CarePay trial: AIS contract was 'not going to be stopped,' says ex-medical chief

Police statement alleges ‘higher ups’ may be involved

The former medical director of the Cayman Islands Health Services Authority said Monday that he was “not comfortable” with either the CarePay patient swipe-card contract or a subsequent contract for a pharmaceutical tracking system being awarded to the local operator of a Jamaican-St. Lucian company, but admitted he did not formally object to either deal. 

With regard to both contracts going to AIS Cayman Ltd., Dr. Greg Hoeksema told jurors Monday that he felt it was already a done deal. 

“I knew this was a battle that I could not win,” Dr. Hoeksema said via a video-link teleconference from Washington state. “I could choose to die on this battlefield or I could choose to let it go and press on with the other issues of the day.” 

“This was not going to be stopped,” he added. 

Cayman Islands businessman Canover Watson, the former chairman of the Health Services Authority board of directors, is charged with six counts under the local anti-corruption law and common law that allege he and his business partner, Jeffrey Webb, ran a scheme to funnel payments from the HSA’s patient swipe-card contract – known as CarePay – to themselves via “sham” frontmen who ran AIS Cayman Ltd. 

Watson and his former personal assistant Miriam Rodriguez are also charged with transferring criminal property – certain proceeds from the hospital contracts – to Webb and others. Both defendants have pleaded not guilty to the charges. 

Dr. Hoeksema, an American military doctor who served as medical director of the HSA between 2007 and early 2012, testified Monday that although he signed the initial December 2010 contract for the CarePay swipe-card system, he was never comfortable with it. 

He told the jury that the entire process for the CarePay contract had played out “very differently” than a number of other contracts he had seen at the HSA, in particular with regard to the “direct way” Watson had become involved. Dr. Hoeksema said the hospital’s former chief of information technology, Dale Sanders, also shared some misgivings about the contract process for the CarePay card system. 

It was revealed during trial testimony Monday that both men told investigators with the Royal Cayman Islands Police Service in January and August 2015 their beliefs that government “higher ups,” including former Premier McKeeva Bush and former Health Minister Mark Scotland, were “caught up in this whole thing.” 

When asked about that police statement, Dr. Hoeksema told jurors: “In my notion of the fraud and corruption that might be occurring, it was difficult for me to appreciate that this was something that was just the workings of Mr. Watson. [I believed] that it went higher than that. But it’s also possible that Mr. Scotland had nothing to do with this and Mr. Watson was just feeding him information.” 

Dr. Hoeksema was asked what evidence he obtained that justified mentioning the name of McKeeva Bush in connection with this case. 

“I indicated I had no evidence and that it was entirely possible that Mr. Scotland and/or Mr. Bush had nothing to do with this.” 

Mr. Sanders made similar allegations, jurors heard, but he has yet to testify at Watson and Rodriguez’s trial. Neither Mr. Bush nor Mr. Scotland has been accused of any wrongdoing by police in connection with the CarePay case, and neither is slated to appear as a trial witness. 

Corruption concerns 

Deputy Director of Public Prosecutions Patrick Moran asked why Dr. Hoeksema, who was filling in for HSA chief executive Lizzette Yearwood at the time, signed the CarePay contract if he had such misgivings back in 2010. 

“I had nothing concrete that I could use to challenge the chairman of the board,” he said. “What am I going to say? ‘Gee, Mr. Watson, I smell a rat. I’m not signing this thing?’” 

Regarding the award of the pharmaceutical tracking system, Dr. Hoeksema said he and several other members of the HSA staff initially recommended in June 2011 that the bid go to American firm Cerner. 

It was Dr. Hoeksema’s recollection that during an HSA board meeting about the pharmacy contract bids, Watson became angry and insisted that no further hospital business would be conducted with Cerner. Dr. Hoeksema testified that a technical evaluation committee of which he was a member was “invited” to re-examine the bids from Cerner and AIS. 

Dr. Hoeksema further testified that Watson did not issue a formal written order from the HSA board excluding Cerner’s bid for the pharmaceutical system because that would have been improper. However, he said, it was clear Watson sought to eliminate the American firm from the bidding process. 

Watson’s attorney, Trevor Burke, QC, also questioned why Dr. Hoeksema signed the initial contract for the CarePay system if he had such concerns about it. Dr. Hoeksema said he raised those concerns with both Mr. Sanders and HSA chief executive Ms. Yearwood. 

“You told the HSA CEO, Ms. Yearwood, who is still in place, that you believed this contract was corrupt prior to you leaving this island in Jan. 2012?” Mr. Burke asked. 

“I don’t think I used the word corrupt,” Dr. Hoeksema said. “Something didn’t feel right. I didn’t understand why Watson was handling this thing by himself … I was uncomfortable with what went on with the [March 2011] meeting in Jamaica with Mr. [Douglas] Halsall [the owner of AIS Jamaica] … over the course of time, I did express those opinions.” 

During the meeting in Jamaica he referenced, Dr. Hoeksema said that Mr. Halsall had offered to bring the American doctor and his family for a visit, when he would host them on his boat. 

“We are dealing with people who, perhaps, play by a different set of business rules than I’m used to,” Dr. Hoeksema said. “I just wasn’t comfortable with it.” 

Mr. Halsall is not charged with any crimes in Cayman and is not a witness in the CarePay trial. 

Pharmacy contract  

Mr. Burke read in court a resolution by the HSA board of directors from April 2011 that indicated by “unanimous decision” it had been agreed not to do any further business with Cerner. Mr. Burke said this directive had been issued prior to the decision to recommend Cerner for the pharmaceutical contract. 

“[The decision to recommend Cerner] only delayed the process,” he said. 

Mr. Burke also noted that both Dr. Hoeksema and Mr. Sanders were not successful in attempts to renew their contracts with the HSA during 2012, hiring decisions that were made during Watson’s tenure as chairman of the HSA board. Mr. Burke asked Dr. Hoeksema if he and Mr. Sanders had spoken prior to this trial. Dr. Hoeksema said they had spoken about a month before, but that they did not discuss their respective testimony. 

“If there is a striking similarity between your testimony and his, that is entirely accident?” Mr. Burke asked Dr. Hoeksema. 

Dr. Hoeksema replied that this was not necessarily by accident as the two men had discussed issues at the HSA many times during the years they were employed with the agency. 

Dr. Greg Hoeksema

Dr. Greg Hoeksema