Audit finds failings in healthcare

| 30/01/2017 | 45 Comments

(CNS): The government does not have the resources or the information it needs to effectively manage the local healthcare system and the public cannot be assured that they are receiving quality health services or getting value for money for the tax payers’ dollars being spent. A new audit by the Office of the Auditor General, made public Monday, outlines a number of problems relating to government’s failure to properly implement its own plan, a lack of important information, regulatory shortcomings, staff shortages and inequalities.

“Without the resources and information needed to effectively manage the healthcare system, the government cannot provide assurance to legislators and the public that it delivers high quality healthcare and achieves value for money,” Auditor General Sue Winspear said in a press release accompanying the report.

The Public Accounts Committee is expected to review the report, “Ensuring Quality Health Care and a Healthy Population”, this week, when public servants will be asked about the findings. The decision by the audit office and the PAC to release the report just days before the hearings begin has left little time for the public to consume the findings and lobby their MLAs about the content before the committee meets Wednesday, despite the implications of the report for the community.

The audit found that health outcomes in Cayman seem to compare well with other jurisdictions but there are important differences between the health of expats and locals. As well as the work government needs to do to implement its own 2012 strategic plan for improving healthcare, there is a shortage of public information about how the system works and how government manages the approximately $138 million of public funds used to provide healthcare.

“When legislators are making policy decisions that affect approximately 18% of total government expenditure, I believe those decisions should be made with the full understanding of how they could impact the health of residents of the Cayman Islands,” said Winspear.

Accompanying the audit of the local healthcare system, the auditor has published an information report to provide the Legislative Assembly and the public with a better understanding of the system, as well as a survey of some healthcare providers.

The OAG raised concerns that the government had invested a great deal of effort in creating a plan for the health system, which was published in 2012. But having spent so much effort to identify what it needed to do, government should have made a better effort to plan for and implement the improvements. Despite government’s own conclusions that the plan would need to be monitored, not only has it not provided the resources needed to implement the plan properly, but there are no resources to monitor it either.

See the reports in the CNS Library

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Comments (45)

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  1. Mango Tree supporter says:

    All they were intrested in is getting the contract for Moses sister company after that never happen they lost interest i give them a W for wuttless. PPM got go bro!

  2. Anonymous says:

    For an island 26 miles x 7 miles with a population of around 55K, Cayman has amazingly good medical services. There are some top-notch doctors, specialists, and para-medicals in Cayman. Sure audit needs an overhaul — can’t argue there — but just because the metrics are not available to accurately audit healthcare doesn’t mean patients are receiving a poor quality product. CINICO is providing excellent coverage for their members, better that most, if not all, of the other insurance carriers in Cayman.

    • Anonymous says:

      12:25. Finally someone actually gets it. What a breath of fresh air.

      If the health care was so bad wouldn’t everyone leave?

      Answer. No this is paradise and the same Civil servants you are blaming have helped create the Paradise.

      • Anonymous says:

        You and the poster above are mentally deficient. The point is not whether you get good healthcare. That is a qualitative / subjective argument.

        Instead they ask does it need $138m a year to run it. Are you getting value, or, are you wasting money.

        Its ALL about metrics.

      • Anonymous says:

        People are angry that the Health Ministry receives $136mln or over 10% of the entire annual budget and then HSA has to ask private donors like the Billes’ or local charities for equipment – even then, equipment like the Seafarers’ Robot sits in a dusty box somewhere. Like poster said, a tiny island that can’t or won’t keep track in the digital age. Something is very wrong with that.

  3. Anonymous says:

    The last line of the article sums the situation up. Thanks Ms. Ahearn!

  4. 345 says:

    Ironically, Gilbert who introduced this failed health insurance plan, is again running to be an MLA. The real issue is that it is not a Public Sector or Private Sector issue, it was the failure to introduce a single payer, universal health insurance plan.

    • Anonymous says:

      I’m not impressed with this audit report. Exactly what was the standard used to arrive at these decisions. Even the Compass points out that the great American has a failed health care system. The UK health service is the 2nd largest employer in the world and they still can’t get it right.

      I think the HSA is getting better slowly and the Ministry is also. No they are not perfect but then again which health care system is.

      AG this report was obviously ill advised and started before you arrived. The inflammatory language in the reports is absent – a welcomed improvement.

      The report does prove that it is not Civil servants who are driving up health care costs.

      • Diogenes says:

        The civil servants are only responsible for the$32m in tax payer funded health insurance contributions. So that’s alright then.

      • Jotnar says:

        The standard is the internationally accepted one in auditing. The fact that the US and UK governments may have less than satisfactory healthcare has no relevance in assessing how well the Cayman government is doing. Its yet more of the tired old excuses – “that guy over there is worse than me so you shouldn’t criticize” BS. We either meet the international standard or we don’t. Simple. And we don’t. Accept it. Saying that the US or UK- who incidentally at least report honestly on the poor performance – are worse does not magically absolve is of our sins.

