March 21, 2024

Thank you, Senator Tucker.
Would any other Senator care to ask questions
on this Statement, on the Scholarships and Awards update that was given by the Minister?
Hearing none, then we will give the Minister an
opportunity to respond.

[Pause]

Sen. the Hon. Owen Darrell: Thank you, Madam President.
With the questions asked about the amount of
scholarships for males, there will be four awards up to $7,500 each. These are to pay for the practicum only.
As far as the second question, the College
Promise is for any public school student with a 3.0
[grade point average] or higher. We budgeted about
$450,000 for that. Thank you.

The President: Thank you, Minister.
Thank you. Those seem to be the only questions that were asked of your Statement.

Sen. the Hon. Owen Darrell: Thank you, Madam President.

The President: Thank you.
We will move on then to the third Statement,
and that is the one that was given by Senator Lindsay
Simmons on the dogs.
Would any Senator care to ask questions on
this Statement? Senator Tucker, OBA Leader in the Senate,
you have the floor.

QUESTION 1: MEASURES TO ADDRESS THE
CARE AND MANAGEMENT OF DOGS

Sen. Robin Tucker: Thank you, Madam President.
My question is, Can the Junior Minister give us
an update on the powers, the increase in powers that
were spoken of quite some time ago to allow the dog
wardens to have greater enforcement powers? (That is really what I am getting at.) I mean, we have heard
about potential changes for quite some time. And of
course with the increase in dog issues, dog attacks and
things that the Junior Minister did mention in her Statement, it would be good to know whether the four dog
wardens . . . sorry, Animal Control officers will have the
greater powers that were spoken of publicly quite some
time ago. It has been a long time. And there is a sense
of urgency needed here, so if she can give an update
on that.
The President: Thank you.
Would any other Senator care to ask questions
on this Statement?
Senator Tucker, do you have an additional
question?

QUESTION 2: MEASURES TO ADDRESS THE
CARE AND MANAGEMENT OF DOGS

Sen. Robin Tucker: I do. Thank you.
So the second question is, the Junior Minister
did confirm that the ad hoc committee to deal with dog issues has been reconvened and they are actively
working. I wondered if she had a time frame for when
we can expect to hear of any progress. And I mentio n
that because this is a reconvening of a committee that
had already made a number of recommendations. So I
am just wondering whether she can give a time frame
on when we can expect further recommendations and
hopefully some action.
Thank you, Madam President.

The President: Thank you, Senator Tucker.

[Pause]

The President: The Junior Minister is having a conversation with the Chief Veterinary [Officer].
Which question? The second question?

Sen. Robin Tucker: Yes, Madam President.
So the second question was in relation to the
reconvening of the ad hoc committee that has been reconvened to make recommendations and to address
the issues that we are seeing with regard to the dogs.
So I am wondering whether [the Junior Minister] can give some kind of timeline as to when we can


Bermuda Senate expect progress to be shared with us, and certainly action. Because as I mentioned, this is a reconvening of
a committee. And recommendations have already been
made some time ago. So I am just wondering, just looking for when we should be looking for some kind of up-date from that —

[Crosstalk]
Sen. Robin Tucker: Yes, please. Thank you, Madam
President.

[Pause]

Sen. Lindsay Simmons: Thank you, Madam President.
To answer Senator Tucker’s questions, the increase in powers for ticketing to occur. And also regarding increased powers, we are limited by constitutional
requirements and judicial process. So we are looking to
amend the constitutional requirements.
And question number two, we are reconvening
mid-April to get more out to the public.
The President: Senator, do you need a clarification?

Sen. Robin Tucker: Yes. Yes, please, Madam President.

The President: What is it?

SUPPLEMENTARIES

Sen. Robin Tucker: So the clarification needed is
when can we expect some type of report from . . . if
there is an estimated time. I do not expect anything down to the day. But is there an estimated timeline as to when we can expect a report?
And my second supplementary would be if the
Junior Minister can confirm that the legislation to enable the Animal Control officers is already enacted for
them to be able to ticket people whose dogs are affecting people. Thank you, Madam President.

Sen. Lindsay Simmons: So to answer your second
question, it has been passed, but not implemented.
And to answer your first question, we should have a
report out by May. Thank you.
The President: Thank you, Senator Simmons.
That completes the Question Period.
We will move on then with our Orders of the
Day.

ORDERS OF THE DAY

The President: The resolution into Committee of the
whole for further consideration of the Appropriation Act,
together with the Estimates of Revenue and Expenditure for the financial year 2024/25. And this is
in the name of Senator Arianna Hodgson, the Junior
Minister for Finance.
Senator Hodgson, you have the floor to move
us into Committee.

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

The President: G ood morning.

Sen. Arianna Hodgson: Madam President, I move
that the Senate do resolve itself into a Committee of the
whole for further consideration of the Appropriation Act
2024 together with the Estimates of Revenue and Expenditure for the year 2024/25.

The President: Thank you, Senator Hodgson.
And for the listening audience, when we move
into Committee the President gives the Chair over to another Senator. And this morning we have Vice Pres-ident Kiernan Bell to take the Chair of the Committee.
Vice President, you have the Chair.

Senate in Committee at 10:44 am
[Sen. Kiernan Bell , Chairman]

COMMITTEE OF SUPPLY

APPROPRIATION ACT 202 4

ESTIMATES OF REVENUE AND EXPENDITURE
FOR THE FINANCIAL YEAR 2023/24

Good morning, everyone.
Senators, we are now in Committee of the
whole for consideration of the Appropriation Act 2024 together with the Estimates of Revenue and Expendi-ture for 2024/25. The Ministry under consideration is
Health. The heads for debate under this Ministry are
Head 21 found at page B -155; Head 22 at page B -159;
and Head 91 at page B -172. The number of hours allocated to these heads is two. The Senator in charge is the Junior Minister for Health, Arianna Hodgson. The
start time is 10:45. So we will finish at 12:45.
Senator, how do you wish to proceed?
Sen. Arianna Hodgson: Madam Chairman, I would
like to move the following heads: Head 21, Ministry of
Health Headquarters; Head 22, Department of Health;
and Head 91, Health Insurance be now taken under
consideration.

Please proceed.

MINISTRY OF HEALTH

358 21 March 2024 Official Hansard Report

Bermuda Senate Sen. Arianna Hodgson: Madam Chairman, the Health
Ministry’s budget is found on pages B -154 through B -
174 of the Estimates of Revenue and Expenditure.
Madam Chairman, today I am pleased to present the budget for the Ministry of Health Headquarters,
Department of Health and Health Insurance Department.

HEAD 21 —MINISTRY OF HEALTH
HEADQUARTERS

Sen. Arianna Hodgson: I start with Head 21, the Ministry of Health Headquarters, found on pages B -155
through B -158 of the Budget Book. Madam Chairman,
the mandate of the Ministry Headquarters is to make
Bermuda healthier.

Expenditure Overview

Sen. Arianna Hodgson: Madam Chairman, a total of
$10,302, 000 has been allocated for Head 21 Headquarters for 2024 /25, which represents a decrease of
$7,000 over the original budget of 202 3/24. Save for
the small decrease, the budget for Head 21 Headquar-ters is unchanged from the previous year.
I will now speak on each of the programmes
and business units under this head , Madam Chairman.

General
Sen. Arianna Hodgson: Madam Chairman, the programme 2101 (General) comprises 1 5 FTEs [full -time
equivalents] and a budget dedicated to grants admin-istration, the implementation of universal health cover-age, health disaster coordinat ion and accounting services. The programme’s total budget on page B -155 of
the Budget Book is $8 ,693,000. Of that, $ 3,980,000 is
set aside to support the implementation of universal
health coverage and to cover expenses associated with
the day -to-day operations of the Ministry, i ncluding the
Accounts section.
Madam Chairman, $4,161,000 is for grants ,
and $ 82,000 is for health disaster coordinat ion, which
is a legacy of the Ministry’s national health emergency
function. The balance of $470,000 supports the Ministry’s corporate s ervices policy directorate.

General Administration

Sen. Arianna Hodgson: Madam Chairman, under
business unit 31000 General Administration, the Government is committed to strengthening our health system to bring about healthy people in healthy communities, a key component of which is a multi -year journey
toward delivering universal health coverage [UHC] for
necessary health care services. The aim is to ensure
that all residents of Bermuda have access to core
health services of high quality when they need them
without suffering financial hardship. W ith a focus on integrating health services across the continuum of
care—that is , public health, mental health, acute and
post-acute care, and community services —the implementation of UHC will seek to contain healt h care costs,
as well as employ prevention and health promotion
strategies to produce better health outcomes for our Island’s population.
The health system transformation to achieve
UHC requires the strategic planning of upcoming projects and ongoing engagement with key stakeholders
to ensure decisions and actions impacting UHC are pa-tient-focused and timely. For this there is an allocation
in the Ministry’s Headquarters budget in the amount of
$948,000 to fund the programme management office
(or PMO) for delivery of UHC , and a further $988 ,000
for consultants.
Madam Chairman, the PMO is managing the
coordination, implementation, execution and integration of all projects and associated workstreams in
2024 /25 and beyond to accelerate change toward the
UHC. The UHC Steering Committee comprises representatives of several government departments as well
as the Bermuda Health Council, Bermuda Hospitals
Board, Bermuda Medical Doctors Association, Bermuda First and patient representatives. It continues to
focus on stewardship and governance, health care service delivery and health care financing.
Madam Chairman, with the transition al governance framework now in place and the key health initiatives and projects identified, the aim in 2024/25 is to establish the core health care services to be included
in a universal health care benefits package for all residents and to undertake a full assessment of the de-mand and cost to deliver these core services. We will
create a more efficient and value- driven health system
where our residents enjoy better health outcomes. With
that said, we must all commit to doing what we can to
live a healthier life. Living healthier lives reduces the
burden on Bermuda’s health system and produces economic benefits. This ends my presentation for line item
31000 General Administration.

Grants Administration

Sen. Arianna Hodgson: Madam Chairman, regarding
business unit 31015 Grants Administration, page C -18,
[this item] lists the Health Ministry’s grants to several
agencies providing essential front -line services to aid
public health and social assistance and also a grant for
health education. The total budget for th e business unit
is $4,161,000. These grant funds are allocated as fol-lows:
• $3 million for the Lady Cubitt Compassionate
Association (LCCA) to cover overseas medical
care for uninsured and underinsured persons;
• $1 million for the Bermuda Health Council;
• $61,000 for the Sexual Assault Response
Team [SART ]; and


Bermuda Senate • $100,000 for the Dr. Barbara Ball Public Health
Scholarship.
Charities and other key agencies provide the
Ministry of Health with supporting services that are vital to the community and complement the Ministry’s mandates. The LCCA, the Bermuda Health Council and the
Sexual Assault Response Team are all critical services
and are fundamental to the success of the Ministry.
Madam Chairman, t he LCCA as an organisation has
been a part of Bermuda ’s community since 1932. In the
1950s the LCCA began assisting residents who
needed to travel abroad for medical treatment not avail-able in Bermuda. T oday the LCCA administers the Patient Overseas Financial Aid Programme, working with
residents with limited or no ability to pay, to find the right
solution.
In fiscal year 2024/25 the LCCA will receive $3
million to cover the costs associated particularly with
exceptional cases involving medical treatment where
the patient’s responsible costs are greater than
$50,000.
Madam Chairman, also included in the Grants
budget for 2023/24 is $100,000 in funding for the Dr.
Barbara Ball Scholarship. The Ministry of Health
awards the Dr. Barbara Ball Public Health Scholarship
annually to Bermudian students with proven financial
need seeking careers or professional development in
public health. The scholarship is offered in honour of
Dr. Barbara Bertha Ball who was the first born- Bermudian woman to practice medicine in Bermuda and a tireless champion for people’s rights. This s chola rship covers a range of health care fields of study that directly
benefit public health and are a priority for the public
health needs in Bermuda. It is another example of this
Government’s commitment to strengthening our health
care workforce and one of eight strategic principles of
the Bermuda Health Strategy 2022– 2027.
This year 10 successful first -time awardees received $10,000 each in support of their continuing stud-ies at universities in the West Indies, the United States of America, Canada and the United Kingdom.
Another grant recipient is the Bermuda Health
Council.

Bermuda Health Council

Sen. Arianna Hodgson: Madam Chairman, I would
like to underscore the indispensable role of the Bermuda Health Council, a pivotal quango within the Ministry charged with providing essential advice on health
care matters . Notably, the council’s operational funding
is partly facilitated through a Ministry grant, enabling its
multi -faceted engagement and projects aimed at advancing Bermuda’s health care landscape.
Madam Chairman, the council’s mandate is
comprehensively to regulate, coordinate and enhance
health care delivery across Bermuda. This mandate is
underpinned by a stable grant of $1 million for the fiscal year 2024/25. Additionally, the council’s financial sustenance is bolstered by revenue streams from di-verse sources including contributions from the mutual
reinsurance fund, licensing fees from health insurers
and registration fees from health professionals. Together these funding sources amalgamate to a total budget of $4.3 million for the upcoming fiscal year, facilitating the execution of numerous impactful projects.
Madam Chairman, in the preceding fiscal year
the council dedicated its efforts to four strategic pillars:
regulation, coordination, enhancement and support for
public health programmes. Noteworthy achievements include the successful implementation of a blockchainenabled online database to streamline licensing and
registration processes. This innovat ive database utilises blockchain technology to ensure the integrity and security of health care data, marking a significant milestone in modernising administrative processes.
Legislative advocacy initiatives, particularly
concerning standardising reimbursement, were pivotal,
aiming to ensure equitable access to health care services across Bermuda. Furthermore, the council spear-headed projects aimed at enhancing public awareness
of health care trends and initiatives including the development of educational campaigns and community outreach programmes. These initiatives laid the groundwork for future advances in health care delivery and
public health promotions.
Madam Chairman, the council’s role as the primary regulator and registrar of the health system was
instrumental in facilitating registration functions for over 1,300 health professionals. Additionally, management
of licensing for a wide array of health care facilities and
equipment ensures compliance with regulatory stand-ards.
Efforts to enhance data integrity and automate
analysis were paramount in facilitating evidence- based
decision -making. By supporting innovative projects and
initiatives, the council paid a crucial role in advancing health care delivery and approving health outcomes for
all residents of Bermuda.
Madam Chairman, looking ahead to fiscal year
2024/25, the council is poised to advance proposed legislative amendments and to enhance regulatory processes. Key projects on the horizon include the expansion of public health education programmes and the development of strategies to enhance health care access in underserved communities. Collaboration
across public, private and third sectors will be pivotal in
addressing evolving health care needs and in ensuring the delivery of high- quality accessible health c are services for all residents.
Madam Chairman, in closing I extend sincere
appreciation to the Bermuda Health Council Board and staff for their unwavering dedication to advancing public health initiatives in Bermuda. The council’s commitment to excellence and innovation is driving posit ive
change and improving health care outcomes for all res-idents. This ends my presentation on 31015, Grants
Administration.
360 21 March 2024 Official Hansard Report

Bermuda Senate Corporate Services and National
Health Emergency

Sen. Arianna Hodgson: Business unit 31020 Corporate Services and business unit 31997 National Health
Emergency. Madam Chairman, the estimated budget
for Head 21, Corporate Services u nit is $470,000 . This
unit comprises the Ministry’s Policy Directorate, and the
staff work closely with the Minister as well as the senior
management team to undertake research and to assist
with the development of policy and regulations. T he
budget allocation for what was known as the National
Health Emergency is $ 82,000. This unit undertakes
critical health disaster coordination for the Ministry . It
focuses on planning and preparedness in accordance
with the Pan American Health Organization’s plan of
action for Disaster Risk Reduction, ensuring we are
well positioned to manage the public health risks associated with disasters and extreme weather emergencies.
That completes my presentation on 31020 Corporate Services, and 31997 National Health Emergency and my remarks on all of the business units under the programme General.

