Two years on, Health City Cayman Islands fails to meet objectives and is raising government concerns on unfair competition. The initial project was designed to attract medical tourism to the area however so far has failed to attract the estimated numbers.
Two years since opening Health City Cayman Islands has failed to attract the number of medical tourists it was aiming for and the government has raised questions over competition issues..
The hospital founded by Dr Devi Shetty has attracted a fraction of the numbers of patients predicted, and has been criticised for competing unfairly with existing health care providers because of the massive concessions package it received under the deal signed with the former government.
The number of medical tourists has been in the hundreds not the thousands predicted. In its first year the hospital was projected to attract more than 17,000 overseas patients, while the real figure is way under 1,000 and year two looks only marginally better.
The Public Accounts Committee and health ministry are concerned that no one has been monitoring the extensive package that it received because of the projections made for many thousands of medical tourists every year.
According to the Memorandum of Understanding signed between Health City and the Cayman Islands in 2010, Health City received a duty concession for 50 years on all medical supplies and equipment; there is no limit on the number of work permits issued to Health City, and a five-year exclusivity from competition on medical tourism in the Cayman Islands. Health City does not have to comply with the medical licensing requirements that all others have to obey.
Under the MOU with the Cayman Islands, Health City was expected to inject $200 million into the local economy during the first phase with a further $1.2 billion over the first 15 years. It was also anticipated to create 2,300 new jobs by 2024.
Health City is offering more than the tertiary care it was originally intended to provide to local patients in an effort to keep the expensive facility afloat. It is offering executive health checks and delivering primary and secondary care to local patients, giving the hospital an unfair advantage in the competition with other facilities.
Given the massive economic and permit concessions, as well as the waivers over doctors’ standards and registration, authorities feel it is competing unfairly with established local hospitals that not only had no concessions but are barred from competing with it for medical tourists, for five years.
The Health Services Authority is worried that instead of encouraging medical tourism, it is preventing it. Not only are existing facilities banned from competing with it, but also no new clinic or hospital can be built that accepts any medical tourists.
The Health Services Authority director, Delroy Jefferson, is concerned that the agreement with Health City lacks any framework surrounding the governance of medical tourism, including issues such as quality control and doctors’ standards. He warns that local health care professionals and students training at the Shetty hospital will not be able to practise anywhere else in Cayman because medical staff at Health City do not meet the medical council’s standards for licensing.
Jefferson says, “The initial intent was for Health City to be a tertiary healthcare provider for services not already available in the Cayman Islands. Their primary market was to be North America and Caribbean region. The expressed intent was that it would not be a competitor to the local market, and as such they would not provide primary and secondary care that is already provided by the HSA or local marketplace. To make Health City viable and sustainable, more and more services in the primary and secondary care are being provided by Health City, in direct competition with HSA.”
Jefferson wants to encourage medical tourism but argues for a governance structure and framework, along with a regulatory body to ensure adequate oversight to monitor quality control and what is going on “Cayman created a situation where the goalposts were being moved as things went along instead of developing medical tourism against a sound structure to begin with. The medical tourism facility is unable to deliver what was agreed because of the overstatement of numbers. Instead of medical tourism, Health City is competing with local hospitals-unfairly as they have benefits other hospitals and healthcare providers are not getting.”
Jefferson has reviewed the Shetty agreement with government and although both have genuine concerns over the concessions and the period of time over which they have been given, the contracts mean there is nothing they can do without a legal battle that neither party will pursue.
The Health Services Authority has changed the rules to help both local patients and Health City but has serious concerns that it is now treating local patients for things that other local hospitals can, to help it stay open.
It has enabled the government to reduce by a few hundred the number of local patients going overseas for treatment, cutting costs and inconvenience for patients, the anticipated inflow expected from medical tourism has simply not happened.