CIG fails on healthcare and welfare policies

| 12/08/2021 | 65 Comments
Cayman News Service
Cayman Islands Hospital, George Town

(CNS): More than six years after the Office of the Auditor General first raised the alarm about the government’s failing social welfare system and almost five years after it warned that the health system was riddled with problems, no policies, plans or strategies have been implemented to address the myriad problems.

In a new report looking back at the recommendations that both the OAG and the Public Accounts Committee made to the previous administration to start tackling the numerous failings, Auditor General Sue Winspear has concluded that virtually nothing has been done and government has regressed on what little progress had made after the reports were made public.

“The Government’s progress with implementing recommendations made by the PAC on two reports covering the significant public services areas of healthcare and social assistance is very disappointing,” she said Thursday following the release of a progress report covering the wider problem of government either failing to adopt recommendations at all or take a ridiculously long time to respond.

“The original recommendations made by my office date back to 2015 and 2017. The previous PAC held hearings on these two reports a number of times and issued its own reports with additional recommendations, the last being in April 2019. Very little has changed since then.”

In this latest review of progress on the healthcare recommendations, she said Cayman still has no overarching strategy or policy for healthcare and the legislative framework is outdated and deficient. “As a result Cayman’s health care system is not providing best value to its people and practices for inspecting heath care facilities, registering health care practitioners and developing Caymanian doctors are still lacking,” Winspear added.

Meanwhile government still has no coordinated social assistance strategies to deal with its welfare programmes.

“It is not clear if the most vulnerable in our society are being adequately supported, and it is likely that there continue to be inconsistencies in the eligibility criteria for accessing support and gaps and overlaps in provision. The Poor Persons (Relief) Law dates from 1997 and has still not been modernised to be fit for Cayman in 2021, despite assurances to the PAC in 2018 that this was under review.”

Even though government officials had made commitments to implement the recommendations and address the shortcomings in both the healthcare and welfare systems, none of these commitments have been honoured and in some cases things have moved backwards.

She said it was “disappointing” that since the last time she reviewed these reports in 2018 it has fallen significantly behind. “Implementing PAC and my recommendations is not just a tick box exercise but something that can and should deliver real service improvements that will positively impact peoples’ lives,” she said.

In the conclusion to the report Winspear said it was “unacceptable such limited progress had been made” in implementing recommendations about significant policy areas that provide services for the entire population so many years after the original findings were spelled out and the recommendations were made.

The report is the first of four that the OAG will be rolling out this year, because the two audit reports relating to healthcare and welfare are not the only ones where government is failing to act on the OAG and PAC’s recommendations.

In this first report Winspear sets out the significant delays and failings by the PPM-led administration to act on 15 PAC reports that were tabled in Parliament between September 2018 and December 2020. The reports generally expand on the OAG’s work as a result of the public hearings they held with members of the civil service tasked with finding ways to meet the recommendations.

This report shows that, as at 22 February when Parliament was dissolved ahead of the April general election, the government had tabled formal responses to nine of those reports, though six of them were well past the three-month deadline. Five had not been responded to at all, some of which date back more than two years.

Responding to the release of this latest report, the deputy governor’s office issued a short statement acknowledging the OAG’s concerns and pointed to the civil service’s commitment to improving the timeliness of its responses to the PAC. Acting Deputy Governor Gloria McField-Nixon said the the civil service had “battled fires on many fronts” during the period in question, which fuelled the delays in some administrative responses.

“As part of our continuing efforts to enhance efficiency and accountability, we are revisiting our processes to ensure that we improve the timeliness for tabling Government Minutes,” she stated. “We appreciate the OAG recording that some, albeit insufficient, progress has been made on reducing the backlog of Government Minutes and we are grateful to the OAG and the PAC for working with the Civil Service to streamline these processes.”  

But the office said nothing about the failure to implement the OAG and PAC recommendations despite long standing commitments to do so, often in timelines well before the COVID-19 pandemic began impacting the business of government.

See this report and the original OAG reports in the CNS Library

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Category: Government Administration, Government oversight, Politics

Comments (65)

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  1. Anonymous says:

    Isn’t it about time that the government admitted that with our small and rather undereducated population, we cannot possibly have experts in all of the necessary fields and disciplines to properly run a government, a civil service, an education sector etc. Stop putting someone it a position just because they were born on the island. Put an expert in that position, no matter where they come from, and let’s start doing a damn good job on all these services, run by people with experience and expertise. Not just because people were born into the job.

