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A NEW HEALTH SYSTEM:

The government of the Turks and Caicos Islands has implemented an ambitious and unique Health Services Renewal Programme that includes a strong focus on Lifestyle and Wellness initiatives; the revitalisation of Public Health facilities and services and the construction of two new full service hospitals in order to improve the range and quality of primary and secondary care services available on-island. The proposed introduction of a new National Health Insurance Plan is designed to help fund some of these service improvements.

A COMPETITIVE PROCESS:

In 2006, the Government of the Turks and Caicos Islands, with the direct involvement of UK and other internationally known specialist advisors, carried out a rigorous and competitive selection process between internationally qualified bidders to appoint a private sector partner for a significant part of its health services renewal programme. InterHealth Canada is proud to have been selected through that process

Following our selection, a Project Agreement was signed between the Government of the Turks and Caicos Islands and InterHealth Canada in January 2008. Under the Project Agreement, we are required to design, build, equip, maintain and operate the new hospitals in Grand Turk and Providenciales on behalf of the government and the people of the Turks and Caicos Islands and will be fully accountable to the government for the full range and quality of clinical and non-clinical services provided.

We agreed to a twenty-seven month programme of hospital construction, equipment selection and installation, full hospital commissioning and staffing. The new hospitals will open with 20 beds on Providenciales and 10 beds on Grand Turk and will begin delivery of a range of primary and secondary clinical care services to the people of the TCI in April 2010. As demand requires, the hospitals will expand to 40 beds on Providenciales and 20 beds on Grand Turk. Ward space for such expansion is being built into the hospitals.

In completing this extensive full service programme, we and our funders will have invested some $124 million - a figure which compares favourably with similar international PPP projects. The funding includes a mixture of senior debt provided by the Export Development Corporation of Canada and First Caribbean International Bank of Barbados, subordinated and junior debt provided by HSBC Infrastructure Fund and equity provided by our Canadian parent company and our equity partner, HSBC Infrastructure Fund.

This unique Project represents a milestone in the development of on-island health services and is the first Public Private Partnership (PPP) involving the construction and operation of full service hospitals in the Region.



During 2008, we have continued to build on those successes

Working closely with the Commonwealth Secretariat, we attended the 2008 meetings of Commonwealth Health Ministers in Geneva and Commonwealth Finance Ministers in St. Lucia and we were recently honoured to be invited to Chair the Commonwealth Business Council’s Focus group on Healthcare Infrastructure. We have been appointed preferred bidder on a further project in the UK to manage a private neurology unit for the prestigious University College London Hospitals NHS Foundation Trust in London, and we were appointed to advise the Government of the UAE on the reorganisation of its emergency response and ambulance services. More recently, we have been consulted and are assisting with the improvement of healthcare in two of the emergent countries of Eastern Europe and have been invited to present similar proposals to a West African government.

More closely to home, you will be pleased to know that your hospitals project has very recently won the prestigious "Latin American PPP Deal of 2008" award from Project Finance Magazine

Underlying our approach to the services we provide is the philosophy that only by providing a quality service can the needs of patients, of sponsoring governments and the aspirations of a qualified staff be properly met. We apply that principle of quality also to the facilities and equipment which we operate, by ensuring that planned maintenance and renewal programmes are drawn up and adhered to.

From project to project, we draw on our extensive corporate expertise to assemble the healthcare experience and leadership required - teams with specialty health service experience to deliver specialty services and teams with full service experience where such is the focus of the Project.

In the case of the TCI hospitals, our Project Team includes individuals with a lifetime of experience in both specialty and full service health care planning, development and delivery. Healthcare has been rightly described as being dependent upon people - a "people business" and this concept is reflected throughout the InterHealth Canada group. All new employees will be given a comprehensive orientation and induction into our high standards of quality patient care and service and will be active participants in the new hospitals' ongoing continuous training and quality improvement programmes.

A YEAR OF PROGRESS:

The TCI Hospitals Project was officially launched in January of 2008 and our Implementation Team, linked to the government through a Joint Monitoring Team, immediately began working on the essential construction, equipment and staffing activities and the development of the necessary operating systems, all strictly in accordance with the detailed provisions of the Project Agreement.

