Legislation for Health ServicesAuthority before Parliament
The Legislative Assembly is set to receiveLegislation to set up a Health Services Authority, and it is anticipatedthat the bill would be approved in time for the authority's plannedlaunch on 1 July 2002.
Minister responsible for Health Services,the Hon. Gilbert McLean, explains that the authority would preservethe quality of health care to which the people of the Cayman Islandsare accustomed. To do so, the current Health Services Departmentneeds to become self-sustaining, he maintains.
In achieving these goals the authority wouldtake over, own and operate all Government health care facilitiesin the Cayman Islands, says Mr. McLean. It would make recommendationsregarding health care services to Government and act upon directionsgiven under the law. He adds the authority would continue to providefree public health programmes, as well as health care for civilservants, the indigent and other persons as agreed by Government.
Mr. McLean acknowledges that establishingan authority would not solve all health-related problems; however,it would result in the transfer of more decision-making powerto health-care workers by changing organisational roles and depoliticisingthe management of health services. As such, the relationship betweenhealth services and Government would shift in specific areas,including the separation of providers (for example, the CaymanIslands Hospital) from regulators and payers.
Continuing to outline the major changes,the Minister notes that the proposed authority would functionas a business, with its own internal controls that include governanceby a board of directors. Similar to private-sector corporations,the board would be the ultimate decision-making body, reportingto the Minister of Health Services.
However, the authority would be subjectto review by the Internal Audit Department; furthermore, it wouldbe expected to meet annual performance goals, including financial,as agreed with the Governor-in-Council. Mr. McLean says that italso could be directed to pay a dividend to Government, unlesssuch direction would cause the authority to breach its duty tomaintain cash reserves.
When the bill becomes law, the authoritywould receive the balance of funds appropriated by Governmentfor the budget year that ends on 31 December 2002. Public servantshired under the Health Services Department would become employeesof the Health Services Authority, under the same terms and conditionsof their contracts on 30 June.
Remarking on the bill's scope, McLean asserts,"Dynamic changes in health care affect not only the CaymanIslands but all health-care systems worldwide, and it is prudentfor us to adapt to these advancements. The Health Services Authorityis therefore intended to establish a long-term, flexible frameworkthat provides the maximum benefit to the people, at the best possibleprice and highest standards of patient care."