Doctor queries purpose of Shetty hospital

| 13/02/2017 | 94 Comments

(CNS): The idea that the hospital in East End, founded by world-famous Indian physician Dr Devi Shetty, was really intended to be a medical tourism facility has been questioned by a local doctor. Giving evidence to the Public Accounts Committee, Dr Darley Solomon said that he felt that from the beginning, medical tourism was an unrealistic goal. But after a conversation with the CEO of the medical partner, Ascension Health, and the medical director, when he learned that they knew nothing about the leading medical tourism companies in the world, he felt something was being “kept from the public”.

Dr Solomon was called as a witness to PAC to discuss a recent report by the Office of the Auditor General that raised questions over the local healthcare system and highlighted some serious problems.

The local physician, who is president of the Cayman Islands Medical and Dental Society (CIMDS), lauded the work of physicians at Health City Cayman Islands (HCCI) as some of the best he had ever seen, but he questioned the separate standards for the hospital. Changes to health-related legislation that paved the way for the Shetty hospital, touted as the kick-start for the medical tourism sector in Cayman, meant the institution could register its physicians under different standards to all other doctors practicing in Cayman by registering them with the specific facility.

Dr Solomon said that the CIMDS had advised against this at the time but the advice which was ignored.  “When you start having alternative pathways, it leaves you open to creating a two-tier system,” he told PAC.

He became the chair of the Medical and Dental Society when the hospital was due to open and had the opportunity “to be obstructionist”, he said. At the time he believed it would serve no good to the Cayman Islands, and he voiced his concerns to government officials and senior civil servants as well as the attorney general and the minister of health because of what he said were “two separate and arguably unequal levels of medical professionals”. He added, “I was opposed to the way it was done.”

The doctor praised the quality of the medicine at Health City and said it would help elevate healthcare standards. However, he said there were some serious questions to be answered about the institution and that he never believed that it was going to be limited to providing only medical tourism.

“I didn’t think anyone was ever coming here from the US to have open heart surgery,” Dr Solomon stated.

He said that around six months after the hospital opened the CEO from Ascension Health, HCCI’s US partner, and the hospital’s medical director had asked Dr Solomon if he could get the local doctors behind Health City for referrals, which he said confirmed his opinions that the hospital was not focused on attracting overseas patients.

“I was not surprised by that,” the doctor said. “What did surprise me… was that the CEO and the medical director for a two-billion-dollar company invested in a medical tourism product and didn’t know about… two of the largest medical tourism businesses in the world. It made me wonder… what kind of homework did they do and gave rise to thinking, is there something else going on here that isn’t for the public eye?”

He said he understood that when the revenue streams made it clear the model wasn’t working, they had to do something, but the mere fact they would need to ask and that they seemed to have so little knowledge of the medical tourism sector was a surprise. “I was flabbergasted,” he added.

Dr Solomon also pointed out that the amount of concessions being given to the hospital on the basis that it was meant to be the launch of medical tourism was not being tracked and he questioned if the public purse was getting value for money.

“I know there is nobody doing that… so is it an open-ended blank cheque,” he warned, but said he didn’t blame the Shetty hospital because it was down to government to monitor the concessions. “Where are they on this?” he asked rhetorically. “We can’t give the ministry of health any more passes.”

Dr Sidney Ebanks, chair of the Medical and Dental Council (MDC), who appeared before PAC after Solomon, agreed that there were problems with the concessions. He said that the money being given away in concessions could have been redirected to training local doctors.

His main concern, though, was the dual standards. “Having more than one standard is not only difficult to police but there will be unintended consequences that arise from that,” he warned, noting that he had made written representations to government about the dangers of a dual registration. He agreed that the hospital was practicing very good medicine but there should be one standard for all because of the loopholes that can be exploited in a two-standard system.

In her report about the government’s health system, Auditor General Sue Winspear pointed out that the concessions given to Health City Cayman Islands was causing concern with the wider health industry locally because other doctors and hospitals were put at a distinct disadvantage as the hospital becomes more and more of a local facility, treating very few overseas patients who specifically travelled for the services.

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Category: Government oversight, Health, health and safety, Politics

Comments (94)

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  1. Anonymous says:

    All of this reminds me of the days when there was only one phone provider and internet provider on Island.............They got a big wake-up call when a competitor moved in and they actually had to make some sort of customer service effort.........

