Video: Minister Wilson & Minister Rabain

[Updated] Minister of Health Kim Wilson and Minister of Education Diallo Rabain will be holding a joint post Throne Speech press conference this afternoon [Nov 9] and we will stream it live, so the video below should start at around 12.30pm.

Update: The live broadcast has concluded and the 56-minute replay is below

Update 2.40pm: Minister Wilson’s remarks:

In this year’s Throne Speech, the Government of Bermuda has reaffirmed its intention to implement universal health coverage for all residents.

Our vision for healthcare seeks to ensure that -

“all people have equitable access to needed informative, preventive, curative, rehabilitative and palliative essential health services, of sufficient quality to be effective, while also ensuring that people do not suffer financial hardship when paying for these services and critical medicines.”

Bermuda is fortunate in that we have a health system that is well-developed and well-supported by dedicated professionals. However, the overall affordability and sustainability of our health system is deeply concerning for this Government. Bermuda has one of the highest per capita health expenditures globally, but our population health outcomes do not reflect this.

Continuing with the status quo in the hope this situation resolves itself is not a responsible option.

Change is required, and the journey is indeed complex and one which we will travel together for several years as we seek to ensure–

• better health outcomes, particularly of chronic disease management,

• essential health services residents can be confident they can afford when they need them, and,

• the elimination of waste and duplication where it occurs.

Having committed to universal health coverage [UHC], the Ministry of Health was tasked with developing the way forward. To do so, the Ministry brought together a core group of stakeholders from across our health system to serve as the UHC Steering Committee to develop the roadmap for strengthening Bermuda’s healthcare.

The UHC Steering Committee is led by the Ministry of Health and comprises representatives of Bermuda First, the Bermuda Medical Doctors Association, Bermuda Health Council, Department of Health, Bermuda Hospitals Board, the Health Insurance Department, Ministry of Finance and a Patient Representative, and its work is supported by KPMG.

In this process, the Steering Committee took note of healthcare systems in other jurisdictions, large and small, who have already taken their first steps on this journey. It is clear there are many paths to reach universal health coverage – and it is advocated by the United Nations and World Health Organisation – but the approach taken here, on our island, must be Bermuda-centric.

Examining our health system, the UHC Steering Committee identified a number of actions to prioritise for its strengthening. These can be grouped into the following three areas:

• 1. stewardship and governance,

• 2. healthcare service delivery, and,

• 3. health system value and financing.

Stewardship and governance is the foundational framework for the health system. This is where vision and strategy are set, population health needs are understood, transparent responsibility and accountability are established, and organisational and legal structures are implemented.

For example, with respect to transparent responsibility and accountability, identified actions include setting standard metrics for measuring and monitoring system and population health performance and public reporting of the results. How does Bermuda measure up against other jurisdictions in terms of our population’s health? How does Bermuda measure in terms of best practices?

Strengthening healthcare service delivery involves ensuring all residents have equitable access to essential healthcare integrated in an efficient manner and which produces good patient experiences and health outcomes.

Identified actions in this area include determining: What are the essential healthcare services? What approach do we take to the delivery of care services? How do we take advantage of advancements in information systems to better manage patient care?

Concerning health system value and financing, this is a very challenging aspect for Bermuda. As stated previously, our health expenditure is high and does not match our health outcomes. However, before making abrupt changes to achieve a sustainable health system, it is crucial to fully understand current and future costs both at a system and individual patient level.

Therefore, identified actions include, but are not limited to: confirming current baseline costs; modelling future costs, as well as the sustainability of the ‘make no changes’ option; identifying saving opportunities across the health system; and, establishing a process to map baseline patient costs and model essential health care benefits.

While the pandemic delayed work on plans for universal health coverage as the Ministry, hospital, Health Council, physicians and allied professionals across Bermuda joined in the fight against COVID-19, this delay created space and time for the Ministry, working closely with the UHC Steering Committee, to develop a refreshed approach to health system change.

As a result, the many actions identified as necessary to strengthen Bermuda’s health system are based on, and framed by, a patient-focused approach that places patient experiences and outcomes at the centre of the work on universal health coverage.

Year 1 of the initial three-year roadmap for universal health coverage is foundational in nature. Three of the Year 1 areas of work are mentioned in the Throne Speech.

• Digital health strategy – Establishing a national strategy for digital healthcare and data that leverages health information systems to harness improvements and efficiencies for patients, healthcare providers and health system payors.

• Integrated patient pathway for essential care – Implementing a ‘patient-pathway’ approach, which focuses on a patient’s journey or pathway through the healthcare system, allows us to examine the fragmented components of healthcare and the costs involved at each point that care is delivered. A pathway can be a particular patient group [such as maternal-child care] or disease [such as kidney disease or heart disease]. By following a pathway from start to finish, we can better see opportunities to improve patient experiences and outcomes, and address any duplicative, wasteful use of resources.

• Commence merging of administration of Government healthcare plans – Review and implement a merger of the administrative functions of the government plans. A portion of this work was undertaken when the Health Insurance Plan and FutureCare were consolidated under the Health Insurance Department. This administrative merger would represent the completion of this process and involves GEHI and funds controlled by Financial Assistance and other patient care subsidies.

