Overhaul of health system for seamen, indigents planned

Following a highly critical report from the Office of the Auditor General last year and more criticism this year from some members of the Legislative Assembly, government plans to overhaul the system of benefits and healthcare for seamen and veterans and medical care for indigents.

The Ministry of Community Affairs plans to put together an outline business case to evaluate the current programs and create a new government-wide policy for the social assistance programs.

In its advertisement for a consultant to prepare the outline business case, the ministry did not include other social assistance programs like welfare payments and housing vouchers that were also criticized in the audit report.

The report, released a year ago by then-Auditor General Alastair Swarbrick, criticized government’s social assistance programs as disorganized and with little oversight and no accountability. In some cases, the audit found, people received government assistance “on the basis of political direction.”

The audit report states, “there is no overall strategy that sets out the results being sought and the priorities to be pursued with the more than $50 million of public funds appropriated to social assistance programmes.”

The Legislative Assembly’s Public Accounts Committee reviewed the auditor’s findings and called for a “major overhaul” of the way social assistance programs are run.

“The PAC is particularly concerned that the emphasis by the ministry seems to be concentrating on the perceived need for substantial, (almost double) additions to staff compliment as a way to deliver services more efficiently and effectively,” Mr. Miller told the Legislative Assembly, tabling the committee’s report last month.

“The PAC would like to suggest that a major overhaul of the procedures and policies, to devolve authority and reduce the bureaucratic duplication that was clearly demonstrated in the public hearings may be a better use of government resources,” Mr. Miller said, reading from the report to the House.

The report covers the full suite of Cayman’s social assistance programs in the 2013-14 budget year, citing more than $51 million in spending on the programs. The outline business case will look at expenses on medical care for indigents, seamen and veterans, almost $35 million that year, and benefit payments to seamen and veterans, more than $6.5 million in that budget cycle.

Those numbers have continued to go up in the intervening years, with almost $80 million slated for social services over the next 18 months and other increases to healthcare for retired seamen, veterans and for people who cannot afford insurance or treatment.

The outline business case is due to Cabinet in November.