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    • Anonymous says:

      Flow have still not received the improved customer service memo.

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  2. Veritas says:

    Dr Solomon is quite right to make the points he has. No matter what the standard of care, this hospital obtained major concessions in many areas including changes to our laws on the premise it was to be a major medical tourism facility. This has not happened.

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    • Anonymous says:

      If you had a heart attack and required a procedure to keep you alive yet GT hospital don't do the procedure and HC can do it. would you prefer to go overseas? because you are not a medical tourist? if a cayman resident walks upto the doors and asks for help are they to turn you away because you live here? the concessions are minimal and people need to appreciate what this facility can offer the Cayman people. If it wasn't built then there would be no duty to pay? yet it provides so many positives for us.

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  3. Anonymous says:

    We welcome them, then start discrediting them. Is this how Caymanian Welcome works?
    The HC staff are probably shocked reading these comments, they learn true nature of Cayman Kind.

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    • Anonymous says:

      We all have a right to criticize any private business that takes so much from the public coffers in tax concessions and then fails to meet the projected contribution back into the Cayman economy. The hospital is failing (some would say has failed) as a medical tourism facility. If Health City Cayman is the "third arm of the Cayman economy", then the arm has gangrene and is just about the fall off!

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  4. Anonymous says:

    If we were not so worried about protecting Cayman Airways, Blue Sky would have been approved and the new routes would have allowed people without a US visa access to the excellent care provided at Shetty.

    Medical tourism is still a very real possibility.

    In the meantime, that is the only place I will go if in need of care on the island.

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    • Anonymous says:

      What you are saying is just plain rubbish. It's a fact CAL gave the Panama route to Blue Sky but they shut down before they even got started. Had absolutely nothing to do with CAL!! It had to do with the company they were leasing the planes from went into bankruptcy and took Blue Sky money with them, end of story!!

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  5. anon says:

    Can someone please tell me why people say Dart owns this hospital? It's the most bogus claim I've heard this year.

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  6. Anonymous says:

    Does it mater whether our good ole Mr Dart is the owner of the Hospital. What matters most is that it is a great place to be when you are very sick and frightened to death. Even some who did not support McKeeva is grateful to him now for his assistance in the getting of this wonderful Hospital. Also our Mr Gene Thompson a real businessman and follower of his late Dad. Jesus could not please some of us. It dosent matter if you are past 70 or not, but Shettys take interest in the patient and wants to save you. On another hand when you are very sick you feel better when the staff is handling you not what I have seen at our hospital with on two occasions two different nurses from the same Country quarelling with a very sick and prominent Caymanian. That alone would make you sick. Disgusting. In fact I have seen it on three occasions. Perhaps that's the way they work in their own Country. We need to get more staff from India like Shettys.

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  7. Questionzz says:

    So this is the way they want to privatize the medical industry? Like they plan to privatize the public water supply?

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    • Anonymous says:

      My water supply is private, Cayman Water, what is the issue?

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  8. A son says:

    I'd like to give my side in support of HC. Putting aside concessions given, different applied standards, here's where my thoughts are and why everything else is, to me, white noise:

    I'm proud to give my support to Health City Cayman Islands. 1 year ago this month, mother had the very first TAVI procedure to be performed in the English-speaking Caribbean. Thankfully with support from the doctors and Administrators at HC and of course Her health insurer, CINICO, this first of its kind operation was given the green light. No doubt allowing her to live on instead of dying just months after it was diagnosed as her last resort.

    Say what you want about Gene Thompson, but without his push and influence and support and waving a large fee, this operation may not have happened. Thank you once again, Gene. Health City is a beacon, keep shining.

    Mother had, most times, great care at the HSA Hospital, but the facilities and staff moral/professionalism raises its ugly head far too often because of mismanagement/poor choices, etc that starts at the very top. After all these years, the service, IMO, is fair to poor. Get it right, and you'll see profits and positive outcomes.

    HC gets my vote because I've experienced their services and seen the results...a person's near perfect health restored and a life changing ordeal for the better.