The other areas of work in Year 1 involve:

• setting up the organisational structure for stewardship and governance [including new working groups for collaboration with stakeholders],

• determining the baselines required, for example, for our health needs and for the metrics to measure our performance, and,

• establishing the economic case for strengthening our health system.

Vitally important for the work on universal health coverage is the engagement of, and collaboration with, the broad group of stakeholders who form part of Bermuda’s health system. There are many questions to answer and decisions to make that will need broader input than is represented solely by the UHC Steering Committee or the Ministry itself.

In the coming weeks, the Ministry will be meeting with the executive and membership of those represented on the Steering Committee, as well as the private insurers, Bermuda Medical Council and Nursing and Midwifery Council, the Bermuda Chamber of Commerce, Bermuda Employers Council, ABIR, ABIC, our union leaders and others. The purpose is to share the roadmap for achieving universal health coverage and the work done so far, and, most importantly, the work still to be done. We know their insight and feedback will be invaluable as we improve healthcare access, experience and outcomes for all who live here.

Finally, I would like to take this opportunity to thank the UHC Steering Committee for their hard work to date. This is the beginning of a multi-year journey with challenges and complexity in front of us. I very much appreciate your contributions, which have put Bermuda on a realistic path to achieve universal health coverage.

Update 6.04pm: Minister Rabain’s remarks:

Good day Bermuda

Today, I will provide an overview of the Ministry of Education’s Throne Speech initiatives and areas of focus for this upcoming legislative year. Education plays an integral part in this year’s Throne Speech theme, Social Renewal and Economic Recovery, Working Together to Move Bermuda Beyond the Pandemic.

Since the onset of the pandemic, we have had to look at, and think of the delivery of education much differently than before. The impact of the pandemic has been significant for our educators, students, and parents; Covid-19 has shifted the educational culture of learning in that:

• We have learned how to move between in-class teaching and remote learning seamlessly,

• Educators and Students have adapted and put their best effort forward,

• Parents have persevered through the challenges of virtual learning while maintaining their work responsibilities, and

• Educators and Students have become vigilant of their surroundings and put health and safety at the forefront of their daily actions

Our educators, students, and parents have displayed unwavering resilience and strength as they have pushed through the social and emotional stress brought on by the pandemic. I am grateful that they have all risen to the occasion and worked together to thrive despite the situation.

It is now time for us to look beyond this pandemic and move education forward. A well-known advocate for children, Ignacio Estrada, stated:

“If a child cannot learn the way we teach, maybe we should teach the way they learn” – Ignacio Estrada

Education Reform is this Government’s priority and has been the focus of the work of the Ministry of Education. As shared in last year’s Throne Speech, a Bill would be advanced that addressed the needed changes to the public school system. I am happy to share that this was done through the passing of the Education Amendment Act 2021.

This amendment paved the way for the phasing out of middle schools and introduction of a 2-tier system with Parish Primary and Senior Signature Schools. The introduction of Signature Schools would not have been possible without this legislation.

In September 2022, Cedarbridge will see the introduction of Signature Learning Programmes in “STEM [Science Technology Engineering and Mathematics]” and in “Trades and Professions”. The Berkeley Institute will have Signature Learning Programmes in Financial and Insurance and “Health and Social Care”.

After many months of preparation, community consultation and research, during the next few weeks the Signature Learning Programmes will undergo prototyping. This will involve testing proposed features of these new programmes, such as what and how young people will learn and be assessed, what kinds of partnerships will be required to deliver the signature curriculum, how we can support and up-skill our teachers, and most of all, what changes will be needed to make these programmes most impactful for Bermuda.

Prototyping will allow further engagement of students, parents, educators, the business community, and any interested person who wishes to participate.

Bermuda, this is yet another opportunity that is necessary, and critical, to ensure we utilise input from stakeholders and Bermuda at large to drive education reform forward.

I urge anyone who wants to participate in the prototyping sessions beginning the week of November 15th to visit www.moed.bm and click on the alert link to register.

“Education can bring the desired change in the future. If you want to shape the future, shape the education system accordingly.”

While much discussion has been centered around the transition of Parish Primary schools, the phasing out of Middle schools, and the introduction of Signature schools, Education Reform involves several streams of work occurring concurrently.

These efforts will continue to be advanced in this next legislative year.

Teams from the Ministry of Education, the Department of Education, the Board of Education, Bermuda First, teachers, students, and members of our community will continue working together to transform public education to meet our students’ educational and vocational needs. There is extensive work ahead, and teams have been assigned to carry out specific targeted responsibilities. These include:

1. The Governance Structure and Accountability Team that consists of members from the Board of Education, the Ministry and Department of Education, Bermuda First and Innovation Unit. Their focus is on creating an Education Authority for overseeing public education to lead all aspects of performance and accountability in public education. Much work has been done in this area, and their initial report will be released in the coming months.

