It is a shocking affair when our own government, or should I say, our own Civil Service cannot manage its own health care system.

Auditor General Sue Winspear made this statement in her report ”Cayman Islands Health System”.

“The government does not have the resources or the information required to manage the health system effectively, and neither the Legislative Assembly nor the public can be confident that high quality healthcare is being delivered, or value for money being achieved,” she said. “The performance of the Cayman Islands health system is not known and accountability to the Legislative Assembly and the public cannot be rendered,”

Even when data is collected and there for use it is not.

“And, except in the case of public health surveillance, relatively little performance-based information is sought from, or provided by, the private sector.”

If the government workers do not ask the private sector for it they are hardly going to provide it. And “Even when data is collected and there for use it is not” speaks for itself.

The Cayman Islands uses a “hybrid” care model where public health, school health services, ambulances, district clinics and indigent care are delivered by the Health Services Authority (HSA).

Direct healthcare services, those provided by public and private healthcare providers are paid by insurance companies or directly by the person having the care. Much of this information does not get into the computer.

So are we a healthy country?

It would appear that Caymanians are not as healthy as non- Caymanians. That is not surprising as the expat work force have to provide medical evidence with their work permit applications they are fit and healthy and their stay here is mainly limited.

So the real answer is – we don’t know.

There is also a serious shortcoming in inspections of the premises used by healthcare providers. The Health Insurance Commission has the same number of inspectors as it had when it began operations in 2004, Three!

There are currently no legislated regulations in Cayman for pharmacies.

Although there is a standard of practice developed by the local Pharmacy Council in 2010, it is entirely voluntary.

As for drugs, “There are no shared pharmacy information systems to ensure that patients are not receiving multiple prescriptions from different physicians and obtaining the drugs from multiple pharmacies,” the auditor’s public interest body found.

How much we spend on healthcare?

The report found that the average person annual spend EACH on healthcare in the Cayman islands during 2015 was approx. $4,454. In 2010/11 it was $3,857.

To quantify it. The private sector’s share of the estimated $269 million in healthcare expenditures during 2015 was approx. $131.2 million. Increased from $95.7 million from 2010/11.

Either the cost of healthcare has gone up or we are steadily becoming more sick.

Appallingly, we just don’t know and the government cannot help us with the answer.