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Premier Lays Out Cost of Hospital Dispute

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Misick details legal losses, mounting healthcare costs and Government’s plan to move beyond the InterHealth concession

 

By Deandrea Hamilton | Editor

Speaking during the House of Assembly on Friday, July 31, Premier Washington Misick delivered what he described as a “full and frank account” of the Government’s long-running dispute with InterHealth Canada, revealing that litigation surrounding the hospital concession has already cost the Turks and Caicos Islands approximately $39.7 million and confirming that another arbitration remains before the tribunal.

“The people deserve honesty,” Misick told the House. “They deserve to understand how we arrived at this moment and what it has cost them and what this Government is doing about it.”

The Premier said he intends to table a detailed paper outlining the history of the hospital agreement, the financial figures and the legal decisions that have shaped the dispute.

“I think we owe it to the public to be transparent at all times,” he said. “At the end of the day, they are the ones who are paying for these things.”

Misick stressed that the hospitals themselves have transformed healthcare in the Turks and Caicos Islands, but argued the concession agreement underpinning them has proven financially and legally unsustainable.

“The hospitals themselves are an asset. The contract on which they operate has become unsustainable.”

Tracing the agreement back to 2008, the Premier said findings by the Commission of Inquiry highlighted the absence of a competitive tender process and identified conflicts of interest that, he argued, contributed to the structural weaknesses of the contract.

“I do not rehearse this history to apportion blame across party lines,” Misick said. “I raise it because the House and the public must understand the nature of the problem we inherited and why the structural flaws embedded in this agreement from the very beginning have proven so difficult and so costly to resolve.”

He explained that the concession created separate responsibilities for infrastructure management and clinical services, making accountability difficult to enforce, while the payment model reimbursed costs plus a guaranteed profit.

“This is not a sustainable model for any healthcare system,” he said.

The Premier also disclosed the scale of healthcare spending, stating that public healthcare cost the country $828 million between 2016 and 2025, representing 32 percent of Government expenditure and 8.1 percent of national GDP.

He then outlined the cost of the first international arbitration, saying Government was ordered to pay $18.5 million in principal and interest, $8.2 million toward the company’s legal costs, in addition to arbitration expenses and the Government’s own legal fees.

“The total cost of the territory from the first arbitration alone was approximately $39.7 million,” Misick said. “I want this House to sit with that figure for a moment. Eight percent of our annual budget consumed—not by schools, not by roads, not by housing—but by the cost of resolving a dispute with a private contractor.”

Turning to the second arbitration, the Premier said the tribunal ruled that Government must pay $9.3 million in outstanding invoices, while the substantive arbitration over maintenance, performance and Government’s counterclaims continues.

“In plain terms, the contract requires the Government to pay first and dispute later,” Misick said. He added that the ruling “does not mean the arbitration is over” and “does not mean that the Government’s position on performance has been found without merit.”

Despite the legal setbacks, the Premier maintained that Government remains committed to bringing the concession to an orderly conclusion.

“Over the coming months, we will resolve the concession. We will reclaim the hospitals and build a healthier system worthy of the trust that people place in it,” he said.

While Misick did not elaborate on what “resolving the concession” will involve, he said the objective is to replace what he described as an unsustainable arrangement with a healthcare system that is “publicly accountable, financially sound and built on a foundation that will last.”

Editor’s Note: This report is based on Premier Washington Misick’s statement to the House of Assembly on Friday, July 31, 2026. The Government has indicated that a supporting paper detailing the history, financial figures and legal decisions surrounding the hospital concession will be tabled in the House of Assembly.

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Facts According to the Turks & Caicos Premier About His Constitutional Amendments    

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What Premier Charles Washington Misick says the proposed constitutional reforms are—and are not.

 

FACT 1: The proposed amendments are not intended to extend the life of Parliament.

According to Premier Misick, his Government did not request longer parliamentary terms and has not sought constitutional changes to keep itself in office beyond the existing electoral cycle.

FACT 2: Cabinet expansion is about governing capacity, not political power.

The Premier says the proposed increase in the number of ministers reflects the growing responsibilities of Government and is intended to improve administration rather than create political advantage.

FACT 3: The Government wants greater local responsibility.

Misick says the constitutional proposals are designed to strengthen the Turks and Caicos Islands’ ability to govern its own affairs while maintaining its constitutional relationship with the United Kingdom.

FACT 4: The Constitution should not become a political weapon.

The Premier argues constitutional reform should be approached as a national issue that outlives individual governments and political parties.

Include his strongest quote on this point.

FACT 5: The Commission process involved consultation.

According to the Premier, the constitutional proposals emerged through discussions with the Constitutional Review Commission and engagement with stakeholders before being presented to the United Kingdom.

Insert his supporting quote.

FACT 6: Government is seeking better governance, not fewer checks and balances.

The Premier maintains the reforms are intended to improve decision-making, accountability and the effectiveness of Government.

Insert his supporting quote.

FACT 7: The Premier says some proposals now being criticized were previously supported.

Misick contends that several constitutional recommendations now under attack had earlier received support across the political spectrum.

Insert the relevant quotation.

FACT 8: The goal is a modern Constitution.

The Premier says the reforms are intended to modernize the Turks and Caicos Islands’ governance framework to better reflect today’s realities and future development.

Insert his closing quotation.

Editor’s Note

This Fact Report summarizes Premier Charles Washington Misick’s explanation of the proposed constitutional amendments as presented in the House of Assembly on July 31, 2026. It reflects the Premier’s stated positions and is intended to help readers understand the Government’s rationale. Responses from the Opposition and other stakeholders will be presented separately.