    Mother's story here - Health City performs first TAVI operation: https://www.caymancompass.com/2016/03/14/health-city-performs-first-tavi-operation/

    Info:
    Transcatheter Aortic Valve Implantation (TAVI) or Transcatheter Aortic Valve Replacement (TAVR), is the replacement of the aortic valve of the heart through the blood vessels (as opposed to valve replacement by open heart surgery).

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    • Anonymous says:

      So glad your mother got her health restored. God Bless Health City.

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    • Anonymous says:

      As far as I'm aware they no longer do that procedure. There is a reason they stopped.

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  9. Anonymous says:

    take me to Shetty any day or night. I don't want to die in town thanks.

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    • Anonymous says:

      I assume before Health City Cayman opened it's doors you never trusted GT Hospital? You travelled abroad for ALL your medical care?

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  10. Knot S Smart says:

    We are really so damn lucky to have the Shetty hospital and such professional service in Cayman!
    or we could depend on the HSA to give us an appointment in two or three months without even trying to find out how serious the patient's health issue is...

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  11. Anonymous says:

    i am visting the pulmonoligist there. dr archita is an excellent doctor. and yes o am caymanian....the gave away 6 million in concessions to the ritz deal....why not to health city that is saving lives and also heling cinico?

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    • Anonymous says:

      Although it's slightly off topic, just FYI: There is only one Board Certified sleep specialist in Cayman -- Dr. Glatz.

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      • Anonymous says:

        Yeah, all the same... Thanks Dr. Archita.
        Another satisfied patient.

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      • Jotnar says:

        Slightly off topic? - OP is talking about a pulmonologist, not a sleep specialist. Is that you, Dr Glatz?

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  12. Anonymous says:

    The fact that HC is properly accredited tells you all you need to know.

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    • Anonymous says:

      Is the hospital in toto JCI accredited, or only some departments?

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    • Anonymous says:

      Be careful: Obtaining a quality systems accreditation is one thing, making sure the facility follows the system is something else.

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  13. Anonymous says:

    I bet you anyone who goes there doesn't have a complaint. I hate our Hospital .

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  14. Anonymous says:

    The concessions to Shetty must stop. It's wrong for a generation of Caymanians to subsidize a private company by way of government tax giveaways that would otherwise be in the public purse for other important projects. Bush gave away way too much in tax incentives.

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    • Anonymous says:

      Idiot. Stop funding the expensive screwed up old system and fund this one that works well for the people of cayman, and make it the priority one unless it screws up... Will save govt a fortune and have happy clients

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      • Anonymous says:

        Health City is a failed medical tourism facility that has been forced to encroach on the scope of other doctors and medical facilities to survive, despite prior promises to the CIG not to do so. Furthermore, they have fallen short of every financial and economic projections given by directors while formulating their MOU with the government. Read this:
        https://www.imtj.com/news/cayman-government-raises-questions-after-failed-medical-tourism-venture/

        Brother, are you sure you're is getting good value for money in exchange for the extraordinary tax concessions given to HC Cayman the CIG. If other medical facilities were given the same concessions, they'd also be able to make their facilities shiny and new.

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        • Anonymous says:

          Im pretty sure the concessions are based on pharmaceutical and clinical supplies. nothing else. they do not get concessions of building materials and other items. i know, i supply them and they have made my business very busy since they opened. in fact i have hired 2 caymanians who deal direct with the health city purchasing team on a daily basis. 80% of the people commenting on this article haven't a clue about the hospital, its mission or how it the overall concept works. Goodnight!

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      • Jotnar says:

        And of course the "tax giveaways" are giving away tax that would never have been collected anyway if Health City wasn't set up - and setting it up was based on getting the tax incentives. So they wouldn't otherwise be in the public purse at all. Passing lightly over the factor that its every man, woman and child on this island that pays for the public purse, not "a generation of Caymanians".

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        • Anonymous says:

          50-years of tax concession IS a generation of Caymanian CONTRIBUTIONS to a private company..

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  15. Anonymous says:

    shetty hospital does not make enough money to survive- medical tourism plan was a hoax ; it is only a matter of time before Acsension (the present backer) pulls the plug - Dart in the meantime is waiting to snap it up. When HSA closes dear fellow Caymanians.... you will be working for Dart and also getting healthcare from Dart at a price set by Dart. HE will own hospitality business, healthcare business, grocery business and utilities.

