e Cayman Net News, Dr Tomlinson noted that he had made several warnings that government stood to lose revenue from the project, but these went unheeded. He further stated that he had asked that government should move slowly on the matter to ensure it was a win-win situation.

Dr Tomlinson recalled how he was perceived last year as being opposed to the creation of the proposed NCUMC, when he raised questions in an article published by Cayman Net News.

The CPPI recently revealed that should the NCUMC continue under its current agreement, government would lose up to $10 million in revenue.

“Even if Dr Shetty is assisted by government to import low-cost foreign workers and medical personnel and runs assembly-line medical procedures, the costs will still be considerably more than in other places. Yet Dr. Shetty’s latest health city in India was only 1,400 beds. So, how can Dr Shetty profitably do a 2,000-bed multi-specialty hospital in Cayman, an island miniscule in size and a more costly jurisdiction, the CPPI asked in a paper on the proposed project?

The institute answered this by noting that Dr Shetty’s local agent Gene Thompson had stated that they only wanted to build a 140 to 150-bed hospital.

“This new statement by the developer is concerning as the MOU specifically requires that Phase One must consist of a 2,000-bed multi-specialty hospital, for which Dr Shetty has already been granted these extensive concessions and the government has undertaken considerable work,” read the CPPI report.

The policy institute noted that government would lose revenue because of the unlimited, guaranteed work permits and key employee status, plus a 15-30 per cent discount off the work permit fees.

“Considering the aggressive structure of this MOU, it would not be unreasonable to believe that Dr Shetty will be given a 30 per cent discount,” the report read, even as the CPPI noted that government stood to lose an estimated $144,300.00 per annum.  The CPPI noted that government failed to consider several other critical obligations, which flow from this deal with Dr Shetty, such as government’s obligations to the influx of persons (workers, medical staff and possibly dependents, patients and visitors) under the incoming Bill of Rights to be implemented in 2012. Guaranteeing these human rights for all persons in Cayman will require substantial infrastructure.

The public institute also noted that the Narayana Hospital would be demanding discounts on basic things like water.

“Considering this tremendous capital outlay, Dr Shetty has further demanded

discounted/preferential rates for water and utilities for this project. This minimises the amount of investment Dr Shetty is required to make, while placing considerable demands on the government and the Caymanian people,” the document stated.

 “The Water Authority will lose approximately CI$65,578.00 per annum in revenue or approximately CI$1.3 million over a 20-year term. At that rate, the

Water Authority would never be able to realise its initial capital outlay,” reads the paper.

 According to the CPPI, other jurisdictions that were competing for this project, were not prepared to concede to every demand made by the developers, including the limitation and wholesale amendments of malpractice laws.

However, the Cayman government is required to pass laws limiting malpractice/negligence to US$500,000 and must pass laws to facilitate organ donation and transplantation.

The CPPI noted that the most that some jurisdictions would have introduced on legislation to attract medical tourism was to offer simpler visas, change laws to enable existing hospitals to attract medical tourists and alter ownership laws to encourage investment. Cayman has taken much more significant steps, with changes to malpractice laws and doctor registration, plus planned changes on organ donation laws, it noted.

The CPPI also stated that no analysis or consideration is provided by government as to how it taxpayers would meet the cost of such infrastructure upgrades or to develop an entirely new airport, particularly given government’s publicised financial constraints.

“How can government fund such an undertaking with no financial assistance? All the infrastructure costs for this project are being borne by the Caymanian people, while all the direct benefit goes to Dr Shetty?” the paper asks.