    • Anonymous says:

      Did you just get off the plane 3:50? The answer is no. It’s like in the old days in jolly old Britain when people said wouldn’t the people in our colonies rather be run well by us than run corruptly and horribly incompetently by themselves and their admittedly ghastly leaders? The answer was NO. If it’s a mess, it’s our mess. So eff off.

      • Anon says:

        Yes but clearly there are no caymanians capable of running a non corrupt and snake government. Give expats the vote and let them run for parliament. Everyone would win.

  2. Anonymous says:

    The legacy of Alden’s PPM in black and white captured by multiple Auditor General’s reports. They do not care

  3. Anonymous says:

    Wow! Just like third world. Why the big surprise?

  4. Oh,well says:

    Mr. Miller kept raising the red flag since 1985 and they would not listen

  5. Anonymous says:

    In Cayman implementing policies, plans or strategies to address the myriad problems is OPTIONAL, only vaccines are mandatory!

  6. Anonymous says:

    This is shocking news…….said NO ONE EVER!!!!

    Government needs to stop appointing COs with zero experience in their field. It’s bad enough we have MPs with no education or experience so the least we can do is have qualified persons over the actual operations.

    Non-compliance with items from the Auditor General’s reports should result in firing! This practice of Civil Service jobs being untouchable has GOT to go away!

    Social services needs a COMPLETE overhaul! The first thing is it should be completely off-limits for politicians to have any access or information on it. This is consistently being used for gaining/keeping voters.

  7. Anonymous says:

    another glorious day for our world class civil service……zzzzzz

    • Really says:

      Why blame the civil service for policy decisions?! Are we, as children, responsible for the shitty decisions our parents make and implement? Come on, now, get real.

      • Anonymous says:

        Because the civil service does not push back. When a politician says “let them build a sea wall on the beach, in breach of law and regulations” the civil service says “OK”. The civil service too often acts without any responsibility or accountability for its actions, or it’s failure to act. That is why they are responsible. Meanwhile they consume more and more of the resources paid by then public and private sector. That is why the disdain grows.

      • Anonymous says:

        How many Policy Advisors, Deputy Policy Advisors, Chief Policy Advisors, etc. are employed in the Civil Service and what do they do all day

  8. Just Sayin says:

    Well obviously the reason Minister Seymour couldn’t get along with Jennifer Ahearn and needed Nellie Pouchie as his Chief Officer didn’t have anything to do with him wanting to deal with the recommendations of the Auditor General or the Public Accounts Committee.

  9. Anonymous says:

    And whines the current Chair of the PAC to hold the current government to account on the failure to apply the recommendations made over the last 6 years? Oh, it’s the former Minister of Finance who was in Cabinet at the time. SMH.

  10. Chet Oswald Ebanks says:

    My 2 cents. I would love for someone from CI Government to finally address the urgent issues I have asked. Still a system in failure. Ran by some of the most heartless humans one would ever want to make contact with. Sadly emails don’t tell lies. But the truth. Boy do I have a story for fhe CI.Government and Cayman Islands punlic to tell, off almost 9 years of. Persons sitting behind desks that don’t care, what, how, if the less vulnerable Caymanians suffer, and continue to. Be judged by who we are and what liveable diseases we have. Someone must step forward from this Government and start to address. Adequate food, housing, Healthcare and where possible. Those that are still able to work should be given opportunities. Not told as they young man from NAU told me a few days ago. Forget the past. Now really. Paperwork, paperwork.

  11. Time to change says:

    In the private sector, when it is determined that something is wrong and needs to be corrected, it triggers what is called “sense of urgency”: identify the problem, brainstorm for a solution, decide how to fix it, FIX IT, test that it is fixed and that the desired result is ongoing. Many people in past administrations just sat and waited for someone to tell them when to do something. I really hope that changes now.

