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Local doctors criticise health system

| 03/02/2017 | 48 Comments
Cayman News Service

Dr Darley Solomon

(CNS): Two local senior physicians slammed the Cayman Islands government health system and its management in Public Accounts Committee on Wednesday, pointing to a catalogue of problems. One doctor said Cayman had blindly followed the American system and another warned of problems in regulation and standards. The doctors complained of the health ministry’s disrespect of private sector physicians and a total lack of accountability. Listing numerous failings, the doctors pointed to the government authority and the health ministry as the source of many problems and a prevailing ignorance of management.

Following the report by the auditor general outlining many problems in the health system, Dr Darley Solomon, president of the Cayman Islands Medical and Dental Society, decried the conduct of the ministry and described the situation in health as “a farce”.

As well as pointing to the problems of communication and the failure to engage with physicians about the issues, he warned that healthcare can bankrupt a society if the right decisions are not made. He said it was time to deal with the problem, as he described his frustrations about what was going wrong and the refusal of healthcare leaders to listen to doctors.

Dr Solomon, a surgeon, and Dr Sidney Ebanks, a GP and chair of the Medical and Dental Council (MDC), both private sector doctors who have worked for the Health Services Authority but are now at the Chrissie Tomlinson Hospital, were scathing about the mismanagement and the failings undermining the current system.

Dr Solomon said “heads need to roll” and that someone in management had to be accountable for what was going wrong. He was particularly concerned about the need for the ministry and the HSA to communicate with doctors to help improve and maintain standards, as he accused government and the authority of blocking advancement.

The local doctor berated the authorities for failing to address the shortage of local physicians years ago, and said government has missed the chance to invest in local doctors and align with a US-based training hospital. He said there was no way that anyone wanting to do medicine could complete appropriate training in the Cayman Islands to include residency, as he criticised the internship at the HSA.

Dr Solomon expressed his broad concerns that from the starting point, the authorities were getting it wrong and accused the ministry of being resistant to raising standards. “Does the ministry have the capacity to manage healthcare? I think their track record is a resounding no,” he said, as he expressed his views about the myriad failings in the system.

Dr Ebanks told PAC that the MDC was not asked to comment on the changes to legislation, though they did volunteer their advice, which does not appear to have been followed.

The MDC is part of government’s health regulatory regime but the communication between them and the ministry also appears to be failing. Dr Ebanks said the council met with ministry officials in June, where medical experts expressed concerns and offered advice about the issues relating to regulation. But he said there have been no meetings since and there are no real channels of communication.

He said that the recommendations his council made to improve the council’s guidelines to meet regulations in the law appeared to upset ministry, but he warned that ambiguous regulations would provide loopholes for people to avoid meeting the best possible standards in healthcare.

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

Comments (48)

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  1. anonymous says:

    How many doctors this country needs? How many people have chronic health issues? It is a known fact that doctors can do nothing for chronic illnesses. You don’t really need a doctor to prescribe you the next pill which would do nothing, just mask your symptoms.
    Acute health issues often resolve on its own.
    So what doctors are unhappy about, I don’t understand.




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  2. Anonymous says:

    Government need to start allow international health Insurance company in Cayman as they have millions and millions of fund which they have better coverage than Cayman health insurance for cheaper membership fee…BUPA is number 1 health insurance company. Cayman island is too small to have own health insurance company due lack of population.




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  3. Anonymous says:

    Look, anyone with half a brain (i.e. the rest of the developed countries of the world) has in place a universal health care system, at a cost to the public of a fraction of what your average American is paying monthly. Typically 3% for everything, including all medication. The U.S. “system” is nothing more than a shakedown/swindle, whatever you want to call it, perpetrated by business opportunists. The tragedy of it is that thousands die each year in the U.S. as a result.




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    • Anon says:

      Obama care……sucks




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    • Anonymous says:

      And most of those countries are broke due to endless entitlements. Instead of constantly trying to get your neighbor to pay for your sh*t, just buy your own insurance. it’s far less costly to the tax paying public.




