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Healthcare in total disarray

Healthcare is one of the most important services a country can provide its citizens, yet Cayman’s healthcare system is failing to adequately meet the needs of Cayman’s population.

As we highlighted in our Feb. 3 issue, according to a recently released report by the Office of the Auditor General, Cayman’s health system is need of a major overhaul.


HSA George Town Hospital


The report highlighted a litany of issues that need to be addressed urgently, including the need for new legislation and regulation, more staffing and resources, better communication between the public and private sector, lack of adequate inspections, and a general failing by government to fully implement the 2012 strategic plan for healthcare.

Of particular note is the fact that the public healthcare system staffing levels have remained the same over a period when the Cayman Islands population has doubled; that, worryingly, not all qualified practitioners were registered; and that not all facilities that provide healthcare services were inspected or certified. Additionally, abuses of the Health Insurance Law, the lack of accountability of the Cayman Islands healthcare system to the Legislative Assembly and the general lack of performance management and reporting were also highlighted.

Additionally, the report also raised concerns about the government-owned insurance company Cayman Islands National Insurance Company failure to offer a choice of providers to the thousands of people it insures.

Add to that a host of financial problems that plague the government run Health Services Authority, including some $95 million in “bad debts,” mostly acquired by unpaid hospital bills. Then there are the hundreds of thousands spent by CINICO to settle a lawsuit brought by Simplifi, a payment administrator for CINICO, who sued the insurance company in an Ohio federal court, which we also reported on in our Feb. 3 issue. And, let’s not forget, the disastrous CarePay system which was implemented in 2011. Designed to prevent the ongoing accumulation of bad debts, CarePay only resulted in more costs to HSA when then HSA Chairman, Canover Watson, abused his position to skim more than $300,000 of public funds for himself.

Indeed a  survey, also conducted by the Auditor General’s Office early last year which formed part of the report, highlighted that Cayman’s medical professionals were also “overwhelmingly” dissatisfied with the financial aspects of Cayman’s healthcare system, including affordability, insurance, reimbursement and payment collection methods.

The Cayman Reporter recently asked members of the public on what they thought about Cayman’s healthcare. Their responses are printed in today’s paper, and include dissatisfaction with wait times to concern about lack of skilled staff and up-to-date equipment.

According to the AG’s report, in 2015 the Cayman Islands spent $269 million on healthcare across both the public and private sectors, and that figure is only likely to rise as healthcare costs continue to soar.

It seems that healthcare in Cayman has suffered from many of the same endemic failures that have plagued multiple successive governments in Cayman’s recent history, including inadequate laws and regulations, the lack of oversight and enforcement practices, to the failure to properly oversee budgetary usage to ensure value for money.

Without a healthy population which extends beyond the wealthy who can turn to the private sector, or seek care overseas, all the construction projects, financial services organisations and flow of tourists and wealth in the world will not be sufficient compensation.

Indeed, the failure to provide proper healthcare leads not only to negative economic consequences, but leaves Cayman wallowing in a moral morass of its own making.  It is time for Cayman’s political leaders to fulfil the covenants of their offices and ensure reasonable equality of healthcare for all.  Indeed, now with the elections looming, it is time for the residents of Cayman to demand it.

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