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Problems in Health Care Delivery

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#TurksandCaicos, September 1, 2022 – I am very concerned about the lack of clinical services being made available to our citizens at both the Cockburn Town hospital, Grand Turk, and the Cheshire Hall Hospital, Providenciales. And when I investigated what clinical services are accessible in Grand Turk, it is extremely far less than being offered at Cheshire Hall.

A number of patients have brought to my attention the difficulty in getting an appointment to be seen, and many have expressed the feeling of being neglected. And as we all know that with health matters timing is everything. Early detection and early interventions almost always save lives and prevent future life-threatening complications.

During my time as Health Services Manager and before that as Laboratory Director, it had always been the target to have both Health Services locations properly equipped and staffed to tackle the citizens’ health needs. Both locations had identical equipment, and identical complement of staff, with a few variations in numbers. Grand Turk Location handled Salt Cay and South Caicos, and Providenciales location handled North and Middle Caicos.

When I was the Minister of Health, much progress was being made in the reestablishing of old community clinics, e.g.; the town clinic location in Grand Turk, and also returning Myrtle Rigby Health Complex location back to a health care facility for our people. The goal was, and still is, to have regular weekly specialist clinics with other needed services for all islands. Additionally, to have all community clinics equipped with basic laboratory testing abilities and imaging capabilities, i.e., blood electrolytes, red and white blood cell counts, glucose and cholesterol testing, blood nitrogen levels, urinalysis, and are equipped with portable x-ray abilities.  These technologies reveal extremely important and timely information on a person’s health status.

We all have to demand more from our health services providers, demand more accessibility, demand more diagnostic competency, demand more high dependency units, demand the availability of Intensive care capability (ICU), demand more attracting and retaining highly skilled personnel, demand increasing salaries of our health personnel. Hence, our people need to demand a high-performing health care system, “A Good Health System.”

A Peoples’ Democratic Movement government will recommence the work of enhancing our Health system to one that we all can be truly proud of, one which we have the most trust and assurance in.

So, what is the “good” health system that the PDM wants to develop for our people? A good system will be one that is organized in a way to ensure timely access to the highest attainable standard of care to all its citizens; one that has the right programs managed by competent well-paid professionals; one in which clinics provide constant preventive and curative care for the most common conditions, and primary health care in facilities or in the community where people live. A good health system under a PDM Government would ensure that our on-island hospitals deliver high-quality secondary or tertiary levels of care to increase the likelihood of desired health outcomes.

A PDM government is committed to continuing the work we started of ensuring our health services are:

  • Effective – providing evidence-based healthcare services to those who need them;
  • Safe – avoiding harm to people for whom the care is intended; and
  • People-centred – providing care that responds to individual preferences, needs and values.

To realize the benefits of quality health care, a PDM Government will also ensure that our health services are:

  • Timely – reducing waiting times and sometimes harmful delays;
  • Equitable – providing care that does not vary in quality on account of constituency/Island location, and socio-economic status, ethnicity;
  • Integrated – providing care that makes available the full range of health services throughout the life course, i.e. from newborn to old age.
  • Efficient – maximizing the benefit of available resources and avoiding waste.

From many personal testimonies from our citizens, it can be concluded that current health system is not serving our people well. We the PDM are confident that we can deliver the health care system that our citizens need and deserve.

 

Hon Edwin A. Astwood 

Leader of The Opposition

Health

29 Million Strong, the World Salutes Nurses as International Nurses Day is Observed

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On Tuesday May 12, the world pauses to honor one of humanity’s most trusted, exhausted, resilient and indispensable professions — nursing.

International Nurses Day is observed annually on the birthday of Florence Nightingale, widely regarded as the founder of modern nursing, and comes at a time when global healthcare systems continue to rely heavily on nurses carrying extraordinary emotional, physical and professional burdens.

