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Overview of Diagnostic Imaging Services Post 2017 Hurricanes

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#Providenciales, February 7, 2019 – Turks and Caicos – Similar to other major service providers across the country, InterHealth Canada – Turks and Caicos Islands Hospital received significant damages during the hurricanes in September 2017.  These included latent damages to the electrical circuitry of medical equipment that only became apparent over time.  The total cost of repairing the damages to the hospital’s infrastructure and medical equipment is estimated to be USD$16 million.

The majority of the equipment in the hospital is highly sophisticated and extremely sensitive.  The environment of CT, MRI and Mammography machines require tight control over temperature and humidity.  An independent review of the Diagnostic Imaging infrastructure at Cheshire Hall Medical Centre was conducted by XRCT Limited, a physics consulting company based in Ontario.

The report stated: “In the wake of the storms, the lack of air conditioning lead to ambient air temperature and humidity conditions within the facility that were outside of the manufacturer requirements.  This created a severely hazardous environment for electronic components.  In addition, the restoration of power to the island created multiple daily power outages, surges and brownouts.  All of these conditions, when combined have led to premature component failure, significant increase in downtime and potentially shortened the expected lifecycle of the diagnostic imaging equipment.”

 

INTERIM CORRECTIVE MEASURES

Biomedical Engineers employed at the facility assisted by overseas specialists worked assiduously to resolve any emerging technical issues.  To date, all diagnostic imaging machines are fully operational.  The intermittent downtime experienced in previous months with CT and Mammography machines were minimal.  The MRI machine was operational, but with limitations on the type of radiological scans that could be performed at the time.

“Despite the high temperatures and lack of humidity control present in the facility, the records show the hospital continued to make every effort to operate the equipment under these extreme conditions in the interest of providing vital and medically necessary patient care,” stated XRCT Consultants in an official report.  These efforts sought to ensure the continuity of high-quality care and to minimize the number of patients who require treatment abroad.  Patients were categorized based on clinical priority and the equipment up-times were maximized by increasing the volume of radiological scans performed per day.

 

THE MAINTENANCE PROCESS

CT, MRI and Mammography machines generate significant heat while in use and at rest.  Therefore, operating temperatures within these areas are closely monitored, checked and reviewed regularly to ensure temperature and humidity is within the guidelines established by the manufacturer.  Any changes in these precise specifications can create the risk of overheating and damage to internal components.  Monitoring the relative humidity of MRI rooms is also crucial to avoid the risk of moisture damage to very delicate electronic components such as electronic expansion boards, cables, and connectors.

XRCT Limited also performed an extensive review of the service records for the Diagnostic Imaging department and stated: “Over the months/years preceding the storms in 2017, the service history for all the equipment was excellent.  In fact, with the exception of a few random downtime events and planned maintenance, the uptime of all clinical systems was quite good, in excess of 99%.”  Based on these expert findings, the technical issues experienced over previous months were evidently not attributed to inefficiencies in the maintenance or management processes established by InterHealth Canada, but were connected to acts of nature, beyond human control.

 

THE COMMUNICATION PROCESS

InterHealth Canada has continued to abide by the terms of the Project Agreement and meet the extensive reporting and service standards detailed in the contract.  As partners in health care, InterHealth Canada is contractually mandated to submit monthly reports to the Turks and Caicos Islands Government (TCIG) related to over 48 clinical key performance indicators, including Diagnostic Imaging services.  These key performance indicators seek to demonstrate how effectively the management company is achieving pre-established targets. InterHealth Canada fully supports and complies with these accountability mechanisms.

The TCI Government via the Contract Management Unit has been kept informed, at all times, where services have required expansion or, where challenges such as the 2017 hurricanes have caused damage to equipment, resulting in some delays to services.  Representatives of TCI Government’s Contract Management Unit and Fortis TCI also conducted a physical inspection of the UPS and surge protectors in the Diagnostic Imaging Department.

    

THE LIFE CYCLE PROGRAM

Managing the lifecycle of medical equipment from planning to purchase, installation, operation all the way through decommissioning and disposal helps medical institutions improve operational efficiency, enhance quality and reduce service-related cost.

The purchase of capital equipment is covered under a life-cycle program, which is a reserve fund established under the contract between TCI Government and InterHealth Canada for equipment replacement.  The decision to purchase equipment involves several key considerations.  These include: Equipment Specifications and Suitability, Procurement and Logistics, Available Financial Resources, Prospects for Maintenance, Repair and Life expectancy.

InterHealth Canada has filed a short term and long-term recovery plan with TCI Government and are actively considering replacement possibilities for key modalities in diagnostic imaging. Negotiations are also underway with the insurance companies relative to the damages ensued.

 

Release: InterHealth Canada

 

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Ministry of Health Welcomes Appointment of New NHIB Chief Executive Officer and Highlights Progress of Organisational Transformation

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Providenciales, Turks and Caicos Islands, 13 July 2026: The Ministry of Health is pleased to announce the recent appointment of Ralph Patrick as the new Chief Executive Officer of the National Health Insurance Board (NHIB).

The appointment marks an important milestone in NHIB’s ongoing transformation journey and comes as the organisation continues to implement a broad programme of stabilisation, improvement and reform under the examination process initiated in March 2025.

Over the past twelve months, NHIB has made significant progress in strengthening its financial management, operational controls, technology infrastructure and strategic planning. Through this work, the organisation has gained greater visibility over its finances, improved reporting capabilities, enhanced cybersecurity, strengthened governance arrangements and identified opportunities to improve both healthcare outcomes and value for money.