Office of the Chief Medical Officer

Sen. Arianna Hodgson: The second programme under Head 21 Ministry Headquarters is the Office of the
Chief Medical Officer. Madam Chairman, programme
2102 under Head 21 is the Office of the Chief Medical
Officer [OCMO ] found on page B-155 of the Budget
Book. Its total budget for fiscal year 2024/25 is
$1,609,000, which funds two business units, 31030
Health Care Registration and Regulation, and 31040
Epidemiology and Surveillance Unit. The office ordinarily consists of eight FTEs.
The remit of the Office of the CMO consists of
five primary duties as follows:
1. registration and regulation of health care professionals;
2. pharmaceutical drug control;
3. epidemiology and surveillance;
4. statutory public health responsibilities; and
5. health emergency planning, resilience and response.
The Office of the CMO currently manages the
registration and re- registration of medical practitioners
as well as the registration and regulation of pharmacies. The O ffice of the CMO also provides administrative support to the Bermuda Medical Council, and the
Chief Medical Officer is the executive officer of the Bermuda Medical Council. The office retains functions relevant to medical practitioners and pharmacy regulation. This includes oversight of the registration processes, the management of patient concerns and en-suring best practice clinical standards are in place and
maintained to protect and support the delivery of ongoing high- quality medical and pharmaceutical care in Bermuda. In addition, this office manages the administration for the Professional Conduct Committee for
medical practitioners on Island.
Madam Chairman, t he O ffice of the CMO’s
pharmaceutical drugs control responsibilities include registration of pharmacies and monitoring the importation of prescription drugs. This ensures that controlled
or banned drugs are imported by appropriate, responsible health care businesses and individuals. Additionally, the office ensures that Bermuda stays within its assigned quotas of controlled drugs and reports on controlled drug importation to the International Narcotics
Control Board [INCB ] in Vienna, Austr ia. The International Narcotics Control Board monitors compliance
with the United Nations International Drug Control Conventions. This office also ensures that medications imported to the Island are in keeping with the provisions of the Pharmacies and Pois ons Act.
Health protection and community health assessment are two essential public health functions car-ried out by the Office of the CMO ’s Epidemiology and
Surveillance Unit [ ESU]. The Epidemiology and Surveillance Unit monitors the occurrence of diseases on
the Island, both infectious diseases and select chronic
non-communicable diseases, to help prevent and control their spread and impact. The Epidemiology and Surveillance Unit r eceives reports from individual
health care providers and laboratories , and investigates unusual disease occurrences. The provision of
contact tracing and case management functions are in-tegral to preventing and/or mitigating any future outbreaks of diseas e.
Periodic community health surveys are conducted to monitor and document the health of Ber-muda’s population. T he STEPS to a Well Bermuda survey, planned for 2024 /25, is just one example. Data
from community health surveys provide population health information essential to setting health system
priorities . The results of the STEPS survey will provide
a snapshot of the health status of our population and
will be used to tailor our strategic plans for health in the
future.
Madam Chairman, additional functions of the
Office of the CMO are to facilitate legislative functions,
advise government departments on health matters and support the essential regulatory work of statutory
boards and councils. The Office of the CMO also
serves as Bermuda ’s public health focal point for communications with regional and international authorities
such as the World Health Organization [WHO], the Pan
American Health Organization [PAHO ] and the United
Kingdom Health Security Agency, and the Cari bbean
Public Health Agency [ CARPHA ].
Madam Chairman, the Office of the CMO
budget of $752,000 is allocated to health care registration and regulation. Over the past year the section has ensured the administration of a variety of professional
services relevant to the more than 200 registered medical practitioner professionals, processed over 130


Bermuda Senate requests for controlled pharmaceutical drug licence requests and completed more than 5 0 pharmacy inspections.
For fiscal year 2024/25, a total of $857,000 is
budgeted for the work of the Epidemiology and Surveillance Unit [ESU]. Capacity building in public health that
was supported by CARPHA, PAHO and the United
Kingdom Health Security Agency has assisted the staff of the ESU, as well as the staff in the Department of
Health to meet the challenges of preventing and controlling emerging and re- emerging diseases. The Office
of the CMO is now better equipped to manage outbreaks of vaccine- preventable diseases such as pertussis and whooping cough and measles .
Through the tireless work of the Public Health
Emergency Response Team [PHERT] and the Surveillance Assessment Response Committee, the Office of the CMO coordinates and collaborates with a broad
range of health and other community stakeholders Island-wide to prevent and mitigate public health threats.
Madam Chairman, the Office of the CMO has
continued to provide critical support to the vaccination programme to ensure that all eligible residents of Bermuda are vaccinated and protected from the COVID -
19 virus. These latest vaccines are targeted against the
Omicron variant. These vaccines have been administered through collaboration with doctors’ offices, community pharmacies and the Hamilton Health Centre.
Madam Chairman, finally, the development of
the important chronic disease register continues to evolve and be refined. We are redoubling efforts at es-tablishing chronic renal disease and hypertension registers.
This ends my presentation on programme
2102, Office of the Chief Medical Officer. Madam Chairman, this concludes my remarks on Head 21, the Ministry of Health Headquarters. We are now moving on to Head 22.

HEAD 22 —DEPARTMENT OF HEALTH
Sen. Arianna Hodgson: Madam Chairman, it gives
me immense pleasure to present the budget for Head
22, the Department of Health, found on pages B -159
through B-169 of the Budget Book. The total current expenditure is estimated to be $31 ,300,000 for 2024/25 .
This is an increase of $871,000 compared with the original 202 3/24 budget , which is a 3.0 per cent increase.
To hold current expenditure at 2023/24 levels, given the 4.5 per cent uplift in salaries, was a great challenge.
The approach taken primarily was to delay recruitment
of vacant posts.

Vision and Mission

Sen. Arianna Hodgson: The Health Department ’s vision is healthy people and healthy communities . The
department’s mission is To promote and protect optimum health and well -being in Bermuda. The 276 Health Department officers work in 26 public health
programmes to ensure the health and well -being of the
general population. The 2023/24 original estimate was
290 posts. The 14- post reduction in 2024/25 represents
posts that will not be funded this year and therefore will
not be able to be recruited until 2025/26.

Administration

Sen. Arianna Hodgson: Madam Chairman, Department of Health programme 2205 , Administration , comprises the business units of Administration, Health Promotion, Comprehensive School Health and Childc are
Regulations. The 2024/25 budget estimate for business
unit 32230 Administration is listed on page B -160 and
is $4 65,000. The 2024/25 budget estimate for Health
Promotion and Wellness business unit of the Department of Health, listed as cost centre 32240 on page B -
160, is $623,000. This is a 17 per cent increase over
the year 2023/24 and can be accounted for not only by salary uplifts, but also additional modest funding for
health promotion events and funds that will support the
Well Bermuda Strategy reboot in 2024/25.
Madam Chairman, the Health Promotion and
Wellness Programme is committed to developing and
implement ing public health policies, programmes and
products that promote health and wellness in the com-munity in collaboration with public health partners.
In 2024, the Department of Health in collaboration with the Bermuda National Athletic Association, the Bermuda Tourism Authority, the Ministry of Social Development and Seniors, and the Ministry of Youth, Culture and Sport will [host] a second annual Move More
Bermuda senior games . This initiative aims to promote
the importance of incorporating physical activity into
our lifestyles. Additionally, we have commissioned an
instructor training course through Mental Health First
Aid UK to train local professiona ls to be instructors in
Youth Mental Health First Aid, thereby strengthening our local capacity.

HEARTS in the Americas

Sen. Arianna Hodgson: Madam Chairman, HEARTS
in the Americas is the Pan American Health Organization’s flagship initiative for improving high blood pressure control and heart disease risk management in
doctors’ offices using a standardised treatment protocol. HEARTS has been implemented in 24 countries in
the Americas. In 2024/25 it is planned to add several
general practitioners’ offices before the protocol is rolled out and available to the entire health system.
The burden of non- communicable diseases in
Bermuda and an age ing population creates serious vulnerabilities in our population and especially when cou-pled with infectious diseases. The HEARTS protocol is
in direct alignment with the Bermuda Health Strategy 2022 –2027 for promoting healthy living and preventative care. The implementation of the HEARTS protocol
362 21 March 2024 Official Hansard Report

Bermuda Senate is an example of how the health system must support
Bermuda’s aged, unwell population with modern treatment protocols coupled with lifestyle intervention programmes to maintain health and support quality of life.

Nutrition Services

Sen. Arianna Hodgson: Madam Chairman, the
2024/25 budget estimate for the Nutrition Services business unit 32110 on page B -59, is $253,000. This is
an increase of $51,000, a 25 per cent increase over
2023/24 which is justified given the high incidence of
diet-related diseases in Bermuda. About half of the increase is from salary uplifts and regrading, and the remainder is intended to enhance programmes.
Programme initiatives for 2024 include the
Grow, Eat, $ave programme, Bermuda’s parish gardening competition; lifestyle intervention programmes;
healthy cost -effective food demonstrations; adult health
preventative clinical group nutrition classes in support
of hearts; and lastly, the Health Promotion and Well-ness podcast , Healthy Beats.
Madam Chairman, a recent Bermuda omnibus
survey examined the types of food that individuals have ceased purchasing, shedding light on the challenges posed by rising food costs on the Island. The survey
confirmed that fruits and vegetables were the food
items that some residents have stopped purchasing
due to unaffordable prices. This highlights the need for
commitment to promoting sustainable nutrition. Consuming five servings of fruits and vegetables daily is fundamental in preventing chronic diseases.
The most recent omnibus survey provided
some good news that approximately two in ten resi-dents are no longer buying sweets, snacks or treats,
given their cost, and that 7 per cent have stopped buying junk food. The Ministry uses the survey to track sup-port for the sugar tax overall. Over half of the respondents remain in support of the tax. Encouraging the pop-ulation to cultivate their own fruits and vegetables not
only makes these foods more accessible, available and
affordable, but also fosters a sense of empowerment.
The Bermuda Parish Gardening competition aims to promote gardening in every parish regardless of skill level, garden size or whether individuals participate individually or in groups.
The Complete Health Improvement Lifestyle
Intervention Programme [CHIP] has been rebranded. This nine- week programme has 18 health information
and support sessions committed to helping persons
make sustainable behavioural changes.

Healthy Schools

Sen. Arianna Hodgson: Madam Chairman, the
2024/25 budget estimate for the Comprehensive
School Health, or Healthy Schools, business unit
32265 on page B -160 is $13,000. In compliance with
the school nutrition policy, the Healthy Schools team is working more closely with the Department of Education to limit all fast -food deliveries to schools for any reason
and food- focused fundraisers to no more than once per
month in schools. Healthy Schools has provided
schools with recommendations for non- food fundraisers and rewards . All public and private schools have at
least one filtered bottled- water filling station and/or filtered water system, making fresh, clean water the eas-iest choice.
In 2024/25, Healthy Schools will continue to
encourage schools to grow edible plants, fruits and vegetables. Also to help students understand their own
health- related fitness, Healthy Schools will continue to
work with the Education Department’s curriculum officer for Physical Education and Health to improve the
completion of the fitness ground assessments for P5 to
S4 students in terms 1 and 3.
Since the summer of 2021, Healthy Schools
has been coordinating out -of-school camps during all
school breaks and after -school programmes throughout the school year . To ensure children’s safety and
health, Healthy Schools provides support and public health updates, monitors safety and health standards
and conducts surveillance visits as needed.
Madam Chairman, the 2024/25 budget estimate of the Child Health Regulations business unit
32290 on page B -160 is $370,000. The increase of
$62,000 is entirely due to staffing and budgeting for four
posts to sustain the programme.
The STARS inspection tool has been fully implemented and allows the programme to evaluate vari-ous aspects of child care while providing support and
guidance throughout the process. A dedicated website was created listing the overall STARS rating and
scores received. This website assists with increasing
transparency and provides another tool to aid the public
when making an informed choice in selecting the best child care settings for their family.
In the coming months, we will be embarking on
a PR [public relations] campaign giving the public more
information on the STARS inspection and the benefits.
The data indicate that compliance and overall scores
are improving.
CCRP [Child Care Regulators Programme]
collaborated with the Customs Department and the Ministry of Education on an import duty exemption for
child care settings, which has been implemented and
well received. The collaboration between CCRP, the
Bermuda Col lege and the Department of Education resulted in a child care certificate being reintroduced in
September 2023. We look forward for those interested
in the field of early childhood taking advantage of this
on Island training and utilising the skills gained through
the training in our day care setting.
This ends my remarks on section 2205, Administration.

