Patients: Waiting times too long

A survey of Cayman Islands National Insurance Company customers show the majority of respondents felt the waiting times at the Cayman Islands Hospital’s accident and emergency department and for outpatient services are “not acceptable”. 

In the survey of 551 CINICO clients, 65 per cent were dissatisfied with the A&E waiting times, while 58 per cent were unhappy with the amount of time they had to wait for outpatient services. 

The results echo the findings of a survey carried out the by Cayman Islands Health Services Authority in 2011 where the majority of those who were asked what could be done to improve services at the hospital responded “more/faster assistance at A&E”. 

To help remedy waiting time delays, the hospital launched an urgent care unit – a walk-in unit attached to the accident and emergency department, where patients can receive immediate medical treatment for urgent, but not emergency, cases.  

Lizzette Yearwood, chief executive officer of the Health Services Authority, acknowledged that waiting times continue to be an issue at the hospital. But she said the new unit, which had a soft launch on 1 December, would help address the problem. 

Ms Yearwood said the hospital did not have any additional staff to man the urgent care unit, but added it would be a system in which a doctor is assigned to the urgent care unit and patients who are considered to be non-emergency, but urgent cases are triaged to that unit. 

“They still go to the accident and emergency area and are directed to the relevant area. We have three rooms for urgent care,” she said. 

Waiting times at the hospital’s pharmacy have also been of concern to patients, Ms Yearwood said. But this has been addressed by setting up a medicine refill clinic at the government administration building in George Town so civil servants can more easily get prescription refills and not have to wait at the hospital pharmacy, she said. Patients can also get refills at district clinics. 

Three quarters of the respondents to the insurance company survey, which was carried out during the summer and the details of which were recently released, said they or an immediate family member had used Cayman Islands Hospital for outpatient procedures in the preceding 12 months. Another 36 per cent of customers who responded self paid for a private doctor or hospital in Cayman for outpatient services. 


CINICO perceptions  

Addressing perceptions of CINICO, the survey indicated that the vast majority of respondents – 81 per cent – were either “very or somewhat satisfied” with the insurance company. 

Of those who said they were not satisfied with CINICO, the main reasons for their dissatisfaction were a need to include private doctors/private healthcare; the company’s reimbursement policy; and long waiting times for medical services. 

Having CINICO coverage made 83 per cent of the respondents feel confident about their health insurance, according to survey results. Nearly 70 per cent felt CINICO provided good value for money and more than half described the insurance company’s staff as “pleasant to deal with”.  

A majority – 59 per cent – said they did not know if CINICO treats all members equally, while 34 per cent felt the company failed to show “good attention to detail”. Less than a third of those who responded to the survey believed that CINICO was financially sound, while 59 per cent of the respondents said they did not know whether it was financially sound or not. 

Only 17 per cent of respondents felt that the statement “CINICO communicates effectively with its members” suited the company “very well”, while 30 per cent felt that statement described it “somewhat well”. The management structure of the insurance company was revamped last year and the survey was carried out to determine members’ “needs, attitudes and perceptions” to help identify areas for improvement. 

According to the survey results and analysis, the research objectives were to understand “perceptions of CINICO overall; experience of interacting with CINICO; HSA perceptions; and reaction to additional CINICO programmes and product ideas”. 

Recommendations contained in the report on the survey results stated: “Given that CINICO is seen as having improved and projected to continue to improve, the primary recommendation is to remain on track with the current changes in CINICO”. 

More than a third – 38 per cent – felt CINICO had stayed the same over the preceding 12 months, while 34 per cent believed the company had improved and 7 per cent felt it had become worse during that period. Another question in the survey asked if the respondent expected CINICO to improve or get worse over the next 12 months. More than half – 54 per cent – said they expected it to get better, with 23 per cent saying it will stay the same.  

The survey indicated that while men are more likely to visit CINICO in person rather than remotely, younger members are more likely to choose remote contact (mail, e-mail and telephone), while women are equally likely to use both methods of contact. The in-person contact was rated as better than the remote contact experience, with 16 per cent rating the in-person communication as negative and 31 per cent rating their remote contact experience as negative.
“Interestingly, groups that are more likely to choose remote contact (women, younger members) are also more likely to have negative perceptions of CINICO,” the survey report stated. 

Hence, the report found that the areas CINICO needed to improve was the remote contact experience; the way staff respond to requests, show attention to detail and treat all members equally; and CINICO’s management process. 

“Making improvements in these areas gives CINICO an opportunity to communicate with members. Effective member communication is not currently seen as a CINICO strength,” the report states. 


  1. There is only one word to use to suffice this, and tht is Disgusting You go to the Hospital Emergency, and you might as well take a bed, lunch and breakfast, because you will have to be waiting for hours and hours. Receptionists are on private phone calls, nurses are on idle personal chit chat, while doctors are nowhere to be seen. There is too much time wasted by every one in this area. All of them need to be sent away to hospitals overseas and see how the Emergency areas are manned. They are too slow, too lazy and does not have a welcoming face. They just do not care here, at least that is the way it is displayed. Heard about under cover Boss, well we need undercover Boss going in at that hospital Emergency area.

  2. Service is absolutely not consistent with expenses. First you pay monthly insurance. In my case its in range of 1,000 US a month. Then if you need to use any service you pay deductibles. Then you still pay co-pays. So you pay, pay, pay. When you come to main service provider in the area – Hospital mentioned above – you wait, wait, wait hours. Once my wife was admitted to their emergency care unit – we actually just went in without invitation – I told them that we are not going to wait hours with her condition and we just forced our way in. Maybe their triage would make the same conclusion, but even to get triaged you sometimes need to wait 15-20 minutes. They allocated us to a box in emergency care. What is interesting is contrast between what was outside and what was inside. Outside was a long line of people, some in better condition, some literally in pain. Inside everything was quiet and silent, doctors strolling around and chatting with patients (we saw three or four coming to our box just to say hello in addition to one who was taking care of us). I didn’t notice anybody saying hey, there is a long line out there, let’s drop this nice chat and get one more patient in.

    Yes you can go to Chrissie Tomlinson, but than you need to pay even more than that.

    I know that Cayman takes example from the worst medical insurance system among developed world (US), but isn’t US12,000 for just potential ability to visit hospital a lot more if you really decide to go waiting 4-5 hours to just get serviced is a little bit too much?

  3. CINICO, let me tell you about the conspiracy of that. I do not know who talks to who, but if you have cinico, that is where it is from the government from non paying civil servants to indigent persons. You need to watch carefully how you are attended to at the hospital. the first thing your doctor will be looking for or asking is how you are paying. When they notice on your file that you are non paying or indigent patient, you are not treated the same. They will give you pain killers, an blood pressure tablets of the lowest grade. They will give you a straight forward exray but not an ultra sound or catscan or MRI. Those things only paying customers are afforded those luxeries. Having CINICO and working for the government or indigent I say watch the service you are getting. A lady went to the hospital just the other day for surgery, she was sent away to Jamaica. I am sure after doing an exray they saw something. Today she has been told that she has cancer in high stage. If they would do pproper investigation they would find out your problem, but they are giving you exactly what you pay for NOTHING. Keep an eye on that hospital and what is happening. The government could’nt care less. You are not a paying customer but a CINICO liability.

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