Cayman: Doctor queries purpose of Shetty hospital

(CNS): The idea that the hospital in East End, founded by world-famous Indian physician Dr Devi Shetty, was really intended to be a medical tourism facility has been questioned by a local doctor. Giving evidence to the Public Accounts Committee, Dr Darley Solomon said that he felt that from the beginning, medical tourism was an unrealistic goal. But after a conversation with the CEO of the medical partner, Ascension Health, and the medical director, when he learned that they knew nothing about the leading medical tourism companies in the world, he felt something was being “kept from the public”.

Dr Solomon was called as a witness to PAC to discuss a recent report by the Office of the Auditor General that raised questions over the local healthcare system and highlighted some serious problems.

The local physician, who is president of the Cayman Islands Medical and Dental Society (CIMDS), lauded the work of physicians at Health City Cayman Islands (HCCI) as some of the best he had ever seen, but he questioned the separate standards for the hospital. Changes to health-related legislation that paved the way for the Shetty hospital, touted as the kick-start for the medical tourism sector in Cayman, meant the institution could register its physicians under different standards to all other doctors practicing in Cayman by registering them with the specific facility.

Dr Solomon said that the CIMDS had advised against this at the time but the advice which was ignored. “When you start having alternative pathways, it leaves you open to creating a two-tier system,” he told PAC.

He became the chair of the Medical and Dental Society when the hospital was due to open and had the opportunity “to be obstructionist”, he said. At the time he believed it would serve no good to the Cayman Islands, and he voiced his concerns to government officials and senior civil servants as well as the attorney general and the minister of health because of what he said were “two separate and arguably unequal levels of medical professionals”. He added, “I was opposed to the way it was done.”

The doctor praised the quality of the medicine at Health City and said it would help elevate healthcare standards. However, he said there were some serious questions to be answered about the institution and that he never believed that it was going to be limited to providing only medical tourism.

“I didn’t think anyone was ever coming here from the US to have open heart surgery,” Dr Solomon stated.

He said that around six months after the hospital opened the CEO from Ascension Health, HCCI’s US partner, and the hospital’s medical director had asked Dr Solomon if he could get the local doctors behind Health City for referrals, which he said confirmed his opinions that the hospital was not focused on attracting overseas patients.

“I was not surprised by that,” the doctor said. “What did surprise me… was that the CEO and the medical director for a two-billion-dollar company invested in a medical tourism product and didn’t know about… two of the largest medical tourism businesses in the world. It made me wonder… what kind of homework did they do and gave rise to thinking, is there something else going on here that isn’t for the public eye?”

He said he understood that when the revenue streams made it clear the model wasn’t working, they had to do something, but the mere fact they would need to ask and that they seemed to have so little knowledge of the medical tourism sector was a surprise. “I was flabbergasted,” he added.

Dr Solomon also pointed out that the amount of concessions being given to the hospital on the basis that it was meant to be the launch of medical tourism was not being tracked and he questioned if the public purse was getting value for money.

“I know there is nobody doing that… so is it an open-ended blank cheque,” he warned, but said he didn’t blame the Shetty hospital because it was down to government to monitor the concessions. “Where are they on this?” he asked rhetorically. “We can’t give the ministry of health any more passes.”

Dr Sidney Ebanks, chair of the Medical and Dental Council (MDC), who appeared before PAC after Solomon, agreed that there were problems with the concessions. He said that the money being given away in concessions could have been redirected to training local doctors.

His main concern, though, was the dual standards. “Having more than one standard is not only difficult to police but there will be unintended consequences that arise from that,” he warned, noting that he had made written representations to government about the dangers of a dual registration. He agreed that the hospital was practicing very good medicine but there should be one standard for all because of the loopholes that can be exploited in a two-standard system.

In her report about the government’s health system, Auditor General Sue Winspear pointed out that the concessions given to Health City Cayman Islands was causing concern with the wider health industry locally because other doctors and hospitals were put at a distinct disadvantage as the hospital becomes more and more of a local facility, treating very few overseas patients who specifically travelled for the services.

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