Doctors challenge CIG deals with new hospitals

| 22/03/2021 | 62 Comments
Cayman News Service
Doctors Hospital in George Town

(CNS): Lawyers acting for the Doctors Hospital (DH), formerly Chrissie Tomlinson Memorial, have filed a judicial review challenging the government’s recent deals offering concession waivers to two new proposed hospitals, one in Camana Bay by Health City and the other in West Bay by Aster Cayman MedCity. The doctors who run the private facility in George Town believe that the “vast unilateral concessions granted to these two facilities creates an unfair environment”, distorting competition between healthcare providers, and could compromise the quality of healthcare available.

The two major deals were announced just under a month ago, and after the government failed to substantially respond to a pre-action letter from DH on 8 March, the company has now filed a judicial review asking the courts to look at the giveaways that government has made to their competitors.

“We believe in fair and competitive marketplaces,” Dr Yaron Rado, Board Chairman and Chief Radiologist, said in press release about the action. “Eliminating the gap between healthcare providers in Cayman is more important than ever. No market should be subjected to anti-competitive, monopolistic, or dominating behaviour. The power held by these companies affects the Cayman economy, our democracy and ultimately the health and well-being of our citizens. It is especially unfortunate for the many local-owned businesses who have been contributing to the country for years, shaping our community to what it is today,” he added.

The hospital confirmed to CNS Monday that the JR was filed, ensuring that the challenge meets the statutory timeline, given that the two deals were announced within a few days of each other at the end of last month.

The government said at a press briefing in February, when it was confirmed that Aster Cayman would be going ahead with their project, that it would not have to pay duty on medical equipment or supplies for 25 years following the start of construction. A few days later, the government announced it would extend its original deal with the owners of Health City, Narayana Hrudayalaya Private, whereby they are also exempt from paying duties on certain medical imports to a second hospital that they would be building at Camana Bay.

The Doctors Hospital team said that they appreciate the intention to attract foreign investment to the Cayman Islands but they believe fair competition and a level playing field for all healthcare providers serves the best interests of all, especially the public.

“CIG’s plans represent a blatant violation of several universal rules of competition and fair law-making,” DH stated as it explained why it was pursuing the issue in court.

The government had originally justified the financials concessions and the changes it made to health regulatory legislation that specifically applies to Health City by saying that it was to carve out a medical tourism sector. But while the East End facility has attracted some overseas health business, the facility is providing more and more care to local patients, not just for specialist work but a wide range of health provision.

It is also clear that Aster MedCity, should it meet the commitments it has made to this project, will also be offering its services to local patients.

However, objections, which CNS has seen, to the proposed site in West Bay and the related application for a planned area development and land clearance have already been submitted this week to the Central Planning Authority by four separate parties who own adjacent land. Residents have already outlined a catalogue of issues with the Aster MedCity proposal, from the significant threats to wildlife in the area to the rezoning of the various parcels of land involved, that are now likely to be the subject of major public concern.

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Category: development, Health, Local News

Comments (62)

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  1. Anonymous says:

    How are new facilities close to WB a bad thing?

  2. Anonymous says:

    Too bad hospitals can’t cure ignorance. If your good you make money. If your not good than you fail. Last I heard Doctors hospital failed a long time ago.

  3. Anonymous says:

    I’m going to file JR over my duty to build my house too. They charge me 15% but waive duty to condos in competition with my real estate market

  4. Anonymous says:

    At election time our politicians need to be thinking about everyone, not just those concerned about their health. If they want to screw with free markets then I suggest they give Citgo a 25-year duty-free concessions so we can get cheaper gas and help the poor people in Venezuela in the process.

    Someone already mentioned Walmart, and I’m sure there is no end to the other big businesses we could attract if government wins the court case.

  5. Anonymous says:

    Release the video!!!!

  6. Anonymous says:

    Health City is accredited by the JCI, Doctors Hospital is not. That is important. It is amazing to see people complaining about having a hospital of recognized excellence on the island.

  7. Anonymous says:

    I don’t know why but I get this bad feeling that Cayman’s days are numbered. I feel that our peak was 2016-2019, but it’s all going downhill now. Don’t be surprised if in the next 20 years, some form of tax is introduced.