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    • Anonymous says:

      Agreed , beware of the creeping stealthy Dart takeover of everything.

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    • Anonymous says:

      wow you seem to know so much about absolutely nothing! lol....stop mixing the pot. do you think DART want to get into healthcare? they don't need the liability. you must have some very good inside information so either must work there or look after the accounts, which i very much doubt with a brain like a geko?. sleep tight and dont ever have a heart attack cos its a long flight to miami when your chest is ready to pop.

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    • Anonymous says:

      while you sit in your hammock with the breeze whistling by your little head..we will all be working hard to provide for our families future...

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    • A doctor says:

      Mr. Dart may have been the owner since day one. He owns most everything else!

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    • Anonymous says:

      But they do things in a quality way!

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  16. Anonymous says:

    I really don't care whether Shetty was meant for medical tourism purposes or not but it has been very beneficial (financially as well as emotionally) for many residents to be able to get a second opinion and/or treatment on Island which previously were only available overseas.

    Also, both facilities (GT and CTH) have failed for years to maintain, upgrade or reinvest into their facilities. If you have your patients sit on shrink-wrapped waiting room furniture in the year 2017, you may want to think where you went wrong, never mind the state of the treatment rooms etc.

    On the other hand, I can also say that Shetty does NOT have the most advanced medical equipment as they make everyone believe. In addition, it is rather concerning that they diversified so quickly and now offer such a broad range of services. Any business which diversifies too quickly lends itself to reduction in quality of service.

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    • Anonymous says:

      They did not diversify quickly. Promotion of the hospital solely as a medical tourism facility, or as the Rt. Hon. McKeeva Bush described it: "The third arm of the Cayman economy", was ALWAYS a scam. It was always going to turn into a "local hospital" by stealth.

      As Caymanians, we have to question if the services being provided by Health City Cayman is truly, TRUELY worth the millions of dollars in government concessions -- I.e., tax payers money, being granted to this private business year upon year, for, as I understand it, the next 50-years.

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      • Anonymous says:

        I rather have concession given to Health City any day than having to bail out Cayman Airways year after year, who continues to provide travel benefits for life for every Tom, Dick and Harry who has ever been associated with the airline via employment or being a board member etc.

        I rather have concession given to Health City rather than having to fund a "water theme park" called Boatswain Bay that is a disgrace and a complete rip-off.

        You may want to check your priorities!

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        • Anonymous says:

          Can't add any thing to this statement well said. They save lives!!!!

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      • Anonymous says:

        Tax payers money? What you never had you will never miss! Hotels get millions in concessions and you may never visit. This facility COULD save you life one day!

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  17. Anonymous says:

    From the governments website at:
    http://www.gov.ky/portal/page/portal/cighome/pressroom/archive/200602/practicinginci

    "Cayman allows the registration of health practitioners who are fully registered, or eligible for full registration, in Australia, Canada, Jamaica, New Zealand, South Africa, UK or US, or those who have met the Caribbean regional registration requirements. The applicant is responsible for providing the council with evidence of his registration or eligibility for full registration in any of the countries listed above".

    You will notice India is missing from the list. So, the question is: Have all physicians at Health City Cayman met the Caribbean regional registration requirements? Of course not. To get around what is essentially an established credentialing process to help ensure quality of healthcare in Cayman, the Bush gowerment established a completely different registration requirement for Health City doctors.

    Of course, Health City administrators went for this shortcut; because unlike very other doctor on the island (not from one of the listed countries) none of the Health City doctors have to meet the Caribbean regional registration requirements. So, despite ". . .the best doctors in the world" hyperbole from Shomari Scott every week on the radio, his assertion has never been put to the test, and the public seems happy to take Mr. Scott's word for it.
    Ask yourself: Why was India omitted from the governments list above in the first place?

    If the directors of Health City Cayman ignore the long-established Caribbean region registration requirement, and continue with the dumbed-down, rubber-stamp, registration process thrown together just for their doctors, the facility will always have it's back against the wall over accusations that their medical staff have not been adequately credentialed.

    I'm sure many Health City doctors would meet the Caribbean regional registration requirements-- so why don't they just get on and do it?

