Public Health to split from HSA

By Lindsey Turnbull

In a bid to vastly improve the quality and quantity of data collected on the health of the nation, it has been announced that Public Health intends to separate from the Health Services Authority, under whose auspices it has always operated.

Interim Chief Medical Officer Dr Autilia Newton explained that if one looked anywhere in the world, one would see that Public Health departments worked best when they were independent. Crucially, Public Health, as an independent operation, would be able to collect data from all healthcare providers if it were to separate from just the one health provider to which it is currently bound (the HSA), she advised. Once it is able to collect data from all healthcare providers, the Public Health department would then be able to build up a much more cohesive and precise picture of the health issues facing residents of the Cayman Islands, present that information to policy makers and then hopefully effect some real, positive changes to improve people’s health.

Health and Wellness Minister Sabrina Turner said the first step in the separation process was for the Health Ministry to create a business case for its importance which would then be presented to Cabinet by the end of the year. The undertaking was huge, Minister Turner said at a press conference.

“This is the first time that an exercise of this magnitude has taken place and that is why it is important that the necessary checks and balances are done…and operational services for those partnerships continue,” she said, adding that she wanted the public to be aware that the initiative had not arisen from any silos, nor was it a unilateral decision from the Ministry.

“That is why it is imperative that we work with the right set of people to get it right,” she confirmed.

Dr Newton outlined the momentum behind the move was the issue surrounding a Public Health team sitting with a provider, which meant the collection of the information was then limited to that population who accessed that service.

“What we need for Public Health to work is you have to have it outside all providers and get the information from everybody,” she said.

The interim CMO took pains to assure people that the information that would be collected (which might require legislation changes to ensure it happens) would be kept private and would be there to then create a subset of information that would be used to better understand public health.

“Information in Public Health is always collected on the basis of need to know,” she stated.

At the end of the day, Public Health needed to collect the right information which would then be the correct information to share with policy-makers. This information would not just relate to communicable diseases such as Covid-19 and the flu, but also to non-communicable diseases such as diabetes, heart disease and cancer.   

Public Health’s Epidemiologist Rachel Corbett outlined some of the surveillance work they had been working on recently, noting the findings from the 2021 Census that highlighted diabetes, arthritis and cataracts as some of the most prevalent disabilities to affect the Cayman population, which she said was helpful. However, she pointed out the flaws in relying too heavily on this data because the Census did not ask questions about other illnesses that people may be suffering from, such as depression, cancer or cardiovascular disease, so the above-mentioned disabilities might not actually be the worst ones affecting people. The nature of the Census itself meant the data was self-reported and some people might have been reticent to report their illnesses and which would thereby also skew the results, she advised. It was therefore important to pull information from many different sources in order to get the full picture as to what illnesses were particularly prevalent in Cayman.

“We are developing surveillance for non-communicable diseases and this includes data on hypertension, diabetes, obesity, chronic heart disease, chronic kidney failure and COPD,” she said. “This will then give us an idea of the prevalence of these non-communicable diseases among the population and which groups are most at risk. We can then target our prevention measures and interventions according to that data. “

Prevention is a key aspect of Public Health, she stated.