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A Statement from the Premier and Minister of Health, Agriculture, and Human services, Dr. The Hon. Rufus W. Ewing on the National Health Insurance scheme

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Providenciales, TCI, November 28, 2016 -The National Health Insurance Plan (NHIP) was established in 2009 as a Social Health Insurance Plan based on contributions from employers and employees who were legally resident in the Turks and Caicos Islands.

The Turks and Caicos Islands Government is also mandated to make contributions to the plan in the following way:

  1. As an employer on behalf of its employees
  2. As a subscriber on behalf of the unemployed, indigent and ward of the state
  3. Transfer of funds for the management and payment of treatment abroad cost
  4. Transfer of funds for the payment of the monthly hospital infrastructure cost

The funds collected by the National Health Insurance Board (NHIB) from its employers and subscribers are utilized to purchase health care locally from the preferred provider (TCI Hospitals), the network of contracted private primary health care clinics and private pharmacies on behalf of and to the benefit of its registered subscribers.

The NHIB on behalf of TCIG manages the procurement of overseas treatment for the beneficiaries of the NHIP. From budget year to budget year this cost is unpredictable as it is a reflection of both the number of persons requiring tertiary level care in any given year as well as the magnitude of their problems.

The cost of healthcare by the end of April 2017 is expected to exceed the budgeted provision by $6 million dollars. It is against that background that a paper prepared by the management of the board with the full knowledge of the Board of Directors, the Ministry of Finance and the Ministry of Health was submitted to cabinet for its consideration – to conclude that there was a cover-up or misappropriation of funds discovered by the acting CEO is incorrect, irresponsible and should be dismissed as political mischief.

The facts are that the treatment abroad programme has skyrocketed in the first half of the financial year amounting to over $5 million of the cost over-run. On average four patients a day are being referred abroad of which five a week are urgent referral requiring medical evacuation via private charters and air-ambulances; at the same time the number of cancer patients has been noted to have increased significantly in the first half of the year, these factors together result in an average cost per patient of around $15,000 with some patients costing in excess of $100,000. Because the NHIB until recently operated a cash basis accounting system, costs were not booked until paid.  This has now been corrected, hence the reporting of the large accounts payable balance.

A number of the more serious cases referred abroad were Turks and Caicos Islanders that were not covered by the scheme. The government takes its responsibility for the provision of its people seriously and has recently introduced changes to the NHIB regulations that would result in healthcare coverage for a wider category of patients while at the same time restricting coverage for some categories of persons which it believes should help to stabilise cost while a comprehensive review of the system is being undertaken after five years of operation.

TCIG has asked for a review of the management and corporate governance of NHIP with respect to the rising cost of overseas treatment to develop cost reduction or mitigation measures where possible without compromising care to beneficiaries of the plan. The Ministry of Health in collaboration with NHIP has already implemented several initiatives to reduce the cost of care, such as:

  1. Establishment of a free extended hours government primary care clinic
  2. Development of a new Pharmaceutical policy which would significantly lower the cost of drugs to both patients and NHIP
  3. Introduced an eligibility waiting time of 6 months for all new work permit applicants to the plan (effective December 1)
  4. Introduced a capitation on overseas care expenditure for work permit holders

The Ministry of Health will continue to implement its cost reduction strategies as outlined in the National Health Strategic Plan, the main ones of which include:

  1. Implementation of the pharmaceutical policy and plan
  2. Implementation of the Chronic Disease Action Plan
  3. Primary Health Care Renewal Strategy
  4. Development of a long term hospice care facility
  5. Expansion of existing and the Introduction of new tertiary level services at the hospitals based of overseas treatment care demands.

Caribbean News

First Caymanian Drafted to NHL as Jaxon Cover Makes History    

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GEORGE TOWN, Cayman Islands – A young man who learned to play hockey on Cayman Islands’ only roller hockey rink has achieved

what once seemed impossible—becoming the first Caymanian ever selected in the National Hockey League Draft.

Eighteen-year-old Jaxon Cover was chosen 32nd overall by the Ottawa Senators, making him the final first-round selection in the 2026 NHL Draft and the first player from the Cayman Islands to hear his name called by an NHL franchise.

The achievement is remarkable not only because of where Cover comes from, but because of how recently he began playing on ice.

Growing up in Grand Cayman, Cover developed his skills playing roller and ball hockey, as the islands have no permanent ice rink. He did not lace up ice skates until he was 13 years old, yet within just five years had developed into one of the world’s top junior prospects.

Last season, the talented right winger starred for the London Knights of the Ontario Hockey League, recording 52 points on 20 goals and 32 assists in 67 games, performances that caught the attention of NHL scouts.

His mother, Nanalie Cover, described the family’s emotions as “very thankful, grateful and humbled,” adding that she hopes her son’s journey becomes “a symbol of what we can do, and what is possible for all, irrespective of where they originate.”

The Cayman Islands Government also hailed the milestone, saying Cover had “redefined the boundaries” of Caymanian sport and demonstrated the limitless potential of the nation’s young people.

Minister for Youth, Sports, Culture and Heritage Isaac Rankine called the draft selection “a proud and historic moment for the Cayman Islands,” saying Cover’s success will inspire a new generation of athletes to pursue their dreams, no matter how unconventional the path.

For a country better known for beaches than ice rinks, Jaxon Cover’s remarkable rise proves that talent, determination and opportunity can overcome even the most unlikely beginnings.

From a roller rink in the Caribbean to the bright lights of the NHL, Cayman has produced its first hockey trailblazer—and perhaps not its last.