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  18. Anonymous says:

    I went to Health City after meeting with a surgeon from the HSA. The HSA guy had no information online about himself and said he could fit me in for surgery in two months. The HC guy had performed over 10,000 gastro operations, published many articles and could operate within the week. Who would you choose? I welcome competition - now I'm just waiting for Uber to take on the taxi cartels

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    • Anonymous says:

      Uber won't work here because work permit holders can't be drivers and all Caymanians who would pick you up are already taxi drivers.

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  19. Diogenes says:

    A paradox - the hospital with a lower regulatory standard apparently has a far higher standard of care.

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    • Anonymous says:

      Good comment..my thoughts exactly...like saying a school has the worse teachers on the island yet the pupils constantly get straight A's XXXXX.

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  20. Anonymous says:

    You got to be blind as a bat not to see this...Shetty is Dart and Compass is Dart and the angle is to shut down HSA. So we are swiftly moving very far away from A UK style to a failed American style which needed Obama care to reconcile some of the defects. True lassiez faire captial model designed to risk the middle class., enrich the elites and create drastic and dangerous divisions between the have not and the haves. At this moment, you can see this playing out in America where the political situation is tense...wait 4 more years and this society can follow that road...but its a road that leads to civil war+

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    • anon says:

      Shetty is Dart? What are you talking about? You didn't even attempt to make the connection. Probably because there is none.

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      • The Spy says:

        And why do you think there is no connection, Mr. Smardbud? He owns most everything else!

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      • Anonymous says:

        No need to.....seems as if many others are coming to the same conclusion......its expanding Shetty....why....whats the timing ......read the compass... not one bad thing about dart...not a bad guy and not a bad idea for better healthcare...its just Govt needs to get smarter...they are going to own a empty hospital....close it down and protect middle class

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    • Anonymous says:

      You need to maybe understand what Shetty is all about. DART is about profit..Shetty is on mission to create affordable quality Healthcare. 2 different worlds on 2 different missions.

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  21. Anonymous says:

    Watch out because it supports a lot of Caymanians, just ask the local partner Mr. Gene T!

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    • Anonymous says:

      Thirty. It supports thirty Caymanians.

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    • Anonymous says:

      Hmmmm. . .what exactly is the ratio of Caymanian to Indian support staff at Health City? CNS: is there a way to find out? Would be interested to see if HC Cayman would be forthcoming with this information.

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    • Anonymous says:

      What does Thompson know about hospitals?

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  22. Anonymous says:

    Man who profited from the lack of a market complains when competitor is allowed into the market. That would be an alternative headline.

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  23. Anonymous says:

    Well at least we Caymanians are getting world class service for the money we are spending and we do not have to jump on a plane or pay for hotels. If it saves one life its money well spent. What the hell are we getting from destroying our pristine beaches and mangroves.

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  24. Anonymous says:

    I'm not sure what the politics is here re Health City and the Govt, but what I do know is, that had my hubby continued going to GT Hospital last year when he had stomach issues, he might not be here today. He was unable to work, he called in sick too frequently. Ended up losing his job (though it was all medical related) It was horrible to watch him in so much pain. After a few calls, we got an appointment at Health City. I took the time off and we drove up there. The Dr. examined him. Gave him a prescription which cost us $6.00 KYD. They gave him an appointment to come back to do a follow up, and to this day my hubby hasn't had any more issues with his stomach. Thank god.

    So, GT Hospital need to get their *^*% together, they are slowly killing us. They need to step up to the standards of Health City!

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    • Anonymous says:

      Let's hope your husband never has to be admitted to an intensive care unit. Give Health City a call then.

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    • Anonymous says:

      What did he take? I have a stomach problem. Can you say on here what he was giving that helped him? Thanks in advance.

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    • Gray matter says:

      That's why the motto of GT Hospital is ... we take you from the womb to the tomb all in the same day.

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  25. Anonymous says:

    But what about all the patients that can go there from the locality that now do not have to go off Island. That must be a real cost saving down the line?

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  26. lo-cal says:

    I have been to Shetty on more than one occasion and i can truly say that the difference in service between them and HSA is night and day. I was so impressed with my first visit that on the second occasion when I felt dizzy and was breathing heavy, i chose to drive past CTMH and HSA and take myself all the way East to Shetty for care.