    • Anonymous says:

      9:42 you might be right about our days being numbered. But….. Long ago, a former very senior civil servant, Dennis Foster, told me the same thing and said he was going to Costa Rica to avoid Cayman’s collapse. He set up a successful farm/plantation there but many years later I gather it was washed out by a flood and Mr Foster returned to Cayman, which far from collapsing was thriving. People have been predicting Cayman’s demise since at least the late 80s.

    • Anonymous says:

      Common sense. Cayman will not be able to pay the bill when it comes due.

  8. Anonymous says:

    what? the drs who bought a hospital only to get more rich, are angry that there is competition? color me shocked! Maybe if they spent more time on focusing on patients instead of profit and horrible billing they wouldnt need to worry about it.
    They are poor business owners who rather suppress competition instead of stepping up their game.

    • Anonymous says:

      Do you really think we need 5 hospitals in a very small area? Maybe health city should open a hospital wing for locals out east so nhs isn’t overloaded with welfare patients.

      • Anonymous says:

        All these greedy assed hospitals and doctors are only fighting like rats in a sack because of the for profit…massive profit…health insurance system we have copied from the USA. In that model, health care is not a right, it is something you have to pay for and to hell with you if you cannot afford it or you reach the age when the insurers just drop your coverage; Government can take you on then. It is a vile system bringing wealth to doctors and insurers and screwing Government which has to provide the health care to those vulnerable ones who really need it.

    • Anonymous says:

      Competition only works on a level playing field!

    • Anonymous says:

      That was my initial reaction as well. But it hardly seems fair that the two new hospitals get concessions for 25 years on equipment and the local doctors do not. Bigger question is – why give such a concession?

    • Anonymous says:

      You really think Health City isn’t here to make a profit? They are the leading contributor to the strongest economic performance of their parent company in India, out of all the other hospitals that the parent company owns in India. India has a population of 1.37 Billion people and this small country contributed the most to the coffers! let that sink in. I guess you would rather see capital sent abroad rather than circulate in the local economy, eh?

    • Anonymous says:

      *Ahem? These Doctors that have been here (dealing with BS insurance, poor Govt, Ivan, and more). All built their Practices and hired/ trained our locals while serving this community. They paid huge fees ans complied with taxes, duty, and honored employment laws.

      Now a new Flashy Govt “building” project with more duty waivers has the eye of our greedy politicians and we simply toss our local physicians aside for a few new bricks? Shameful!!

      I’ll go back to my local Doc who has done house calls for my CI family for over 20 years and thank him again for not being a turn-key profit, but a real person of a respected profession.

  9. Anonymous says:

    I only wish that CNS, when mentioning the objections to the new Aster Cayman Medcity PAD application, included the THIRD main point of the objection which was the inclusion of yet ANOTHER medical waste incinerator on a small island with already high cancer rates and the issue that DEH does NOT have the equipment to test or control the volatile emissions being released into our environment from incinerators. Almost ironic that we are pushing for Medical Tourism but have not taken steps to mitigate the pollution from all these existing and proposed new medical facilities.

  10. Anonymous says:

    I am glad CTMH/DH has taken this action,
    Health City has not met a single one of its projected goals on which they were granted these massive concessions. for example the following projections are taken from the document tabled in the Parliament to defend and justify these concessions;
    Number of overseas patients per day 2018 – 765/2019 – 810.
    Number of overseas patients per year 2018-111,690./2019- 118,260
    Medical University to be built in 2017 investment $170 million.
    Number of hospital beds 2018-300/2019-300
    Number of Caymanians employed 2018-931/2019-977.
    Number of hotel rooms needed 2018-7650/2019-8100.
    Revenue to Cayman Airways 2018-$93/2019-$105 million
    Number of passengers on CAL daily 2018-93/2019-105
    Total amt. money spent in transport sector 2018-$158/2019-$178 million.
    Total amt. spent shopping and recreation 2018-$317/2019-$356 Million.
    Please notice I used the pre covid projections.
    These concessions were granted on “youdo” economic projections
    I hope the judicial review orders them to pay back the concessions they received since non of their projections have been realized. without local business which the agreement does not allow the place would be bankrupt.
    There can be no justification to extend the concessions granted to health City to allow them to construct a clinic at Caymana Bay or anywhere else.
    Their model of “Medical Tourism” is a dismal failure and no new hospital should be allowed in Cayman on the same model

  11. Anonymous says:

    “CIG’s plans represent a blatant violation of several universal rules of competition and fair law-making,” DH stated as it explained why it was pursuing the issue in court.”

