By: Barrie Quappé MPA, RN, BSN – Consultant/Director:
Try an online search to find out how healthy is healthcare on our three Cayman Islands and you will get travelers advice on vaccinations and how to prevent mosquito bites but no information on the safety of healthcare in Cayman. A report from the Office of the Auditor General, Cayman Islands from January 2017 provides that
“This public interest report addresses the lack of current, complete and readily accessible information on the Cayman Islands health system, including all types of healthcare services that fall within the public sector as well as those that are private.” (Office of the Auditor General, 2017)
“Appendix 8 – Patient Empowerment”, iterates what the Constitution and various legislation have on the books for patient’s rights. However, this same report notes that:
“In general, there are no reliable, consistent publicly available sources of information that provide quality ratings of healthcare providers, hospitals, nursing homes, home healthcare and ambulatory clinics in the Cayman Islands.” (Office of the Auditor General, 2017).
News sources may relate tragic cases, but rarely can a member of the public find information on any inquiry nor, if there was an inquiry, if any of the recommendations of an inquiry were ever implemented. Why not?
The cost of healthcare has soared:
“Government initially budgeted just under $11 million in spending last year to pay for tertiary level healthcare for those classified as “indigent,” mostly unemployed people and seniors without health insurance. By the end of the year, those costs had escalated to $25 million.” (Whittaker, 2019)
All of these factors and more, make it very difficult to gauge how healthy is our healthcare system, public and private.
The Cayman Compass editorial from 2016 queries the design of a consultant report of “Canada-based company Morneau Shepell”(Editorial Board, 2016,) who
“asked 139 physicians and 67 health practices to voluntarily provide financial information so Morneau Shepell could study how much medical procedures cost in Cayman. Only 40 responded, according to the consultants, and fewer than 10 provided the financial information.”
The editorial goes on to offer a rationale as to the low responses from local physicians, noting “Providing business information, when your competitors do not, can put a company at a decided disadvantage.” What surprises me on this piece, is they missed that the National Standards against which all healthcare facilities in the Cayman Islands are inspected, requires the facility to provide the Department of Health Regulatory Services Health Practice and Facility Inspector with their “Current fee schedule”. (National Standard A-1.1.4). In other words, the government already has this information.
If we cannot take the temperature of healthcare, how can we improve and further grow from mistakes to work towards preventing injuries or morbidities? An article out of the United States puts this more succinctly:
“Healthcare providers want to improve outcomes while reducing the risk of patient harm. Despite provider best efforts, medical error rates remain high with significant disability and death. Preventable medical errors contribute substantially to healthcare cost, including higher health insurance costs per person expenses. Only by health professionals working together will the cost and injury associated with medical errors be mitigated.” (Hipskind, Rodziewicz, 2019)
Is Cayman in a similar conundrum? Let’s work together, shall we?
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- Editorial Board (2016) ‘EDITORIAL – The health of healthcare in the Cayman Islands’, Cayman Compass [Online] Available from: https://www.caymancompass.com/2016/11/21/editorial-the-health-of-healthcare-in-the-cayman-islands/ (Accessed 22 July 2019)
- Office of the Auditor General (2017) ‘Cayman Islands Health System’, Public Interest Report, Office of the Auditor General [Online] Available from: https://cnslibrary.com/wp-content/uploads/OAG-Report-Cayman-Islands-Health-System-January-2017.pdf (Accessed 25 July 2019)
- Whittaker, James, (2019) ‘Healthcare costs rise as ‘indigent’ population grows’, Cayman Compass [Online] Available from: https://www.caymancompass.com/2019/01/17/healthcare-costs-rise-as-indigent-population-grows/ (Accessed 25 July 2019)
- Rodziewicz T.L., and Hipskind J.E. (2019) ‘Medical Error Prevention’, [Updated 2019 May 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499956/ (Accessed 25 July 2019)