According to the World Health Organization, there are an estimated 29 million nurses worldwide, making nursing the largest professional group within the global healthcare workforce. Yet despite their numbers, many countries continue to face severe nursing shortages, burnout crises and migration challenges as healthcare demands rise faster than staffing levels.

Still, nurses remain the heartbeat of healthcare.

They are present at life’s first breath and often its final moments. They work through hurricanes, pandemics, emergencies and violence. They calm fear, interpret pain, comfort families and frequently become the bridge between doctors, patients and hope itself.

In small island nations like those across the Caribbean, nurses often carry even greater responsibility — serving communities where resources may be stretched, specialists limited and healthcare systems under constant pressure.

This year’s observance again shines a spotlight not only on the compassion nurses bring to their profession, but also on the growing global call for better pay, safer working environments, improved mental health support and stronger investment in healthcare staffing.

For many people, the most memorable face in healthcare is not always the surgeon or specialist — it is the nurse who stayed a little longer, explained a little more gently or cared a little more deeply during a difficult moment.

Tomorrow’s observance is therefore more than ceremonial.

It is a reminder that behind every functioning hospital, clinic, emergency room, health center, operating theatre and recovery ward stands a nurse — often overworked, sometimes underappreciated, but consistently essential.

To nurses across The Bahamas, Turks and Caicos, the Caribbean and the wider world: thank you for showing up, even on the hardest days.

Developed by Deandrea Hamilton • with ChatGPT (AI) • edited by Magnetic Media.

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$94.1Mfor Health; Knowles Pushes to Keep Care at Home

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Turks and Caicos, April 25, 2026 – A major shift in how healthcare is delivered in the Turks and Caicos Islands is at the center of the Government’s latest budget, with a focus on reducing reliance on overseas treatment and strengthening services at home.

Presenting his contribution to the national debate, Kyle Knowles outlined a strategy aimed at building a more sustainable healthcare system—one that allows more residents to access quality care within the country.

The health sector has been allocated $94.1 million, making it one of the largest areas of public spending in the $550.8 million Budget passed on April 23.

Central to the Minister’s approach is a restructuring of the Treatment Abroad Programme (TAP), which has grown significantly in recent years as more patients are sent overseas for specialized care.

The Government now aims to reverse that trend.

“We are reforming healthcare to ensure long-term sustainability,” Knowles indicated, pointing to efforts to strengthen local services and reduce the need for travel.

The strategy includes improving healthcare infrastructure, expanding services available within the islands and increasing efficiency through the digitization of medical records.

Digitization is expected to support better coordination of care, reduce delays and allow for more accurate tracking of patient needs—part of a broader effort to modernize public services.

The Minister emphasized that the goal is not only cost control, but improved access.

“No family should have to leave home to get quality care,” he said, underscoring the Government’s intention to refocus healthcare delivery on local capacity.

The shift comes as rising healthcare costs continue to place pressure on public finances, with overseas treatment representing one of the most expensive components of the system.

By investing more heavily in domestic services, the Government is seeking to reduce that burden while improving outcomes for residents.

While the direction is clear, details on timelines and the pace of expansion for local services were not fully outlined in the presentation.

Still, the emphasis on sustainability, access and modernization signals a strategic pivot in how healthcare is expected to evolve in the Turks and Caicos Islands.

Angle by Deandrea Hamilton. Built with ChatGPT (AI). Magnetic Media — CAPTURING LIFE.

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Turks and Caicos Islands Hospital Celebrates 16 Years of Advancing Quality Care and Innovation

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PROVIDENCIALES, Turks and Caicos Islands – April 9, 2026 – Turks and Caicos Islands Hospital (TCIH), operated by InterHealth Canada, proudly marks 16 years of service to the people of the Turks and Caicos Islands, celebrating a legacy of delivering safe, high-quality, and evidence-based care since opening its doors 10th April 2010.

