![Premier Hon Alden McLaughlin]()
Premier Hon Alden McLaughlin
Speaking on Radio Cayman’s morning talk show On the Record on Monday 21 March, Premier Hon Alden McLaughlin stated that then Minister of Health Gilbert McLean and then Leader of Government Business, Hon McKeeva Bush “knew full well what they were doing and intentionally sought to protect the HSA from malpractice” with regard to the contentious Section 12 of the HSA Law.
Section 12 has been interpreted by the local courts to give blanket immunity to HSA doctors in cases where malpractice is alleged.
Mr McLaughlin has announced his government’s intention of repealing that section of the law.
The premier further alluded to correspondence between members of the then government which stipulates that they knew exactly what they are doing and any claims otherwise being made today are simply “untrue”.
Mr McLaughlin said he intends to reveal this correspondence when his Government brings a motion to the Legislative Assembly to amend Section 12.
However when contacted by The Cayman Reporter, Mr McLean stated categorically that there was no intention by government in 2004 to exempt doctors from malpractice liability in the passage of the Health Services Authority Law.
“I as minister held no such thought, then or now,” Mr McLean asserted.
These sentiments were also shared by then Leader of Government Business, Hon McKeeva Bush who concurred with the sentiments of Mr McLean, in that, the question of exclusion from malpractice was never intended to apply to doctors.
Mr McLean further contends that the question of immunity was sought specifically to apply to members of the Board of Directors and was not intended to apply to doctors or nurses.
The Cayman Reporter obtained copies of the 13 December 2004 Legislative Assembly Hansards, which quote Mr McLean, as saying, “Like any private entity, the HSA has a Board of Directors that is responsible for the policy and general administration of the affairs and business of the organisation.”
![Former Minister of Health Gilbert McLean]()
Former Minister of Health Gilbert McLean
Mr McLean continued, “Board Members who hold office at the pleasure of the Governor in Cabinet carry a heavy responsibility, both to the Authority and to the public which they serve. The time and energy required by Board Members is substantial and the remuneration is small. It is therefore vital that we do everything possible to minimise the risk of potential liability of persons willing to volunteer their time and skills to serve on board”, suggesting the amendment in question applied specifically to appointed Board Members and not to medical staff.
This point was debated at length and included submissions from both the then Leader of the Opposition, Hon D. Kurt Tibbetts and Second Elected Member for George Town, Alden McLaughlin.
The pair debated at length the definition of “bad faith” as outlined in the amendment and how the then government distinguished between what is considered “bad faith” versus “neglect”. According to the hansards, Mr Tibbetts said, “While I respect the fact that the Members of the Board need to be protected and perhaps indemnified, this is going to be part and parcel of the main legislation. So I believe we need to have a very clear understanding.”
In his submission, the then Second Elected Member for George Town and Opposition Member, Alden McLaughlin expressed his staunch opposition to the changes being recommended at the time.
He said, “There is a fiduciary duty that is imposed to the company as result of someone becoming a director. That duty requires the individual who is the director to act in the utmost good faith, to act with diligence, to act with caution, to act responsibly generally.”
He went on to point out that “it is the directors who make the decisions, whether they are in relation to the hiring or firing of people or what direction the Authority takes in relation to any matter. I believe it is fundamentally wrong to permit any director or employee to have such blanket immunity or indemnity, that essential allows them an out, no matter what they do.”
Mr McLaughlin said, “In my view, Mr Speaker, that it is wrong, wrong, wrong. If directors of the HSA have acted improperly, then they ought to pay for it.”
In his response, then Minister of Health, Mr McLean stated that while there was some disagreement with the wording in the amendment, “the present wording here is what I have been given as legal advice from the Government’s Chief Legal Advisor” referring to the Attorney General.
Mr McLean added that “I can say to the Member that there is certain disagreement still with the legal wording but the wordings that I have to use or to bring to this Honourable House is that which satisfies the Legal Department of Government and the Attorney General.”
Mr McLean continued to assert that the intention of immunity was intended solely for board members and general employees of the HSA. It was not intended to apply to doctors.
As reported in The Cayman Reporter on 15 March, Mr McLean stated that the debates that occurred in relation to the Health Practice (Amendment) Bill 2004 further prove that the question of malpractice always applied to medical staff. However at the time, it was a question of whether or not an individual could sue a doctor individually versus suing the Authority or government.
The Cayman Reporter also obtained copies of the Official Hansard of 27 October 2004 whereby amendments to the Health Practice Law 2002 were made. In the debate, Mr McLean stated that “the Health Practice Commission was recently established to carry out regulatory functions as outlined in the Law. The Commission was advised that health practitioners who are members of the Medical Protection Society (as was the case for most doctors in the Cayman Islands at the time, be they in Private or Public Practice) could be in breach of the Law because the society is not an insurance company and does not offer malpractice coverage.”
He went on to state that “after receiving legal advice, I accepted the Health Practice Commission’s recommendation to amend Section 15 of the Health Practice Law 2002 permitting it to be legally acceptable and sufficient for health practitioners in the Cayman Islands to have medical indemnity.” This indemnity meant that “an operator of a health care facility (namely the HSA or Government) could obtain as an alternative to malpractice insurance, indemnity cover approved by the Health Practice Commission for registered practitioners employed by the health care facility.”
In short, in the event of a lawsuit, aggrieved persons would have to sue the government and not the individual doctor, who had been indemnified from fault. As such, Mr McLean is quoted in the hansard as stating that, “The Bill achieves the objective of insuring that the public is protected, while allowing practitioners to access cost effective malpractice insurance coverage.”
The hansard further indicates that the Minister received push back from the Cayman Islands Medical and Dental Services (CIMDS) who “attempted to persuade me not to put this requirement in the law.” However the hansard also shows that Mr McLean “was not persuaded in that regard” because he thought that it is better to have that requirement in the Law, as incidents do happen, and it is better that doctors are covered, and the person who may have to sue for damages knows that he is not suing a medical practitioner who can declare bankruptcy or does not have any coverage of money to pay them.
While a further debate that remained unanswered concerned whether or not doctors themselves should be asked to contribute to the costs associated with this indemnity, the hansard indicated simply that this would be a question of policy, however it clearly suggests that the amendments to the law were never intended for doctors, but more so, for Board Members and general employees. The word “doctor” was never referred to during any of the debates outlined in the official hansard.
And so, in the words of Gilbert McLean, the mover of the amendments, the public interest would be served by allowing aggrieved persons to sue for damages that could be defined as being in “bad faith”, but such lawsuit would be against the government and not the individual practitioner.
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