Health City filled key gap during lockdown

(CNS): The challenges of getting medical attention during the border closure in 2020 and 2021 were mitigated by Health City Cayman Islands, the management at the East End hospital has said. As the medical facility prepares to break ground on another hospital in Camana Bay and gets ready for the return of medical tourists, the hospital’s clinical director and chief cardiac surgeon, Dr Binoy Chattuparambil, said that for most of the last two years the hospital has been providing care to local people and building new relationships with the community.

The hospital may have been originally designed to cater to overseas patients but it has provided state-of-the-art care to residents, preventing the need for thousands of critically ill local people to be airlifted overseas for treatment.

Dr Chattuparambil told CNS that, despite the difficulties presented by COVID-19, the hospital, which was established by world renowned heart surgeon Dr Devi Shetty, found a new opportunity to provide care to more local people and to prove the quality of that care.

Health City was the first place to be impacted by COVID-19 in the Cayman Islands when they accepted a patient from a cruise ship who had suffered a heart attack in February 2020. When it turned out the patient was positive for SARS-CoV-2, it triggered a full lockdown at the hospital and soon afterwards Cayman’s borders were closed.

The patient sadly died, largely as a result of his existing health problems. Nevertheless, although a number of staff members tested positive, no one else suffered and the virus was contained.

When the hospital reopened it became an integral part of the battle against the pandemic, treating a number of COVID-19 patients during the early days. To date HCCO has treated 22 seriously ill COVID patients.

While playing a role in treating COVID-19, HCCI has also played a significant part in providing quality care to patients at a time when flying overseas was extremely difficult, if not impossible. As a result, more local people have become aware of the expertise at the hospital.

According to statistics published voluntarily by Health City, its key performance indicators compare extremely well with some of the best hospitals in the world. Its general mortality rate is 1.62%, well below the CDC benchmark of 2%.

HCCI’s rate of hospital-acquired infection among patients is only 0.69%, compared to the CDC standard of 4%, and the unplanned return rate to theatre is 0.88%, compared to the WHO benchmark of 4%.

In the coming months Health City will be unveiling a Da Vinci minimally invasive surgical machine, one of the first hospitals in the region to offer this advanced technology for surgeons. The machine will be housed at the flagship hospital in East End and will provide state-of-the-art surgical treatment for local patients.

As the hospital gears up towards the return of medical tourists, HCCI Chief Business Officer Shomari Scott confirmed that, at the beginning of 2020 prior to the pandemic lockdown, around 40% of the patients at Health City were from overseas. But the rest were local people who have benefited from the healthcare provision that historically was only available overseas.

He explained that over the last six years since the hospital opened, it has performed some 3,575 surgeries on local patients. At the point of lockdown in March 2020, HCCI had saved almost $24 million in air-ambulance and travel costs alone for patients who would otherwise have had to travel overseas to seek the critical care they needed.

Scott also noted that during the three years prior to the border closure the hospital had contributed more than $80 million to the local economy.

Health City still promotes its healthcare services to the region and beyond, and Scott believes it will continue to attract patients from abroad, given the additional services it will be able to offer with the new facility, which is expected to begin construction in the coming weeks. But local patients remain a key part of the services that it now offers.

The new hospital will be providing cancer services, and the location at Camana Bay was seen as optimal as it will cut the travel time for those who need regular treatment. Scott said that with over 90% of the population either living or working in George Town and West Bay, the new site will cut more than 3,200 trips per year for patients, especially those who may require treatment for the rest of their lives.

As well as a range of cancer treatments and surgery, bone marrow transplants and radiation-oncology, the new facility will provide CAR T-cell therapy and a much needed neonatal facility.

HCCI has faced controversies over the years, including the deals that were struck between the original developers and hospital management and the government of the day, as well as the special provisions that were carved out regarding liability insurance and doctors’ licensing requirement.

However, Dr Chattuparambil said the team at Health City has proved that they are providing the best possible care to local people as well as their medical tourists. He maintains that the hospital has not undermined other providers but has contributed to better healthcare access for all, and more importantly, successful outcomes for less than the cost of healthcare in the United States.

Scott said HCCI hopes to expand its partnership with the Health Services Authority so that it can offer even more support, such as in the area of accident and emergency, eliminating the need for those who need emergency care in the Eastern Districts to travel to the George Town A&E to be triaged before they can travel back to the East End hospital.

Health City also said it has fulfilled its commitment to provide work for local people. Although the medical team is still dominated by healthcare workers from overseas, the non-medical workers are now 90% Caymanian. The hospital has also opened its doors to thousands of students for placements, allowing them to learn about the medical profession and healthcare administration through its Healthcare Explorers programme.

Even though HCCI has never reached the original target of 70% of its patients coming from overseas, another international hospital has recently purchased land in West Bay and is seeking to muscle in on the medical tourism sector.

Gene Thompson, one of its original developers of Health City who parted company with that facility some years ago, is now partnering with Aster Cayman MedCity, a group based in the Middle East. Their proposed business model is similar to that originally proposed by HCCI.

There is some concern in the Cayman Islands that having another large facility aimed at medical tourism may lead to a need to chase patients and cause the hospital to cut corners to keep running costs down. Rather than creating a centre for excellence for medical provision in Cayman, this could lead to a competitive downward spiral in quality provision.

Dwayne Seymour, when he was health minister and before the West Bay hospital was given the green light, had said that it would have to be something different than the existing facilities in the Cayman Islands.

However, before he left office he went ahead and signed the deal with the developers anyway, even though it does not indicate how this new hospital will attract sufficient medical tourists to reach the 70% target when Health City has consistently stated that a realistic goal is around 60%.

This project has also given rise to controversy. The planned facility is to be developed on one of the last remaining swathes of mangrove wetland in West Bay and was granted planning permission even though the developers did not offer the required replacement for the bio-diversity loss, as recommended by the Department of Environment.

The project also faces another hurdle, as the Doctors Hospital has filed for a judicial review of the government’s decision to grant favorable terms to Aster, similar to those given to Health City, when the George Town private hospital has been given no such favours.

Doctors Hospital argues that the duty and fee waivers that have been granted to Aster and HCCI discriminate against its facility by denying it any of the same concessions. As a result they believe the deals between the government and Aster, as well as the last agreement between the government and Health City for its new project, maybe unlawful and breach the Constitution.

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