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  4. Anonymous says:

    So sorry that I did not finish my last sentence where I spoke of a promotion for a very efficient who works in serious and bad situations so calm and and professional. He is no other than Sean Tealing whom the Public so often speak of. There is never no confusion when Dr Tealing is on duty. When Government is looking to give away Residence and Status its folks like him that should have first priority. After all he has been here for many a year and has helped many a Caymanian in times of serious illnesses. There is nothing worst than having to listen to confusion and noises. When we get a good foreign Dr we need to appreciate appreciate protect and cherish them. God bless you Doc.




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  5. Anonymous says:

    Is there some sort of system in place where the Chrissie Tomlinson , Health City and other local Dr’s are used instead of the millions in overseas care being paid to the overseas hospitals every month?




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  6. Oooohyeaaaaa says:

    I say put Mr. Syed in charge of Health Care and watch Alden gush about what a wonderful job he’s doing.




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  7. Walkas Road Yute says:

    The health system as it stands is unsustainable, as the top doctors noted. If one thing is certain, it’s that the ever enlarging civil service needs to undergo reform; the perks of having free, tax-payer funded health coverage will leave future generations heavily indebted and cash-strapped.

    Repealing the policy would be most sensible. Gov’t employees AND politicians should start making equitable contributions out of their own pocket too…




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  8. Michel Lemay. says:

    I am in total agreement with Dr. Solomon and Dr. Ebanks. Time for government to listen and act accordingly for everyone’s benifit.




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  9. Anonymous says:

    cayman doctors write out prescriptions like they were candy. ive never seen someone leave the pharmacy with so much garbage and drugs that offer no help im sure.
    I don’t feel confident at all going to the doctor and if I do I google all my meds when I get home then bin most of them.




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    • jcan nurse says:

      Idiot. Then just die. Dont get the meds at all if you dont trust your doc and plan to put them in the trash. You are a real idiot so just go to bed and put up with the problem. Cha man. Me no say yi na go get some sense man.




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    • anonymous says:

      Not just drugs, but tests as well. Because they get insensitives. Florida Urologist Agrees To Pay More Than $3.8 Million For Ordering Unnecessary Medical tests…..he received approximately $2 million in bonus payments associated with these tests.
      Doctors are not delivering value for the money they are being paid. They have become pills dispensers. When was the last time your doctor actually examined you, the old fashioned way examination? I never knew what examination should be until a Florida doctor had spent 3 hours examining every inch of me and made a diagnosis, while Caymanian doctor could not, because she would just prescribe me anxiety pills. That FL doctor charded me $350.
      I know just one wonderful doctor in the Cayman Islands, Dr. Ecke. He does examine you thorough instead of suggesting right away you have gerd. The visiting dermatologist from Jamaica was first class doctor as well.




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  10. Bill O'Reilly Ebanks says:

    Will the Deputy Governor and Premier as Minister of Health through directions to the HSA Board of Directors have the courage to sanction or fire the Chief Officer of the Ministry of Health Jennifer Ahearn and the Chief Executive Officer Lizzette Yearwood of the HSA for poor performance related issues? How many more examples does the government need?




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    • Anonymous says:

      There are two sides of every story, and there is normally shades of gray in the middle – not just “black” or “white”. From what I’ve seen and read over the years, both CO Ahearn and CEO Yearwood are doing really good jobs with the majority of their work – there have been improvements at the HSA over CEO Yearwood’s tenure, and CO Ahearn is one of the brightest in the service.

      Audits are useful and necessary – checks and balances. They also state what works – not just what needs improvement. There are many variables. Imagine firing people whenever aspects that need improvement of any company/CIG entity have an area highlighted for improvement. I am all for change – but that would be completely destabilising, because one CEO/CO after the other would be fired: all work tirelessly and usually intelligently – but yes – all are human and with other variables, there are areas for improvement.

      The knee-jerk dramatism of Dr Solomon has no place at PAC.




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      • Anonymous says:

        But I bet if your appendix ruptured or a hernia popped out in your groin, you would be very happy and grateful to have Dr.Solomon as your surgeon! Anyone who listened carefully to the PAC questions and his answers – and Dr. Ebanks’s also – would conclude that these fine doctors are frustrated with the blocks they encounter as they faithfully and diligently perform their highly skilled services to our people. They are two of our own and deserve our respect and support!