Background: Public-Private Partnership Model
Turks and Caicos Islands Hospital is delivered through a public-private partnership (PPP) between the Government of the Turks and Caicos Islands and InterHealth Canada Limited (ICL). In January 2008, InterHealth Canada entered into an agreement with the Government to design, build, finance and operate the country’s acute secondary healthcare facilities. This partnership was established almost two decades ago aimed to modernize healthcare infrastructure, improve access to services and ensure the delivery of high-quality care aligned with international standards.

Under this model, hospital operations are delivered through two specialized entities operating within the InterHealth Canada framework:

A clinical services company, responsible for the delivery of all medical and clinical care
A facilities management company, responsible for infrastructure, maintenance and non-clinical support services

Both entities operate under InterHealth Canada Limited, have distinct management structures and provide services in accordance with the terms outlined in the Project Agreement with the Government.

The hospital services were officially commissioned on April 10, 2010, with:
20 inpatient beds at Cheshire Hall Medical Centre
10 inpatient beds at Cockburn Town Medical Centre

Importantly, both facilities collectively called the Turks & Caicos Islands Hospital (TCIH) were designed with built-in expansion capacity, including “shelled” spaces that can be retrofitted to increase inpatient bed capacity as demand grows. This forward-looking design on the part of the Turks & Caicos Islands Government aimed to support long-term scalability and enables the health system to respond to the evolving needs of the population.

Since its establishment, TCIH has transformed healthcare delivery across the islands through infrastructure development, international partnerships and a steadfast commitment to clinical excellence. The hospital system, comprising facilities in Providenciales and Grand Turk, introduced a new era of accessible, comprehensive care for residents and visitors alike.

A Legacy of Quality and International Recognition
Since its establishment, TCIH has maintained a strong focus on quality improvement and patient safety. Turks and Caicos Islands Hospital continues to distinguish itself as one of the few internationally accredited hospitals systems in the Caribbean, reflecting a sustained commitment to quality, safety and accountability. TCIH has maintained Accreditation Canada International accreditation at the Diamond level since 2012, the highest level achievable under the program, demonstrating consistent compliance with rigorous global standards in patient safety, governance and clinical care. Accreditation Canada’s Qmentum Global program is an internationally recognized framework used in more than 40 countries to drive continuous quality improvement, strengthen safety culture and ensure evidence-based care delivery across health systems. Within the Caribbean, hospitals achieving full international accreditation remain relatively limited, underscoring the significance of TCIH’s achievement.

As a growing centre for education and workforce development, TCIH has played a pivotal role in building local capacity within the healthcare sector. In 2019, the hospital achieved accreditation through the University of the West Indies accreditation body to support physician internship training, marking a major step toward developing a sustainable, homegrown medical workforce.
The hospital has also delivered a robust institutional training program since inception, supporting several health professionals across the Turks and Caicos Islands. Through collaborations with the Ministry of Education, TCIH has hosted one of their largest cohorts of interns and apprentices, while partnerships with the Turks and Caicos Islands Community College have enabled the introduction of the first clinical nursing rotations on-island.

Advancing Evidence-Based Care: Best Practice Spotlight Organization(r)
Turks and Caicos Islands Hospital has further strengthened its commitment to quality care through its designation as a Best Practice Spotlight Organization(r) (BPSO(r)) by the Registered Nurses’ Association of Ontario in 2025. The BPSO(r) programme is an internationally recognized initiative that supports healthcare organizations in implementing and sustaining evidence-based clinical practices. Through this designation, TCIH has demonstrated its ability to integrate best practice guidelines into everyday care, improving outcomes in key areas such as patient safety, person- and family-centred care, falls prevention and pressure injury prevention. For the community, it means greater confidence that care delivered at TCIH is safe, consistent and aligned with internationally recognized standards, ultimately contributing to better patient experiences and improved health outcomes across the Turks and Caicos Islands.

