Cayman’s Public Health department will be separating from the Health Services Authority, to become an independent body, Minister of Health Sabrina Turner has announced.
Turner, speaking at a press briefing on Wednesday morning, 31 Aug., said Cabinet had approved “in principle” for her ministry to develop a business case to reform Public Health, which currently falls under the umbrella of the HSA. Those reforms would include Public Health becoming a separate entity, she said.
The minister said that, while the COVID-19 pandemic had highlighted a need for Public Health to be independent from the HSA – which is one of the government’s statutory authorities and also a health service provider which runs the Cayman Islands Hospital and district health clinics – there had been reports dating back to 2008 supporting such a move.
Asked why is was necessary to separate the Public Health department, interim Chief Medical Officer Dr. Autilia Newton said that the main reason was because, as the HSA is a service provider, this means that most of the information gathered by Public Health is directly from that body.
“The issue is that you have your Public Health team sitting with a health service provider, and so the collection of information is limited to the population which accesses that provider. What we need for Public Health to work is to have it outside of all providers, and getting the information from everyone,” she said.
She added, “If you look around the world, Public Health works at its best when it is independent.”
Both she and Turner highlighted the importance of collecting and accessing data on a wide variety of diseases and conditions among Cayman’s population, so as to form appropriate policies and responses.
While the 2021 Census included some questions on health matters, such as disabilities and diabetes, that shed light on their prevalence, and the HSA gathers statistics on the cases that its physicians see, the collection of data on most conditions and diseases locally is not very comprehensive as it often does not include statistics from private sector health providers.
In a bid to address this, the health officials at the media briefing said the Ministry of Health has hired epidemiologist Rachel Corbett, who led the UK’s international travel risk assessment team which helped form government policy on travelling during the pandemic.
Corbett said at the briefing that there are plans to expand the collection of data on a variety of health issues, including hypertension, diabetes, obesity, chronic heart disease and others, to determine the prevalence and formulate responses to reduce it.
Key indicators of health
She said that next year, there would be a repeat of a Cayman-wide survey, called STEPS, which in 2012 gave a detailed insight into key indicators of health on the islands. These included information on tobacco use, alcohol consumption, diet, physical activity, history of raised blood glucose, history of raised blood pressure, history of raised total cholesterol, lifestyle advice, family history of non-communicable diseases and health screening.
Corbett said this survey would not only give Public Health a snapshot of the current state of health and certain habits in Cayman, but would also compare the situation to a decade ago.
Turner noted that Public Health’s role extends “far, far beyond” the prevention of the spread of diseases like COVID, flu and monkeypox. She said the department is also concerned with being proactive about preventing non-communicable diseases – such as heart disease, cancer and diabetes – and part of tackling such diseases was having access to accurate data about their prevalence.
While certain communicable diseases, like dengue, COVID or monkeypox, are considered ‘notifiable’, in that a physician or laboratory is obliged to report any cases they encounter to Public Health, there is no mandate for the medical community to report non-communicable diseases. In Cayman, for example, there is a cancer registry that tracks the prevalence of various cancers, but it is voluntary.
Newton said the planned enhanced tracking of conditions and diseases in Cayman would be done on a district-by-district basis and would be fully anonymised, stating that reports on individual patients would not be required.
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