  5. Anonymous says:

    The Seafarers Association purchased a ROBOT for the Hospital four years ago and nothing has been done to bring it to use. Not one penny has ever been put in the budget for the implementation of the machine.Mervin Connoly has done nothing to implement the special codes, Jenifer Ahearn has done everything to stop the hospital from using the machine,Lonnie Tibbetts has done everything he can to stop the use of it and so has Lizzette .That machine is one of the most unique pieces of equipment for the Hospital and yet the people that can make it work has done nothing. There is no end to the things that that machine can be used for, Heart, Strokes, you name it and that machine can be used to save lives.It is the only one the whole English speaking Carribbean and absolutively nothing has been done so that the Hospital can make use ot it

    • Anonymous says:

      But why buy a machine that the hospital wasn’t going to use.

      Seafarers stick to the sea.

      • Anonymous says:

        12;43 am, how would the Seamen know that the Hospital would not use the machine, you are stupid, don’t forget what the seamen did for these Islands, when it was nothing else to depend on, you are a Johnny come lately if you don’t know about these Islands and the seamen, so shut up about these people.

    • Anonymous says:

      Does the robot have a work permit? Its job can be done by a Caymanian.

    • Anonymous says:

      I can see immense advantages in using robots to replace civi servants. They don’t commit crimes and get suspended on full pay, they don’t take sick leave, they will answer the phone and they dont need gold plated free medical coverage and pensions.

    • Anonymous says:

      Thanks for this – I was wondering about this machine just the other day when a loved one needed a foreign specialist consultation. What are we doing people?

    • Anonymous says:

      Could have bought a few “Humans” for the price of that Robot that still required Humans to operate it.
      At least out of 10 humans, 1 might have been able to put a band aid and rub some vicks on someone. while the others do what they do.
      Play on the phone and talk Patioa.

  6. Anonymous says:

    I once went to the hospital to settle my bill. I was told I would have to go home and get the bill because they would not know how to credit the cash. Well I went home alright, not to get the bill but shaking my head at the wasted trip.

  7. Ambassador of Absurdistan says:

    Just Another Day in Absurdistan.

  8. Anonymous says:

    Now there’s a surprise NOT ,

  9. Anonymous says:

    Third world brains=third world results. Maybe its time for a younger, more educated Government before it’s even too late for that. Then again you would need younger, more educated voters to make that work. Younger we got. More educated? Soon see.

  10. Jotnar says:

    The numbers contained in the report defy logic. The combination of indigent health care, premiums for pensioners and seafarers and overseas treatment for all 3 exceeds $60m per annum – nearly twice the $32m in civil servants premiums everyone focuses on. <ore to the point, just how many indigent, pensioners and seafarers do we have that the bill is that high? According to ESO there are less than 1600 Caymanians over 65. Most seafarers must fall in that class. Just how many people are receiving this, and why is the level of uninsured spend quite so high? It just doesn't seem possible, and makes me wonder if all this money is actually going to the persons or for the reasons it said it is.

    • Anonymous says:

      Don’t forget that every insured in the private sector has to contribute $10 to Government for indigent coverage, but there is no contribution from Civil Servants either for thir medical coverage or for indigents.

  11. UnCivil Servant says:

    No Accountability in CIG. Premier McLaughlin fails as Minister of Health while Jennifer Ahearn and Lizzette Yearwood must have nine lives or be sacred cows

    • Anonymous says:

      It also reflects poorly upon the Board of Directors, to whom the CEO is supposed to receive directive from. But you cannot blame just the current Minister of Health.

      The previous Minister of Health, the disgraceful (not honorable) Ozzie proved that he was way in over his head during his tenure at the Ministry of Health and this will also be revealed again when the OAG audits the current Ministry of CAY&S in a couple more years.

      Time and time again we read about these audits – makes you wonder why some of the CFO’s/bean counters are working for government instead of the private sector – just saying.

      Anywho, you got some great staff working at H.S.A. but you have VERY POOR Senior Management and VERY POOR Leadership – from the CEO, CMO, CFO, Ministry Chief Officer, Board and the Minister himself.

      President Trump – Hhhhhhelllllpppp – the Cayman Islands needs some strong, kick butt, make changes, hold people accountable leadership. We have very weak political leadership that lacks the courage to totally revamp and streamline the Civil Service.

      • Anonymous says:

        6:48 utter rubbish….what exactly does this report have to do with CFO’S. Have you read the report? Can’t believe no one has realized that the report is actually very positive and the AG strained to find something wrong with the system.

        It seems like a few more staff and few more fines to the whacky private sector companies who are obviously guilty of victimisation of their poor employee by refusing to provide health insurance will address the majority of the problems.