Advancing Surgical Safety: AORN Go Clear(tm) Award
Turks and Caicos Islands Hospital has also demonstrated leadership in surgical safety through its achievement of the AORN Go Clear(tm) Award in 2020, an international recognition granted by the Association of Perioperative Registered Nurses. The Go Clear(tm) Award recognizes healthcare facilities that have successfully implemented a comprehensive surgical smoke evacuation program, ensuring that operating theatres are effectively “smoke-free.” Surgical smoke-produced during procedures using lasers or electrosurgical devices-can contain harmful chemicals, toxic gases, and biological particles that pose risks to both patients and healthcare professionals. By meeting AORN’s stringent criteria, TCIH demonstrated that it has:

Adopted standardized protocols for smoke evacuation in surgical procedures
Equipped operating rooms with appropriate smoke evacuation technology
Trained clinical teams in safe surgical practices
Embedded a culture of safety within perioperative care

At the time of receiving this recognition in 2020, Turks and Caicos Islands Hospital was recognized as the first hospital in the Caribbean to achieve the AORN Go Clear(tm) Award, marking a significant milestone for patient safety and clinical excellence in the region. For patients, this achievement translates into safer surgical environments, reduced exposure to harmful airborne contaminants, and alignment with international best practices in operating room care. For healthcare professionals, it reflects a workplace that prioritizes occupational health and safety, reducing long-term exposure to surgical smoke and supporting a safer, more sustainable clinical environment.

Investing in the Next Generation of Healthcare Professionals
Turks and Caicos Islands Hospital is committed to building a sustainable healthcare workforce by inspiring and developing the next generation of health professionals. Through its READY Programme, TCIH provides high school students across the Turks and Caicos Islands with early exposure to careers in healthcare. The programme introduces students to a wide range of clinical and non-clinical roles, helping them better understand the pathways into the health sector and equipping them with foundational knowledge and career guidance. Complementing this initiative is the hospital’s Clinical Observership Programme, which offers students currently pursuing tertiary education in health sciences the opportunity to spend their summer months immersed in the hospital environment. Participants gain valuable hands-on exposure by shadowing experienced healthcare professionals, while also benefiting from structured mentorship and professional development support. Together, these programmes reflect TCIH’s commitment to nurturing local talent, strengthening workforce capacity and supporting long-term sustainability within the health system-ensuring that future generations are equipped to meet the evolving healthcare needs of the Turks and Caicos Islands.

The hospital has also contributed to workforce development in the Turks and Caicos Islands. Through partnerships with the Ministry of Education National Internship and Apprentice program and the Turks and Caicos Islands Community College. Further strengthening professional development, TCIH has worked closely with the Health Professionals Authority to introduce nurse clinical examinations locally. In collaboration with international partners, including the Hamilton Education Foundation, Massachusetts General Hospital and Harvard Medical School, TCIH has supported the introduction of Advanced Trauma Life Support (ATLS) training within the islands-enhancing emergency care capacity and preparedness.

Building Life-Saving Skills in the Community
Turks and Caicos Islands Hospital has also played a leading role in strengthening emergency response capacity across the islands through education and training. TCIH is recognized as the first fully accredited training centre in the Turks and Caicos Islands under the American Heart Association, delivering a comprehensive suite of internationally recognized resuscitation programmes. Through this initiative, the hospital provides annual training to more than 300 participants, including healthcare professionals, first responders and members of the wider community. These programmes focus on essential life-saving skills such as cardiopulmonary resuscitation (CPR), first aid, and advanced resuscitation techniques. By expanding access to this training, TCIH is helping to build a more resilient community, equipping individuals with the knowledge and confidence to respond effectively in emergencies and improving outcomes in critical situations. This achievement reflects the hospital’s broader commitment not only to delivering high-quality clinical care, but also to empowering the community with the skills needed to save lives.