    Kind of like how MP’s are able to with no repercussions assault a woman then assert they were themselves were assaulted ? – that kind of neglect of universal rules and fair lawmaking ?

  12. Anonymous says:

    Cayman islands economy is dying. This is just one of the many symptoms. Your top guys in Government are not up to the task of saving yourselves. The island is in for a tough time soon as everything catches up. When all the expats get tired of the bullshit and leave Caymanians will have the island all to themselves along with massive debt and no way to make a living. Unless Expats want to satay then they will save it for themselves.

    • Just saying. says:

      @23/03/2021 at 7:35 am – Yep, you’ll go right back to your home country to face the daily thrill of dodging bullets when you go down to the King Sooper’s to pick up a bag of Doritos and a Coke, or your kids will be dodging bullets at school, or your family will be dodging bullets at church, or at Walmart, or the movie theater, or on your way to work, or at work, or at a concert, or…you get the picture. Enjoy!

    • Anonymous says:

      Not just economy is dying, more people get cancer and die prematurely. It is not hospitals and new towns that are needed, but draconian laws and its enforcement to cleanup the environment people living in.
      Lakeview residents are the hostages of poisoned environment. Surprised that even after the hellish 🔥 last year, they can’t organize and start working on a class action against CIG.

  13. Anonymous says:

    Had my life saved by Health City using some of that duty free equipment. Last time I visited CTMH it looked a bit sad and tired. Doubt that a 22% duty concession would bring a world class emergency cardiac theatre into it though.

    • Anonymous says:

      CTMH is a JOKE, give me HSA or Health City any day

    • Anonymous says:

      For your information, when Health City was shut down last year due to COVID-19, Doctors Hospital opened its Interventional cardiology Service, stepping up to the plate and saving many lives despite the unfair treatment received at the hands of the CIG

  14. Anonymous says:

    And will health insurance creep up even more because of this?

  15. Anonymous says:

    How is it okay for shetty to have a $500k liability cap and employ doctors with degrees that are not allowed by medical council. Make the law same for everyone.
    Shetty admits that medical tourism was a lie and he has to be in the towncenter of Cayman since all his patients are Caymanian.
    CI govt should not be able to give concessions at all in the future.

  16. Anonymous says:


    Creating an unfair playing field for everyone else who are local and do not qualify for concessions.

  17. Anonymous says:

    cig getting caught out again…i love it.
    time for class action lawsuits against their negligence and general incompetence.

  18. Anonymous says:

    This is ultimately not going to end well as we do not have the population to support all these facilities. The proposal from Medcity is for a facility that is twice the size of the HSA, Health City has already demonstrated that the medical tourism model is unsustainable, which is why they are now turning to local businesses to remain a going concern.

    The Government will either need to scale back the HSA and the 500+ Caymanians working there (so that these new facilities staffed by Indian nationals can survive) or it will have to provide more subsidy to maintain a public healthcare option.

    They looked at the short term construction job impact (something we don’t presently need with an overheated construction industry) and ignored the long term sustainability aspect.

    No one bothered to do a needs analysis, if they did, Health City would not be going to Camana Bay (with the benefit of limited liability and concessions) to provide maternal and neonatal care when that market is already well served locally. How many kids do they think are being born annually?

    I wish they would have a period of stakeholder consultation with the parties impacted before they approve these things and make grandiose announcements,

  19. Anonymous says:

    excellent! as a native i glad to see uncovering crap….fair is fair man! british may hace to step in here in a little bit to save us from our own greed and corruption spiraling into destruction…

  20. Peter says:

    25yrs!?? How can our Government see this far ahead for concessions but yet be unable (or unwilling) to see the impacts on our infrastructure all around?
    Why can we not have categories to which prospective developers can apply and specific requirements that have to be met for these projects to begin qualification for a concession?

    Who knows what the financial state of the Cayman Islands will be in 25yrs to be confident enough to make such concessions (25yrs)? I think we can safely say none of the people making these decisions.