        But then again it’s the wacky private sector that causes the majority of the problems. Including the private sector doctors who are handing out sick notes to anyone stupid enough to visit them. Shame on you.

      • Anonymous says:

        Anyone wanting Trumps help needs a psychiatrist…

    • Anonymous says:

      Uncivil. Still worried about you. Mental health visit in order?

  12. Dr. Feelgood says:

    Ministry Staff and HSA management proving again that incompetence is rewarded by the Deputy Governor and PPM.

    • Anonymous says:

      Feelgood AKA Dr Bla Bla…Stop being jealous and get a life. Rubbish comment with no solution. Typical private sector mentality. Oh it’s wrong but don’t ask me to come up with a solution that might require me to think. Is there a document I can crib please??

      Public sector work is far to complicated for you.

      • Anonymous says:

        Not seeing your solution 12.57a.m- obviously too complicated for you too, and writing at that time of the morning is probably an indication of your sobriety

  13. Healthcare is not a Joke says:

    The government couldn’t care less about healthcare system in Cayman because it doesn’t bring any revenue in for them. Only when something serious happens to one of them, a family members, or there own children, will they perhaps take a look at our failed system. There are people working up there who are unqualified, and equipment that is outdated in the hospital. A hospital needs to be run like a business, with knowledgeable people from each area in the hospital reporting what they need to make their depart more efficient, along with top HR, Insurance managers and Accountants to ensure every department gets what it needs to operate to its best and meet the needs of the patients, Under The BUDGET. Honestly sick and tired of trying to bring light to this subject, CI Government. While you all screw around, I’ll take my money and healthcare from one of the up and coming businesses or maybe I’ll just go down to Health City, because Health City, is doing great things, has great patient care and is run by brilliantly Doctors/Healthcare professionals and business managers.

    • Anonymous says:

      Seems a familiar issue throughout government. it is the same with the school system.

      • Anonymous says:

        Been saying this for years. Everything our Gov’t is involved in is bottom of the barrel. From the teachers in Gov’t schools to the doctors/nurses at HSA.

    • Anonymous says:

      Hospitals should produce ROI via offsets in other areas (like lower mortality rates) that are net contributors to GDP. It’s not (and shouldn’t be) direct revenue calculus per se. In any case, we can agree that there is no plan being carried out at HSA – despite an incredible $136mln Health Care budget at the parent ministry which carries on with its unaccountable sleepwalk.

      • Diogenes says:

        It’s $138m PLUS the $42m spent on policy, infrastructure, assistance programs etc. Non private sector expenditure ( ignoring the premium contributions for indigents from the private sector) $180 million. Each and every year. Over $20000 an hour.

  14. anonymous says:

    Hope CNS would publish my comment as it directly relates to the quality of health care in the Cayman Islands.
    Cardiac syndrome X. If you are a woman keep reading.
    Heart disease is the leading cause of death in women according to Harvard Health. Women far more likely to succumb to heart disease than to breast cancer. NINE times as likely, in fact. Discoveries from the WISE (Women’s Ischemia Syndrome Evaluation ) suggest that many women have a form of heart disease called coronary MICROVASCULAR dysfunction that isn’t detected by standard diagnostic procedures and thus goes unrecognized and untreated. The procedures used to diagnose and treat heart disease are based on research conducted only in men. Women had angioplasties and bypasses, but they didn’t do as well as their male counterparts. More of them suffered heart attacks or congestive heart failure after treatment. Even women whose coronary arteries were clear continued to develop and die from ischemic heart disease (IHD). By 2000, heart disease was claiming 60,000 more women than men every year.
    What does it have to do with the article? The cayman islands hospital is in need of functional vascular imaging equipment and specialists.more than it needs a new mammogram machine.
    You would think the Cayman city doctors are aware of the cardiac syndrome X? It is appears they are entirely oriented on the male form of heart disease and doubt they approach to women’s heart problems differently. I have good reasons to say that. Even their leading doctors, as brilliant as they are, do not think outside the box.

  15. Anonymous says:

    Really! Ha….the enteral mess.

  16. Anonymous says:

    no hospital can be rum by politicians?

  17. Anonymous says:

    as always goverenments fail and we the people pay the price?

  18. Anonymous says:

    With teams of sighing overwhelmed admin staff filling out paperwork in triplicate and stamping receipts by hand, it’s no wonder the billing system is such a mess – across all levels of CIG. The hospital takes all the time to re-enter resident patient information and insurer info every visit – and then doesn’t bother to compile and manage that information, because, I’m told, “it might change”. There is duplication and multiplication of effort at every corner that wastes time and energy. It makes collecting payments more difficult and delays patients from receiving treatment, and more often than not, the public foots the bill for the inefficiency.

  19. Anonymous says:

    No sh*t Sherlock.

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