Rising Utilization Reflects Growing Demand for Hospital Services
TCIH’s milestone comes at a time of rapid national growth, placing increasing demand on healthcare services. According to the Turks and Caicos Islands Statistics Authority, the population has grown significantly-from 18,491 in 2000 to 50,828 in 2024-while total visitor arrivals reached approximately 1.81 million in 2024, driven largely by continued expansion in the tourism sector. This growth trajectory is expected to continue. The Government’s National Tourism Development Strategy projects an increase in registered accommodation rooms to over 6,000 by 2032, reflecting sustained expansion in the hospitality sector and further growth in visitor and migrant workforce numbers. This demand is further intensified by the rising prevalence of chronic non-communicable diseases, which is contributing to greater complexity in care delivery and placing sustained pressure on both critical care services, outpatient visits and overseas referrals. At the same time, the hospital is closely monitoring an increase in trauma-related cases, adding another layer of demand on emergency and acute care services.

Over the past fourteen years, Turks and Caicos Islands Hospital has experienced a significant increase in patient activity, reflecting both national population growth and rising demand for healthcare services. Between February 2012 and February 2026, total patient encounters across the hospital system increased from 5,841 to 9,050, representing a substantial rise in overall service utilization. This growth has been particularly pronounced in outpatient care, where on-island clinic visits more than doubled, increasing from 2,617 to 6,439 encounters over the same period.

At Cheshire Hall Medical Centre, the impact of this demand is most evident in inpatient services. Bed occupancy levels have risen from an already high 85.34% in February 2012 to 115.71% in February 2026, indicating sustained periods where demand has exceeded available bed capacity.

These trends are creating capacity challenges across several key areas:
Inpatient beds – High occupancy driven by medical complexity and longer lengths of stay
Emergency Department – Increased patient volumes, acuity and trauma presentations
Outpatient Clinics – Growing demand for both on-island and visiting specialist services
Laboratory Services – Expanded testing needs to support chronic disease management and acute care
Diagnostic Imaging – Increased reliance on ultrasound, CT, MRI and other imaging to support timely diagnosis and treatment

These trends underscore the critical need for greater investment in expanding services at TCIH to support reliable, high-quality healthcare services to both residents and the millions of visitors who travel to the islands each year and reduce the need the overseas care.

Recognising the Strength of Our People
At the heart of Turks and Caicos Islands Hospital’s success over the past 16 years is the dedication, professionalism and compassion of our naturally excellent team. TCIH recognizes that the strength of its services lies in its people-highly skilled and committed healthcare professionals and support teams who work every day to deliver safe, high-quality care to the community. Across both Cheshire Hall Medical Centre and Cockburn Town Medical Centre, our team continue to demonstrate resilience, teamwork and an unwavering focus on patient-centred care, even as demand for services continues to grow.

The Board of Directors of InterHealth Canada extends its sincere appreciation to all members of the TCIH team for their outstanding contributions over the years.

“We recognize and deeply value the commitment of our facilities management and clinical services team, whose daily efforts make a meaningful difference in the lives of patients and families across the Turks and Caicos Islands. Their dedication, expertise and compassion are the foundation of the hospital’s success. As we celebrate this milestone, we thank them for their continued service and for the vital role they play in supporting the health and wellbeing of the community.”

Dr. Denise Brathwaite-Tennant, CEO, highlighted the importance of forward planning and partnership: “As we celebrate 16 years of service, we are proud of how far we have come in transforming healthcare in the Turks and Caicos Islands. Our achievements reflect the dedication, expertise and compassion of our entire team, who continue to place patients and families at the centre of everything we do. As demand for healthcare continues to grow, driven by population increases, chronic disease and evolving patient needs, we are seeing sustained pressure across all areas of the hospital, including critical care, outpatient services and emergency care. We are also closely monitoring the rise in trauma cases, which further underscores the need for responsive and resilient systems. In collaboration with our partners, we continue to advocate for the additional resources and investments required to meet this rising demand and to ensure we maintain safe, high-quality care for our community. We remain committed to working collaboratively with our key partners the Ministry of Health and the National Health Insurance Board to strengthen capacity, enhance service delivery and plan strategically for the future, ensuring that the health system continues to meet the needs of the Turks and Caicos Islands.

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