A new pay-scale has been introduced for Health Services Authority directors after board members racked up almost half-a-million dollars in meeting stipends in 18 months.
The Health Services Authority Board, which until recently was paid on a per-meeting basis, held 190 meetings, collectively billing the government $490,000 up to the end of June, according to an open records inquiry by the Compass.
The lay-board, which consists of six to eight people, has an oversight role, but no day-to-day responsibilities for running Cayman’s healthcare system.
According to data shared with the Compass and with MP Chris Saunders, who has campaigned for reform in Parliament, some members took home more than senior doctors. Speaking in Finance Committee earlier this year, Saunders highlighted how the board held 18 meetings in a single month in September, with one member taking home more than $10,000 in stipends. He claimed some members were billing for attending ribbon cutting events.
Former members including Osbourne Bodden, who previously served as chair, have defended the board’s performance and said they had acted with full transparency in the best interests of the Health Services Authority amid human resources and management concerns.
Now government has announced a change to a flat-fee structure, where board members will be paid the same money, no matter how many meetings they organise and hold.
Instead of the $500 per meeting fee (rising to $750 for the chair and $600 for the deputy), members will be paid $2,400 each month (rising to $3,360 for the chair and $2,760 for the deputy). The new rates are in line with some of the highest paid boards in Cayman, including telecoms regulator OfReg, also known as URCO, and financial regulator Cayman Islands Monetary Authority.
Announcing the change, a Health Ministry statement indicated the aim was to “enhance transparency, strengthen governance standards and ensure responsible management of public resources.”
The statement notes that the board is responsible for policy direction and oversight of the Health Services Authority’s operations, “a mandate that requires sustained time, expertise, and informed decision-making.”
Citing data from the Compass article the press release states, “Between January 2022 and June 2023, the Board held 190 meetings at a total cost of CI$490,850, compared to 13 meetings costing CI$23,700 during the 2016–17 period.”
It adds that the auditor general’s office had investigated the fee structure further and “highlighted concerns regarding the number and categorisation of meetings counted for payment, instances where board remuneration exceeded the earnings of full-time medical professionals, and inconsistencies in remuneration practices across statutory boards.”
It adds, “The per-meeting model did not regulate meeting frequency, allowing costs to escalate without a corresponding increase in accountability or value for money.”
The revised framework establishes a clear monthly cap on payments, improves cost predictability and removes incentives linked to meeting volume, the statement adds.
Minister of Health, Katherine Ebanks-Wilks, said, “Transparency, accountability and strong governance standards must guide the stewardship of public resources. This revised remuneration framework responds directly to concerns raised by residents and oversight bodies, ensures better value for money, and reinforces the principles that underpin effective public-sector governance.”
Part of the Compass Freedom of Information request, still under review with the ministry, was a request for the minutes of the 190 meetings held up to the end of June this year.
In its statement the ministry indicates further changes under consideration include additional accountability mechanisms for senior management as well as steps to improve transparency in board operations.
“This includes examining how board decisions and minutes can be made more accessible to the public through clearer and more consistent publication on the HSA website, alongside existing statutory requirements.”