2. The Learning First Programme is led by the Education Governance Team, Innovation Unit, and the various Schools and System Transformation Teams. Their focus has been on redesigning what happens inside schools and collaboratively designing an improved school system focusing on what matters the most, learning. These teams are responsible for the development and testing of our first Signature Schools for S1 students in September 2022, the design and development of Parish-Primary Schools, the development of the additional Signature Schools that will be eventually introduced in the coming years and the redesign of the Department of Education to ensure that the right conditions are in place for new models of learning and teaching to thrive. With their help, and with yours, we will redesign different aspects of public education that need to change to make it both authentically Bermudian and effective.

3. School Buildings Realignment Process will be led by a Strategic Programme and Project Plan in which the RFP has recently concluded. The realignment of our schools is necessary to remove the middle school system to create a 2-tier system of Primary and Senior Signature schools. As the Parish-Primary School consultation has been completed, the next phase of planning, designing how the transition and rebuilding of our primary schools and Signature Schools will be done over the next five years is underway. It will be critical that the planning of this phase be done to provide minimum disruption to our children’s learning. It will be equally critical that this plan includes details about the necessary finances and financial planning needed to ensure the required outcomes.

4. The History and Legacy Committee was an idea born out of the Parish Primary consultation process. Based on the feedback received, it was clear that our country has done a poor job of recording our educational history. This has been a huge disservice to our culture and communities. After reaching out to Bermudians experienced in historical preservation both based in Bermuda and overseas, we will be announcing shortly a working group that will develop a long-term plan for preserving our rich education history and legacy.

We will continue to provide opportunities for collaboration to ensure the voices of our stakeholders are part of the foundation of Education Reform. We intend to keep the guiding principles of transparency, inclusivity, and engagement to the redesign of the public-school system to produce a system the Bermudian public deserves.

“Giving is not just about making a donation. It is about making a difference” Kathy Calvin

Public Education is critically important to the success of any country as Public Education is the only comprehensive education system in any country. The United Nations article 26 states, “Everyone has the right to education. Education shall be free, at least in the elementary and fundamental stages”. The requirement and ability to have a Public Education System that provides a quality experience for Bermuda’s Students requires all of us to move in the same direction.

I am proud to stand here today as your Minister of Education and be able to speak to the significant partnerships that have helped our students and system thrive, even in the midst of a pandemic.

• The donation from the Hasso Plattner Foundation has resulted in every one of our students from P3 to P6 having a Chromebook in their hands.

• Countless small and mid-sized donations have placed devices in the hands of several Middle School and Senior School students.

• The recent donation from Exempted Business Partners will provide nearly 100k Lateral Flow Tests which will be used to enhance our Covid Screening programme.

However, I wish to mention one partnership in more detail: the donation of funding to Bermuda College to construct the new Career Development Centre and various other upgrades. The Athene Career Development Centre has been constructed due to a $3.8 million donation from a group of international companies located in Bermuda. We look forward to the grand opening of this facility that will include the Athora Division of Professional and Career Education [PACE] offices along with a model classroom [Catalina Classroom], a model computer lab [Athora Computer Lab], and the Aspen Innovation Lab.

The Innovation Lab is a flexible, collaborative space for exploring and sharing ideas/concepts, mentoring with various industry experts [virtually and face-to-face] and professional development opportunities to enhance knowledge and competency in the technology space. This space will be open to Bermuda College students and the community and includes a 3-D printer, 3-D scanner, educational robots, and prototyping equipment.

Additionally, the Lecture Theatre in Hallett Hall has been upgraded to support local and international training, seminars, webinars and the like. Lastly, the IT infrastructure has been upgraded to include doubling the bandwidth on campus, replacing all networking cabling, a new telephone system, a new firewall and a modern digital workplace. The grand opening is scheduled for later this month.

The unrelenting effects of the pandemic have prevented us from moving as fast and as nimbly as some have desired, especially with Education. Every day, we field calls from parents and our private school partners asking for Covid guidelines to be changed or modified. I get it and understand the COVID fatigue some of us are experiencing. However, we cannot and we will not allow Covid to prevent us from moving forward.

In the face of adversity, our school staff have been nothing less than phenomenal. Their commitment to go the extra mile to ensure our students get that extra boost during the last 2 years has been commendable. They are a testament to what can happen when you make the decision to look at the cup as half full and our country owes them a level of gratitude.

To everyone, from the custodians to the principals within our schools to the staff at the Department of Education and the Ministry of Education Headquarters to the teams working hands on with Education Reform, I thank you on behalf of the Government and the people of Bermuda.

We will continue to forge ahead and do the necessary work to transform and reform Public School Education, so all of our students can lead personally and professionally, compete locally and contribute globally.

We will transform education to provide a public school system that produces students equipped for vocational, academic, and multi-faceted careers that they have chosen based on their passions, and supported by our resources.

There is a lot of work to be done, and we rise to the occasion of getting it done. We will continue to work alongside Bermuda, and encourage Bermudians to work alongside us, to make the necessary changes that will bring Education Reform.

The focus is on what is best and required every day to build a better, fairer, and stronger education system for our children and Bermuda’s future.

Thank You

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