Community Health



Bermuda Senate Sen. Arianna Hodgson: Madam Chairman, the Department of Health section 2201, Community Health,
on page B -159 of the Budget Book comprises 13 business units and has a 2024/25 estimated budget of
$23,188,000. Overall, this represents an increase of
4 per cent over the 2023/24 original budget and is on
par with the salaries uplift already mentioned.
Madam Chairman, t he 2023/24 budget estimate for Child Health , listed under business unit 32030
on page B -159, is $3,075,000. The Child Health budget
in 2024/25 will increase by $148 ,000, which is a 5 per
cent increase. The Child Health unit consists of four
sections: Immunisation, Child Health , School Health including Asthma Education, and Travel Health. These
sections provide preventive and curative health services for infants, children, adolescents, adults, seniors
and the traveling public. These are conducted through various clinics, schools and community settings.
Services include health and developmental assessments, screenings, referrals, treatment of minor ailments, health education, health promotion, anticipa-tory guidance, adult and senior immunisations and
travel consultation for travel to high- risk areas. Madam
Chairman, Bermuda’s Expanded Programme on Immunisations [EPI] plans for the needs of vaccines in the
child and adult schedules. The Expanded Programme
on Immunisations procures most of its vaccines
through the Pan American Health Organization’s revolving fund. This process assures safe, effective and
quality vaccines. Universal access for many of the vac-cines is provided through the public and private sec-tors.
Data on immunisation coverage are 85 per
cent for two- year-olds, a decrease of 1 per cent from
the previous year and still below the global target of
95 per cent coverage. Low vaccination coverage increases the community’s vulnerability to re- emerging
vaccine -preventable diseases such as measles, diphtheria and pertussis (or the whooping cough).
Vaccine hesitancy remains a challenge, and
we are working on strategies to provide the community with education relating to vaccine- preventable diseases. The Healthy People BDA app was launched in April of 2023 during the Vaccination Week in the Amer-icas celebration and won first prize for Mobile App of
the Year at the 2023 Tech Awards. This app acts as an
informational resource for immunisation and child
health and makes it easier for people to remember and
plan childhood vaccinations and boosters.
Madam Chairman, health visitors play a critical
role in providing health services for all families with chil-dren under five years of age. The programme has restarted the Moving Mamas free walking group at the
Botanical Gardens and added a second location at Riddell’s Bay. The aim of this initiative is to build community empowerment, increase physical activity and to foster positive social and emotional wellness for mothers. Antenatal breast feeding classes were offered
to promote and increase breast feeding rates in Bermuda. Further initiatives to increase antenatal support
are also being considered and will be implemented
soon. The need for antenatal support was highlighted in the first 1,000 Days Integrated Care Pathway survey,
a report that was conducted as a Throne Speech initiative and a universal health coverage pathway.
Madam Chairman, school nurses are working
on promotional activities to increase school health assessment parental consent numbers. Of the screenings conducted, 20 per cent of five- year-olds were identified
as overweight or obese. This is concerning. School
nurses continue to prioritise tackling childhood obesity
and educating on healthy nutrition.
Madam Chairman, the School Asthma Education programme is working in partnership with Open Airways to re- establish and update the school asthma
registry in all schools across the Island. One focus will
be to investigate and tackle school absences due to
asthma.
Madam Chairman, the 2024/25 budget estimates for Physiotherapy, listed as business unit 32080 ,
and Occupational Therapy , listed as business unit
32120, both on page B -159, are $1, 210,000 and
$1,091,000, respectively. Both budget amounts have
increased 7 per cent over the 2023/24 original estimate. T he remit of the Community Rehabilitation Services Occupational Therapy [OT] and Physiotherapy
[PT] services is to maximise the functional potential of
children with delays in normal motor development or
people with physical movement challenges.
Madam Chairman, the community rehabilitation programme staff are undergoing specialised training in neurodevelopmental treatment [NDT]. This certification equips them with additional advanced strategies tailored for individuals facing neurological challenges in paediatric, including stroke, developmental
delay, cerebral palsy and various other neurological conditions.
Madam Chairman, the 2024/25 budget estimate for Speech and Language Services , listed at business unit 32100 on page B -159 is $1,642,000. This is
a 3 per cent decrease over the 2023/24 original estimate and represents a planned delay in the recruiting
of two vacant speech language pathologist posts until
2025/26. T he Health Department’s Speech and Language Programme provides speech, language and
feeding , or swallowing assessments and intervention
services across the community.

Community Health Nursing

Sen. Arianna Hodgson: Madam Chairman, the
2024/25 budget estimates for Community Health Nurs-ing, listed as business unit 32060 ; and Community
Health Administration, listed as business unit 32010,
both on page B -159, are $1,826,000 and $1,2 97,000,
respectively. The Community Health Nursing budget in
364 21 March 2024 Official Hansard Report

Bermuda Senate 2024/25 will increase by $103,000, which is a 6 per
cent increase.
The Community Heath Nursing team comprises a team of highly skilled, dedicated and committed nursing staff. Currently the team operates with only four full -time nurses and three additional service providers. The initiatives underway for 2024 such as the
adult prevention clinic and the HEARTS programme
demonstrate a proactive approach to promoting healthy
living practices and addressing prevalent health issues
like hypertension and diabetes.

Social Worker Team

Sen. Arianna Hodgson: The social worker team remains in demand. The complexity of clients has in-creased, reflected in a 21 per cent reduction in client
needs not being met compared with the previous year.
Collaborations with non- governmental organisations to
address homelessness was a significant part of the
work this fiscal year. Madam Chairman, the main reasons for social worker referrals continue to be as follows:
1. financial, that is, persons having insufficient
funds to meet their needs including ability to
purchase medication;
2. nursing and home care needs, both long- term
residential care and in- home care needs; and
3. housing needs.
Collaboration with the Long -Term Care Referral team maintains consistency in helping to manage the referral process for admission into Sylvia Richardson Care Facility.

Sexual and Reproductive Health

Sen. Arianna Hodgson: Madam Chairman, the
2024/25 budget estimate for Sexual and Reproductive
Health, listed as business unit 32040 on page B -159, is
$929,000. Savings are being achieved by delaying the
recruitment of a vacant administrative post for part of
the year. Promotion of family planning and ensuring access to preferred contraceptive methods are essential
for securing the well -being and autonomy of women
while supporting the health and development of com-munities. We offer comprehensive family plann ing services to the uninsured and underinsured population at
low cost. A pronounced 20 per cent decrease in demand for family planning services was seen in the last year, which is concerning given the dropping birth rate and the apparent trends in emigrati on of Bermudians of
reproductive age to the UK.
Sexual and Reproductive Health has a strong
partnership with private obstetricians to provide antenatal care and safe delivery for underinsured and uninsured women. Eighty -five per cent of pregnant women
attending the clinic received four or more antenatal appointments. The maternity benefit, introduced on the 1
st of November of 2021, continues to assist antenatal clients with payment for specialist visits.
Sexual and Reproductive Health will continue
to campaign to promote the HPV vaccine for persons
who did not receive it as an adolescent. The HPV vac-cine is routinely recommended for anyone from the age
of 9 through to age 26 years. Human papillomavirus (or
HPV) can cause certain cancers in both men and
women, and is a common sexually transmitted infection.

Bermuda Government Clinical Laboratory

Sen. Arianna Hodgson: Madam Chairman, the
2024/25 budget estimate for the Clinical Laboratory ,
listed a s business unit 32090 on page B -159, is
$799 ,000. This budget reflects the merged laboratories
which were once separately the clinical laboratory at
the Hamilton Health Centre and the Bermuda Molecular Diagnostic and Research Laboratory (or MDL) in
Warwick . The merged laboratory is now renamed and
registered by the Bermuda Health Council as the Ber-muda Government Clinical Laboratory. The merged
Government Clinical Laboratory has the capacity to
provide clinical, chemistry, haematology, serology and
immunology, microbiology and molecular testing, using
a robust quality assurance system. The laboratory con-tinue s to collaborate in annual projects such as antimicrobial resistant surveillance. Antimicrobial resistance
is a global threat that requires much attention and collaboration with several sectors in the public health system.

Lefroy Care Community and
Sylvia Richardson Care Facility

Sen. Arianna Hodgson: The Department of Health operates two exemplary long- term care facilities, the Sylvia Richardson Care Facility in St. George’s, and the
Lefroy House Care Community in Sandys. The 2024/25
budget estimate for Lefroy House Care Community
listed at business unit 32000 on page B -159, is
$5,005,000. The 2024/25 budget estimate for Sylvia Richardson Care Facility, listed as business unit 32015 on page B -159, is $5,947,000. These amounts are increased by 3 [per cent] and 4 per cent each from t he
original 2023/24 budget amounts. Both facilities pro-vide care and promote independence and optimal
health for persons aged 65 years and over who have
significant nursing and care needs requiring 24- hour facility-based care.
The two facilities are residential care communities providing comprehensive medical, nursing, and environmental and recreation services to the resident
and respite- care elders. Our aim is to maintain and improve quality of life for elders and their loved o nes. Demand for nursing beds continues to far exceed capac-ity, Madam Chairman. Sylvia Richardson and Lefroy
House collaborate with Ageing and Disability Services,


Bermuda Senate Community Health and the social work teams from the
Department of Health and the Bermuda Hospitals
Board to prioritise and fill the vacant beds as they become available.
This ends my presentation on the business unit
for section 2201, Community Health.

ANNOUNCEMENT BY THE CHAIRMAN

SENATE VISITOR

I also just wanted to do a time check.
We have been going for nearly 45 minutes, one more
head to go. So if we can try and leave matters in the
blue book as read and enable us to get to some questions, that would be good. Thank you.

Sen. Arianna Hodgson: I am sure we will have plenty
of time for questions, Madam Chairman.

Oral Health

Sen. Arianna Hodgson: Madam Chairman, the
2024/25 budget estimate for the Department of Health, Oral Health section 2202, is $1,443,000. It comprises
the business units 32150, Oral Health Control; 32155,
Oral Health Administration; and 32160, Oral Health
Prevention on page B -160.
Savings were found by delaying the recruitment of a trainee dental officer to the Oral Health Con-trol programme. The Oral Health section provides comprehensive public health dental services to Bermuda’s
children and seniors aged 65 years and older. Our service is based on high- quality patient -centred care, including dental examinations, consultations, and preventive and dental hygiene appointments, as well as a
range of restorative clinical treatments including extractions and fillings. There is an overall strong emphasis
on prevention and working with our community, and we
also offer an emergency service during regular working
hours.
The school -based programmes are an essential part of the Oral Health section’s service. Oral health
education is offered to our schoolchildren and a school -
based fluoride supplemental programme for children
aged 6 months up to 11 years of age.
This ends my remarks with respect to 2202,
Oral Health.

Central Government Laboratory
Sen. Arianna Hodgson: Madam Chairman, the
2024/25 budget estimates for the Department of Health Central Laboratory, section 2204, are listed as business units 32200, Forensic Analysis; and 32220, Water and Food Analysis, on page B -160. The estimates are
$854,000 and $583,000, respectively, for a total of
$1,437,000.
Central Laboratory’s budget in 2024/25 will increase by $137,000, which is an 11 per cent increase.
The drivers for this increase are increases in salaries
due to uplifts, increased call -out remunerations for fast -
track cases, additional funds for laborat ory supplies
and lab gases, import duties, preventative maintenance
contracts for equipment and increased electricity bills.
The Central Government Laboratory performs
a wide range of analytical services divided between two
programmes, the Forensic Programme and the Food and Water Programme.

Forensic Programme

Sen. Arianna Hodgson: The Forensic Programme
performs seized drug analysis and toxicology analysis.
The number of drug cases submitted to the laboratory
has been increas ed together with the corresponding
number of exhibits per case. T oxicology analysis is performed on coroners’ cases, cases of driving under the
influence and urine analysis for stakeholder agencies.
The compounds that are routinely tested for are the
common drugs of abuse in Bermuda, which include
cannabis, cocaine, heroin, ecstasy and fentanyl. There
continues to be a steady year on year increase of cases
submitted to the laboratory .

Water and Food Programme

Sen. Arianna Hodgson: Madam Chairman, the Water
and Food Analysis p rogramme performs analytical testing of potable (drinking) and non- potable water samples, dairy products and food. It is primarily a laboratory
support service to Environmental Health, with the results used to identify bacteriological and chemical risk s
to human health and animal health. It is through this collaboration that the Department of Health can main-tain a low incidence of water and foodborne disease.
Potable water analyse s include samples from Works
and Engineering, Watlington Waterworks, Rocon Lim-ited, L. F. Wade International Airport, many of our hotels, private dwellings, restaurants and care facilities.
Non-potable water samples include seawaters, sewage
effluent and water from animal habitats.
The World Health Organization has recommended the global elimination of trans -fatty acid [TFA].
The Water and Food Analysis programme helped to ensure a baseline survey to determine the amount of
trans -fatty acids in various food samples in Bermuda.
The option to create a legal order to ban trans -fatty acids in food in Bermuda will be examined. And this
366 21 March 2024 Official Hansard Report

Bermuda Senate project is supported by the United Kingdom’s Health
Security Agency.
This ends my remarks for section 2204, Central Laboratory.

Environmental Health
Sen. Arianna Hodgson: Madam Chairman, the
2024/25 budget estimates for section 2203, Environmental Health of the Department of Health, are listed at
page B -160 as cost centres 32170, 32171, 32172,
32173, 32175, 32180, 32190, 32270 and 32285. And
the combined operational budget estimate is
$3,761,000. Savings of 5 per cent over the 2023/24
original estimates are being achieved through delays in recruitment of some vacant posts and a reduction in the
use of overtime as much as is practicable. T he Environmenta l Health section is an essential service providing monitoring, investigative and regulatory functions in
such diverse areas as food safety, occupational safety,
nuisance control, water quality and tobacco control.
Madam Chairman , the Occupational Safety
and Health Office inspects places of work throughout
the Island. It investigates serious workplace accidents
and ensures Bermuda’s workers ’ safety through development of policies and procedures such as the requisite training and permit system for asbestos abatement.
A programme of proactive workplace inspections ensures compliance with regulations and that safety committees are established and operational. Industry out-reach, collaboration with employer organisations , and
worker education and awareness activities are underway to raise the profile of safety at work, thereby improving standards. Investigating serious accidents can
identify uncontrolled risk s or poor safety standards.
Progress with ticketing for high- risk contraventions and
re-establishment of the Advisory Council for Safety and
Health are key priorities for 2024/25.
Madam Chairman , the Port Health Unit of Environmental Health assists in the monitoring of persons
arriving on Island at the airport and other ports of entry
to provide controls against any infectious diseases arriving on Island from overseas. This includes carrying
out inspections of cruise ships and other vessels v isiting the Island. Additionally, a new inspection room and
temperature- controlled storage facility for imported
food is now in use at the L. F. Wade airport cargo shed.

Vector Control

Sen. Arianna Hodgson: Madam Chairman, the
2024/25 budget estimate for Vector Control is listed as
cost centre 32190 on page B -160. The allocated
budget is $1,612,000. Vector Control ensures that
threats of rodent -borne and mosquito- borne diseases
do not manifest themselves in Bermuda. Vector Control
staff educate the public by participating in various
events such as Ministry health fairs and career days. Vector Control will facilitate and attend pesticide training sessions for golf course superintendents.
Sessions are scheduled to take place in June and in
September of 2024. The Vector Control team will undergo training on the new data system in collaborat ion
with Environmental Health, Occupational Safety and
Health, and Port Health. This comprehensive training
aims to improve the efficiency of their services and will
further improve the customer experience.
This ends my presentation with respect to section 2203, Environmental Health.

Revenues for the Department of Health
Sen. Arianna Hodgson: Madam Chairman, r evenues
for the Department of Health are projected to reach
$3,633,000 for 2024/25. These estimates can be found on page B -161. These revenues come from the sale of
medications, vaccines and biologicals ; fees for clinical
services; patient fees from the two long- term care facilities; as well as fees for licences and permits issued by
the Environmental Health Section of the department.
This concludes my remarks for Head 22, Department of Health.

HEAD 91 —HEALTH INSURANCE
Sen. Arianna Hodgson: Madam Chairman, I will now
present the budget for Head 91—Health Insurance,
found on pages B -172 through B -174 and C -19 of the
Budget Book. Madam Chairman the mission of the
Health Insurance Department ( or HID) is to provide equitable access to affordable benefits and collaborative
programmes leading to improved community health
outcomes . The Health Insurance Department is committed to promoting equality in health care, accessibility
and affordability.
Madam Chairman, for fiscal 2024/25, a total of
$3,442,000 has been allocated for this head. This is an
increase of $ 99,000 compared with the original
2023 /24 budget, or a 3 per cent increase. The Health
Insurance Department is responsible for developing
and administering the Government’s social health insurance products offered to the public, including the fol-lowing:
• Health Insurance Plan (HIP);
• FutureCare Plan (FutureCare);
• Mutual Reinsurance Fund (MRF); and
• Government Subsidy Programmes [ Subsidy ],
which pay toward the hospitalisation costs of
select populations.
There are 18 full -time equivalents [FTEs] associated with the Health Insurance Department . Madam
Chairman, the HIP monthly premium remains at
$459.24, while the monthly premium for FutureCare remains at $530.14. This is unchanged since November
2021, reflecting this Government’s commitment to
maintaining stable and affordable premium costs for


Bermuda Senate HIP and FutureCare participants, the most vulnerable
in our community.