  12. I remember says:

    In the late 90s, when they were warned that illegal weapons were being smuggled seemingly undeterred and gang activity was burgeoning. Then in the 2000s they were warned about education and that graduating high schoolers that could not read would lead to a rise in unemployment and delinquency. They were warned that the reports of sexual child abuse was increasing. They were also warned by the Caymanian builders not to allow people to build past the water line. All to no avail. I guess they felt that since they were elected, they knew better than the people who elected them. Now we see the results… I hope today’s administration learn from those mistakes. Seek and mull your people’s counsel.

  13. Anonymous says:

    No news here but really unnecessary to start naming the various ministries…CIG fails is sufficient

    • Anonymous says:

      Disagree. We need to know who is responsible for this in particular. While you might not be happy with CIG as a whole, some departments are in much more terrible state than others.

  14. Anonymous says:

    What do we really expect when we put people in positions of huge importance who aren’t qualified, experienced or driven enough? Get the requisite help, put an appropriate Caymanian beside them and build some resilience and succession planning at the same time. Instead we chuck people into roles they aren’t ready for just because they are local. Utter madness.

  15. Say it like it is. says:

    To be brutally honest the only way to address these myriad and longstanding problems is to replace a lot of our politicians and senior civil servants with people like the Auditor General who is more than qualified to do her job and who is 100% resistant to influence and corruption, and answers her phone.Sadly this won’t happen, so we get what we overpay for.

    • Anonymous says:

      Auditor Generals are always wonderful at pointing out shortcomings of government but they are like film and theatre critics, they can comment negatively but it doesn’t mean they can do any better themselves.

      • Chris Johnson says:

        Auditor Generals make recommendations as do all auditors. It is part of their job. If the Government or client ignores their recommendations it is their prerogative. There is nothing theatrical about Auditor Generals and you should be pleased that we are blessed wit such a good one.

        • Anonymous says:

          Dan Duguay was good too. Not that they listened to him either…

          • Chris Johnson says:

            I agree and his successor was also good. Each AG has their own style but their expertise is very high. It is sad that their recommendations are ignored.

        • Anonymous says:

          Well, to quote the late great Mandy Rice Davies, you would say that wouldn’t you, Mr Johnson?! But I agree with you about Ms Winspear who is very professional and focused and does not puff herself up in the way of others. The point you make about the client’s prerogative is also well taken.

          • Chris Johnson says:

            I am not familiar with Mandy Rice Davies. Should I have been?
            Was she the AG before Nigel Easdale? Just wondering.

            • Anonymous says:

              No Mr Johnson, I believe the Auditor General before Nigel was Nick Treen. Ms Rice Davies’s assets lay elsewhere in rather different sheets from balance sheets.

        • Anonymous says:

          Auditors general Chris.

      • anon against ignorance says:

        9.43pm You should be Deputy Governor, with a comment like yours you are more than qualified.

  16. Anonymous says:

    This story is really a story about a lack of accountability within government and the continued attempts from the people at the very top of the civil service to make excuses for incompetence instead of holding people accountable for their actions or inaction.

    The only conclusion that can reasonably be reached is that our problems start at the very top and that meaningful change can only be achieved after we make fundamental changes at the top.

    • Anonymous says:

      You read the report and your conclusion is that it’s expats fault. Jesus wept. It’s our elected officials that are the problem. You think the wrong people get benefits from the NAU. Let’s assume you are right. Who allows them to do that. Then let’s look at the healthcare system. How is that the fault of expats? SMH

      • Anonymous says:

        this reply makes no sense to the comment from 3:39… They never mentioned expats. How did you read that into their comment?

      • Anonymous says:

        It is the fault of a civil service that does not fight to protect the public purse, including by paying money to support expatriates who should not even be here.

  17. Anonymous says:

    Tens of millions are being squandered providing assistance to hundreds of non Caymanians who under our laws should never have been permitted to come in, let alone remain here. Meanwhile Caymanians in actual need are denied support. No one is willing to confront this issue and it will bankrupt us. We need to stop the mass importation of poverty. Just because you are employed by government or married to a Caymanian should not mean that the Cayman Islands is supporting and educating multiple foreign dependents at no cost.