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    • Anonymous says:

      7:45 am preach, the sermon needs to be aired louder. Incompetence at its heights. Do we need a Donald Trump to drain the SWAMP?




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    • Anonymous says:

      Fire for what? The system has been in trouble for years and these ladies are finally fixing it. Do we really believe that Dr Shetty would build a world class hospital and CTH would have been sold if these investors did not have conference in the Ministry of Health.

      Doctors try and get sick notes under control…if you can’t do that don’t critize others for much more complicated matters.




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  11. Anonymous says:

    I total agree that the HSA need to come together with the Local Drs especially the surgeons that is so much needed. They need to identify the better and more skilled Drs if I can use those words. I just cant comprehend how in the world that we managed to let go a Dr so efficient as Dr Hessler, who was born to a Caymanian mother and a Norwegian father. Then I don’t see the expertise of one of the very best Dr Bromley who with his skill made many live for years longer than expected. What is most gross now a day is to hear nurses argueing with sick patients. We need to weed out those who are looking for a pay check and keep those who love their jobs. There are also a need for better Physiotherapy service. We have some very good workers not not enough. A lot of patients recovery depends on that area. I believe that Heads of Hospitals should be like Politics, up for grabs every every one or two terms depending on your performance. I would like to see our most efficient who all Caymanians give their praise to, promoted to being in charge of Emergency. He works so calm in any situation. A well organized Doctor who has won the hearts of Caymanians.




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  12. Anonymous says:

    Mortgage $1500
    School fees $900
    Electric $300
    Water $100
    Phone $100
    Groceries $600
    Health Insurance, Pension $600
    Car Expenses $150

    Crap, that’s CI $4250 per month just to exist for a family of 3. Cayman has become silly.

    Come on Rudy, we spoke yesterday, Gilbert, Suckoo, and other compassionate independent Caymanians, make promises that you can keep.




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    • Anonymous says:

      Hahaha, Gilbert is part of our problem today. He was there before, what did he do? Lmao. The time has past for feeble brains, we are now in the 21 st Century.




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    • Anonymous says:

      This is pretty much my exact rundown of monthly bills…throw in the cyclical medical co-pays, fees for spots/clubs, school pictures, school uniform, etc. and you are looking at an average of 6k a month for the basic for your children. If mom and dad dare sqeeze in a hair cut or a pedicure or anything for themselves then they can pretty much expect not to pay some other bill that month. Oh no, and here comes Christmas and birthdays and we haven’t left the island for a vacation in over two years!

      Something has to give…and I believe healthcare costs are the most logical first step!




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    • Anonymous says:

      Well said 3:34! The question is! How can we meet those monthly expenses on a $6 hr job?




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    • Anonymous says:

      Why are you paying school fees if you cannot afford them. Send your child/children to government school.




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      • Anonymous says:

        It may be pre-school fees. For two kids in pre-school full time – $900 per month is the minimum you can find almost anywhere. And Govt does not offer pre-school care. Plus – if you make over $3k a month with less than 3 dependents, you do not qualify for government pre-school assistance. They have also dropped the early intervention assistance for pre-school children with learning disabilities. Cayman is truly not for young Caymanian families any more.




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  13. Anonymous says:

    AMEN: Dr Solomon said “heads need to role” and that someone in management had to be accountable for what was going wrong. He was particularly concerned about the need for the ministry and the HSA to communicate with doctors to help improve and maintain standards, as he accused government and the authority of blocking advancement.




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    • Anonymous says:

      It is those same people now complaining, who sit on the medical boards that prevent incoming doctors from getting licensed to practice locally….just to protect their incomes.




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    • Anonymous says:

      Rubbish Heads needs to roll for the sick note abuse.




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  14. anonymous says:

    Sick and tired of the word “slamming”. Everything seems to be expressed in overdramatized manner these days.




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  15. Audrey S. says:

    I hope the elections this year bring in some educated young blood and a few Donald Trumps. We need leaders who truly believe in and actually achieve the things they campaigned on.