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“The Contract is The Problem, Not The Hospitals”

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Premier says people deserve the full story as he lays out the cost of the InterHealth Canada concession and Government’s plan to reclaim public control

By Deandrea Hamilton | Editor

Turks and Caicos, August 4, 2026 – PROVIDENCIALES, Turks and Caicos Islands — Saying the public deserved to hear the whole story, Premier Charles Washington Misick laid bare the InterHealth Canada debacle, revealing that more than $827 million has been paid by the people of the Turks and Caicos Islands under the hospital concession while insisting, “the contract is the problem, not the hospitals.”

Delivering what he described as “a full and frank account” to the House of Assembly on July 31, the Premier said the people “deserve honesty. They deserve to understand how we arrived at this moment, what it has cost them, and what this Government is doing about it.” He acknowledged that the opening of modern hospitals in Providenciales and Grand Turk marked “a genuine step forward for healthcare,” but argued that the agreement supporting them was fundamentally flawed.

“The hospitals themselves are an asset. The contract under which they are operated has become an unsustainable burden.”

Turning to the origins of the agreement, Misick relied heavily on the findings of the Commission of Inquiry led by Sir Robin Auld, saying the public must understand why the dispute has become so costly.

“There was no competitive tender. The construction contract was awarded to a company linked to the same ultimate beneficial owner as InterHealth Canada itself — creating, in the Commission’s own words, a closed commercial loop in which public money flowed from the government to one entity and back to the same private interest through another. The Commission found this constituted an unacceptable conflict of interest.”

He continued:

“Those findings had consequences that extended far beyond this project. They contributed directly to the suspension of our Constitution and the imposition of direct rule from London in 2009.”

The Premier said he was not revisiting the history to assign blame but because “the House and the public must understand the nature of the problem we inherited — and why the structural flaws embedded in this agreement from the very beginning have proven so difficult and so costly to resolve.”

Misick also outlined what he described as the staggering financial burden now carried by taxpayers.

“Between 2016 and 2025, this Territory spent $827.8 million on public healthcare. Today, healthcare consumes more than 32 percent of all government expenditure and 8.1 percent of our GDP.”

He argued the concession’s payment model is largely responsible for those costs.

“The operator was reimbursed for its actual costs, plus a fixed margin… That is not a sustainable model for any healthcare system. And it is a central reason why the cost of this arrangement has grown to the levels we are now confronting.”

Looking ahead, the Premier said the Government’s focus is not only on resolving the current concession but also on preventing small island states from facing similar legal and financial burdens in the future.

“We will engage the United Kingdom Government… We will work through CARICOM and the Commonwealth to advocate for reform of international arbitration — to introduce procedural flexibility, development-sensitive interpretation, and affordability safeguards that protect small states from the disproportionate burden that the current system imposes.”

He closed by reaffirming his Government’s objective:

“This Government will resolve the concession. It will reclaim the hospitals. And it will build a healthcare system worthy of the trust that our people place in it.”

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80 DAYS. $80 MILLION. – PDM Demands Answers from Government

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By Deandrea Hamilton | Editor

Turks and Caicos, August 4, 2026 – The People’s Democratic Movement (PDM) has launched a sweeping attack on the Washington Misick administration, warning that the Turks and Caicos Islands is running out of time to prepare for one of the most significant transitions in the country’s modern healthcare system while simultaneously demanding greater transparency over a reported $80 million interim airport terminal project.

Speaking at a July 29 press conference, PDM Leader Douglas Parnell argued that the country has roughly 80 days remaining before Government assumes responsibility for the hospital system following the termination of its agreement with InterHealth Canada. He questioned whether adequate preparations have been made and whether the public has been fully informed about what comes next.

“The people of these islands cannot afford government by announcement, where the headline comes first and the answers come later,” Parnell declared.

He said the hospital issue is too important to become another political battle, insisting that the country deserves to know how Government intends to manage the transition once the existing agreement comes to an end.

“The transition period is very short and next to impossible for even the very best in healthcare to meet the deadline,” Parnell said, referring to what he described as a 90-day transition period. “Only 90 days for the Turks and Caicos Islands Government to take over.”

The PDM leader questioned whether the necessary recruitment, training and operational planning are underway and challenged Government to release its transition strategy.

“We have offered our help. They have refused. They are lost and they are in over their heads,” he said.

Parnell also accused the administration of failing to adequately explain the financial implications surrounding the hospital dispute, calling on Government to disclose the reasoning behind previous arbitration payments, the strategy behind delayed payments over the past 18 months, and the country’s current exposure in ongoing legal proceedings.

“I’m asking the Government not for political rhetoric, but for the truth,” he said. “Explain the approximately $18 million payment last year. Don’t just tell us you had to pay it. Explain why.”

He continued: “Show the country the transition plan.”

Parnell broadened his criticism to include the Providenciales International Airport redevelopment, questioning the reported $80 million interim terminal and calling for greater public disclosure surrounding the project.

“Tell us who is building Terminal B. Tell us what exactly is breaking ground within days. Tell us how this interim terminal fits into the permanent redevelopment,” he said.

The PDM leader argued that the hospital and airport issues reveal a wider concern about governance and accountability.

“Healthcare and the airport may appear to be separate matters, but together they raise a much larger concern about the way this country is being governed,” he said.

He concluded by insisting that transparency must accompany every major public expenditure.

“Turks and Caicos Islands is not a poor country. Our people should expect world-class healthcare and world-class infrastructure, but they should also expect world-class governance, transparency and accountability.”

The Government has since addressed aspects of the hospital dispute during the House of Assembly debate, including financial exposure arising from the InterHealth matter. However, several of the specific questions raised by the PDM regarding the hospital transition timeline, operational preparedness and the airport redevelopment project had not been publicly answered at the time of the party’s press conference, setting the stage for what has become one of the most significant public policy debates now facing the country.

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