Prescription Drug Benefit

Sen. Arianna Hodgson: Since April of 2023 , Madam
Chairman, a total of 2,071 HIP participants and 4, 425
FutureCare participants have taken advantage of the
prescription drug benefit . This benefit covers 100 per
cent of the cost, providing up to $1,000 annually for HIP
participants and up to $3,000 annually for FutureCare
participants . To date, 2,071 HIP participants and 4,425
FutureCare participants have utilised the prescription drug benefit. In total HID’s total spend on prescription
drugs is $7,489,000, an increase of almost a quarter of
a million dollars at the same time last fiscal year. These
figures underscore the need and the importance of the
financial support provided by the Health Insurance Department.

Maternity Benefit Programme

Sen. Arianna Hodgson: Madam Chairman, the Health
Insurance Department continues to administer the Maternity Benefit Programme , upholding its commitment
to fostering equity and accessibility to vital maternity -
related care. The programme extends financial support by covering maternity -related claims for up to 100 qualifying pregnant women who are either uninsured or underinsured.

Personal Home Care Benefit

Sen. Arianna Hodgson: Madam Chairman, the Health
Insurance Department extends the Personal Home
Care [PHC ] benefit to eligible participants, effectively
addressing home care gaps within the community and supporting the concept of ageing in place. This benefit
involves a pro- rata monthly maximum amount aimed at
supplement ing the cost associated with in-home caregivers, providing financial support for individuals including family members who dedicate themselves to caring for eligible participants. Currently, approximately 438
participants regularly utilise the PHC benefit (that is the Personal Home Care benefit) with the Health Insurance
Department, receiving an average of 10 new requests
weekly.
In fiscal year 2022/23, the Health Insurance
Department dispersed $6,169,000 in personal home
care claims. Projections for the fiscal year 2023/24 an-ticipate a total of $6 million in PHC claims. As the population continues to age, the expectation is that t his
benefit will exhibit significant growth.

Enhanced Care Programme

Sen. Arianna Hodgson: Madam Chairman, the Enhanced Care Programme (or the ECP) is a programme
that the Health Insurance Department has administered since 2017 for the treatment of chronic,
non-communicable diseases for the underinsured and
uninsured. The programme provides access to primary care, which enables participants to receive treatment
that they may not have had access to prior to becoming
part of the programme. Currently , the programme has
93 active participants. These participants continue to
receive access to their PCP [ primary care physician]
four times a year without a co- pay and access to vital
medications to assist in the management of their chronic diseases. Consensus from the programme participants has been positive, and we continue to see clinical measures trend down for this small cohort.

Summary of Operating Results

Sen. Arianna Hodgson: Madam Chairman, I will now
summarise the operating results of the various funds
under the Health Insurance Department administration.

Health Insurance Fund

Sen. Arianna Hodgson: The Health Insurance Fund
[HIF] includes two products and policyholder groups, these being the Health Insurance Plan (or HIP) and FutureCare. Fiscal 2023/24 sees an average policy enrolment of 8,734, a 1.2 per cent increase over the
2022/23. Projected gross policyholder HI F premiums
earned for fiscal year 2023 /24 are projected to be
$52,400,000, an increase of $759,000, or 1.5 per cent ,
over 2022 /23. Claims for 2023 /24 are projected to be at
$56,300,000 by fiscal year end. This represents a decrease of 6 per cent over the previous year.

MRF Operating Results
Sen. Arianna Hodgson: The MRF [ Mutual Reinsurance Fund] premium for 2022/23 fiscal year remained at $376.97 per person per month. The 2023/24 MRF
total is projected to be $215, 080,000, an increase of
$2,500,000, or 1 per cent , over the prior year .
This concludes my presentation on Head 91 —
Health Insurance Department.

Conclusion

Sen. Arianna Hodgson: Madam Chairman, in closing,
the Ministry of Health operates under an extensive mandate. Fortunately, we benefit from the tireless ded-ication, hard work, expertise and experience of a diverse group of health and business professionals.
These professionals are committed to the public health
despite resource challenges, the growing health needs
of our ageing population and the need to strengthen our
health care workforce.
I am grateful to our dedicated staff and health
partners, who work long hours to address gaps, reach
out to those who may have otherwise fallen through the
cracks and attend to their health and social needs.
368 21 March 2024 Official Hansard Report
B ermuda Senate Their efforts deserve applause, and I urge the entire
community to recognise and appreciate their invaluable contributions. Without them, Bermuda would be a vastly different place. Madam Chairman, we look for-ward to further collaboration with our stakeholders, and anticipate that changes can be implemented together
to enhance our health system, aligning with the Ministry’s vision of achieving healthy people in healthy com-munities .
Madam Chairman, this concludes my budget
brief for the Ministry of Health.

Thank you, Senator Hodgson, and
thank you for doing as you promised, leaving plenty of time for questions.
Would any Senator care to speak on these
heads?
Senator Tucker.
Sen. Robin Tucker: Thank you, Madam Chairman.
And thank you to the Junior Minister for leaving us some time for some questions.
So I have a few. What I will do is I will kick off
with the various heads. And then I will let others who wish to ask.
Head 21 on page B -155, the General Summary, line item 31000. The Junior Minister mentioned that part of the funds in this particular line item are to help pay for universal health care initiatives. So can she
tell us, if she is able to, what portion of this total
amount? The original for 2023/24 was $4,328,000. And it was revised to $4,271,000. And then it is estimated to be $3,980,000 for 2024/25. So there is a decrease there of $398,000, or 8 per cent. So two questions in
there. One, if she can tell us s pecifically how much is
allocated to UHC; and two, if she can provide some clarity around why the decrease. What does that repre-sent?
The next question would be concerning the National Health Emergency, so in the same section, General Summary, 31997. I am just curious to know
whether sufficient funding has been allocated for this particular unit. The original amount in 2023/24 was $158, 000, revised to $189,000. And then in 2024/25 we
are back down to $82,000. So if [the Junior Minister] can provide some clarity as to the 76 per cent decrease, because it is quite sizable. So if she can pro-vide some information about that.
I have a next question about the Office of the
Chief Medical Officer, business unit 31040, the Epide-miology and Surveillance unit. The original estimate was $479,000 revised to $458,000. And the 2024/25
estimate is $857,000, so a 79 per cent increase. So if
we can get some clarity around the reason for that particular increase.
Business unit 31000, same page on page B -
155, General Administration. I am just wondering, hav-ing sort of reviewed our debate last year, there was
mention of the National Health Accounts Report which speaks to health financing. I could not find a recent report. So I am wondering if the Junior Minister can give
us some information about when a most recent report
will be provided. They were working on it last year, so
that is why I raised it again here. I think the most recent
that I was able to find might h ave been 2019, thereabouts. So if [the Junior Minister] can provide an update
on that.
Page B -154, the Ministry overview indicates
that the 2024/25 estimate of employee numbers, total
employee numbers across the Ministry of Health. No
. . . I do apologise. It is across the Ministry, so I was
right the first time. This is 317 employees. So I would
like to know how many of those posts are funded but
remain unfilled. That is Head 21.
Would the Junior Minister prefer that I just ask
the questions, initial questions I have on the respective
heads? Or wait and allow others to ask on the first
head?
Sen. Arianna Hodgson: I think it would be perhaps
easier to get all of the questions on the head and then
we can move to the next.
Sen. Robin Tucker: Okay. Those are my questions at
this time for Head 21. Thank you, Madam Chairman.
The C hairman: Thank y ou.
Does any other Senator car e to speak t o this
particular h ead?
Senator D e Couto.

Yes. Thank you, Madam
Chairman. I actually had some of the same questions
as my colleague.
But if I flip over to page B -156 under Professional Services, under Subjective Analysis, Professional Services we are budgeting $2.6 million, or
$806,000 less than last year’s budget, as well as less
than the . . . last year actually came in pretty close o n
budget. And if we could have some commentary on
what is driving that, I would appreciate that.
I see Salaries on that same page are up. The
budget is up 17 per cent. So I guess if [the Junior Minister] could confirm that that is just driven by the headcount across the whole Ministry that would be good to
know. And then I have questions on Performanc e
Measures, page B- 158, Corporate Services, 31020,
“To develop a package of essential health care benefits
. . . complete identified . . . health coverage roadmap
actions/projects.” Has that list . . . I mean, it says it has
been complete at the revised forecast, 100 per cent.
Has that been made available to the public?
The Performance Measure underneath that,
“Establish Programme management office . . .” was
forecast to be completed this year at 100 per cent. I assume 100 per cent means completed, and it is listed at
only 40 p er cent. So if we could receive a comment on
which components of that programme management


Bermuda Senate office for universal health coverage have been completed. Why was it not completed completely?
Then I go down to business unit 31030,
“Healthcare Registration & Regulation.” I am looking at
things like “Timely submission of quarterly reporting . . .” and “% of complaints . . . resolved.” And I see the
revised forecast for them, respectively, were on ly
50 per cent and 25 per cent. And they are only forecast
to get up to 75 per cent in the next year. I find that —
well, as a health care consumer —unsatisfactory,
frankly. So if we can understand what is driving the gap there.
And let me pause there. Thank you, Madam
Chairman.

Thank you.
Senator Robinson, then Senator Tucker.
Sen. Dwayne Robinson: Oh—.

[Laughter]

Sen. Dwayne Robinson: Thank you, Junior Minister.
Thank you, Madam Chairman.
Just two questions for me on Head 21. In the
Subjective Analysis of Current Account Estimates, I just
see that Training was marked as zero in 2022/23 ac-tual. And then we saw an increase in the revised 2023/24 to $10,000. And then another marked increase
in the 2024/25 estimate to $30,000. And I just wanted
to ask the Junior Minister if this is to make up for the
training that was not offered in 2022/23, and whether or
not we have any of our folks in this particular line item
being forced to play catch- up because there was not
anything budgeted in that 2022/23 year.
Also, coming down to Advertising and Promotion, we see that there is no budget being given to Advertising and Promotion in the 2024/25 estimate. I know
that the Ministry is often running adverts and health- related promotions to the general public. So I just wanted to know why this particular line item has not received any budget, and whether or not this will affect the ability
of the Health Ministry Headquarters to get out its message or to notify folks about various health happenings.
Thank you, Madam Chairman.

Thank you.
Senator Tucker.

Sen. Robin Tucker: Thank you, Madam Chairman. I do have a couple more questions. So page B -
156, General Administration. Again, from last year’s debate we learned that the Bermuda Health Council was
to be working with the Bermuda Hospitals Board to integrate unique patient identifiers. So I am just wonder-ing . . . I do realise that there maybe have been some
adjustments since then. But I would like to know if that
is still in play. And also, if it is, whether there has been,
at least at this point, a beginning of information flowing
between the two ent ities so that we can progress the
data needed to identify who is actually utilising the services. So that is one question.
The second question is related to page C -19,
Grants and Contributions, in line item 6934. Can the Junior Minister provide some clarity around the grant
that is being awarded? So 6934, which is the [Statutory]
Hospital Patient Subsidy, and then 6946 is a grant to the Mid- Atlantic Wellness Institute. So I just am looking
for some clarity around the budgeted amounts because
the original estimate for 2023/24 was $155 million.
Then we have a revised estimate to $172 million, which
indicates an overspend of what we originally budgeted
for. And then we have an estimate back down to $155
million.
So, can the Junior Minister explain to us if the
Ministry is receiving the actual amount or close to what
they need in order to operate? Because of course we
have this significant overspend. So I would like to get
some clarity about that. And also can they just provide
some information about what this new figure is generally covering? That would be helpful.
Then on page C -27 on Rentals, we see that
Health HQ, the revised estimate for rentals for the Con-tinental Building was $470,838. And then the estimate
for 2024/25 is $429,200. So if the Junior Minister can
provide some clarity around why the decrease, tha t
would be helpful.
The final question on this head comes again
from Grants, page C -18. I am not sure if the Junior Minister can answer this question. But line item 7088, and
that is regarding SART, the SART room that actually
works with victims of sexual assault. I would be interested to know if [the Junior Minister] can provide the number of visits in maybe just 2023. And the reason for
my asking that is that I am a former sexual abuse hot-line counsellor. And I have had my fair share of visits in
the SART rooms. I recognise from a personal point of
view how important that is. So the reason why I would
like to know the number of visits is to assess whether that $61,000 is sufficient. So if the Junior Minister could
provide that information.
Thank you, Madam Chairman.

Thank you.
Senator Hodgson, do you want to provide any
answers to those? Or should we move on to questions on the other heads?

370 21 March 2024 Official Hansard Report

Bermuda Senate Sen. Arianna Hodgson: I can begin with some answers, Madam Chairman.
Okay. So there was the initial question from
Senator Tucker that had to do with the budget for universal health coverage and why the year on year de-creased. The short answer would be that the overall
budget for Salaries would actually not be a decrease;
however, it is a shift in salaries for the filled posts.
There was a question about sufficient funding
for the National Disaster Recovery. The response
would be that much of the work related to ensuring that our healthy disaster preparedness is updated, and it
has been completed at this time.
There was a question from Senator Tucker
pertaining to the increase in the UHC [universal health
care] budget. And that increase is primarily due to the
STEPS population health survey which we will be push-ing out. And it also increases due to the enhancem ents
of the existing surveillance system for data collection,
collation and reporting. So that one is very important in
this upcoming year.
There was a question posed about the report
on the national health accounts. And I can confirm that
the Health Council is actually currently re- engineering
health accounts to bring them up to date. There were
some delays with obtaining insured data. Howev er, we
do anticipate bringing health accounts up to fiscal year 2023 by this summer.
There was a question about UHC deliverables
being made available to the public in corporate ser-vices. Minister Wilson, I know she did announce the completion of 90 per cent of the deliverables with the
most recent being the completion of the chronic kidney disease integrated care pathway. However, the final pathway which is the only deliverable remaining to be
announced will be made public this April.
I am . . . just to clarify the question about the
BMO [Budget Management Office] and the setup.
When the information was supplied to the Budget Office we were at 40 per cent. However, that number has
been revised, and so we are currently at 80 per cent for
the Project Management Office.
There was also a question about being able to
resolve complaints in a timely fashion. And I can say that the Medical Practitioners Complaints Committee
has faced some challenges with appointments on conflicts of interest, as well as the appointment of a new
chairperson back in 2023. Since then those issues
have been resolved, and we have appointed a chairperson. The resulting backlog is being streamlined and addressed. And so for 2024/25 it is expected that the
target will be achieved and/or exceeded.

Senator Tucker.
Sen. Robin Tucker: Yes. Thank you, Madam Chairman.
I would just like to ask one more question. Is
the Junior Minister able to give us an update on the appointment of the Chief Medical Officer, just sort of
where we are with that process?
Thank you, Madam Chairman.
Sen. Arianna Hodgson: Senator Tucker had some
questions about the unique patient identifiers and
where we were with that. I can say that the unique patient identifiers have been established and that it will be
implemented as part of a larger digital health strategy
plan to ens ure broader alignment with other initiatives
on digital health standards that have been identified.

