Dear Sir,I write further to the letter sent to me and copied to The Royal Gazette from Margaret Kirk about her cancelled operation.I wrote back to Mrs Kirk on November 29 after her letter was received, but as she shared her story as a Letter to the Editor, I felt we also owed an explanation to the community we serve. We are very sorry and apologised to Mrs Kirk for the postponement of her surgery. Not only did we experience a surge of emergency admissions on that day, which put pressure on available beds, but a patient required an emergency response in surgery, which pressured our surgical resources as well. It is never an easy decision to make, and we are particularly sorry as Mrs Kirk was waiting in the hospital. It is very unfortunate for an individual who is impacted when we are required to prioritise emergency patients and their needs are not met as expected. I would stress that every option is exhausted to complete a planned surgery, although we sympathise immensely that this means a patient can be left waiting while we try. However, as the only community hospital, when an emergency requires immediate action, we are required to prioritise. Every decision has a consequence, and frequently we are in the position of focusing where the need is greatest, and the least harm will be experienced. Our employees are working hard to improve our process and minimise situations such as these. Figures for surgeries cancelled for non-medical reasons had been trending down until October. In fact, the number of surgeries we have carried out has actually risen year on year, as we have improved efficiencies, helping us to care for more people. Our emergency department and ward staff members are also working hard to improve their processes; and we have been seeking to prepare in advance for winter, when flu and respiratory illness increase the pressure beyond the issues we are already experiencing with an older and less healthy community.In the end, for an individual impacted such as Mrs Kirk, we can only apologise again and assure her and the community that we will continue to find ways to reduce the likelihood of such cancellations in the future.MICHAEL RICHMOND, MDChief of StaffBermuda Hospitals BoardPaget