(CMR) The pressure is on the coalition government to explain why proposed legislative changes to the Health Practice Law are being pushed through that would directly benefit only Health City Cayman Islands (HC) – the island's sole registered institutional provider.
Several areas of the new bill are extremely controversial including what appears to be an indemnity clause that purports to remove any and all liability for institutional registered professionals for negligence. On first reading, most have interpreted that to read that Health City cannot be sued and there is a serious question about whether or not it's also retroactive.
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Opposers to this section are asking why would the Health Services Authority law be changed in 2017 to remove a blanket government indemnity clause but now reintroduced to benefit Health City. One observer shared that the wording was almost verbatim to the repealed clause.
MLA Ezzard Miller of North Side noted he heard the minister shared, during his tabling of the bill, that any pending lawsuits at HC would have to stop if this bill is successfully passed.
The indemnity clause was not the only controversial component of the bill. The bill also sought to have the Chief Medical Officer, currently Dr. John Lee, sit as a voting member of the Medical and Dental Commission (MDC) as well as the Health Practice Commission (HPC). Practitioners shared this was a clear conflict and noted:
The Ministry of Health also needs to be reminded that as a statutory body the MDC with all legal authority to discharge its functions under the Health Practice Law when applying the ruling by AG C.J. Hercules in Ebanks v. Central Planning Authority (August 1982) which stated that government:
“must act on matters coming before it independently of advice or comment from any other body or authority. Any decision made by this body must be its own independent decision uninfluenced by any outside influence whatsoever. There can be no abdication of its authority. If outside influences are brought to bear upon any of its deliberations, then any decision arrived at in such circumstances would certainly not be in keeping with what must have been the spirit and intendment of the legislature, and would be a travesty of justice. This august body, like any similar body performing a judicial or quasi-judicial function must carry out its function by conferring only amongst its members and making decisions without external influence or pressure. The decision must be the authority’s decision. Anything done to the contrary is to my mind illegal and cannot be sustained”.
Opposers shared that undue influence by the Ministry of Health in the decisions of the MDC should be considered corruption. The outcry was so loud regarding this element of the bill that the minister withdrew the proposed clause 7 at the committee stage of the bill.
A number of medical professionals first contacted CMR regarding their concerns about this proposed bill in early January. They have also reached out to elected officials and the governor with their numerous concerns. The bill was placed on the floor of the Legislative Assembly yesterday for debate. The debate started in earnest yesterday in the Legislative Assembly when the Minister of Health Honourable Dwayne Seymour shared …
However, a strong number of elected officials appear to not be in favor of the amendments which they shared are designed solely to benefit Health City; which they say is completely unacceptable. In fact, an exclusive legislative source shared that a member of the government privately indicated their intention to appeal to the government to withdraw the bill entirely.
In opposition to the bill, MLA Miller indicated that numerous medical professionals contacted him including “an invitation to lunch by Health City.” That representative indicated that they only part of the law they wanted to be amended was the removal of the cap of six years on their doctors. He shared:
“And I was quite straight forward with the gentlemen and said well you know I am not going to support that because that cap was introduced during the debate trying to reduce my argument against institutional professionals and it was claimed they would not be working on Caymanians so it was ok for them not be licensed to the same high quality as Cayman doctors and people with general registration had to achieve.”
According to Miller that Health City representative as unaware of any other proposed changes to the bill specifically the clauses relating to indemnity etc.
Miller recalled his opposition to the introduction of institutional registration back in 2013 which at the time he referred to as “barn door”. Reconfirming his concerns at the time he noted that Cayman was:
“Setting up a separate system of health care professionals who could not qualify under the high standards required for Caymanians which this country has developed for some 39 years.”
Miller stressed that “what we are doing here today is not just for eight doctors” this is for all health care professionals registered at that institution which includes nurses, pharmacists, radiographers, and lab technicians.
Whilst Miller admitted that he had concerns about other proposed amendments in the bill the “subtle, little amendment” to remove the current cap of six years was the “most dangerous thing to the Cayman healthcare professionals.” He went on to share that he had not encountered a single health care professional who supported the legislation and he would be interested to see the minister table support for the legislation from the various medical boards.
Miller indicated that his real concern with this section of the amendment is now opening it up to unlimited renewal will allow Health City workers to eventually apply for permanent residency after the nine-year mark – eventually positioning them to unfairly compete with Caymanian health practitioners after having come to the Cayman Islands via a substandard registration process.
Medical professionals are also in strong opposition with Dr. Sanjib Mohanty sending correspondence to both the Governor and Premier Alden McLaughlin. The Governor informed him that this does not fall under his remit and he would contact the Minister to respond to his concerns directly. However, to date, no response has been forthcoming.
UPDATE: The bill was approved with some amendments. CMR will be following up this story about the amendments made to the bill.