Senator Wight.

Sen. John Wight: Thank you, Madam Chairman.
If you would permit me to ask three questions.
Two are on Head 91. I know that is the last head, but I was concerned if we go head by head, I will not get an
opportunity to ask my questions.

Sen. Arianna Hodgson: Only for Senator Wight.

[Laughter]

Sen. John Wight: I feel honoured. Thank you, Junior
Minister.
So Head 91 on page B -172, the mission statement refers to “improved community health outcomes,”
which I agree fully with. Certainly, healthy outcomes for
Bermudians and guest workers have to be a top priority. Yet none of the performance measures monitor, analyse or determine whether Bermuda is meeting the ob-jectives of our country as it relates to healthy outcomes.
So my question is, With a budget of $200 million for this Ministry, how does Government determine
whether they are delivering value for service to our
community? And how do Bermudians who are funding
this through their tax dollars of $200 million get comf ort
that their tax dollars are being spent effectively and efficiently? So that is my first question.
My second question, on page B -174, the BHB
[Bermuda Hospitals Board] subsidy obviously is an
enormous number; $138 million was the current year
amount. I note that for the ensuing year the claims per
participant —so the claims per person —are expected to
remain the same per person as it was last year. Now,
we know from the last 20 years that medical inflation
runs between 6 [per cent] and 8 per cent. So if we


Bermuda Senate factor that medical inflation in, all of a sudden the claims
number for the hospital subsidy becomes a whole lot
larger. So my question is, why would Government assume that there is no medical inflation for the ensuing
year? That is my second question.
And my third question is on Head 22 where the
full-time equivalent numbers of employees are increasing. Over the last two years the full -time equivalents
have increased from 241 in the Department of Health
to a projected 276. So that is 35 additional roles over a
two-year period. And many of them relate to an ageing
population, so additional people for Lefroy [House]
Care Community, Sylvia Richardson. This is not unexpected. So I guess my question is, Does Government
consider this to be the continuing trend with our ageing
population of having to add quite substantial numbers
year on year to address Bermuda’s ageing population as it relates to our community health?
So those are my three questions. Thank you,
Madam Chairman.
[Pause]

Yes. Thank you, Madam
Chairman.
I wanted to actually follow up on Senator
Wight’s question. And on page B -174 . . . and maybe I
will just put some numbers on it to make it really spe-cific.
You know, I am looking at the hospital subsidy.
And last year it was budgeted or forecast for 249[,086] claims. Revised came in at 210[,000]. I do not really understand because the year before it actually came in
at 163[,000], the actual outcome for 2022/2 3. And
again, it was forecast to have 40,805 participants. The
revised forecast is now 21,000. I struggle to understand
the gap.
There are kind of similar things going on with
the HIP [Health Insurance Plan] and FCF (FutureCare) numbers. So again it was forecast for HIP total claims
to be at $9.9- odd million last year, but it came in at
$14.46 million on actually fewer policyholder s. Comments on that discrepancy or difference in outcomes would be appreciated.
Thank you, Madam Chairman.

Senator Tucker.

Sen. Robin Tucker: Thank you, Madam Chairman.
The questions on Head 91 mostly have been
asked already. One question that I would like to know is from page B -173 as it relates to Salaries. If the Junior
Minister can provide some explanation as to why in the
original estimate for 2023/24 it was $1,419, 000, which was revised to $605,000. But then the 2024/25 estimate is $1,440,000. So if she can provide some detail
around the reason for the fluctuation there.
Also, I would be curious to know . . . this is a
general question as it relates to FutureCare and the drug benefit. So it has obviously increased to $3,000.
Can the Junior Minister let us know what happens if
someone exceeds that amount? Is it just as nor mal as
it would be for others? You know, if you exceed that amount then you have to come out of pocket? If she
can just confirm that that is the case.
On page C -28, Rentals. Health Insurance Department, the revised estimate was $141,848. And then
the 2024/25 estimate is $153,272. So if the Junior Minister can just provide some clarity around that, the reason for that particular increase.
I do have a couple of questions from Head 22
(if I can find my notes).

Senator Tucker, I think you can ask
your question. Oh, you do . . . Okay.

Sen. Arianna Hodgson: Sorry. Thank you, Madam
Chairman.
There was a question about how many funded
posts there were out of the 317. There are 54 vacant and funded posts in the Department of Health to date.
And of these 54 posts, 36 posts are under active recruitment.
There was a question about training. And as
Senator Robinson alluded to, given that little training
took place during and just after the pandemic, we provided an allowance that would allow staff to take up
training and to stay up to date with their skills. So yes,
this was a matter of recouping some of that lost training time. And of course the rolling out of the staff survey
will also include some training as well.
There was a question about rentals and a decrease. So essentially, the Ministry has actually reduced the space requirements post -pandemic. So that
is driving much of the decrease in the negotiations that took place concerning the rental amount.
In terms of the budget for advertising, funds are
actually allocated from another object code in the
budget. This was not highlighted under this head.
And Senator Tucker can continue while I compile more answers.

Thank you.
372 21 March 2024 Official Hansard Report

Bermuda Senate Senator Tucker.

Sen. Robin Tucker: Thank you.
So a question regarding Head 22 on page B -
159, Lefroy [Care Community], business unit 32000. So we see that the original budgeted amount for 2023/24
was $4,867,000 revised to $3,752,000. And then the
estimate for 2024/25 is [$5,005,000], so obviously an
increase of $138,000. Is the Junior Minister . . . and she
may have mentioned this in her [brief], so I apologise if she has, but I clearly missed it. I would just like to know if this sizable increase is solely to do with salaries. Or
is it impacted by something else? Is it just salary uplift,
or is it something else?
The other question that I have regarding Lefroy
House is if the Junior Minister can also give some insight as to why the original budgeted amount, which I mentioned, of $4.9 million, which was revised to $3.8
million . . . so I am a bit confused as to why the new
estimate is $5- plus million.
The second question I have is on the same
page regarding Child Health, so business unit 32030.
Original estimate is $2.9 million revised to $3 million.
And the 2024/25 [estimate] is $3- plus million, so there
is an increase of $148,000. I am wondering agai n if this
is to do with the salary uplift. Or is it something else?
And particularly because that particular line item, as we
see from page B -162, has reduced their headcount by
two staff.
Another question that I have from Head 22 is
found on page B -161, Subjective Analysis, Repair and
Maintenance. The original budgeted amount from
2023/24 was $1,045,000, and it was revised to
$839,000. And then for 2024/25 it is back up to $1,196,000. So i f the Junior Minister can give us a
breakdown of the additional cost expected there.
[Inaudible interjection]

Just a quick check- in with Senator
Hodgson whether we have had any answers come in.

[Pause]

Sen. Arianna Hodgson: Yes, Madam Chairman.
With regard to the status of CMO [Chief Medical Officer] recruitment, I can confirm that we are ad-vancing this recruitment. Candidates have been short -
listed, and we are expected to complete this recruit-ment in the coming months.
There was some question about staffing at the
long-term care facilities. And obviously this is a case
where there are some vacancies, and we have not been able to fill all of those posts. Of course, you know,
I think about the worldwide shortage of nurses and therapists and dentists, and a general loss of staff as a result of COVID -19. So going forward, we are making
considerable effort to ensure that we are able to fill these hard- to-fill posts. And this includes, I guess bursaries and training engagement s where appropriate.
There was a question from Senator Tucker
about what happens if someone exceeds the prescrip-tion drug benefit allowance. And the response would be that the Health Insurance Department actually covers
the cost of prescription drugs up to the legislated benefit amount. But anything over and above that would be
an out -of-pocket expense.

Thank you. I have a couple of additional questions. Is now an okay time? Thank
you, Madam Chairman.
Page B -161, Department of Health, Professional Services last year was budgeted at just under $1.5 million, came in at $2 million. If we could understand what that was about, that would be useful to
know.
Actually, I just want to say that I think this department is one that all Bermudians come into contact
with. So I do thank you, thank them for all of their effort
in keeping us healthy, from vector control to vaccines to restaurant inspections.
If I go to page B -163, [business unit 32010,]
Community Health Admin. And if I am reading these correctly, it seems like percentage of clients contacted
by the social workers . . . the benchmark has been
moved from 72 hours, or three days, to five busines s
days. If we could have a comment on what is happen-ing behind that. I would appreciate that.
And then I go down to business unit 32030
[Child Health], and the vaccination rates . . . I find this
pretty concerning. I know that globally in many countries it is an issue because vaccines are one of the
modern health miracles. And I am glad to see we have
a 95 per cent targeted outcome for next year. Two
questions: Does the Government think that it might legally mandate vaccines for all infants? And second is,
How does that —

[Inaudible interjection]

Well, that is the question.
Has that been considered by the Government?
And the second question is, that revised forecast of 90 per cent and that target outcome of 95 per
cent, How do those rates compare to, let us say the
OECD countries or some other similar (I will call it) developed world benchmark? I would say not the US because I know they have a particular issue with vaccina-tion rates.
Thank you, Madam Chairman.

Senator Tucker, 20 minutes remaining.


Bermuda Senate Sen. Robin Tucker: Thank you, Madam Chairman.
So question from page B -161, Revenue Summary, 8149, Inspection Fees; 8152, Tobacco Distributor Fees; 8155, Registration—Nurses. There is no anticipated revenue in those line items, although there were revised amounts in each of those line items from
2023/ 24. So if we could get some clarity as to why there
is no revenue expected there.
In the same section, line item 8457, Licence
General, anticipated is $68,000 increase equating to
14 per cent. If the Junior Minister could tell us what is
included in that particular line item that would be great.
Another question I have is from page B -169,
Port Health, business unit 32285. This is under Perfor-mance Measures, and there are some itemised things
here, Burial, Cremation, Air transport of remains and
Reinternment. But there is nothing under any of the out-comes. So maybe it was overlooked or did not make
the book. I do not know. But could the Junior Minister
let us know why that is?
Thank you, Madam Chairman.

Thank you.
Over to you, Senator Hodgson.

[Pause]
Sen. Arianna Hodgson: Madam Chairman, I will just
go back to the question about the Lefroy House redevelopment budget in particular and why it was revised
downward significantly. That would be primarily due to the vacancies that we are currently recruiting for. So it
is expect ed that they will actually be filled in the
2024/25 fiscal year.
There was a question about the budget increase while the headcount is reduced by two under
Child Health. And the increase is in vaccine costs to address vaccine hesitancy. There is also an element of
the vacancies and a reorganisation of the programme
to [ensure] an effective delivery of services.
Senator De Couto had a question about the
[social worker] contact commitment shifting from 72
hours to the five days. So essentially, we are using a
systematic case management system, and it focuses on the best use of time and efficiencies to address the
high demand and prioritise accordingly. So as it stands,
they are conducting weekly assessments on forward
referrals. And this is allowing us, I guess, greater efficiency in terms of our response.
Senator De Couto also explored the idea of
mandating vaccines for infants. This is an item that will actually be discussed with the Bermuda Advisory Committee on Immunisation Practices. And as you know,
different countries around the world, they have moved
to mandate some (not all) vaccines. And I guess we will
make the best decision at the time.

We have 15 minutes remaining. And in
case it was not clear from the beginning, we will be going straight through to 12:45. So hopefully we will get the answers for the remaining questions on Head 91
within that time frame. Thanks.
Sen. Arianna Hodgson: Senator Wight had some
questions about claims per person and how it is that
that will remain unchanged given medical inflation being around 6 [per cent] to 8 per cent. The short answer
would be that, in line with our decision not to increase the standard premiums for 2024/25, this would be a
matter of assisting to combat inflation in that sense and
so we are hoping to be able to transfer the monies from
the Sinking Fund to the Mutual Reinsurance Fund to be
able to fund this.
Senator Wight also asked about improved outcomes and how we determine whether or not persons
are receiving value for money. So the implementation of a value- based health care system is something that
the Ministry is keen to progress, but of course it is not
in place at this time. It does require working closely with
health service providers to set care standards and to
ensure the submission of data to monitor health outcomes, in addition to the need for lifestyle change. Implementation of the National Digi tal Health Strategy will
be key in this regard. However, for now the Health Insurance Department, working along with the LCCA, ensure that there is a safety net in place for the uninsured
and the underinsured residents of Bermuda. Right now
the demand on c are services does reflect our ageing
population and their health care requirements.

Senator Robinson, do you have a
question?
Sen. Dwayne Robinson: Thank you, Madam Chairman.
Just on Head 91 under Subjective Analysis of
Current Account Estimates, I see Communications was
budgeted in the 2023/24 original to be $18,000. And
that does not appear to have been used. So I wonder if
that funding was reallocated. And I see it has been rebudgeted for in the 2024/25 estimate with a $1,000 increase, even though it does not appear that this budget
was used at all in the 2023/24 revised.
Also, just for my curiosity, under Rentals I just
wanted to know what this line item pertains to underneath the Head 91, Health Insurance. What does this
Rental line item pertain to? And why the budget that
was zero from 2022/23 and in the 2023/24 revised has
been increased to $180,000 in the 2024/25 estimates?
[Pause]
Sen. Arianna Hodgson: Madam Chairman, as I continue to gather information, Senator Tucker had asked a question earlier about the hospital patient subsidy
and the MWI [Mid- Atlantic Wellness Institute] grants.
Are you able to recall when you asked that
question?
374 21 March 2024 Official Hansard Report

Bermuda Senate [No audible response]

[Pause]
Sen. Robin Tucker: Yes. Yes, Madam Chairman.
So the question came from page C -19 where
basically there is fluctuation in amounts that have been
awarded. So when we look at the original estimate for
the grants to [line item] 6934, Statutory Hospital Patient
Subsidy; and 6946, Mid- Atlantic Wellness In stitute, if
we look at 2023/24 we will see that the total amount
was $155 million, $155,159,000. Then we have a revised estimate for 2023/24. That amount totals $171,
682,000. Then our estimate for 2024/25 is back down
to $155,398,000. So my question was around whether
this grant amount is sufficient because of the overspend that we have seen from 2023/24.
Thank you, Madam Chairman.

[Pause]

Sen. Arianna Hodgson: Madam Chairman, the short
answer to Senator Tucker’s question . . . Actually, I am
getting a bit more clarity. Hold on.
So, of course there was a fluctuation in grant
amounts to KMH [King Edward VII Memorial Hospital]
and MWI. There was an additional $16 million grant to
BHB [Bermuda Hospitals Board] in 2023/24. That was to make up for the committed funds not received between 2019 and 2023. If you recall, the block grant did
come into effect in 2019. Then we had COVID -19 hit in
2020. Reduced headcount during that time meant that
less money had been flowing to the Bermuda Hospitals
Board via the MRF [Mutual Reinsurance Fund].
There was a question about port health and the
performance measure outcomes. This is actually a newly established programme, and we have recently started filling permanent posts. All of those staff were
reassigned to fulfil the role of port health officer s, which
was very evident during COVID -19. Two of the permanent posts have since been filled. The new measure of
percentage of ship sanitation inspections completed
was created actually during fiscal year 2023/24, and so
there were no results for 2022/23.

