The Ministry of Health, working with the Bermuda Health Council, will begin a targeted consultation on 14 September 2026 on a proposed approach for reviewing major changes in Bermuda’s healthcare system before they take effect.
Bermuda’s health system is small and closely connected. A major decision by one insurer, provider, pharmacy, supplier or public body can have wider consequences for patients, access to care, costs, staffing and the availability of important services. The proposed framework is intended to ensure that those impacts are considered early enough for the health system to respond appropriately.
Changes that could fall within the proposed approach include major changes to health insurance premiums or benefits, mergers or changes in ownership, closure or significant reduction of important services, changes in medicine supply, changes to provider payment arrangements, and major digital or administrative changes affecting access to care.
Where a change meets the definition of a significant or material healthcare change, the proposal is that there would be a legal requirement for advance notification and review before implementation. The Health Council would undertake the health system assessment and provide its recommendation to the Minister of Health, who would make the final public interest decision for the health sector.
That decision could include approval, conditions or safeguards, modification, delay or, where significant harm could not be adequately addressed, refusal of the proposed change. Routine operational decisions would not be captured.
The framework would build on work the Health Council already carries out under its existing legislation, including reviews of certain new health technologies, equipment and services. The proposed approach would broaden that work so that major changes can also be considered for their wider effects on patients and the health system.
This work is taking place alongside Government’s consultation on the proposed Competition Act 2026. Competition considerations are an important part of healthcare oversight and would inform relevant health reviews. At the same time, decisions affecting Bermuda’s healthcare system must also consider matters that extend beyond competition, including patient safety, access, affordability, continuity of care, workforce capacity and the sustainability of essential services.
The Ministry of Health will continue to work with the relevant Government bodies so that these responsibilities are coordinated, proportionate and do not create unnecessary duplication for stakeholders.
The Hon. Kim Wilson, JP, MP, Minister of Health, said: “Healthcare decisions can have consequences well beyond a single organisation or transaction. The Ministry of Health has a responsibility to ensure that major changes are considered in the context of patient needs and the sustainability of Bermuda’s health system as a whole. This proposed framework would strengthen our ability to do that before significant changes take effect.”
Dr. Ricky Brathwaite, Chief Executive Officer of the Bermuda Health Council, said: “The issue is timing. Too often, Government and the wider health system may only learn about a major change once the decision has effectively been made. At that point, there may be very little room to manage the consequences for patients.
“This framework is about creating an opportunity to ask the right questions earlier. What does this mean for access? Who will be affected? Is there another service available? What happens to patients if this goes ahead? Those are the questions we want answered before significant changes become difficult to reverse.”
The consultation will involve insurers, Bermuda Hospitals Board and community providers, pharmacies and pharmaceutical suppliers, professional bodies, employers, unions, patient and senior groups, Government agencies, regulators and digital health organisations.
The targeted consultation will run from 14 September to 2 October 2026. The consultation paper and survey will be made publicly available on the Health Council’s Engage page at healthcouncil.bm/engage and feedback received will help shape the final policy.
