The Standing Public Accounts Committee (PAC) resumed today, Wednesday, 9 September, for the second day of the public hearings examining the Office of the Auditor General (OAG)’s Report, “Summary of Outstanding OAG and PAC Recommendations” published in April 2026.
The Chief Executive Officer of the Health Services Authority, Ms Lizette Yearwood, was called to provide an update on 17 outstanding recommendations made to the Authority. She was accompanied by Senior Chief Financial Officer Mr David Duynhoven and Ms Sheila Thomas, Chief Financial Officer. Ms Yearwood acknowledged that there was still work to be done but significant progress had been made, with several findings requiring a comprehensive redesign across a diverse healthcare system. She stated, however, that this was a priority for the Authority, and that 14 out of 17 of the recommendations had been completed, with 3 still in progress that required data to be published. Ms Yearwood noted that there were challenges to the implementation of the remaining recommendations because they had elements outside the ability of the Health Services Authority, but that one of the outstanding recommendations would be completed during the fourth quarter of 2026 and the remaining two by the second quarter of 2027.
Ms Yearwood also outlined improvements to pharmaceutical procurement and inventory management, including strengthened procurement controls and two-year vendor contracts aimed at improving price stability and continuity of supply. She noted that the number of out-of-stock items had fallen from 180 to 22, with 10 of those subsequently resolved.
Chief Officer Tamara Ebanks and Chief Financial Officer Troy Claxton from the Ministry of Health, Environment and Sustainability provided updates on 16 outstanding recommendations, 12 of which were more than five years old. Chief Officer Ebanks noted that 10 of the recommendations had been completed, with five in progress and one not accepted. On the recommendation concerning the extension of the CayHealth programme to the wider population, Ms Ebanks noted that this had not been accepted due to the anticipated cost. Instead, the Ministry was exploring the HEARTS Programme, aimed at reducing medication costs and barriers to accessing care.
Addressing concerns raised by the Committee about reports of nurses working without verified credentials or qualifications, Ms Ebanks stated that these would be addressed through strengthened inspection services and revisions to practitioners’ licences under appropriate legislation.
The Committee called Mr Michael Nixon, Acting Financial Secretary and Chief Officer of the Ministry of Finance and Economic Development. In his statement, he noted that of the 57 recommendations made, 32 had been completed, with 19 in progress and others either not accepted or reassigned to another ministry or portfolio following review with the Office of the Deputy Governor. Throughout the hearing, he recategorised several recommendations that had previously not been accepted, indicating that the Ministry would review them further and marking them as in progress.
Mr Nixon noted that many of the recommendations still in progress related to policy and legislative reform beyond the sole remit of the Ministry, requiring broader public service changes around budgeting, financial management and reporting. As a result, he said it was not possible to provide precise completion dates for some recommendations but assured the Committee that work continued.
Continuing, Mr Nixon provided an update on the planned transition to an outcome-based budgeting framework, aimed at better aligning government expenditure with strategic priorities and placing greater emphasis on the results achieved through public spending. He confirmed that full implementation is planned for the 2030/2031 budget cycle, allowing time for the necessary systems, legislative changes, stakeholder consultation and training. However, he noted that some changes would be introduced for the 2028/2029 budget cycle, including efforts to simplify budget documents and make information easier to find. Mr Nixon added that the new framework would seek to improve how Government measures and reports the impact of public spending, moving beyond activity-based measures towards clearer outcomes for the Cayman Islands.
He also answered several questions from the Committee regarding the process for the granting of concessions, which he noted were approved on a case-by-case basis rather than through an approved policy. He explained that, although the recommendation in the report had been transferred to the Ministry of District Administration and Home Affairs, a formal policy was being actively developed by the Ministry of Finance and Economic Development for consideration by Cabinet before the end of 2026. The policy would seek to clarify responsibility for monitoring specific conditions attached to concessions.
Watch Wednesday’s proceedings:
Public Accounts Committee | 9 September 2026 | Part 1
Public Accounts Committee | 9 September 2026 | Part 2
Watch live broadcasts of sittings on CIG YouTube and CIGTV (Logic - Channel 23, C3 - Channel 3, Flow - Channel 106).
For further information visit: www.parliament.ky