Yes. Thank you, Madam
Chairman. The Department of Health, Subjective Analysis, Professional Services, was budgeted at $1.5 million. This is page B -161. [To be exact, it was] $1.457
million last year and came in at $2,080,000. I would ap-preciate a brief explanation of the variance.
Thank you, Madam Chairman.

[Pause]
Sen. Arianna Hodgson: I am sorry. As I await details
pertaining to the questions asked by Senator De Couto,
Senator Robinson, you asked a question about rentals
and the variances year over year. Do you recall what
that was pertaining to?
Sen. Dwayne Robinson: I just was asking about the
2024 estimate being, I believe it was $180,000. (I am
not on the page.) Yes. So that would be on page B -173,
the Rentals being $180,000 in the 2024/25 estimate after being zeroed out from 2022/23 to the 2023/24 revised. Just wa nted to get some clarity on that.
[Pause]

I mean Senator Hodgson! I am sorry.

[Laughter]

Sen. Arianna Hodgson: No worries. We are at the
end.
I do have a response to the question about salaries from Senator Tucker. The revised numbers were
down. But then we have gone higher again via 2024/25.
So the Health Insurance Department actually has a
number of contract workers who are actually going to
be regularised as FTEs. So hence the increased salaries budget in that space.

So the Committee will adjourn now for
lunch, for the listening audience. And we will resume at 2:00 with Senator John Wight taking the next steps.

Proceedings in Committee suspended at 12:47 pm

Proceedings in Committee resumed at 2:0 3 pm

[Sen. Dr. Douglas De Couto, Chairman]

COMMITTEE OF SUPPLY

ESTIMATES OF REVENUE AND EXPENDITURE
FOR THE YEAR 2024/25
[Continuation thereof]

Listening audience and Senators, we
are in Committee of the whole for further consideration of the Appropriation Act 2024 together with Estimates
of Revenue and Expenditure for the year 2024/25. The
Ministry under consideration is Education. The heads
for debate under this Ministry are Head 16, the Ministry
of Education Headquarters; Head 17, Department of Education; and Head 41, the Bermuda College.

Sen. the Hon. Owen Darrell: I am sorry; Head 1?

The Senator in charge is Minister Darrell. We have three hours allotted to this Ministry.
Minister, how do you wish to proceed?

Sen. the Hon. Owen Darrell: I will proceed . . . I mean
how . . . I don’t understand the question.

The Clerk: Move the heads.

Sen. the Hon. Owen Darrell: Thank you.

[Laughter]
Sen. the Hon. Owen Darrell: Thank you, Mr. Chairman.
I move that the following, Head 16, Ministry of
Education Headquarters; Head 17, the Department of Education; and 41, the Bermuda College, be now taken
under consideration.

We will start at 2:04, so we will finish
on or before 5:04.

Sen. the Hon. Owen Darrell: Thank you.

MINISTRY OF EDUCATION

Sen. the Hon. Owen Darrell: Mr. Chairman, I am
pleased to present the budget for the Ministry of Education which comprises the Ministry of Education Headquarters, Head 16; the Department of Education, Head 17; the Department of Libraries and Archives, Head 18;
and the Bermuda College, Head 41.
Mr. Chairman, the 2024/25 budget for the Ministry of Education of $142,589,000 is found on page B -
132 of the Estimates of Revenue and Expenditure for
the year 2024/25. This represents an increase of
$2,742,000 compared to 2023/24’s original budget.
The current account 2024/25 estimated revenue for the
Ministry of Education is $262,000.
Mr. Chairman, the capital expenditure estimates for acquisitions and development increased from
$6,085,000 to $8,012,000 in 2024/25. The number of
full-time equivalents for the Ministry decreased by 23
from 1,099 to 1,076 employees. Mr. Chairman, it is important to note as seen on page B -132 that the revised
budget for 2023/24 was adjusted to $142,589, a rise
primarily due to recently finalised union- negotiated paid
awards. These necessary adjustments, which resulted
in a $5,585,000 increase from the origi nal budget, underscore the Government’s commitment to fair compensation for our educators. The supplemental for
these additional expenses was passed in the House of Assembly last Friday due to the ability to locate additional funding within the Ministry. T he overall overage
was $4.8 million with $4 million to pay uplifts, $431,000 for substitutes and $466,000 for paraeducators.
Mr. Chairman, this year we have also undertaken a comprehensive review of the past three years’ budgets to enhance our financial stewardship. This rigorous evaluation, which aims to identify and implement
spending efficiencies, ensures that every dollar r equested and allocated supports our educational mission as effectively as possible. I will discuss the outcomes of this exercise in more detail when addressing Head 17, the Department of Education.
Mr. Chairman, some may wonder why our proposed budget for 2024/25 does not match or exceed last year’s adjusted figure. This question is valid and important. I feel it necessary to mention this to provide
some clarity to the public and the colleagues about the
reasoning behind our budgeting decisions —particularly
why our proposed budget for 2024/25, though higher
376 21 March 2024 Official Hansard Report

Bermuda Senate than last year’s initial budget, is set below the previous
year’s revised total.

HEAD 16 —MINISTRY OF EDUCATION
HEADQUARTERS

Sen. the Hon. Owen Darrell: Mr. Chairman, I commence the Budget [Debate] by detailing the expenditure for the Ministry of Education Headquarters, Head
16. The mission of the Ministry Headquarters, which is
found on page B -133, is To provide strategic leadership
and policy direction for education and lifelong learning.
The objectives of the Ministry Headquarters have been
outlined accordingly on the same page. (Excuse me,
Mr. Chairman.)
Mr. Chairman, the commitment to educational
transformations in the public school system remains the main priority. The Education Reform Unit, the Project Management Office and the transformation initiative have grown in capacity over the last year to meet
the growing demands of our transitioning public school system. Mr. Chairman, the unit is led by Ms. Lisa DeSilva, an educator with over 25 years of experience. Including Ms. DeSilva, 10 Department of Education staff
members are reassigned to the Education Reform Unit, and their salaries continue to be paid by the Department of Education. Ther efore, over $1 million of the Education Department’s budget is directly allocated to the
Education Reform Unit’s resources. There are also
three local consultants working with the unit.
Mr. Chairman, the unit is fully engaged in determining the changes that are necessary
• for the classroom such as curriculum, teaching,
learning and assessment;
• in our schools such as ensuring they are more
inclusive and culturally responsive, and the
learning environments are fit for 21
st century
learning; and
• in the system itself including the way it is governed and funded.
We remain steadfast in our goal of enabling
every young person to lead personally and professionally, compete locally and contribute globally.
Mr. Chairman, the workload of the unit involves
17 workstreams and working groups consisting of the
following:
1. Inclusivity and Cultural Responsiveness;
2. School Choice and Admissions;
3. School Leadership;
4. System Leadership;
5. Professional Learning and Capability Building;
6. Learning Environments (including not only the
physical space but also IT and transportation);
7. Learning Partnerships;
8. Personalised Learning;
9. Data and Metrics;
10. Resourcing and Budgeting;
11. The Education Authority;
12. Communications and Engagement; 13. School Transformation;
14. Curriculum and Assessment, (which include
not only our Bermudian frameworks but also the design of our Signature Learning Programmes, revision of the senior school curric-ulum aligned with the new graduation requirements and design of the Parish Primary School
curriculum learning experiences);
15. Future Workforce;
16. Student Services; and
17. Early Years.
Mr. Chairman, this extensive listing of working
groups provides insights on the breadth of work re-quired and undertaken for impactful education reform.
It also indicates the extent and type of workforce and
focused efforts needed to sustainably transform our
schools and the Bermu da public school system.
Mr. Chairman, in September 2022 the first two
S1 Signature Learning programmes were implemented
at CedarBridge Academy offering Trades and Professions in Science, Technology, Engineering and Math (STEM); and at the Berkeley Institute offering Health
and Social Care along with Financial and Insurance
Services. These students are now in S2, with another
cohort entering in September 2023. At the same time
our first P1 and P7 students experienced the new
teaching, learning and assessment models at our first Parish Primary Schools in Hamilton and Warwick Parishes.
Mr. Chairman, as we have stated from the beginning, the journey to transform our schools is inten-tionally staged and phased. This means that teams are
currently working to ensure that even more children
and young people of Bermuda benefit from the trans-formation that is underway. I ask that you and the listening public bear with me while I explain what this looks like. Mr. Chairman, in the upcoming academic year beginning September 2024, we will have students
experiencing the new models in S1, S2 and S3 at our
current Signature Schools and P1, P2, P5 and P8 at
our current Parish Primary Schools.
Mr. Chairman, in September 2025 not only will
these models continue to reach even more children and
young people at CedarBridge Academy, the Berkeley Institute , Francis Patton and Purvis, but this is also the
year where the following will take place:
• The next wave of Parish Primary Schools
phase in for Smith’s Parish on the Harrington
Sound site, and in Devonshire Parish on the
Elliot Primary School site.
• Our third Signature Senior School opens for S1
students on the Sandys Secondary Middle
School site, offering Hospitality and Tourism
and Education Services Signature Learning
Programmes.
• The existing Signature Learning Programmes
at the Berkeley Institute and CedarBridge
Academy are expanding to include Sports and


Bermuda Senate Leisure Management, and Arts and Culture
strands, respectively.
Mr. Chairman, September 2025 is also the
point at which our Signature Senior Schools will become five- year programmes, the remaining Middle
Schools will [continue to] be phased out, and our noncontinuing Primary School sites will be closed or
phased out, in accordance with the rescoring process
underway.
Mr. Chairman, this Ministry continues to work
with the Ministry of Public Works to develop the individ-ual site plans for the learning environments at each of
our schools in transition and the master plan for school
infrastructure development. Details for the plan will be
finalised once the rescoring process is complete. Mr. Chairman, education reform also includes the ongoing
work to establish an Education Authority. In collabora-tion with the Attorney General’s Office, the legislation
for the Authority wil l be tabled in this legislative year.
Mr. Chairman, the Ministry continues media
outreach to keep our stakeholders and the general public informed about the progress of education reform
through the Education Reform Unit’s public relations
strategy. Most recently we aired our Education Reform
101 series over five weeks on TV. This series delved into the critical aspects of reshaping education in Bermuda. The key topics were Curriculum and Learning
Experiences, Teaching and Learning Assessment, Learning Environments and Graduation Requirements.
We will continue media outreach to focus broadly on
awareness of education reform progress as well as specific objectives that form part of the reform process.

Programme 1601, General

Sen. the Hon. Owen Darrell: Mr. Chairman, on page
B-133 you will see that the Ministry of Education Headquarters has been allocated a budget of $7,177,000 for
the 2024/25 fiscal year. Within business unit 26000,
General Administration, $869,000 will support the operational and admini strative functions of the Ministry.
Mr. Chairman, under business unit 26140, the
total of $4,135,056 is allocated for operational expenses for the Education Reform Unit. This includes $221,500 for general office expenses, operations and
supplies, and approximately $3,910,000 for consultants
for media and other professional support services for
professional learning, meetings and events, and professional technical services required for systems and
school building infrastructure changes that form part of education reform. Of the $3,910,000, there are
$707,856 set aside for the Innovation Unit’s consultant
contract, and additional funding for anticipated consultancy for the next phase of [education] reform.
Mr. Chairman, business unit 26080 maintained
the [same] level of budgeting as last year, $630,000. These funds are allocated for external grants and the
Bermuda College Promise merit award programme. Mr. Chairman, $1,543,000 has been set aside
for business unit 26090. This business unit manages
the administration of the Ministry’s annual Scholarships
and Awards programme. The Ministry continues to support students in their pursuit of tertiary education. Mr. Chairman, these awards are in place to improve Bermudians’ access to education and training beyond senior school. As most of our scholarships and awards
have a financial need criterion, many recipients would
have had difficulty realising their post -secondary education goals if not for scholarship funding. Our scholarships and awards give countless opportunities to students to help them achieve academic and career success for the benefit of our economy and community.
Mr. Chairman, last year the Ministry received a
total of 638 student application submissions, which is
an increase of 187 applications compared to the 451 received in the previous year. We provided 72 scholarships and awards in total.
Mr. Chairman, in an effort to promote greater
gender diversity in the teaching profession, the Ministry
is launching a new awards programme designed to encourage and assist men to embark on a teaching career. Four new awards will be offered to male students
pursuing teaching practicum experiences as well as
aim to inspire the next generation of male educators to
bring examples of more men as role models into
schools for the benefit of all students.
Mr. Chairman, on page B -134, the Subjective
Analysis of Current Account Estimates are shown for the Ministry of Education Headquarters. Line one, Salaries, stands at $644,000 and shows a minimal increase of $26,000 when compared with 2023/24.
Mr. Chairman, this year $44,000 has been
budgeted for transport. This is a new expenditure for
the Ministry and is for transportation for students to and
from education reform Signature Learning Programme’s Taster events where students get exposure
to det ails of all of the Signature Learning Programmes
available to them. Reserves are also budgeted for contingency programmes. This year Purvis students were
transported to and from the former Heron Bay school
site to practice for Sports Day while the Purvis s chool
field is not fully available due to construction onsite.
Mr. Chairman, the travel expenditure line item
of $94,000 increased by $46,000 which is directly related to travel expenditure for education reform, conferences, visiting other jurisdictions that have been
through reform that have fully implemented similar pro-grammes as Bermuda, and training. Expenditure for
grants and contributions increased by $163,000. The
full breakdown of the $2,138,000 budgeted for grants
and contributions can be found on page C -18 of the
Budget Book.
Mr. Chairman, $3,685,000 has been budgeted
for professional services. This reflects a decrease of
$315,000 for consultancy services by the Education
Reform Unit. Mr. Chairman, on page B -134, the number of full -time equivalents or employees in the Ministry
378 21 March 2024 Official Hansard Report

Bermuda Senate of Education Headquarters remained the same as last
year at six. Mr. Chairman, finally, on page B -135 performance measures for the Ministry Headquarters are outlined. The targeted outcomes for last year were either achieved or are in the process of being c ompleted
by the end of March of this year.
Mr. Chairman, the Ministry Team comprises
the Permanent Secretary, our Senior Policy Analyst, the Ministry Comptroller, the Scholarships and Awards
Programme Manager, a Relief Policy Analyst, the Administrative Assistant/Accounts Officer and the Execu-tive Assistant to the Minister and Permanent Secretary.
Mr. Chairman, each team member has contributed to
the success of the Ministry’s work programmes. I sincerely thank the Ministry Headquarters team, the Education Reform Unit’s team and the working groups f or
their continued support and diligence.
Thank you, Mr. Chairman. This concludes my
presentation for Head 16, the Ministry of Education Headquarters, and I will now move to Head 17, the Department of Education.

Thank you, Minister. Please proceed.

