Health Minister Osbourne Bodden has acknowledged that waiting times for obstetric services at the Cayman Islands Hospital is longer than ideal, with patients waiting about two weeks for appointments.
In cases where a pregnant patient requests a specific doctor, the waiting time can be up to eight weeks, Mr. Bodden said in a statement released Monday.
“The HSA acknowledges that the waiting periods for specialist services are generally longer than it would like,” he said.
Mr. Bodden made the comments in response to concerns raised by North Side independent MLA Ezzard Miller in the Legislative Assembly last month about long waiting times for obstetric care at the public hospital.
The minister said the hospital had taken measures to reduce wait times, including putting on extra clinics and staff.
The issue of accessibility to obstetric care in the Cayman Islands was highlighted recently following the closure of the Chrissie Tomlinson Memorial Hospital’s maternity ward in December last year. The private hospital handled 120-130 births a year, leaving the Health Services Authority’s Cayman Islands Hospital to absorb an increased demand for obstetrical care.
Another issue leading to increased demand for obstetric doctors in the public sector is that private obstetricians are being priced out of the OB-GYN field due to huge hikes in malpractice insurance premiums. This year, the private practitioners face an increase of $100,640 in annual premiums, bringing their yearly malpractice insurance fees up to $292,255. Some private obstetricians reported that they may stop delivering babies locally due to these soaring rates.
The Health Services Authority would also be responsible for providing additional antenatal, prenatal, and postnatal care if the numbers of private obstetricans continue to drop.
The Cayman Islands Hospital is staffed by three consultant OB-GYNs, two OB-GYN registrars, and 22 midwives.
Mr. Bodden admits that the high volume of patients has led to increased waiting periods, saying, “The volume of persons seeking care still drives long waits.”
He explained, “The waiting period for obstetric and gynecological services is approximately two weeks. If a particular physician is requested, the waiting time may be six to eight weeks, although most physicians will see extra patients in clinic, if the need is confirmed by the midwife.”
Health Services Authority CEO Lizzette Yearwood said the hospital’s OB-GYN Department is currently looking at the entire service “to create greater efficiency.”
“Changes may include the clinic schedule, the shared care distribution and the appointment system. When the assessment is complete, any changes made will be publicized,” she said.
However, she admitted that as the Cayman Islands Hospital was the provider of OB-GYN care for the majority of patients who needed that service in the Cayman Islands, the hospital expected to be “challenged in perpetuity by this issue and the expectations of our community.”
She added that each specialty is reviewing their workload and adding clinics as needed. “Some clinics will be continued for the foreseeable future, others will be temporary additions to address demand,” she said.
Currently, the Health Services Authority holds 15 physician clinics a week, with each scheduled for four hours, though they generally run for five to six hours, Mr. Bodden said. The clinics run every day, except surgery days on Monday and Thursday, he said, and noted that an OB-GYN is on call every day. He added that there is no waiting time for midwife clinics, which offer antenatal care, family planning and postnatal care.
He pointed out that in the case of emergencies, such as miscarriages, patients are directed to the emergency room.
He added, “On behalf of the [Health Services Authority], I apologize for any inconvenience experienced by its patients. The Authority strives daily to improve customer care and service, and will do whatever is necessary to achieve continued improvements.”
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Curious about the ‘insurance hike’ mentioned?
If I recall, there was legislation passed as in consultation with Dr Shetty as part of the Health City development, which put a ceiling on the payouts in the event of claims. It was precisely because of soaring medical insurance rates that this safeguard was needed.
If that’s the case, was the OB-GYN sector somehow exempted, OR, are the insurance companies just using USA risk tables and (accidentally or deliberately) failing to factor in this legislation when calculating their liabilities and therefore the premiums charged?
This would surely be something for the Minister to question the insurance companies about – Cayman is a small market and there is a lack of competition but even so, the cap on payouts should mean the costs here should be well below corresponding premiums in the USA!
Mayhaps as a foreigner I don’t understand certain particularities of ultra-peripheral territories, but being the Cayman Islands is a United Kingdom territory, I can’t but wonder on why (oh, why!) the worst (period) health-care system in the world is imitated here, with the dismal outcomes everybody knows about.
Because, as far as I know, this is not how medical affairs, whether physician or patient-related, work in the UK territories in the European continent.
In where they already use the metric system either, Alas.