The Cayman Islands Health Services Authority (“HSA”) announced they have received an unmodified/unqualified (clean) audit opinion from the Auditor General for the HSA’s 2018 financial statements.

A clean audit opinion means financial statements are free from material misstatements (an unmodified audit opinion) with no material adverse findings regarding financial operations or non-compliance with legislation.  A clean audit opinion is the best outcome that can be obtained.

This goal was one of the HSA Board’s main strategic priorities for 2018, and follows the HSA’s public commitment to the Legislative Assembly and Public Accounts Committee that it would achieve this standard for the 2018 fiscal year.

In pursuing this commitment, the Board and management deployed sustained initiatives to improve the quality and reliability of the HSA’s financial information.  Major contributors to the HSA’s improved financial health include (and are not limited to) strengthening of, and ongoing training around, our policies and procedures; improved processes around collections; and ongoing monitoring of accounts receivable balances.

Financial managers, physicians, clinical professionals and staff at all levels worked collaboratively to implement various recommendations from Deloitte and the Auditor General.  Areas of focus included: finance and supply chain management; revenue and budget management; asset management; and general control programmes.  Implementation of those recommendations was a key factor in realizing this outcome.

HSA Chairman, Jonathan Tibbetts, says the achievement was driven by strong leadership commitment at the Board and management level, and commended the staff for reaching this milestone.

“The achievement of this first unmodified audit opinion is a major accomplishment for the HSA and a testament of our commitment to accountability and reform which has been reflected in other areas of improvement since this Board was appointed.  This includes reaching and sustaining a 90-day cash reserve as mandated in the HSA Law for the first time since the inception of the HSA; improvements in clinical outcomes and performance metrics; and providing better access to timely healthcare through facility improvements and expansion.”

“We appreciate the diligent work done by every single employee,” Mr. Tibbetts added. “The organisation recruited the right people, put together strong teams and designated ‘champions’ to lead various tasks, groups and initiatives to achieve this outcome. This helped to inspire everyone around the shared goal and the importance of achieving an unmodified audit opinion”.

HSA CEO Lizzette Yearwood paid tribute to the exceptional work of the staff who embraced the challenges and worked collaboratively in making this historic achievement possible. “Our talented and dedicated workforce came together in implementing strong internal policies and business practices to resolve complicated financial management issues leading to the achievement of this unmodified audit opinion,” Ms. Yearwood said. 

Ms. Yearwood expressed her appreciation to the Minister, Ministry, and Board for their vision and support, in addition to all of HSA’s staff, past and present, for their hard work and dedication to achieve this goal. 

Recording the transactions for over 1,000 daily patient encounters facilitated by almost 900 staff across all three Islands, delivering diagnostics, therapy and pharmaceutical supplies creates a complex business environment for the HSA. However, Ms. Yearwood pointed to the implementation of strong, effective internal control measures, development of comprehensive policies and the commitment of staff as the critical pieces that led to the outcome.

“We are very conscious that the hard work is far from over and this achievement poses an even greater responsibility upon us all to maintain our financial integrity with unmodified audit opinions in future years,” she said.

“As always, we continue to focus on delivering the best quality care to our patients, from reduced error rates to shorter wait times and improved patient satisfaction.”

Health Minister, Hon. Dwayne Seymour congratulated the tremendous work of the Board and the HSA management and staff in achieving this milestone.

Auditor General, Sue Winspear confirmed the unmodified/unqualified audit opinion and congratulated the HSA on this achievement.