Now in its 15th month, we are delighted to be able to report that the Project is well and truly on time and on budget and ALL the milestones set out in the Project Agreement have been met. The construction of both hospitals suffered some damage last October, as did all of the TCI, from Hurricanes Hannah and Ike, but we and our contractors have worked hard to ensure that the agreed opening date for the two hospitals will remain unchanged.

SKILLED AND DEDICATED WORKFORCE:

The key challenge of ensuring that the new hospitals have the qualified and experienced staff needed to deliver the agreed patient services is also being addressed by us. The staffing process is going forward in 3 phases (current staff re-employment, local new recruiting and international recruiting). In the past 10 months, the existing TCI hospitals' staff were encouraged to apply for positions with the new hospitals. Following assessment by our clinical and HR teams, we were pleased to be able to offer to re-employ some 118 of the current staff in the new hospitals and more than 90% of those people have already accepted.

The next staffing phases are now in full swing. Our search is primarily focussed on Belongers and other healthcare professionals in the TCI who might be considering a career with the new hospitals, but we are also beginning to widen our search to the international market. We expect to complete this wave of staffing over the coming Spring and Summer.

There are still some 20-25 medical staff positions and numerous nursing and other allied health professional positions as well as a number of support staff positions, available. ALL interested individuals should send their expression of interest to our Director of Human Resources and Recruiting, Nick Ofield, at Recruitment@interhealthcanada.tc. Nick is based permanently in the TCI to ensure that our recruitment process is managed in close cooperation with all stakeholders.

QUALITY CARE & SERVICES:

When the new TCI Hospitals open in April 2010, they will offer a standard of care and services that will allow them to apply for full accreditation by Accreditation Canada within their first two years of operation and for that accreditation to be maintained. That is a contractual obligation under the Project Agreement which we readily accepted because such Accreditation constitutes an esential benchmark of quality in both the clinical and non-clinical services being provided and the hospitals themselves.

The new hospitals will work hard to ensure that services are delivered “closer to home” and only those cases requiring the highest and most complex levels of care - usually called "tertiary care" - will be referred to the Treatment Abroad Programme.

FREQUENTLY ASKED QUESTIONS (FAQs):

1) What services will the new hospitals provide?

Services provided at the hospitals will include diagnostic services, primary care and outpatient specialty clinics, emergency services and inpatient care. Included are:

a. primary care clinics
b. outpatient consultation following referral by a GP or Primary Care Provider
c. pre-operative assessment and preparation
d. diagnostic imaging
e. laboratory investigation
f. surgical, obstetric and endoscopic procedures
g. inpatient care of admitted cases
h. follow-up outpatient consultation
i. pharmaceutical care
j. emergency care

Hospital services, both primary and secondary care, will be delivered in cooperation with services provided by other on-island healthcare professionals and, for more complex or tertary level care, in cooperation with Governement approved "prefered overseas providers".

2) Who owns the hospitals?

Following an intensive tender and bidding process, InterHealth Canada was awarded the contract to build and operate the new hospitals on behalf on the government. The new hospitals are being provided as a Public Private Partnership (PPP) arranged by us and the government and with the support of a group of financial institutions. In accordance with the agreement between the parties, the hospitals are government hospitals and the buildings and equipment will revert to the Turks and Caicos Islands at the expiration of the current contract.

3) Will Private Doctors be involved with the new hospitals?

In addition to the medical staff who will be working at the hospitals, private doctors may choose to apply for "privileges" at the hospitals: when granted privileges those private doctors may admit and treat their patients at the hospitals in accordance with hospital policies and procedures. Also, private doctors may refer patients to the hospitals for diagnostic tests or treatment.

CONTACTING US:

We hope that this first edition of the TCI Hospitals Project Newsletter answers some of your questions and that you will be interested to receive future editions as they are published. Also, if you have comments or suggestions for future editions, please send them to rcheesman@interhealthcanada.tc. More ‘"requently asked questions" will be answered in future Newsletters.
 

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