    The main oversight of not insisting that these hospitals have a trauma center and still are qualify to receive such massive concessions is beyond me. The lack of such accommodation is the reason why regardless of the tragic situation everyone has to be taken to GTH. (i.e. A person in a car accident at the Blow Holes in East End would have to be transported to GT despite a hospital being 5mins away!) That’s a life or death consideration that the government decided was not worth it!

    We (the people) need to get a grip on how much we can afford to give away blindly and without any control.

    It makes one upset to the stomach! Discusting!! Simply discusting! How do they sleep at night?

  21. Anonymous says:

    Competition? Pretty sure Cayman has no competition or fair trade laws. Also no “universal rules of competition and fair lawmaking,” whatever those may be. If Doctor’s Hospital wanted to open a new wing or a satellite clinic, I have no doubt they could get the same concessions. Coulda, woulda, shoulda…shedding no tears for them.

    • Anonymous says:

      But there are laws on government acting reasonably and impartially, which is rather the issue, isn’t it?

      Like you I have no doubt Doctors Hospital could have achieved similar concessions if they approached the right people and made the right promises! But that is the essence of the problem.

      Welcome to the new Cayman, where government does whatever the Premier and his buddies think expedient or in their interest, whether its duty or planning concessions to favoured friends, changing the laws on medical practice liability, planning limitations, or access to the beach, and the only way to stop it is judicial review. And the Governor thinks everything is fine, nothing to see, lets move on. Sigh.

  22. SSM345 says:

    “No market should be subjected to anti-competitive, monopolistic, or dominating behaviour.”

    I believe that is how Cayman’s business landscape operates in a nutshell.

    • Nothing raises eyebrows anymore says:

      Not to mention the corruption endemic to most Cayman big businesses that is business as usual. Ethics are non existent in both public and private sectors. Conflicts of interest, collusion, price fixing and undercutting just to score contracts are just a few things I’ve seen but no one on the inside bats an eyelid. And if you’re subjected or witness to this malarkey as employee speak out and you’re on your way out.

  23. Anonymous says:

    Just like the Dart hotels have concessions for the next 20 years but none for every other hotel.

    • Anonymous says:

      Nothing at all like that but whatever helps you sleep at night. These other hotels of which you speak, what did they contribute in return? Infrastructure, land, anything at all?

      • Anonymous says:

        5:42 not sure leverage for gain is something to crow about or more simply manipulation or even vague contract corruption, but hey if that’s acceptable to you I’m probably not the one with a sleeping problem

    • Anonymous says:

      well done, beat me to it 👍

  24. Anonymous says:

    The residents of these islands are extremely fortunate to have access to Health City and the new two planned new hospitals. Health City has saved numerous lives of individuals who would probably be dead if all that was available was HSA and CTMH.

    The new hospital at Camana Bay will be offering cancer treatment and neonatal care – two of the most stressful medical matters families have to suffer through. Alleviating some of the stress of this by reducing or eliminating the need to travel to the US to receive adequate care is a massive improvement to the quality of life to everyone in Cayman.

    Duty concesssions for developers of luxury condos that zero Caymanians can afford should be considered an outrage by everyone who lives here. Duty concessions to build hospitals are entirely different. I also question the allegation of “threatening competition”. Last time I checked, CTMH can’t treat cancer or provide care for high risk pregnancies/pre-mature deliveries.

    • Anonymous says:

      If Walmart and Home Depot was given duty free concession to setup shop here, I’m sure Fosters and ALT and Kirk who pay duties would have issues with it, as they should. No difference here. Backroom deals for good politics.

    • Anonymous says:

      Concessions are concessions…….. Our fearless leaders use them to better their own position, not the patients in hospitals nor the guests in hotels.

    • The Sphinx. says:

      Concessions is just another name used in the payola game, isn’t it?

    • Lomart says:

      CTMH has been offering cancer treatments for years! Imagine how much more they would be able to offer if Government would give them similar breaks.

    • Anonymous says:

      Maybe CTMH could if they could get the millions in concessions..I think that is the point..

      Not everything that come from foreign is better..

      A good working old thing better than a new thing anytime!

  25. Anonymous says:

    Shine the light in on all this stuff.

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