I am not surprised the Ministry of Health, the Health Services Authority (HSA) and the Cayman Islands National Insurance Company (CINICO) have issued a joint statement in response to the Auditor General’s Public Interest Report on the Provision of Air Ambulance Services.

When I read the Auditor General’s report it was the first time I have not 100% agreed with him. This is probably because I view the air ambulance service with compassion and not as a cold accountancy issue.

The joint statement is absolutely correct when it says they “would like to stress that their chief concern is the well-being of any persons who may require an emergency air evacuation (EAE). It has been our experience that depending on a patient’s unique needs, the most cost-effective solution is not always what is required in each case.”

I also can concur on personal experiences with their next statement:

“While our system is not without flaws, which we are determined to address, its effectiveness has also been repeatedly proven.”

The proof is in the eating and the local broker that has been providing air ambulance service, and came in for criticism from the Auditor General, has had an exemplary record for twenty plus years. The joint statement also confirms this.

In the number of instances I have witnessed and/or had family using the local broker it has been executed with not only efficiency but with compassion. In fact the agency has always gone well beyond the normal because they normally know the persons involved. You cannot put a price on that.

The joint statement further says:

“There are a number of reasons why there is presently no contract in place with the air ambulance broker.

1.     There is only one licensed air ambulance broker in the Cayman Islands.

2.     The broker currently charges no direct fees to CINICO for the limited services they provide.

3.     To facilitate a contract with any broker could possibly expose CINICO to even greater risk in a situation whereby,

a.     it is limited to the use of that particular broker,

b.     it is limited to that particular brokers’ air ambulance provider(s),

c.      the limited choice may fail to meet the needs of a peculiar case,

d.     the limited choice exposes CINICO to price gouging and no real value.

“The fees earned by the broker are not directly paid by CINICO, but through a commission from the individual air ambulance companies, and the prices of EAE (emergency air evacuation) services show no material variance to those procured by either CMN (Canadian Medical Network) or the broker.

“The broker in question possesses a Trade and Business License (TBL) for an Air Ambulance Broker. We are unaware of any other category of TBL required to provide such services.

“The “ground handler” license is a requirement of the CIAA (Cayman Islands Airports Authority) for the provision of services related to the handling of commercial aircraft.”

Yes I do have anxiety since reading the Auditor General’s report. We never know when we have to be air ambulanced off. The one area that has worked efficiently has been the air ambulance service currently being executed and the superb service from the current broker.

I hope this will not be changed through a pure accountancy perspective that with the so called tighter controls could result in lives being lost by the increase in paperwork. With increases in paperwork it is my experience there is a cost attached to every bit of it. Time is money. The tighter controls the Auditor General wants could in fact cost more.

And then there is the question of how much a life is worth?

To view the whole joint statement please go to iNews Cayman story published July 30^th 2013 “MoH, HSA & CINICO joint statement on air ambulance services” at: http://www.ieyenews.com/2013/07/moh-hsa-cinico-joint-statement-on-air-ambulance-services/