Public Health, HSA work toward ‘historic split’

Plans to separate the Public Health Department from the Health Services Authority to create an independent entity are now moving ahead, Health Minister Sabrina Turner has said.

However, the process will take some time.

“An exercise of that magnitude has never, ever been done in the history of the Cayman Islands because where Public Health sits right now it’s housed under a statutory authority,” she told the Cayman Compass in a recent interview, as she provided an update on plans for the transition, which was announced in 2022.

Turner said the strategic business case to reform Public Health, which falls under the HSA, is in final draft which will outline the process and the recommendations for the separation.

“I should be getting a presentation on what that looks like,” she said, adding she understands that the financial implications and all the “minor details” are actually in the now-completed document.

Law changes

In working on the business case it was determined that an accompanying legislative framework is needed to be able to execute the changes, Turner said.

“Because how the law is written it has [Public Health] housed under its current construct. So priority was given as well [to that],” she said, explaining that the Public Health Act is being reviewed as the process of the separation evolves.

That work, she said, is happening in tandem with the formulation of the business case.

As a former nurse, Turner said Public Health is “near and dear” to her, and being able to move forward with reforms to enhance the delivery of healthcare is a priority.

When the proposed separation was announced, the main reason given at the time was the fact that the HSA is a service provider, which meant that most of the information gathered by Public Health is directly from that body.

Data driven

“I am separating Public Health and bringing it back into core government as a standalone department so that it can be more autonomous, more independent, not housed under a competing authority… [W]e’re looking at moving forward from a data-driven approach,” the minister said.

Consideration will also need to be given to legislation that touches on public health like the Tobacco Act and the Misuse of Drugs Act, Turner said.

Just looking at doing an entire piece of legislation in its totality, said, is “why we have gotten nowhere with keeping up to speed with our legislation and anything that is going to be too controversial, but brings us forward, moves us forward in modernizing what legislation should be.”

However, it is a matter of “small bites” she said, which is the approach she has taken.

“But that is largely based on the pace and the delivery of my ministerial team,’ she added.

Turner also pointed out that even the Department of Environmental Health is housed under the same Public Health Act and that entity also needs its own legislation.

“We are actually playing catch-up at the Ministry of Health,” she said, adding that apart from there not being continuity of ministers of health to move the reform process forward, there was also an issue of resources.

One of the biggest hindrances was “we lacked the manpower, the right skill set in order to be able to deliver at pace”, she said, however now she said there is now Chief Officer in place with that skill set.

“Now I’m just waiting for the results,” she said.