Doctors’ society oppose health practice bill

The Cayman Islands Medical and Dental Society has opposed a bill that will recognise medical qualifications from India and other countries not currently accepted in Cayman.

A bill to amend the Health Practice Law is one of four laws the government is amending or introducing to meet conditions of an agreement with Indian cardiologist Dr. Devi Shetty to set up a large medical tourism hospital in Cayman.

In a letter presented to the Legislative Assembly by independent member for North Side, Ezzard Miller, the medical and dental society said it welcomed the prospect of medical tourism, but was concerned over the lack of consultation with the medical community in the drafting of the bill, which also creates a new special registration list of medical tourism practitioners and facilities.

The organisation said it believed the current credentialling process was already of “very high standard” and questioned the need to create a special registration status for medical practitioners in the medical tourism field.

Currently, only medical staff who have received qualifications from seven countries – Australia, Canada, Jamaica, New Zealand, South Africa, United Kingdom and United States – can register to practise in Cayman.

Minister of Health Mark Scotland, in presenting the bill to the House, said under the new special registration category, practitioners from countries other than those seven can apply to Cayman’s four medical councils to acquire registration to work at medical tourism facilities.

“This has the added element of ensuring that those persons who fall into the special registration category will be attached to a specific facility,” Mr. Scotland said, adding, for example, that a medical member of staff at the Dr. Shetty facility would not be able to work elsewhere or set up his or her own practice locally.

The amended bill creates registers, which would be drawn up by medical councils, with five lists – a principal list, visiting practitioners list, overseas list, special registration list, and provisional list.

The Cayman Islands Medical and Dental Society said the bill would create the “peculiar” situation of a two parallel healthcare system and would remove the task of registering medical practitioners from legitimate authorities and council and place it in the hands of politicians.

Under the amended law, the Governor in Cabinet, in the national interest, may designate any person as a medical tourism provider or any healthcare facility as a medical tourism facility.

Mr. Miller objected to the bill during a two-day debate in the House last week, describing it as unnecessary and the most “troubling and disturbing” he had seen presented to the legislature. He said it had the potential to destroy “any hope of a sustainable medical tourism” in Cayman because it would lead to sub-standard medical qualifications being accepted locally.

The member for North Side queried why doctors, nurses and other medical staff could not sit Caribbean-standard exams in Jamaica that would qualify them to practise in Cayman.

“It can’t possibly be an improvement in the quality of healthcare if we have to create a special registration list because they cannot meet the current regulatory regime to be registered to practise in the Cayman Islands,” Mr. Miller said.

He pointed out that the head of the Medical Council of India, which regulates the medical education and the medical profession in India, had been forced to step down following his arrest on corruption charges. Mr. Miller said those charges stemmed from licensing people and institutions in India that did not meet the qualifications.

India’s Central Bureau of Investigation arrested Dr.

Ketan Desai last year for allegedly demanding a bribe to recognise a college in Punjab. The Medical Council of India subsequently suspended its former president’s licence to practice medicine.

Mr. Miller also opposed an exclusivity clause in the agreement between the government and Dr. Shetty that states no facility with more than 25 beds offering medical tourism and owned by non-Caymanians can open in Cayman in the five years following the establishment of the Shetty project.

He also objected to a new provision under the law which would make it an offence, carrying a penalty fine of $25,000, to operate a medical facility for medical tourism purposes if that facility was not designated as such. He said this could lead to a situation whereby a medical tourist may fill a prescription at a local pharmacy, making that pharmacy, if not a designated medical tourism facility, guilty of committing an offence under the amended law.

Opposition member for George Town, Alden McLaughlin also spoke out against the proposed amendments, saying one of his main concerns was that Cabinet, which he said did not have the experience or knowledge to do so, would now determine who could become a medical practitioner in Cayman.

“Over-riding all of that is my concern that we don’t create a sub-standard, or perceived sub-standard, category of medical practitioners practising from Cayman with all the attendant problems, criticisms and concerns, if not condemnations, they are bound to invite both locally, but more importantly, internally. There is a reputational issue here – Cayman is so small that whatever affects one industry internationally is bound to have spill over into the financial services and tourism and our reputation generally,” Mr. McLaughlin said.

The minister of health insisted that the government did not intend to lower the standard or regulation of medical practitioners. “It certainly would not be in our interests, or that of Dr. Shetty for that matter, to lower standards if we want to develop medical tourism and if he wants to develop a successful and reputable facility,” Mr. Scotland said.

Responding to the opposition from the Medical and Dental Society, Mr. Scotland said he had set up a meeting to discuss the Shetty project with the society prior to the signing of the agreement last April, but only five or six doctors had shown up, and only three had shown up to a subsequent meeting about the drafting of the bill. He added that the society had 40 members, out of about 200 practitioners in Cayman.

“That is a society formed by the doctors themselves, which does not seem a very strong group or very cohesive group… I’ve only seen a very small number of them get together at any one time,” he said.

He urged pharmacies to register as medical tourism facilities so they could take advantage of the growing numbers of potential customers brought in by the medical tourism industry.

West Bay MLA Cline Glidden said the bill gave Dr. Shetty and investors “a level of confidence” to know, that if they followed the rules and laws and satisfied requirements, they would not be subject to the “negative discretion” of the medical councils.

Responding to the member of North Side’s comments on corruption charges against the former president of the Medical Council of India, Mr. Glidden said that the council had “weeded out” that individual, with the help of Dr. Shetty, who is a member of the board of the Medical Council of India.

The bill was voted through a second reading with 11 votes to two.


