$85.4M health budget is OK’d

A new senior citizens home for North Side, a remand facility for juveniles and a long-term mental health centre were some of the big-ticket items approved in an $85.4 million Health and Human Services budget last week.

The Health Services Authority receives $6.4 million to cover expected operating losses and a further $1.75 million to purchase new medical equipment, while $4.8 million is being devoted to revitalising Grand Cayman’s five district health centres with renovations, new staff and services.

Health Minister Anthony Eden said the renewed emphasis on district health clinics would be more convenient for patients, while reducing strain on the Cayman Islands Hospital.

$1.1 million goes toward a merger of the Health Practices Commission and the Health Insurance Commission; a move Mr. Eden expects will improve the HIC’s capacity to inspect healthcare facilities, to amend and enforce health practice and health insurance laws and to investigate and resolve complaints in both areas.

Mr. Eden also discussed plans to split the Department of Children and Family Services into three – a Department of Children Services, a Department of Social Services and a Community Empowerment agency.

Mr. Eden suggested a focus on health prevention and wellness programmes would help counterbalance escalating healthcare costs.

HSA finances improving

Legislators also heard evidence of an improving financial situation for the HSA – and also a sobering warning of the financial costs bad health habits could inflict on the country.

Expected losses for the authority in the 2008/09 budget are forecast at $6.4 million. If that figure holds, it will be down from a better-than-expected operating loss of $9.8 million in the 2007/08 year (originally forecast for $11.3 million), which was down from $14.2 million in 2006/07.

Mr. Eden highlighted a new fee structure and better billing procedures as reasons for the improvement, but added that vacancies in several key positions until recently has also saved the authority money.

HSA Acting CEO Lizzette Yearwood indicated the authority faced an uphill battle to continue cutting operating losses in the face of rising healthcare costs, which are escalating at between eight per cent and 12 per cent annually.

‘As time goes on we do think we can rise to the challenge in order to reduce the operating loss, but it remains to be seen whether we can close the gap completely.’

Health Ministry Deputy Chief Officer for Policy and Planning Leonard Dilbert warned the country needs to make better lifestyle choices if it wanted healthcare costs to remain in check.

‘In this country now … much of the cost that we are seeing arises from the lifestyle decisions people have chosen. We continue to make our lifestyle choices as if we can behave any way we choose and not deal with the consequences,’ he said.

‘The body responds to everything we do. Whether we choose to eat the wrong food; not exercise; stress ourselves unduly; the body responds – it gets sick.

‘Any analysis of our current cost structure will show that the push on the escalation of costs is definitely coming from that area. If we cannot impress upon the population that they must change their behaviour – from children way up to the older ones – we are not going to be in a good position in the long run in this country,’ he said.

‘We just simply cannot afford to pay the costs that we will be faced with.’

CEO still acting

If – or when – the authority’s acting CEO will be confirmed in the position was also a hot topic during last week’s meeting.

Both North Side MLA Edna Moyle and West Bay representative Rolston Anglin asked the minister to indicate how long Ms Yearwood would continue to carry the acting title that she assumed following the sacking of former CEO Craig Brown in October 2006.

‘It seems to me Ms Yearwood is going to wind up with a Golden Globe or some kind of golden statue,’ said Mr. Anglin. ‘She must be the greatest actor – or actress – there is.’

Mr. Eden said he is caught in a situation, because, after taking over as minister in 2005, he commissioned a review of the authority that had recommended that any CEO have at least a Master’s degree in Hospital Administration – something which Ms Yearwood is working towards but has not yet completed.

But he pledged his full support toward Ms Yearwood, and suggested a consultant could be brought in to act as CEO until Ms Yearwood completed her Master’s degree.

‘Once she has finished … and this is a [HSA] board decision … but as far as I am concerned, she should be the CEO,’ he said.

‘She has demonstrated at some very difficult times … that she has a wonderful personality. She has proven to staff and people that have worked with her – not only in Cayman – the way she gets things done in a positive manner.’

‘I have to say things as I see them,’ the Minister continued. ‘I think she does a wonderful job and I have no reservations in this individual taking over at the appropriate time as the CEO confirmed.’

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