Minister of Health, Hon. Knowles, said:

“The appointment of a permanent Chief Executive Officer comes at a pivotal time for NHIB. Over the past year, significant effort has been invested in stabilising the organisation, improving transparency and building the foundations for long-term sustainability. We are grateful for the dedication of the NHIB team, the Interim leadership, Board members and our advisers who have helped drive this progress. The new CEO inherits an organisation with a clearer understanding of its challenges, stronger controls, better information and a solid platform from which to drive future improvements.

The Ministry is also advancing the recruitment of additional senior leadership positions to further strengthen NHIB’s executive capacity. Building a permanent and capable leadership team will be critical to sustaining momentum, enhancing accountability and supporting the delivery of long-term organisational and service improvements.”

The newly appointed CEO will work with the Board and stakeholders to build on the progress already achieved, helping to embed sustainable improvements, strengthen organisational capability and support the delivery of NHIB’s long-term strategic objectives.

The Ministry also thanks the Interim CEO, Dr. George, and the team at NHIB for their leadership, commitment and resilience during a period of significant change and transition.

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PDM Alleges Governor ‘Bias’, Opposes One-Year Extension    

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PROVIDENCIALES, Turks and Caicos Islands — People’s Democratic Movement (PDM) Leader Douglas Parnell is urging the United Kingdom not to extend Governor Dileeni Daniel-Selvaratnam’s tenure, alleging that a pattern of decisions and omissions has demonstrated “bias” in the exercise of her constitutional responsibilities.

Speaking during a nationally streamed address from PDM Headquarters on Friday evening, Parnell said his party’s National Executive Committee had carefully reviewed the Governor’s performance and concluded that she should leave office when her current term expires.

“We believe she should depart the Turks and Caicos Islands and not be given an extension,” Parnell declared. “The Governor must not be extended for another year.”

The Governor was appointed on June 29, 2023, to a four-year term. Parnell claimed that during the June 25 sitting of the House of Assembly, Government members confirmed to the Leader of the Opposition that efforts were underway to secure a one-year extension.

Parnell outlined what he described as six reasons for opposing any renewal of the Governor’s appointment.

Foremost among them, he said, was her refusal to commission an independent review of the Royal Turks and Caicos Islands Police Force promotion process after such a request was made by the Opposition.

He also criticized what he described as delays in making constitutional appointments, citing the appointment of Dudley Been to the Integrity Commission.

“His appointment was held up for over six months,” Parnell alleged, arguing that constitutional appointments should be made in a timely manner.

The Opposition Leader further accused the Governor of neglecting the Office of the Governor in Grand Turk, saying she spends only “a small fraction” of her time there. He suggested that if the United Kingdom no longer intends to occupy Waterloo, the historic waterfront property should be transferred to the Turks and Caicos Islands Government for redevelopment, either as an official Premier’s Office and residence or as a beachfront hotel investment for Islanders.

Parnell also criticized the absence of a Boundaries Commission following the General Election, saying one should already have been established given the prospect of constitutional changes.

He further argued that constitutional discussions with UK Minister Stephen Doughty should have included the Leader of the Opposition.

“That failure demonstrates bias,” Parnell said, adding that he was also concerned by what he described as the selective leaking of sensitive information that, in his view, could only have originated from the Governor’s Office, the Premier’s Office or the Civil Service.

The Governor has not publicly responded to the allegations made by Parnell during his address.

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Government Takes Case to Washington After U.S. Keeps TCI at Level 2  

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PROVIDENCIALES, Turks and Caicos Islands — The Turks and Caicos Islands is taking its case for an improved United States travel advisory all the way to Washington, enlisting the British Embassy as the Government argues that the destination’s dramatic reduction in violent crime deserves greater recognition.

The objective is clear: convince the United States that current security conditions justify moving the Turks and Caicos Islands from Level 2 — Exercise Increased Caution to the more favourable Level 1 — Exercise Normal Precautions.

Acting Governor Her Excellency Anya Williams confirmed that the Governor’s Office is “working with the British Embassy in Washington to ensure that the internal security situation in the Turks and Caicos Islands is accurately represented in U.S. travel advisories.”

That carefully worded statement signals that the matter has moved beyond local reassurance and into diplomatic channels. The Government is effectively taking its evidence to Washington after the latest State Department review maintained Level 2 because of crime, particularly in Providenciales, and cited potentially limited police resources for investigations.

Premier Charles Washington Misick says the statistics demonstrate meaningful progress. Murders are reportedly down 40 percent, while serious sexual offences have fallen 33 percent year over year. He also pointed to increased investment in border security, intelligence-led policing, crime prevention and law enforcement.

Tourism Minister Zhavargo Jolly added that the territory welcomed 203,587 stayover visitors during the first quarter, more than 10,500 above the corresponding 2025 period, with March alone approaching 80,000 arrivals.

The combined argument is unmistakable: crime is falling, visitor numbers are rising and hundreds of thousands continue to enjoy the destination safely—so why has the rating not improved?

This is also not the first time TCI has challenged an American assessment.

During the COVID-19 pandemic, then Health Minister Erwin “Jay” Saunders publicly objected after the U.S. Centers for Disease Control and Prevention lowered TCI only from Level 4 to Level 3. Calling the assessment disproportionate and potentially arbitrary, Saunders said he would contact the CDC directly and demand clarity about the criteria being used.

TCI was subsequently classified by the CDC at Level 1 — Low Risk, with the territory promoting its strong vaccination programme, low positivity rate and stringent visitor protocols.

That history will likely encourage the Government as it begins this latest fight—tongue firmly in cheek—with Washington.

This time, however, the issue is not a temporary health emergency. It is the international safety reputation of a tourism-dependent country. The Government hopes its falling crime figures, strong visitor performance and diplomatic engagement through the United Kingdom will persuade U.S. authorities that Turks and Caicos has earned a better rating.

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