CarePay trial: 'Everyone' supported CarePay system, claims defense

QC says former minister authorized extra $2 million spending

Fearing they would be caught up in a sweeping corruption investigation, a number of government officials involved in the award and implementation of the CarePay hospital swipe-card contract sought to blame former Health Services Authority board chairman Canover Watson for what occurred, defense attorneys alleged Friday in opening speeches at Watson’s criminal trial. 

Watson, 45, is accused in six counts alleging he and former personal assistant Miriam Rodriguez conspired – along with Caymanian businessman Jeffrey Webb and unidentified “others” – in a scheme prosecutors said defrauded both the Health Services Authority and the Cayman Islands National Insurance Company of more than US$3 million over the course of three years. Watson himself is alleged to have personally benefitted to the tune of at least US$348,000, according to the charges. 

Watson’s attorney, Trevor Burke, QC, appeared particularly disturbed that even Crown prosecutors could not identify who “the others” in the CarePay investigation might be at this stage, although he said they appeared content to “get a lot of free kicks” at Webb who wasn’t there to defend himself. Webb is facing criminal charges in connection with an unrelated matter in the U.S. and is not being tried in this case. 

Nonetheless, Mr. Burke stated that “every prosecution witness” jurors will hear from during what’s expected to be a two-month trial “absolutely endorsed” Advanced Integrated Systems [AIS] of Jamaica and its owner, Douglas Halsall, for the implementation of the CarePay swipe-card project. Former Health Minister Mark Scotland – who is not on the witness list – secured an additional $2 million in funding for the expansion of the swipe-card project to private sector insurers, attorneys said. 

“There was no more enthusiastic supporter of AIS than … the minister responsible,” Mr. Burke said. 

When things started to fall apart on the CarePay deal in 2012, Mr. Burke said those supporters backed away. 

“Everybody tried to distance themselves from the decision they had so willingly made,” Mr. Burke said. “Everybody tried to minimize their own involvement and shove the blame up the line to the [Health Services Authority Board] chairman [Watson]. “Some of them were under suspicion themselves at the time, and may still be.” 

The lead defense counsel, instructed by local attorney Ben Tonner, also lamented that not only Webb, but Mr. Halsall would not be appearing in the case to testify, though they were clearly involved in the AIS Jamaica, AIS Cayman Ltd. [the Jamaican company’s local partner] and the CarePay system. 

Mr. Burke said Watson would testify in his own defense during the course of the trial. 


By way of background, Mr. Burke raised the specter of the previous criminal allegations against West Bay MLA McKeeva Bush during his opening speech. 

Mr. Burke said the May 2013 general elections took place “against the backdrop” of Mr. Bush’s “personal problems” – referring to a pending criminal trial in which the former premier was accused of using a government credit card to get cash for gambling. Mr. Bush was eventually acquitted of all charges in 2014. 

Following the elections, the new Progressives-led government appointed new Minister Marco Archer – also a witness in the CarePay trial – who raised questions about the swipe-card contract, who Douglas Halsall was and what his relationship was with others in the islands. 

However, prior to the election, defense attorneys said it appeared that the CarePay project had 100 percent political support. 

‘Enormous’ problems  

Watson, who was initially appointed to the Health Services Authority board in 2008 and who took over as chairman in 2010, encountered “enormous problems” when he arrived at the health authority, attorneys said. 

In 2008, the authority was losing about $7 million per year, largely due to a poor business structure and bad decision making, Mr. Burke said. By mid-2010, with Watson running the board’s finance committee, the authority was making a profit, he said. 

The CarePay system was brought in and supported by Watson as a way to identify Cayman Islands National Insurance Company patients in real time and charge their hospital bills immediately. The system was supposed to speed up patient processing and at least partly eliminate “bad debt” [long-term unpaid bills], of which the hospital had about $55 million at the time. 

Prosecutors said the CarePay system did neither of those things and ended up being abandoned by the hospital system last year. The bad debt total is expected to grow to some $80 million by the end of the next government budget year. 

However, Mr. Burke sought to blame that failure on former hospital system contractors Cerner [*] and CBCA, which he said were reluctant to provide patient data from the Health Services Authority, knowing it would mean the end of their contracts. Mr. Burke accused the American firms of “raping” the Cayman Islands for profits over a period of about a decade. There was also a distinct lack of cooperation from CINICO with AIS Jamaica officials, he alleged. 

These difficulties led to delays in implementation that lasted for more than a year and eventually scuttled government plans to expand the CarePay swipe-card system to the private sector, Mr. Burke said. In addition, a recession hit the Cayman Islands hard from 2008-2010, cutting available government funds in the process. 

“It all became a mess,” he said. “Then there’s a change in government, a big investigation and the whole thing collapses. That, in a nutshell, is the sorry tale of what went wrong.”

{*] Editor’s note: Corrects company name referred to in the opening speeches.