By now, the troubles of the Health Services Authority are well-documented and well-known. Everyone in the Cayman Islands is aware that years of mismanagement at HSA have resulted in uncollected debts, cash shortfalls and other problematic “symptoms” about which we editorialized just last week.
We see two potential courses of treatment for the HSA. The more radical prescription would be to get government out of the business of delivering healthcare, and to devolve that function to the private sector. (Under that model, the public sector would retain the responsibility for ensuring everyone has access to quality healthcare, but the services would be delivered by private physicians and healthcare professionals.)
We don’t sense that the political will exists for that particular solution, at least for the time being.
That leaves the second option: Uniting as a country behind our public healthcare system and working together to ensure that it produces satisfactory patient outcomes without bankrupting the treasury.
Earlier this month, HSA leaders were brought before the Legislative Assembly’s Public Accounts Committee to face tough questions from PAC members, particularly MLA Chris Saunders. At a follow-up hearing this past week, HSA leaders — including CEO Lizzette Yearwood and board chairman Jonathan Tibbetts — demonstrated evidence of a willingness to make necessary changes, and provided positive updates on stepped-up bill collection efforts and moves to write off some of the “bad debt” that has been plaguing the agency’s balance sheets.
Healthcare officials also described policy and procedural changes designed to forestall future financial issues.
Mr. Saunders and the PAC may have done Cayman a good service by highlighting problematic practices at the HSA and demanding straight answers from those in charge. But now, the treatment should be given the opportunity to take effect.
It is neither reasonable nor helpful to attempt to make “political hay” out of the HSA’s historical shortcomings for personal gain.
And it appears, at least to us, that is precisely what Mr. Saunders did last week when he took a “second bite” out of the HSA. Of particular concern is his questioning of the professional credentials of individual HSA officials, most notably the entity’s chief financial officer.
Either intentionally or out of ignorance, Mr. Saunders misrepresented the qualifications of CFO Heather Boothe, disputing her accounting pedigree and stating that she was appointed after a brief consultancy. (Ms. Boothe has a degree in economics and management, and possesses the relevant professional accounting certifications. She was initially hired as a finance officer, and then years later was promoted to CFO following a formal interview process.)
If those “misstatements” weren’t enough, Mr. Saunders went on to label her as the dependent wife of a doctor at the hospital, who had been in the home for two years before going to work for the health authority, and then – as a matter of course – speculated on the ubiquitous but elusive “qualified Caymanians” who could have gotten the job instead.
Mr. Saunders’ statements were misleading at best, and they smack of sexism and nativism. For a sitting MLA, that sort of language is ungentlemanly, unworthy and unfair.
Perhaps the freshman lawmaker requires a reminder from his more veteran colleagues that there is a clear line separating MLAs from the civil service. Decisions on human resources and the particulars of individual employees are well outside the remit of legislators – and, as we can see, for good reason.
In the future, Mr. Saunders should keep his focus on shaping policies, rather than playing politics, and should refrain from making personal attacks on individuals who do not enjoy access to an equivalent public platform or parliamentary protections – particularly when he’s in error.