HEAD 17 —DEPARTMENT OF EDUCATION
Sen. the Hon. Owen Darrell: Mr. Chairman, I now present the budget for Head 17, the Department of Educa-tion. Under the Commissioner’s leadership, the Department of Education is dedicated to advancing the quality
of education for Bermuda public school students and their families. The mission To evolve into a top- tier 21
st
century education system which is complex and critical,
especially as the department works closely with the Education Reform Unit on its transformative efforts.
Mr. Chairman, as shown on page B -132, the
Department of Education has allocated $117.5 million
for the fiscal year 2024/25, an increase of $2.64 million
over last year’s budget. This increase primarily supports mandated salary increases and programme enhancements.
Mr. Chairman, I would like to follow up on the
presentation of the Education Ministry’s budget. I would
like to highlight our proactive steps this year. As found
on page B -132, our proposed budget for 2024/25 sees
an increase of $2.64 million over the pri or year’s approved figure. Yet it is essential to note the context of
last year’s revised budget, which at $120.4 million reflects an unplanned increase of $5.56 million due to recently concluded union- negotiated salary agreements.
Mr. Chairman, this year we have rigorously reviewed the past three years’ budgets and embraced the
zero- based budgeting approach. This deep dive revealed instances of year over year overestimation with
some allocations remaining unspent for consecutive
years. Such findings were eye- opening and underscored the need for a more disciplined and reflective
budgeting process. Mr. Chairman, our objective is not
merely to adjust the numbers but to fundamentally rethink how we reallocate those resources. This shift in
perspective is crucial as we embark on transformative
education reform. The changes in our budget reflect a move toward more strategic and considered expenditure, ensuring that funds directly contribute to enhancing educational outcomes.
Mr. Chairman, this budget is not just a financial
document; it is a testament to our commitment to ensuring every student has access to quality education. It
represents a thoughtful reallocation of resources, prior-itising efficiency and impact. As we proc eed, I will delve
into specific adjustments made within our business
units detailed on page B -137, illustrating our strategic
approach to funding education in these challenging
times.
Central Administration 1701. Mr. Chairman,
the upcoming budget for business unit 27000, General
Administration, will provide for the purchase of educational and office supplies needed throughout the school
year. For the fiscal year 2024/25, expenses are
planned to be reduced by $216,000 compared to the
previous year. As mentioned, this adjustment reflects our commitment to efficient budget management while
ensuring our schools are well -equipped with the necessary supplies.

Programme 27001, Office of the Commissioner

Sen. the Hon. Owen Darrell: Mr. Chairman, this year
the Office of the Commissioner which includes the
Commissioner of Education, the Director of Academics,
the Director of Educational Standards and Accountabil-ity (ESA) and an administrative assistant has been allocated $685,000. This marks an increase of $287,000
over last year primarily to support operational costs.
This team leads strategic planning and staff supervision and supports education reform initiatives.

Human Resources

Sen. the Hon. Owen Darrell: Mr. Chairman, business
unit 27030, Human Resources, has been allocated a
total of $701,000 to fund the salaries of technical and
administrative staff, expenses to advertise and recruit
staff, and monies for annual long- service awards to
teachers and other employees who are members of the
BUT [Bermuda Union of Teachers].

Staff Development

Sen. the Hon. Owen Darrell: Mr. Chairman, 27031,
Staff Development. This year the Staff Development budget has been minimally decreased from last year to
$629,000. This funding supports the salaries of four mentor teachers and enables a range of local training
and professional develo pment activities. These initiatives are designed to boost the skills of our educators including teachers, support staff and Department of


Bermuda Senate Education personnel, reinforcing our commitment to
continuous professional growth across the board.
Mr. Chairman, key highlights of the professional training are as follows:
• Professional Development Days ;
• Bermuda Teacher Induction Programme
[BTIP ];
• Focused Training for Early Childhood and Primary Education;
• Professional Development for Instructional Team Leaders ;
• Specialised Training Programmes .
Mr. Chairman, this year’s theme, Empower,
Evolve, Excel! underscores our dedication to fostering
a culture of excellence and continuous improvement in
education through targeted professional development
and training.

Educational Standards and Accountability
Sen. the Hon. Owen Darrell : Educational Standards
and Accountability 27090. Mr. Chairman, the funds allocated to this business unit 27090 are $676,000, an
increase of $31,000 over the last year’s budget. Mr.
Chairman, the Educational Standards and Accountability [ESA] unit plays a pi votal role in overseeing the quality and performance of our educational institutions in-cluding 18 primary schools, three middle schools, two []senior secondary schools and the Dame Marjorie
Bean Hope Academy. Mr. Chairman, the E SA team,
led by an Assistant Director, focuses on enhancing
leadership, teaching quality services and [distributing]
programme offerings across all schools. The Assistant
Director also supports the four school transformation teams, continuing our commitment to elevating educational standards and accountability. Through dedicated leadership and targeted support the ESA aims to en-sure that every student receives a high- quality education that prepares them for success.

Attendance

Sen. the Hon. Owen Darrell: Business unit 27095, Attendance. Mr. Chairman, the budget for the Attendance
unit, previously under business unit 27095, has been
incorporated into business unit 27090. This change
supports the [salaries for] the registration and attendance coordinator and four school attendance officers.
This dedicated team ensures daily school attendance
compliance for children of compulsory school age. The
coordinator leads the attendance officers and manages
the annual school registration and transfer processes
for all [public] schools.

Substitutes

Sen. the Hon. Owen Darrell: Business unit 27160,
Substitutes. Mr. Chairman, substitute teachers are essential for maintaining educational continuity at our schools. They step in when regular teachers are unavailable due to illness or leave. In the past year a specialised group of substitutes supported our schools, especially during the critical phases of school transformation and redesign activities at CedarB ridge Academy, the Berkeley Institute, Francis Patton Primary and
Purvis Primary.
Mr. Chairman, for the upcoming fiscal year
2024/25, we have adjusted our strategy to have staff
involved in School Transformation Teams [STTs] complete their tasks after school hours. This shift aims to lessen daily teaching and learning disruption, thereby
reducing our reliance on substitute teachers. Consequently, the substitute budget (business unit 27160)
has been adjusted to $3,380,000, marking a $260,000
decrease from the previous year. Mr. Chairman, as
mentioned already, the department has been chal-lenged to adopt different methodologies than may have
been used in the past. This budgetary decision reflects
our commitment to financial efficiency without compromising the quality of education.
Mr. Chairman, the overall budget for the Central Administration programme is $6,528,000, which is
$215,000 less than the previous year’s budget.

Programme 1702, Student Services

Sen. the Hon. Owen Darrell: Mr. Chairman, Student
Services facilitates 13 essential programmes that provide direct services such as counselling, screening,
early intervention and assessments across Bermuda’s
public schools for all students, and special education
for the students with exceptionalities and special education needs.

Behaviour Management

Sen. the Hon. Owen Darrell: Business unit 27061, Behaviour Management. Mr. Chairman, this budget sup-ports the crucial work of behavioural therapists in preschools and primary schools and funds two Alternative
Education Programmes designed for students facing
behavioural challenges. T he total allocation for the upcoming fiscal year is $1,558,000.

Success Academy

Sen. the Hon. Owen Darrell: Business unit 27062,
Success Academy. The Success Academy Primary
Programme [SAPP] was relocated to Paget Primary in
September 2023. SAPP is designed to support students with social -emotional and behavioural challenges
with a focus on fostering positive behaviours for reinte-gration into mainstream classes.

School Psychology
Sen. the Hon. Owen Darrell: Business unit 27063,
School Psychology. This year $846,000 has been
380 21 March 2024 Official Hansard Report

Bermuda Senate allocated to support our school psychologists, who play
a pivotal role in addressing students’ academic, behavioural and mental health needs.

Adapted Physical Education

Sen. the Hon. Owen Darrell: Business unit 27064,
Adapted PE [Physical Education]. This year $313,000
has been allocated to support the Adapted PE delivered by three specialist male teachers.

Hearing

Sen. the Hon. Owen Darrell: Business unit 27065 is
Hearing. A total of $305,000 has been allocated to sup-port the Deaf and Hard of Hearing Programme. This
funding supports the employment of a specialised teacher for the deaf and hard of hearing. This teacher
provides tailored academi c instruction and works
closely with classroom teachers to ensure that all students’ needs are met effectively during regular class-room activities.

Vision

Sen. the Hon. Owen Darrell: Business unit 27066, Vision. Mr. Chairman, a budget of $111,000 has been dedicated to the Vision Programme, focusing on sup-porting students with visual impairments.

Office Support

Sen. the Hon. Owen Darrell: Business unit 27071, Office Support. Mr. Chairman, the business unit 27071 Office Support has been allocated a budget of
$678,000. This business unit serves as the secretariat for the Student Services section and funds the salaries of one Assistant Director of Student Services, two administrative assistants and four learning support teachers who provide services to students with special education needs.

Counselling

Sen. the Hon. Owen Darrell: Business unit 27072,
Counselling. Mr. Chairman, this year the Counselling
Programme has been allocated $3,109,000 to support
a comprehensive and developmental approach to student counselling.

Learning Support

Sen. the Hon. Owen Darrell: Business unit 27074,
Learning Support. Mr. Chairman, this year’s Learning Support budget of $4.38 million supports the crucial
work of two Education Officers for Special Education and Learning Support, and 38 Learning Support Teachers. These professionals provide special education services across the educational spectrum including preschools, primary and middle schools, the Dame
Marjorie Bean Hope Academy and our trauma- responsive programmes at Success Academies. This budget allocation also covers essential assessment materials
for accurately diagnosing students with special education needs.

Early Childhood Education

Sen. the Hon. Owen Darrell: Business unit 27076,
Early Childhood Education. Mr. Chairman, Early Child-hood Education has been allocated $142,000 which reflects the funding for the salary of the Education Officer
for Early Childhood Education.

Paraprofessionals

Sen. the Hon. Owen Darrell: Business unit 27079,
Paraprofessionals. Mr. Chairman, the Paraprofession-als unit has been allocated a budget of $6.384 million
for the upcoming fiscal year. This reflects a decrease of
$1.258 million from the last fiscal year.

Autism Spectrum Disorder

Sen. the Hon. Owen Darrell: Business unit 27083, Autism Spectrum Disorder [ASD]. This business unit has
a budget of $696,000. This funding covers salaries for
teachers and paraprofessionals working in ASD programmes across three primary schools, one middle
school and one senior school.

Alternative Education

Sen. the Hon. Owen Darrell: Business unit 27084, Alternative Education. Mr. Chairman, this budget supports the Success Academy Middle– Senior [SAMS]
and additional alternative education placements for eight students who cannot be accommodated at Success Academy. With the closure of Im pact Mentoring
Academy, we are exploring local alternative pro-grammes to accommodate our students’ needs. Currently, three students are enrolled in Adult Education
with two more awaiting placement, increasing our alternative education enrolment to 12 students.

Programme 1703, Finance and Corporate
Sen. the Hon. Owen Darrell: Mr. Chairman, in this programme, business unit 27002 Finance and Corporate
Services, with a budget of $732,000 employs a dedicated team of 10 staff members to manage the Education Department’s financial operations. The team comprises a range of roles inclu ding a Departmental Comptroller (currently vacant), a Trainee Departmental Comptroller, a Financial Services Manager, a Payments Supervisor, a Salaries Supervisor, a Salaries
Clerk, three Accounts Clerks and a Messenger.



Bermuda Senate Office Accommodation

Sen. the Hon. Owen Darrell: Business unit 27003, Office Accommodation. Mr. Chairman, this business unit
has a budget of $489,000 that funds the salary of the office receptionist and covers the costs for the annual
rent, office maintenance, electricity and communication
costs for the department ’s physical offices at 44 Church
Street.

Educational Stores

Sen. the Hon. Owen Darrell: Business unit 27040, Educational Stores. Mr. Chairman, this business unit has
been allocated a budget of $483,000 which supports
salaries for six staff and other expenditures such as
rent, inventory, freight costs and gas/diesel. The Stores Section provides centralised purchasing, inventory
management and distribution services to all public
schools, Bermuda College and other government departments such as the Department of Youth, Sport and Recreation. (It no longer exists.)

School Transport

Sen. the Hon. Owen Darrell: Business unit 27041,
School Transport. Mr. Chairman, this business unit has been allocated a budget of $458,000 and funds the sal-aries of three bus drivers and two bus attendants to
transport students who attend Dame Marjorie Bean
Hope Academy safely to an d from school and to
transport students in the ASD programmes in other
schools.

Buildings, Grounds and Equipment

Sen. the Hon. Owen Darrell: Business unit 27042,
Buildings, Grounds and Equipment. Mr. Chairman, this year the budget for maintaining our public school buildings, grounds and equipment is set at $1,112,000, a
decrease of $222,000. These funds are critical for the
Facilities Manager t o oversee the comprehensive
maintenance across all public school facilities.

IT Support

Sen. the Hon. Owen Darrell: Business unit 27050, IT
Support. Mr. Chairman, for the fiscal year 2024/25 the
Information Technology [ IT] section has been allocated
$2,429,000. This budget supports the salaries of key IT
personnel including an IT Manager, Computer Services
Officer, Management Systems Officer and IT support
officers who are essential for delivering and managing
the department’s IT s trategy and services.
Mr. Chairman, key achievements, ongoing projects and priorities over the next year within the IT De-partment are as follows:
• Wi-Fi Enhancements ;
• IT Security ; • Transforming IT Support ;
• Chromebooks and Laptops Distribution;
• IT Operations and Service Delivery ;
• PowerSchool Ecosystem;
• IT Security Awareness ; and
• Wi-Fi Infrastructure.

Programme 1704, Preschools

Sen. the Hon. Owen Darrell: Programme 1704, Preschools, and that is on page B -138. Mr. Chairman, the
total budget for our 10 preschools for the fiscal year
2024/25 is $5,019,000. A significant portion, 94 per
cent, is allocated to staff salaries, highlighting our commitment to quality early childhood education. The remaining 6 per cent covers essential operational costs
such as resources, training, development, electricity, part-time cleaning services, telecommunication, office
equipment and drinking water.

Programme 1705, Primary Schools

Sen. the Hon. Owen Darrell: Mr. Chairman, continuing on to page B -138, the budget for our [18] Primary
Schools for the fiscal year 2024/25 stands at
$32,672,000. This allocation supports the operational
costs of providing high quality education across these
schools.

Programme 1706, Special Schools

Sen. the Hon. Owen Darrell: Mr. Chairman, continuing on page B -138, business unit 27120, Dame Marjorie Bean Hope Academy [DAME], provides dedicated
services to students with severe to profound and multiple challenges and special needs. A total of $578,000 has been allocated to DAME, a decrease of $81,000
over the last fiscal year.

Programme 1707, Middle Schools
Sen. the Hon. Owen Darrell: Mr. Chairman, although
the plan is to phase out middle schools as part of the Education Reform efforts, I want to assure the community that the leadership and staff at the remaining middle schools are committed to ensuring that our stu-dents’ learning exper iences and achievements continue to improve.

Programme 1708, Senior Schools
Sen. the Hon. Owen Darrell: Mr. Chairman, continuing on page B -139, the Senior Schools [programme]
provides grants for the Berkeley Institute and Cedar-Bridge Academy. The total budget allocation for 2024/25 is $28,887,000. Mr. Chairman, each senior
school is provided with an annual grant for the operational management of their respective school. For the fiscal year 2024/25, CedarBridge Academy’s funding
382 21 March 2024 Official Hansard Report

Bermuda Senate increased by $1,520,000. The Berkeley Institute’s funding has risen by $1,280,000.
Mr. Chairman, I wish to extend commendations
and applaud the boards, teachers, staff, and support
staff members of the Berkeley Institute and Cedar-Bridge Academy for their commitment and dedication
to the continued development of the Signature Programmes, which have entered their second year of existence.

