(CNS): Expectations regarding the launch of medical tourism with the opening of Health City Cayman Islands in East End have so far failed to materialise some two years after the hospital founded by Dr Devi Shetty opened. But the Public Accounts Committee also heard from witnesses this month that the facility has not only failed to attract all but a fraction of the numbers of patients predicted, it is also competing unfairly with existing health care providers because of the massive concessions package it received under the deal signed with the former UDP administration.
Over the last few weeks at the PAC meetings, health ministry and authority staff have revealed that no one has been monitoring the extensive package that the facility received because of the projections made for many thousands of patients. But the numbers of medical tourists has been in the hundreds not the thousands predicted. In its first year alone the hospital was projected to attract more than 17,000 overseas patients, while the real figure has been under 1,000 since it opened two years ago.
On Wednesday, Delroy Jefferson, the medical director at the Health Services Authority, confirmed that there are now also concerns that Health City is offering more than the tertiary care it was originally intended to provide to local patients in an effort to keep the expensive facility afloat. Doctors there are said to be doing executive health checks and delivering primary and secondary care to local patients, which is giving the hospital an unfair advantage in the competition with other facilities.
Given the massive economic and permit concessions, as well as the waivers over doctors’ standards and registration at that facility, the medical director pointed to the inequality the hospital has created in the private health care sector, without making any significant contribution to the public purse or boosting other sectors of the economy.
Jefferson also warned that the deal given to Health City may stifle the possible development of medical tourism, given the length and number of concessions in the exclusive arrangement. Having visited and researched a number of other countries that have been developing medical tourism markets, Jefferson indicated that the CIG’s agreement with Health City did not compare well and he raised concerns about the lack of any framework surrounding the governance of medical tourism, including issues such as quality control and doctors’ standards. He warned, too, that local health care professionals and students training at the Shetty hospital will not be able to practise anywhere else in Cayman because medical staff at Health City do not meet the medical council’s standards for licensing.
Jefferson told the PAC there are real benefits to pursuing medical tourism but without a governance structure and framework, along with a regulatory body to ensure adequate oversight to monitor quality control and more generally what is going on, he warned that Cayman had created a situation where the goalposts were being moved as things went along instead of developing medical tourism against a sound structure to begin with.
“What was originally intended to be a medical tourism facility … we are now noticing, because of the issues regarding the agreement and its inability to deliver some of what was agreed because of the overstatement of benefits, we are constantly moving posts. Instead of medical tourism, Health City is competing with local hospitals … unfairly as they have benefits other hospitals and healthcare providers are not getting,” Jefferson said.
The medical director has reviewed the Shetty agreement with government and said he had genuine concerns over the concessions and the period of time over which they have been given. Other countries exploring medical tourism “did not give such sweeping concessions”, he added, pointing out that other jurisdictions should learn a lot from Cayman’s mistakes. He said that changes in EMS have also been made and costs incurred by the Health Services Authority to accommodate Health City.
While he accepted the facility was enabling the government to reduce the number of local patients going overseas for some tertiary treatment, cutting costs and inconvenience for patients, the anticipated inflow expected from medical tourism had simply not happened.