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  16. Quack says:

    The three basic duties of a government are:
    1. To maintain law and order: Individual residents do not have to make direct payments for this;
    2. To provide education: Caymanians do not have to make direct payments for this;
    3. To provide a health service: WHY is this different and everyone is expected to pay for the service?
    If police and education are ‘free’ then so should healthcare be.




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  17. Anonymous says:

    It is always an issue if some paper pushers sitting at a desk with no experience in the actual field of the industry they are to support, regulate and advise make up the regulations, rule and processes and then conveniently overlook the most important part, which is bringing in all stakeholders for advise and consultation.

    On top of it all, people in Cayman get SCREWED with the outrageous health insurance cost. In order to have an insurance that covers the majority of medical issues (minus dental, minus vision), someone has to shell out CI$ 2,000/month for a family of 4. Tell me who can afford that??? What is the plan for all people once they are retired? Are they all supposed to move over to CINICO? What is Government doing to get health insurance back under control?




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    • Anonymous says:

      As usual they are doing NOTHING because they get good coverage and do not give a damn about anyone else except when elections roll around. Hell health insurance is just a part of the retirement problem around here. After filing for my pension in August of 2015 I am still waiting on the pension board staff as they are really overworked and need some time off. How the hell are you supposed to retire?




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    • Anonymous says:

      Doctors need to first of all start offering offer healthcare related scholarships. The medical and dental society does nothing in this regard.




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    • Anonymous says:

      Exactly!..I would go a step further. My government should not be able to force me to buy health insurance and pensions from a private (for profit) company! At least with car insurance, I can choose not to drive.

      It is an election season. Whoever advocates for a government run health care and pension system that we all pay into, will win my vote.




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      • Anonymous says:

        “….we all pay into…. Good luck with that. Far too many Caymanians think that “Government” should cover the costs of health care, education, school lunches, pensions etc etc without them having to contribute anything towards these costs. After all, we’re Caymanians and built this place up, starting with the seamen sending money home, so we are entitled to reap the benefits now blah blah.




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      • Anonymous says:

        When Cinico was set up the plan going forward was that it would become the national insurance company of the Cayman Islands. Everybody would pay in to it and If someone/ company wanted additional insurance then they could go ahead and purchase additional coverage. No government did anything to insure that Cinico could become viable because private insurance companies were upset about the possibility. Private insurance companies were allowed to price their policies out of the reach of most people and once a person reach retirement and really need health insurance then they drop you. Gilbert McLean was the Minister who implemented Cinico and as usual the next Minister did nothing to progress the company as was planned. Now that Mr. McLean is standing up for election I hope he is successful and can bring Cinico to the level that was envisaged. If I remember correctly Mr. Suckoo was also a member of the board during the initial stage of Cinico. If the two of you can fix Cinico to where it can help us Cayman will thank you!!




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      • Anonymous says:

        Mine as well!!




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      • Anon says:

        Can you afford an air ambulance transfer, and the specialty treatment that you’re be flown away for? That one way flight alone with the nurses and doctor on it can be roughly $13,000 or more, and you won’t even get on the plane or see the oversea physician unless the money is secured. The total bill – service, nights in overseas hospital, food – can run into the hundreds of thousands. Unless you’re a multi-millionaire, health insurance is a necessity.

        Your house may never burn down, the hurricane may never come and mash it up. You have to pay thousands a year to insure it and that cost is painful, but when those disasters happen and the insurance company says don’t worry I got you, you feel good, at ease.

        Think on that before you say to hell with with health insurance, or any insurance if you’re not ultra wealthy.




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      • Anonymous says:

        Sounds like income tax then for you.




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    • Anonymous says:

      the politicians and civil servants don’t have to pay for health insurance so why should they care that the rest of us have to pay $2,000 and higher (try $3400 for a family of 3) per month. It’s a travesty.




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      • Cyril says:

        Actually we the general public pay for civil servants health care and pension through General revinue




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      • Anonymous says:

        Civil servants not only get free gold plated medical care but unlike the long suffering private sector don’t even contribute for indigent coverage.Inflated salaries for deflated performance.




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