Editorial for 02 July: Clear the air on emergency services

It’s the one flight no one wants to take.
Being airlifted off our islands for a medical emergency in an air ambulance is
fraught with anxiety, uncertainty and considerable expense.

While local hospitals and medical
practitioners can address most routine and even serious medical matters, truly
life-threatening instances require efficient evacuations – usually to medical
centres in South Florida, Houston or Kingston.

These emergency evacuations are fairly
commonplace. In the financial year 2012, for example, the country’s public
sector medical insurer CINICO paid out slightly more than $800,000 for 71
emergency evacuations. Hopefully, once Dr. Devi Shetty’s Health City Cayman
Islands becomes operational in February 2014, many of these serious incidents
will be able to be treated locally.

Not surprisingly, based on a recent report
by Auditor General Alastair Swarbrick, it is not just the patients who are at
risk in these medical emergencies. The government itself – because of lax or
lacking regulation of air ambulance services – is vulnerable to potential

Mr. Swarbrick writes: “The operations
relating to the provision, costs and oversight of the air ambulance services
have not been managed effectively, resulting in uncertain value for money for
services solicited through the air ambulance broker. Furthermore, we believe
that the practice of utilising the services of a non-contracted air ambulance
broker, if continued, represents an unmanaged risk to the government in the
event of a catastrophic incident because of a lack of prudent management of
public resources.”

Effectively, there are few rules,
regulations or laws governing the use of air ambulances in the Cayman Islands,
and Cayman history is replete with would-be service providers encountering
politically based opposition to their bringing competition into the

Mr. Swarbrick is correct in sounding the
alarm and trying to sort out this mess. He cites the role of CINICO, which is
ultimately responsible for the provision, cost and oversight of ambulance
services and the Health Services Administration, which is responsible for
passing on the paperwork and medical notes to the service providers.

The auditor general took further issue with
the Health Services Authority’s role in the process:

“We expected to find current and clear
procedures for how the referral’s office of the authority initiates the process
of air ambulance procurement. What we found was a collection of undated procedures
that are not consistently followed.”

(It is worrying that our journalist was
ignored by top officials at both CINICO and the HSA when contacted about the
story that ran in Friday’s Caymanian Compass.)

While Mr. Swarbrick’s interest,
understandably, is immunising government from expensive litigation and
potentially substantial judgments, Cayman residents have a more personal and
practical interest in the matter: They need assurance that soon after they
place the 911 call, their lives, or those of their loved ones, will be in the
hands of experienced, licensed and professional practitioners.