    • Anonymous says:

      BS, 3:36. Total BS. You really need to cut yourself free from this idea that if there were no foreigners in Cayman everything would be wonderful. It’s sad, pathetic, delusional and brainless. “Tens of millions”! LOL. How much is spent on Caymanian…born Caymanian …seamen and their young Filipino wives for pension and medical benefits? Prisoners..mostly Caymanians ..for medical and other costs. And as for indigents, the large number I know and see hanging around the well known deadbeat spots around Grand Cayman ( come on, we all know them) are 100% useless Caymanians who haven’t hit a lick since they left school.

      • Anonymous says:

        Not BS. Fact. Millions of dollars of public money is being spent supporting and maintaining foreign nationals who ought not to even be here if our laws were being applied. The reasons are many but corruption and ineptitude come to mind as being amongst the most prevalent. Whatever the reasons it needs to stop. We are not some pot of gold at the end of the region’s rainbow. Such excess as we have should be reserved for Caymanians Not only because that is what the law expects, but what sustainability and basic economics require.

    • Anonymous says:

      Without non caymanians here you would not have enough staff to even have a hospital !

    • Anonymous says:

      You said that they are Caymanian. Nuff said, all Caymanian are to be treated equally under the law as applies in all civilized societies. Unless you want first and second class citizens. This approach does not work in the 21st century. You obviously need to seek psychological help for your pathological discrimination.

      • Anonymous says:

        Can you read? I have no problem with government supporting Caymanians in need. In fact I want it to do more. What I cannot abide is Caymanians being denied support they need because government has spent the money or resources to support foreign nationals.

  18. Anonymous says:

    Could have saved yourself the trouble and just stopped typing after the first two words of your headline.

  19. Anonymous says:

    Unfortunately the modus operandi of the acting Chief Officer of health is to ignore things and hope they go away. Reports don’t get tabled, she doesn’t attend the board meetings she has oversight of, Cabinet papers don’t progress, contract renewals are not addressed, draft legislation gathers dust, emails are ignored etc etc. one would think the individual is busy writing a policies to govern healthcare why everything else gets ignored, I am therefore shocked that there is failure here too. I just cannot understand how these levels of non-performance are tolerated in the Civil Service while the deputy Governor goes around touting what a world class service it is.

    • Anon says:

      So true. Can you imagine if the health minister acted like this in the uk, USA, any European country? They’d be sacked within a week. Here they just carry on for 5 years. Where does all the expat taxpayer money go…. import duty, work permit fees, and all the rest? Billions seems to go nowhere.

      • Anonymous says:

        Just visit the clinics in the districts. What a mess. Drs running around confused and wayyy too busy!

    • Anon says:

      Who appointed her? See a trend?

  20. Unfortunately says:

    the answer to this is corruption. Many slip through the cracks and get little to no support while others are benefiting from a Scandinavian level of assistance.

    As long as politicians are able to dole out favours to voters and other constituents nothing will change.

    You don’t have to be overly cynical to believe that many of our elected members like it this way.

    It would also be interesting to see a report on the hiring practices within CIG and the authorities. We have far too many people doing far to little and yet headcount increases year after year.

    • Weary Caymanian says:

      Sad but true! Leadership has just been a word for the last dozen years. Our leaders just couldn’t keep their snouts out of the trough. Sad, sad, sad! Which way are we going ? Onward and upward, or back to the trough? Is anyone listening? Does anyone care?

  21. Anon says:

    Sounds like Ozzie, Jaron and the new HSA board has some work to do.

    Bless their poor hearts

    • Anonymous says:

      This is a failing at the policy level of the central government, the HSA nor its board cannot pass legislation, set the strategic policy for health or address the myriad of issues this OAG report is talking about. This is squarely on John John and his Ministry staff. The new Minister is who we should be feeling sorry for.

      • Weary says:

        To 4:24pm: Jon Jon and his predecessor Health Ministers. I only hope today’s Minister has the humility and wisdom to understand she cannot fix everything alone. I would not know where to begin. It took years to get to this point.

    • Anonymous says:

      Do they get a phone allowance?

    • Anonymous says:

      Ozzie?? Is the woman still on that Board too??!

      CNS: HSA Board of Directors.

    • I wonder says:

      Am I the only one that thinks that Ozzie’s Chaimanship is a consolation prize for not winning in April?

    • Anonymous says:

      2:33 and yet NONE of them are qualified to do anything.

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