minister Hodgson, you have the floor.

Sen. Arianna Hodgson: Thank you, Madam Chairman.
Madam Chairman, I would like to move that
clause 1 be approved.

[No audible response]

Sen. Arianna Hodgson: Madam Chairman, I move
that clause 2 be approved.

[No audible response]

Thank you.

Sen. Arianna Hodgson: Clause 2 amends section 5
(Functions of the Council) of the Bermuda Health Council Act 2004 by renumbering the current provision
as subsection (1) and inserting subsections (2), (3) and
(4). Subsections (2) and (3) provide for the Bermuda
Health Council, upon the direction of the M inister, to require licensed health service providers, licensed insurers, and approved schemes to provide (in an anonymised form) returns, statistics or other information nec-essary to support objective decisi on-making with respect to health care service delivery, health care utilisation, health care costs, the payment of fees for health
products and services, and to support implementation
of universal health coverage. Subsection (4) makes it
an offence for a l icensed health service provider, licenced insurer, or approved scheme to fail to provide
the returns, statistics or other information required by
the Council.

AMENDMENT TO CLAUSE 2

522 26 June 2024 Official Hansard Report

Bermuda Senate Sen. Arianna Hodgson: And the amendment in clause
2 in the new section 5(4) deletes the words “or to imprisonment for twelve months or to both such fine and
imprisonment.”
Thank you, Madam Chairman.

Thank you, Madam
Chairman.
For the record we want to state that the One
Bermuda Alliance supports this amendment, to this amendment (to be clear) that removes the threat of imprisonment of medical professionals for failing to provide undefined information to the Health Council.
It is important for the record to show, Madam
[Chairman], that in the other place the One Bermuda
Alliance in fact attempted to bring this precise same
amendment which was then overturned by 18 Govern-ment MPs who voted to keep language that would put
medic al professionals in jail over being unable to provide undefined information. I would like the record to
show that. Thank you, Madam Chairman.
But we in the OBA support this proposed
amendment to clause 2 of this Act that we are discuss-ing. Thank you, Madam Chairman.

And I have been told that as the Chair
I am entitled to say something so I too support the
amendment to this provision removing the threat of imprisonment for failure to provide the data that may be
requested by the Health Council.
Would anybody else like to speak on this
amendment?
Is there any . . . would you like to move the motion?
Sen. Arianna Hodgson: I move that clause 2 then be
approved with the amendment.