  1. What troubles me about this is that it sounds like Dr Shetty is positioning himself to be protected from multiple complaints regarding the services they will offer. Mainly that fact that right of the back he is concerned about malpractice suites and the credentialing requirements for Indian Doctors to practice in Cayman. I work in the IT industry and have dealt with quite a bit of support for IT Services coming out of India and as for the IT Industry, it is the general perception that while you get very cheap services out of India you also get less than adequate and below standard services.

    I do believe that this is a great idea to bring Medical Tourism to Cayman and applaud Shetty for being willing to finance it, but I truly believe that Local Doctors should have more control on how this is done, to insure that it maintains an high level of Customer satisfaction.

    Cayman Doctors should sit on the board in this project and have some control over the business and hiring practices. Politicians have no medical experience and should not be making decisions that effect medical care. Where is the Medical Board or Minister of Health for the Caymans?

  2. You cant have your cake and eat it, you know. If you want this special medical facility in Cayman – and I see litle reason why not,- you will have to accept the necessary medical qualifications which enable it to be staffed; and the necessary protection against USA style medico-legal extortion.
    Otherwise, settle for less. And dont expect the outside world to pay for medical arrangements you cant.
    Ref NJ2Cays comment: The IT world is a strange one; much younger than medicine, and highly competitive and manipulated by huge financial interests. Medical practices can probably be more competently regulated by law than IT and the Internet?

  3. I do agree that Cayman does need this and will most likely do what it takes to get it there, I cant say I blame them. Hopefully Old Hand is right and it can be more competently regulated by law than IT. I for one would really like to see it happen. Since I know nothing about the Medical Profession I can only hope it works out right. However I still would like to see local doctors more involved, maybe 10 years from now youll see more Young Caymanians going into the medical field do to this and I dont really think Shetty would be willing to dig so deep into his own pockets to finance a lemon.

    I also wonder if any of the local doctors will work there…That would be nice to see.

  4. No wonder the medical society are against this, they must be shaking in the boots! Bye bye all those customers, they have been ripping people off for far too long and now they are desperately trying to stop this project going ahead so they can maintain their monopoly….Bottom line: Do you want this HUGE 2000 bed, MEGA economy boosting hospital or not?? You Caymanians are always complaining about how there are no jobs for us, (which by the way is the biggest pile of -expletive- I have ever heard, there ARE jobs, it is just that you are too lazy to do them) Anyway, Imagine how many cleaners, security guards, admin staff, receptionists, porters, drivers, nurses etc this hospital will require and all the jobs it will create. Not to mention the significant boost to the local economy. Wake up cayman because if I were Dr Shetty I would be looking to elsewhere to invest my millions of dollars… I am sure plenty of other islands would welcome him with open arms.

  5. If the Island needs this huge facility I have to wonder why the Government thinks it can control the professionals required to operate it. The Medical Council should be the recognised authority and regulatory body. It will mean a two tier system where it will require a medicaldental professional from the 7 listed countries being able to work under a different set of rules. Those from the Indian sub-continent who would not be recognised before wil come through the back door and the inference can be drawn that they are less qualified.

    If this facility is to be credible then all should be under the same set of rules. Dr Shetty seems to be frightened to expose his professional to the Western values and legal system. If I were coming from outside Cayman to have treatment in this facility I would expect the staff to be trained to recognised and registered level in one of the 7 listed countries. If the staff cannot come up to this standard then I would not use the facility. I am sure once word got out to the USA or any Western Country then patient numbers would decrease. There are plenty of cases in the media about inappropriate treatment in India for the Medical Tourism patients.

    Cayman beware!!!!! It is time the Medical Profession in Cayman voiced it concerns and not sit back and watch the reputation of medical profession become a possible laughing stock.

  6. No no no no no!!!! This is opening the door for so many malpractice suits HOWEVER, what attorney in Cayman knows anything about medical malpractice?!

    I do not agree with the medical tourism. Do you want to be like Mexico and Cuba and other countries where people go to get third rate face lifts and other medical procedures that their own doctors wont do because they arent safe for their patients?!

  7. Dear all,
    One word sums it all: Protectionism. In order to continue favouring doctors from 7 countries, this Doctors Society is giving the Opinion against the interest of the people of Cayman Islands. According to the current law, a doctor who graduated in Germany or Spain or India CANNOT practice medicine in Cayman, but someone who graduated in Jamaica is OK… Hmmm.. With all due respect to Jamaica, ALL 3 countries mentioned above are more developed and have better education system than Jamaica (check the ratings); therefore, Cayman Lawmakers please change the law to allow Dr. Shetty to build the hospital. Apart from recognizing degree from India, in my humble opinion, Cayman should recognize the degrees from all EU countries as well… Best Regards,

  8. I must respond to Tarafels inaccurate statements. The seven countries listed under the Law are the countries from which medical registration/licensure is recognized in Cayman and not the geographic location of medical schools. It is immaterial where you studied and from which medical school you graduated, but a question of where are you LICENSED.
    There are at least three doctors who were trained in Germany working in Cayman, they hold licenses from Germany, the UK and the USA. Hence this licensure allows them to practice in Cayman.
    There is a prominent Cuban trained plastic Surgeon working in Cayman who holds lincenses from Spain and the UK. Therefore, he is entitled to practice in Cayman and he does.
    There are at least four Indian doctors who trained in India working here; they hold UK licenses so they have no problem either.
    I implore you, please check your facts before you make these inflammatory accusations.
    As for protectionism, yes, it is protectionism IN THE PUBLIC INTEREST.

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