PROVIDENCIALES, Turks and Caicos Islands — In 2008, the Turks and Caicos Islands (TCI) government entered into an agreement with Interhealth Canada for the construction and operation of two new hospitals – one in Providenciales and the other in Grand Turk – and the provision of associated secondary health care for TCI residents.
Since then, the contract with Interhealth Canada has remained a source of considerable controversy in the TCI for a number of reasons.
First, the contract itself has never been released for full public scrutiny. Late in his term of office, in response to public pressure, then Governor Gordon Wetherell permitted one-hour viewings of the document. However, few took advantage of this full yet restricted disclosure, as they could not take away any information which, in the short time allotted, could only be partially read in any event.
Given the sheer size of the full document – comprising a total of 187 separate files and a mind-numbing 7,665 pages – Wetherell’s concession appeared to be disingenuous at best, paying only lip service to the concept of government transparency often promoted by the British Foreign and Commonwealth Office (FCO) but equally frequently ignored by it in practice.
Second, the enormous ongoing financial obligations created by the agreement, which ultimately have to be funded by the people of the TCI through new and increased taxation, have brought the territory to the verge of bankruptcy.
The new healthcare scheme is currently costing the administration some $60 million annually and, as well as effectively bankrupting the government’s finances, has resulted in civil service layoffs and major cuts in salaries, slashing of lease and rental payments to landlords and a drastic reduction of the education budget for overseas scholarships.Medical services have been highlighted by CFO Hugh McGarel Graves as the most expensive portion of government spending at $60 million per year or $2,000 each for every man woman and child in the TCI.
Despite the expensive health care costs incurred by the new National Health Insurance Plan (NHIP) and Interhealth Canada, there have been ongoing complaints over the quality and availability of primary healthcare services, which until his recent resignation were the responsibly of new Progressive National Party (PNP) leader Dr Rufus Ewing as the former director of medical services.
In fact, current Governor Ric Todd spoke out publicly against the then Ewing-run health services, labeling them a “poor level of primary health care”.
After the NHIP came into being in April 2010, Ewing had the responsibility for managing primary care in the TCI and Interhealth Canada took over the responsibility for hospital management and secondary care.
Third, in addition to the cost of the NHIP that requires mandatory insurance payments for the provision of healthcare in the TCI, islanders have been up in arms over the cost of construction of the two new hospitals initiated by the former PNP administration, which were originally estimated to cost under $50 million.
The two small two-storey hospitals – one in Provo with 20 beds and the other in Grand Turk with 10 beds – are encumbered by a mortgage of $235 million. If the mortgage runs its full 24-year course with interest, the buildings will have cost TCI residents half a billion dollars.The hospital construction contract was awarded to local contractors Johnston Construction (now in liquidation) without an open bidding process.
A new hospital recently built in the Virgin Islands has been reported to have cost $90 million, with 6 storeys and 122 rooms.
Fourth, the Interhealth contract and the NHIP has become something of a political hot potato, with PNP leader Ewing scrambling to distance himself from it.
At the time, the scheme was touted by Ewing and others in the upper echelons of the then PNP government as a move to save millions of dollars from a bloated medical treatment abroad program.
However, since becoming leader of the PNP, Ewing has claimed that, as director of medical services, he was not responsible for making the decisions that brought the NHIP into being.
“I do not and did not have the expertise to make those decisions,” said Ewing.
“This was the responsibility of the ministers and those within the Progressive National Party… I was only an adviser,” he went on to say.Ewing’s claim has, nevertheless, been contradicted by Royal Robinson, former deputy premier in the short-lived PNP administration of Galmo Williams, who has stated publicly that Ewing was a member of the inner circle that contracted with Interhealth Canada as the health services provider and with Johnston Construction as the hospital building contractor.
Government CEO Patrick Boyle has also stated that Ewing had a “central role in developing the policy that led to the creation of the NHIP”.
According to local media reports, a number of civil servants (believed to be five) received payments of as much as $20,000 each — described as an “honorarium” — for doing a “good job” in negotiating and concluding the health care contract with Interhealth Canada. Ewing is said to be one of the five civil servants that received such payments.
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