    Whatever the two tier standard is it is clear to me that both CTMH and HSA needs to raise theirs to meet Shetty. Just turn the healthcare over to them and let GOV same some money.

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    • Anonymous says:

      And they don't give out sick notes whilly nilly

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    • Anonymous says:

      Very interesting, because Health City Cayman promised they would be only a tertiary care facility --i.e., only take referrals from a primary care physician so they would not be in competition with local doctors. From what you say, HC Cayman is not just a hospital, it is encroaching overtly into primary care. One of a number of broken promises.

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      • lo-cal says:

        I really don't care! As far as i am concerned they just cut out the middle man. Medicine has become just another pyramid scheme where one doctor feeds the other doctor a patient in order to fleece the insurance who is already sticking it to the people.

        The broken promises i am interested in are those to do with educating Caymanian's and preparing them to work in their own country. I hope against all hope that the same broken promise can be applied to education.

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  27. Sharkey says:

    This is exactly what I said about one developer and the Government , not careing or thinking about the future of the Islands , as
    long as we developer and politicians make an get our millions today , to hell with you and tomorrow is how they are thinking .

    But I thought the same thing as what Dr. Solomon is saying today when I heard what it was supposed to be.

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    • Patrizia says:

      This facility is a great place and is of the highest standards, we should be proud and thankful, we have such high caliber of medical professionals on the Island at decent prices....

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      • Anonymous says:

        Who says the standards are higher at Health City than the HSA? Just because the place is new and looks pretty? Show me the data to support your claim? And you think they charge less than other facilities? Really? Evidence suggests they charge "reasonable and customary" fees like everyone else. Sure they may void copayments sometimes, especially for x-rays and scans, otherwise their charges for local services is on a par with everyone else.

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  28. Anonymous says:

    Well then, let's just close down the HSA hospital and Chrissie Tomlinson and ask the Health City people to run the whole thing for us since even these two local doctors admit they provide a fantastic service.

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  29. This government stinks. says:

    C'mon, the purpose is to fill the pockets of the invested. That is all.this

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  30. Anonymous says:

    Who would want to do business with the Cayman Islands in the future?

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  31. Anonymous says:

    It may put local doctors at a disadvantage, but they have have years with no competition, yet the level of care remains substandard, as also shown by the AG report.

    As a Caymanian, I find it wonderful to have a facility in which I feel confidence.

    As Tara Rivers said in defense of sending her child to a private school, as opposed to a government school, it is all about choice right?

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    • Anon says:

      I agree with your comment, but will say that if there is to be competition for the local market let it be fair competition, meaning equal concessions for all or no concessions for all.

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      • Caringmom says:

        Amen!

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      • Concerned says:

        So the multi millions that HSA lose every year and the public pays for it is not a concession?

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        • Anon says:

          Politicians and the HSA board for years now seem happy with HSA management's poor performance, so what can we do?

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        • Anonymous says:

          No that's not a concession. That's a a simple fact of healthcare economics that exists in every civilized country. Duty relief on clinical equipment and supplies, discounted fares on Cayman Airways for HC staff, and on, and on ,and on -- they're concessions.

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          • Anonymous says:

            discounted airfare on CAL? where do you get your info..i need to speak with my boss! your deluded.

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  32. Anonymous says:

    shetty hospital is a bizarre riddle wrapped up in mystery.

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    • Richard says:

      Why is the medical councils pushing young GP doctors back off the island, to institutions where 83% of the time they never come back to Cayman because they have then acquired a level of seniority? Why gave they not approved the request of 4 Caymanian doctors to work at health city, gain experience, decide on a specialty and then be funded by health city to go back and train for that speciality then return to Cayman and either work at health city or do their own thing? Because of the protectionism the conflicted members of the councils practice. Having been at that meeting with the CEO and the Ascension official, i can categorically say they were not confused nor unaware of other medical tourism facilities. Daddy used to always say "the mouth will always say anything after it learns to talk"

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      • Anonymous says:

        Yeah, and like my daddy used to say: "Don't p#ss down my back and tell me it's rainin'!" Have a nice day.

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    • Anonymous says:

      And I'm trapped in a glass case of emotion. WTF does your comment even mean?

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