Hospital gets clean audit for first time

| 07/05/2019 | 12 Comments
Cayman News Service, Cayman Islands health ministry

Cayman Islands Hospital entrance

(CNS): After almost fifteen years of trying, the Cayman Islands Health Services Authority has finally received an unqualified audit opinion from the auditor general for its 2018 financial statements. The report is not yet available to the public, and in a press release celebrating its first ever clean audit since at least 2005, when the current legislation on public finances was passed, no details were given about the fiscal position of the government hospital and the network of clinics. Although getting an unqualified opinion of public accounts should be the expectation, HSA Board Chair Jonathan Tibbetts said it was a milestone and congratulated the staff.

“The achievement of this first unmodified audit opinion is a major accomplishment for the HSA and a testament of our commitment to accountability and reform which has been reflected in other areas of improvement since this Board was appointed,” Tibbetts said.

“This includes reaching and sustaining a 90-day cash reserve, as mandated in the HSA law, for the first time since the inception of the HSA, improvements in clinical outcomes and performance metrics, and providing better access to timely healthcare through facility improvements and expansion.”

Tibbetts said the goal to get a clean audit was one of its main strategic priorities for the last year and follows a commitment made to the Public Accounts Committee. According to officials, the clean audit was down to “sustained initiatives to improve the quality and reliability of the HSA’s financial information”.

Officials said that major contributors to the HSA’s improved financial health include the strengthening of, and ongoing training around, policies and procedures, as well as improved processes around collections and ongoing monitoring of accounts receivable balances.

In a press release about finally getting to a clean set of accounts, the HSA said that financial managers, physicians, clinical professionals and staff at all levels worked collaboratively to implement various recommendations from Deloitte and the auditor general.

Areas of focus included finance and supply chain management, revenue and budget management, asset management, and general control programmes. Implementation of the recommendations was a key factor in realising this outcome.

“We appreciate the diligent work done by every single employee,” said Tibbetts. “The organisation recruited the right people, put together strong teams and designated ‘champions’ to lead various tasks, groups and initiatives to achieve this outcome. This helped to inspire everyone around the shared goal and the importance of achieving an unmodified audit opinion.”

While it took 15 years to get to this point, HSA CEO Lizzette Yearwood added, “Our talented and dedicated workforce came together in implementing strong internal policies and business practices to resolve complicated financial management issues leading to the achievement of this unmodified audit opinion.”

The HSA handles around 1,000 daily patient encounters by almost 900 staff across all three Cayman Islands, delivering diagnostics, therapy and pharmaceutical supplies, which officials said creates a complex business environment for the HSA.

Yearwood said the implementation of strong, effective internal control measures, development of comprehensive policies and the commitment of staff were the critical elements that led to the outcome.

“We are very conscious that the hard work is far from over and this achievement poses an even greater responsibility upon us all to maintain our financial integrity with unmodified audit opinions in future years,” Yearwood said. “As always, we continue to focus on delivering the best quality care to our patients, from reduced error rates to shorter wait times and improved patient satisfaction.”

Health Minister Dwayne Seymour congratulated “the tremendous work” by the board and HSA management, as did Auditor General Sue Winspear, who confirmed the clean audit opinion.

While the HSA may have finally got its books in order, its financial problems are not over, as numerous patients using the services are either uninsured or under-insured and so are leaving unpaid bills or seeking help from government. The public purse continues to pump millions of dollars into the authority to cover treatment for patients who have no or insufficient insurance and are unable to pay their medical bills.

However, the authority has also come in for considerable criticism for opting to contract a law firm to collect some of the outstanding debt to help balance its books.

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Category: Government Finance, Health, Politics

Comments (12)

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  1. Anonymous says:

    ha ha ha…oh please stop! maybe politicians did the audit…they control the hospital anyways! ha ha ha

  2. 1+1=2 says:

    This is even a bigger shock than Liverpool’s 4-0 win over Barcelona. We are now going into raptures after one of Governments biggest departments after decades finally produces a set of unqualified accounts. But should we be celebrating the “tremendous work” when all they have done is produce what they were paid to do but never did?.

  3. Anonymous says:

    such good news…we thought this could never materialize buts its done!

  4. Anonymous says:

    Great job HSA it took you a while but it got done. Ignore the negative comments and tell us how many other authorities this size have done the same!

    They said they could not release data right away until Cabinet approved they didn’t say it wouldn’t not be available eventually.

    Give them a chance geez! this is a huge accomplishment and it should be celebrated!

  5. Jotnar says:

    Well, good news that they have managed to assemble unqualified accounts. But if no one gets to see them….bit like the old saying about the tree in the forest; if the accounts exist but no one can look at them, does it really matter if they are unqualified or not? Your understanding as a tax payer of the financial state of the hospital is exactly the same.

    • Anonymous says:

      Good point, no one has seen their 2017 accounts either because the incompetent people in the Ministry of Health hasn’t sent it to the Legislative Assembly to make it a public document. Per the law, it is only public when it has been presented to the LA, not the HSA’s fault, it’s the law, minister and ministry

  6. Anonymous says:

    “numerous patients using the services are either uninsured or under-insured”

    This shouldn’t be a surprise when the minimum standard insurance policy allowed by government doesn’t even cover basic medical costs. People think they are covered with the basic insurance plan, and then when they get sick (or pregnant) the harsh reality hits that the insurance covers nothing substantial. Would be better off in Cuba.

    • Sharkey says:

      And that is the reason why the HSA has lost so much over the years…
      If the Government truly cared, they would insist that every employee has adequate insurance cover in place but the reality is VERY different, because nobody is prepared to pay the realistic premium, for their Helper/Gardener
      This “head up your arse” mentality has created a culture that basically condones indentured slavery…

  7. Anonymous says:

    This is impressive given that it’s a very large and complex organization. Maybe send their finance team to help out all other government departments and entities?

    It’s about teamwork. Board, management and staff all have to be pulling in the same direction.

    • Caylass says:

      Not sure the Finance team can help any other dept since honest persons still can’t pay a bill if they don’t have a hard copy in their hand which is nigh impossible since they rarely send out bills. If you ask them to print a statement whilst there they inform you that they can’t produce that and would have to print each bill individually so it will take too long.

  8. Anonymous says:

    I know there will be negative posts, so let me be the only positive person on CNS. There are people working hard in Cayman, in all walks of life, industries and sectors. There are people making real contributions to society and making these islands better for us all. No one is perfect, no organization is perfect, no country is perfect. But, this story is a good story so let’s all take it as such.

    That is all. You may now resume your regularly scheduled negativity.

    • Anonymous says:

      Caymanians are so gullibly quick to applaud, with blind and ignorant trust. How do you know the accounts are squared if they won’t show you? “Trust but verify” should be the absolute minimum governing standard for all of this self-congratulatory accounting BS from all depts – and that fact you don’t come to that same conclusion after two decades of institutionalized larceny is appalling.


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