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Caribbean News

Migration Is No Longer Just About Borders

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What Caribbean migration dialogues reveal about the region’s future

 

By Patrice Quesada, Coordinator, IOM Caribbean

Migration has become one of the defining issues shaping the Caribbean’s future—not simply because people are moving, but because our economies, labour markets, populations and climate realities are changing.

Over the past several weeks, I have participated in migration discussions at the global, regional and national levels. While each conversation was different, they all pointed to the same conclusion: the Caribbean is beginning to recognize migration not only as a border issue, but as a development issue.

The challenge now is moving from dialogue to action.

From Global Commitments to Caribbean Solutions

That shift was evident during the International Migration Review Forum held at the United Nations in New York, where Caribbean participation was particularly strong. Delegations from ten Caribbean countries, including ministerial representatives from Barbados and Belize, reinforced the region’s growing commitment to shaping international migration policy.

Two messages emerged clearly.

First, migration governance must be grounded in each country’s realities and supported by concrete national commitments. Second, migration cannot be viewed in isolation. It is closely linked to labour markets, demographic change, climate vulnerability and long-term development planning.

Every Caribbean Country Has Its Own Story

Across the region, governments are approaching migration through different lenses.

In Saint Lucia, the launch of the country’s draft migration policy reflected concerns about declining birth rates, labour shortages and continued emigration. The discussions recognised that labour needs, diaspora engagement, remittances, return migration and protection must all work together within one national strategy.

Jamaica demonstrated how migration planning can begin at the local level, with Clarendon becoming the country’s first parish to integrate migration considerations into its long-term development strategy.

Guyana, meanwhile, is managing migration in the context of rapid economic growth, balancing increased labour demand with worker protections and orderly migration systems.

Barbados has also begun incorporating migration into broader population planning as it addresses demographic decline and an ageing population.

The Bahamas has focused on disaster preparedness, bringing together government agencies to strengthen national plans for managing inter-island and cross-border movement during emergencies while safeguarding the rights and dignity of displaced people.

Different countries face different challenges—but all are recognising migration as an essential part of national planning.

The Caribbean’s Greatest Untapped Asset

One message resurfaced repeatedly throughout these discussions.

The Caribbean diaspora should no longer be viewed simply as a source of remittances.

Across the region, citizens living abroad continue to contribute through investment, entrepreneurship, professional expertise, advocacy and, in many cases, by returning home with new skills and experience.

The opportunity now is to engage the diaspora more deliberately as a strategic development partner.

Turning Dialogue into Action

Technical discussions held throughout May demonstrated that governments are beginning to move beyond policy conversations.

CARICOM, supported by the International Labour Organization and the Inter-American Development Bank, convened regional labour migration specialists to explore how migration can help address workforce shortages while ensuring fair recruitment and decent working conditions.

Together, these initiatives suggest the Caribbean is entering a new phase—one where migration is no longer viewed simply as movement across borders, but as a tool for economic resilience, demographic planning and sustainable development.

The conversations have begun.

The next challenge is ensuring they lead to meaningful action.

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Health

Cleveland Clinic Completes Its First Robotic Lung Transplant in US

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Cleveland Clinic staff performing their first U.S. robotic lung transplant surgery

Health system is one of only a handful in the world able to perform the complex robotic procedure

In May 2026, surgeons at Cleveland Clinic successfully completed the health system’s first robotic lung transplant in the United States, marking a significant advancement in minimally invasive organ transplants. Cleveland Clinic is among only a small number of centers worldwide offering this surgical approach and was the first in Ohio to complete this type of procedure. Robotic lung transplants have rarely been performed because they require advanced robotic capabilities and a skilled surgical team.

Gregory Jones, MD, a thoracic surgeon at Cleveland Clinic’s Heart Vascular and Thoracic Institute, led the surgical team for the single lung transplant procedure, which also included Kenneth McCurry, MD, a cardiothoracic surgeon and surgical director of lung transplantation and enterprise director of transplantation.

“This achievement reflects the collaboration and innovation across our transplant and surgical teams,” said Dr McCurry. “As these technologies continue to evolve, they will play an increasingly important role in improving patient outcomes and advancing the future of transplantation. Indeed, our kidney and liver transplant programs in Ohio have also been at the forefront of robotic organ transplantation with great success.”

In a traditional lung transplant, surgeons commonly gain access to the chest by dividing the breastbone or ribs to access the lungs. This is often associated with significant pain, which can prolong recovery. In a robotic lung transplant, surgeons use small incisions and robotic instruments and 3D visualisation to perform the procedure with a less invasive approach. This approach is designed to help reduce postoperative pain, shorten hospital stays, and accelerate recovery.

“This milestone reflects an important step forward in how we approach lung transplantation,” said Dr Jones. “It builds on our experience with both robotic surgery and transplant care and adds another option for some patients who may benefit from a minimally invasive approach.”

Robotic surgery has transformed many types of cardio-thoracic procedures over the past decade. By bringing this technology to lung transplantation, Cleveland Clinic is expanding access to advanced, minimally invasive transplant care.

The surgery was performed on a man in his 70s with pulmonary fibrosis, a progressive lung disease that causes scarring of the lungs and can make breathing increasingly difficult. Following the transplant, he was discharged from the hospital and is recovering well.

Cleveland Clinic’s Lung Transplant Program is a national leader in advanced lung transplant care, having performed more than 2,500 transplants since 1990. In 2025, Cleveland Clinic performed 146 lung transplants in the U.S. The program is known for its expertise in caring for complex transplant patients, many of whom have been turned down elsewhere, and for advancing new approaches in transplant care.

In addition to the US, Cleveland Clinic is also a leader globally in transplantation. A team at Cleveland Clinic Abu Dhabi performed the enterprise’s first robotic lung transplant last year. It was also the first procedure of its kind performed in the Gulf region.

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