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.