OAG DISAPPOINTED IN PACE OF HEALTHCARE AND WELFARE REFORMS

By Staff Writer

The Cayman Islands Office of the Auditor-General(OAG) has lamented a government's failure to act on recommendations to improve the healthcare system and welfare programmes.

In its newly-published report, ‘Follow-up on past PAC recommendations 2021 – Report 1’, the OAG said there's only been limited progress in implementing not just its recommendations but also those coming out of hearings by the Public Accounts Committee(PAC).

The current report updates two previous assessments dating back to 2018 that the OAG previously rated as 'red' (limited progress) and 'amber' (some progress).

Those reports are; Government Programmes Supporting Those in Need (May 2015), and Ensuring Quality Healthcare and a Healthy Population (January 2017). According to the current review, very little progress has been made on the priority areas tagged ‘red’ (limited progress).

Auditor-General Sue Winspeare said: “The original recommendations made by my office date back to 2015 and 2017. The previous PAC held hearings on these two reports a number of times and issued its own reports with additional recommendations, the last being in April 2019. Very little has changed since then.”

In a statement accompanying the report, she called the situation very disappointing.

“The Government’s progress with implementing recommendations made by the PAC on two reports covering the significant public services areas of healthcare and social assistance is very disappointing.”

Addressing the state of the healthcare system, the Auditor-General concluded that severe shortcomings still exist despite being highlighted previously.

“We find that Cayman still has no overarching strategy or policy for healthcare and a legislative framework that is outdated and deficient. As a result, Cayman’s health care system is not providing best value to its people and practices for inspecting health care facilities, registering health care practitioners and developing Caymanian Doctors are still lacking.”

The review of the Government’s welfare programmes, is equally disappointing.

Ms Winspear says: “There is still no co-ordinated social assistance strategy and so it is not clear if the most vulnerable in our society are being adequately supported, and it is likely that there continue to be inconsistencies in the eligibility criteria for accessing support and gaps and overlaps in provision. The Poor Persons (Relief) Law dates from 1997 and has still not been modernised to be fit for Cayman in 2021, despite assurances to the PAC in 2018 that this was under review.”

The timeline of the report clearly places the responsibility for the current state of affairs at the door of the previous government, providing a status update on 15 PAC reports tabled in the Parliament between September 2018 and December 2020.

It shows that as at February this year when Parliament was dissolved before the April election, the Government had tabled formal responses to nine of the PAC reports. Of those, only three were tabled within the 3-month timescale required by the Parliament’s Standing Orders.

The OAG said the Government had also not responded to five PAC reports.

“It is disappointing that since my last report in 2018 on Government’s progress with implementing PAC recommendations, the Government has fallen significantly behind.” Ms. Winspear observes.

“Of the nine Government responses tabled, only three were done so within the required timescale and the Government has not yet responded to five PAC reports, some dating back to 2018. Implementing PAC and my recommendations is not just a tick box exercise but something that can and should deliver real service improvements that will positively impact peoples’ lives.”

Acting Deputy Governor reacts

Meanwhile, Acting Deputy Governor Gloria McField-Nixon, acknowledged the OAG’s concerns and pointed to the Civil Service’s “commitment to improving the timeliness of its responses to the PAC.”

In a press release she stated, “The Civil Service has battled fires on many fronts during the two-year period in question, which has undoubtedly delayed some administrative responses. As part of our continuing efforts to enhance efficiency and accountability, we are revisiting our processes to ensure that we improve the timeliness for tabling Government Minutes.”

The Acting Deputy Governor also said, “We appreciate the OAG recording that some, albeit insufficient, progress has been made on reducing the backlog of Government Minutes and we are grateful to the OAG and the PAC for working with the Civil Service to streamline these processes.”

PACT picks up the slack

In an earlier reaction Hon. Min, for Social Development, Andre Ebanks said the current administration is working on improving the social welfare situation.

"The PACT Government is committed to re-imagining social development…We intend to deliver on a decade of reforms that were not prioritised previously,” Min. Ebanks declared.

He referred to the newly-initiated "social development pillar” grouping the Needs Assessment Unit(NAU), the Department of Children and Family Services, the Sunrise Adult Training Centre, Children and Youth Services (CAYS) Foundation, the Housing Repairs Committee and the Adoption Board.

The Auditor-General’s ‘Follow-Up on past PAC Recommendations 2021 – Report 1’ is the first in a series of four reports.