Programme 1709, Curriculum, Assessment

Sen. the Hon. Owen Darrell: Mr. Chairman, staying on
page B -139, the Curriculum, Assessment section covers funding for the Cambridge International Curriculum, City and Guilds, Penn Foster, system- wide reading assessments, Career Pathways, dual enrolment
and all other related curricular resources.

Assessment and Evaluation

Sen. the Hon. Owen Darrell: Business unit 27020, Assessment and Evaluation. The allocated budget for the
continued and effective delivery of assessment and
evaluation is $343,000. We are pleased to say that the assessments for learning are improving the approach
to teaching and learning by creating feedback to im-prove students’ performances.

Design, Development and Implementation
Sen. the Hon. Owen Darrell: Business unit 27520, Design, Development and Implementation. Through the Design, Development and Implementation business unit, the Department of Education is dedicated to enhancing educational outcomes through comprehensive programming and skilled officers .
[The following is a streamlined overview of our
efforts across various units: ]
• The Arts —The Acting Education Officer for the
Arts is developing culturally relevant fine arts
pathways, emphasising community partnerships and professional development to elevate
the arts within our curriculum;
• Information Computer Technology ;
• Reading ;
• Physical Education and Health ; and
• Social Studies .
Each officer [ and programme] plays a critical
role in our mission to provide a well -rounded and effective education system. Their work supports academic achievements and prepares our students for global citizenship and personal growth.

College Career Pathway

Sen. the Hon. Owen Darrell: Business unit 27524,
College Career Pathway, has been budgeted
$443,000. This business unit funds the Employability Skills programme, the Certified Nursing [Assistant certification], and the EMT certification at Bermuda College. This cost centre covers the cost of the leadership
management of two College and Career Pathways Officers. In addition, this cost centre covers the salary of
the Applied Science Technology Instructor for our dual
enrolment students in the Trades and STEM.

Early Childhood Education

Sen. the Hon. Owen Darrell: Business unit 27175,
Early Childhood Education [ECE], on page B -139. [This
business unit encompasses] Early Childhood Special
Education and Quality Assurance. Mr. Chairman, starting with the Basics initiative, we have introduced a parent education and coac hing programme targeting families with children from birth to five years old. This programme is a cornerstone in closing developmental
gaps before children enter primary school, offering personalised age- specific parenting tips via WhatsApp and
SMS at no cost. To amplify this initiative, we invest in widespread engagement through social media, radio,
digital ads and family events, ensuring continuous visibility and participation.
Mr. Chairman, the total budget allocation for
programme 1712, Early Childhood Education, that covers Child Development and After Preschool Care, is $1,767,000.

Subjective Analysis of Current Account Estimates

Sen. the Hon. Owen Darrell: Mr. Chairman, I now refer you to page B -140, the Subjective Analysis of Current Account Estimates for the Department of Educa-tion. This page provides an aggregate of the detailed
line item expenditures previously mentioned. The variances of significance for the categories are as follows:
• Salaries and wages increased by $1,985,000
(or 3 per cent) and $284,000 (or 8 per cent),
respectively . And this was due to salary uplifts
and the addition of personnel for the Signature
Learning schools and the Parish Primary schools located at Francis Patton and Purvis
Primary Schools.
• Other personnel costs decreased by $31,000
(or 7 per cent), reflecting a decrease in recruitment expenses.
• Training costs are $82,000 (or 27 per cent)
lower, while Transport decreased by $15,000
(or 28 per cent) over the prior fiscal year.
• Travel costs decreased by 63 per cent , down
by $31,000 over the prior fiscal year.
• Communication costs decreased by $75,000
(or 11 per cent).
• Professional services decreased by $727,000
(or 34 per cent) due to the reallocation of funding for E ducation Reform to the Education Reform Unit established in 2023 and the realisa-tion of expenditure efficiencies.


Bermuda Senate • Rental costs decreased by $363,000 [ or 34 per
cent] due to the IT and Facilities Sections being
relocated to the same office space for efficiencies.
• Repair and Maintenance costs decreased by
$109,000 (or 6 per cent) due to reduced
COVID -19-related expenditures.
• Energy costs decreased by $316,000 (or 26 per cent) from the prior fiscal year due to
expected efficiencies at Clearwater Middle
School and Heron Bay Primary.
• Materials and Supplies expenditures are
$432,000 (or 21 per cent) lower due to decreases in the purchase of inventory, assessment materials and office/stationery supplies.
• Grants and contributions increased by
$2,565,000 (or 9 per cent), and funds have
been allocated to support CedarBridge Academy’s school redesign and system transformation work.
Mr. Chairman, pages B -141 and B -142 show
1,047 full -time [equivalent] posts, a reduction of 23 full -
time [equivalents] compared to 2023/24. Most of these
relate to the decrease in paraprofessionals based on
the previous year’s spending. The department will continue to monitor and review the number of full -time
[equivalents], ensuring both efficiency and effective-ness in staff resources.
Mr. Chairman, pages B -143 through B -146 list
the performance measures for the Department of Edu-cation. These measures reflect the priority areas that will be monitored and for which school and department
staff will be held accountable during the year.
Mr. Chairman, I thank the Department of Education and school staff for all efforts undertaken in Education Reform and general operations over the past
year. I look forward to the achievements and outcomes in Education Reform over the 2024/25 fiscal year t hat
will move us closer to our vision for a 21
st century worldclass public education system of learning for Bermuda’s children.
Mr. Chairman, this concludes my presentation
on Head 17, the Department of Education. I will now
move on to the Budget Estimates for Head 41, the Bermuda College.
[Sen. John Wight, Chairman]

Thank you, Minister. Please proceed.

HEAD 41 —BERMUDA COLLEGE

Sen. the Hon. Owen Darrell: Mr. Chairman, Bermuda
College’s mission is To provide the community with innovative programmes, training, support services and access to partnerships that lead to local and global success. [The college] demonstrates its commitment to the
success of its diverse student body by offering transfer
programmes leading to success at the university level, professional and technical training leading to success
in the workforce and preparatory programmes leading
to success in the classroom.
Mr. Chairman, as found on page B -153, for the
2024/25 financial year Bermuda College has been allo-cated an annual grant of $14,653,901 by the Ministry of
Education (as last year), with an additional capital grant
of $350,000 for campus maintenance and upgrades.
Mr. Chairman, the college is led by Interim
President Dr. Branwen Smith- King and a Board of Governors chaired by Mr. Nasir Wade. It maintains high standards as an accredited institution by the New England Commission on Higher Education [or NECHE] and
is working toward re- accreditation in 2025 to continue
offering top- notch education.
Mr. Chairman, notable achievements for the
past year include the success of the Dual Enrolment
Programme, with 64 participants this past year and
three dual enrolment students graduating from the college before earning their high school diplomas in the
May 2023 commencement. Twelve “students of excellence” were inducted into the Phi Theta Kappa Honour
Society, joining the other 55 who have been inducted
since the college’s chapter was established in 2019.
The college also partners with organisations like B EST
[Bermuda Environmental Sustainability Taskforce] for
environmental sustainability initiatives and hosts influential events like the annual Roche Science Week to
engage the community in science and conservation.
Mr. Chairman, significant educational milestones were celebrated including the graduation of 102
students across various disciplines. The college also
graduated 11 students with Bachelor’s Degrees in Business Administration in partnership with Mount
Saint Vincent University.
Mr. Chairman, in May 2023 the Athora Professional and Career Education [APACE] Division awarded 269 professional designations and Workforce
Development Certificates that included 10 public high
school students who received their Certificate as Nursing Assi stants as part of the Education Department’s
Dual Enrolment programme with the college. And 72
high school students earned the City and Guilds Certificate in Employability Skills, underscoring the college’s
role in workforce development.
Mr. Chairman, financially the college’s revenue
comes from government grants, student tuition and other sources totalling approximately $19.1 million. Sal-aries and benefits are the most significant expense, accounting for 69 per cent of the budget. The co llege also
invests in campus improvements and educational resources supported by the Bermuda College Foundation, which contributes to scholarships, programming
and sustainability projects.
Mr. Chairman, the Bermuda College Foundation plays a critical role in supporting and enabling the college’s efforts to modernise its campus and programmes. Bermuda is grateful to the donors who have
supported the current Bermuda College Foundation
384 21 March 2024 Official Hansard Report

Bermuda Senate Fundraising Campaign and shown their commitment to
ensuring that all Bermuda residents have access to
quality, relevant, tertiary education right here at home.
Mr. Chairman, to celebrate its 50th anniversary,
the Bermuda College has created a commemorative logo and postage stamp. In addition, several other celebratory activities are being organised. These will include a gala banquet next year.
Mr. Chairman, as I close, I would like to thank
the board, the executive, the administration, the faculty
and staff of the college for their work throughout this year. And I look forward to working with them in the
coming year to help students of all ages pursue their
careers and personal aspirations.
Thank you, Mr. Chairman. This concludes the
budget for Head 41, the Bermuda College, and my
overall presentation of the 2024/25 budget for the Ministry of Education.

Very good. Thank you, Minister.
Would any other Senator care to speak on
these heads?
Senator Robinson, over to you.
Sen. Dwayne Robinson: Thank you, Mr. Chairman,
and thank you to the Minister for allowing plenty of time
to ask questions. And I want to commend him for that
brief.
Just right off the top, I am just going to jump out
of order because this is something that is a little bit near and dear to me. But in the capital expenditure (if I can just flip to it, trying to find the thing) on page C -12, I just
did not see any fundi ng spent on CedarBridge Academy. And I am an alumnus, so I had to go right there first and look. I saw something at business unit 76836
allocated to the Berkeley Institute. So I just wanted to
get a little bit of clarification for my alma mater whether or not it is being left out. Or is it just in that good of a
condition?
So I will hop back now to the original head,
Head 16, and start from there. So in the General Sum-mary in 26000, General Administration [on page B -133]
it is $2.153 million less than the 2022/23 actual in the 2024/25 estimate. And I just wanted to get some clarity
on why there was such a large drop there. And in 26140
[Educational Reform Unit] it was a $277,000 decrease
compared to the 2023/24 revised. And there is a $3.935
million increase from the 2022/23 actual. I know that it
was mentioned briefly in th e Minister’s brief, but I just
wanted to get that information for me personally so I
can jot it down (because as you know, it is hard to get
the notes as the Minister is reading).
Okay, just a general question. The rescoring
process was mentioned under the Ministry of Education Head 16. Could we get a bit of insight into when the
Minister believes that that may be completed and whether or not those decisions will be able to be appealed? As we know, last time they had to go back to
rescore. So I just wanted to know whether or not we could get some insight as to when that will finish, and
whether these decisions on the rescoring will be final.
It was mentioned in the brief.
Continuing on. So we have salaries. And employees have stayed the same, but salaries decreased $64,000 in 2024/25 estimate when compared to the
2022/23 actual. I just wanted to know what the reason
for this decrease was. And wages actually decreased
entirely and were zeroed out. So I just wanted a bit of
clarity on that. Training also was marked as zero in 2022/23 and the 2023/24 original. And this is page B -
134. Yet we see in the 2023/24 revised, $3,000 was
spent. So I just wanted to know, was there no tr aining
allocated in 2022/23 or 2023/24? And was this $3,000 unexpected or was it just a budgeting mishap?
The Minister actually gave a very good brief on
travel. So I will leave that alone.
Coming over now to Performance Measures,
we have “Consultation with key stakeholders during the
development of policy initiatives geared to enhance the
public education system,” and it is achieved in 2022/23.
In the brief it was mentioned that a lot of th ese performance measures would be wrapped up in March 2024.
However, this particular one in the target outcome does
not have a particular end date. So maybe we can get
some clarity as to when the Minister believes that this
particular performance measure w ill be achieved. And
it is the same thing for the “Key Stakeholders consulted
on policy decisions supporting the transformation of the
public education system.” The same question that I just
asked was, we heard March [20]24 in the brief. I just
wanted to g et some clarity as to when this one will also
be completed, or at least estimated to be completed.
And this is page B -135.
Moving down to the Legislative amendments, I
see the date “March- 24.” And then heading into
2024/25 target outcome, we see “On- going.” So I just
wanted to get a bit of clarity there as to whether or not this is the completion of one initiative and then moving
into a completely new one. Or are we expecting that
this will be considered to be ongoing and was said to
be completed in March 2024 but is actually still ongoing? And also can we just get a bit of clarity on some of
the achievements that are now ongoing in that particular line item?
And I could make way for other Senators to ask
questions if not on this head.

Oh, I am sorry.
Senator De Couto, did you have your hand up?
Sen. Dwayne Robinson: Oh.



Bermuda Senate Sen. Dr. Douglas De Couto: Yes, thank you, Mr.
Chairman. My colleague actually did pick up quite a few
of the quantitative questions on the expenses and so
forth.
But looking to the performance measures, yes,
we did hear quite a lot about the scholarships earlier
today and in the brief, which is quite good to see. And I
am glad to see that on page B -135, business unit
26090, Scholarships & Awards, I am pleased to s ee
that all of the recommendations made by July 31 . . .
And then I see that all of the awards are disbursed by
October each year. I feel like a lot of students would
need the funds before they start their term time. Often
those bills have to be paid befor e you can register for
classes, and that would typically be in late August or [early] September. So is that October like a drop- dead
date? Or on average, how early do you think these
funds are paid? And that would be my question.
Thank you.

Senator Tucker.

Sen. Robin Tucker: Thank you, Mr. Chairman.
My question comes from page B -132, and it is
also in relation to page C -4, and that would be Capital
Development. I did notice a couple of things in this par-ticular section.
So, looking at business unit 75242, Improvement of School Fields [on page C -4], there was no actual for 2022/23 and nothing for the original estimate in
2023/24 and nothing that is estimated for 2024/25. I do recall that the Minister in his brief did menti on that there
was some work going on at Purvis. And as we go through this transition and reform process, I am just wondering whether any funds have been allocated perhaps somewhere else that would deal with the fixing of the school fields. So if he can let us know if there is
additional funding set aside somewhere else to do that,
or if Purvis is the only school that needs work.
But even with that, where is the money coming
from, because it is not allocated here? Maybe it is
somewhere else.
The second question would be connected to
page B -12, Capital Acquisitions. It may be just for my
benefit, but if the Minister can just give some information about something he mentioned in the brief
about the purchasing of a vehicle. So if he can let us
know where we can find that budgeted amount, what
line item that is included under, because I did not see it under Capital Acquisitions.
So those are all of my questions for now. Thank
you, Mr. Chairman.

Thank you, Senator Tucker.
Senator Robinson.
Sen. Dwayne Robinson: Yes. And I just have one final
question on Head 16, and then I will move on to the
next head. We see overall that the current expenditure
was increased compared to the original 2023/24 estimate. And I did hear in the brief that there are some
initiatives going on within the Ministry to try to streamline or to improve budgeting. But my concern was that even though it did improve, increase, it is still underneath the 2023/24 revised amount. And I understand
that they are attempting to be more fiscally prudent. I
just want to make sure that we are not doing too much
short -changing when it comes to the Ministry of Education, because it is a $2,843,000 drop. So with that, I can
move on because I think that most of us will have most
of our questions here in Head 17.

[Crosstalk ]