Many small Islands around the world share similar problems when it comes to provision of healthcare. Now, KPMG has launched a global healthcare hub for small islands, enabling them to share experience and best practice to tailor their approach to the specific needs of their people.
Manx Newscast
Global Centre of Excellence for Island Healthcare
Hi, I'm Simon Richardson from the Banks Radio Newsroom. It seems the Isle of Man is not alone in having to deal with the problems posed by operating a comprehensive healthcare system in a small island environment. Similar problems are shared by island nations worldwide. Now though, a new initiative aimed at providing small islands with tailored solutions to help deal with the issues they face has been launched. The Global Centre of Excellence for Island Healthcare is operated by KPMG through its 70 member firms worldwide. It unites dedicated island-based professionals from the Crown Dependencies, Caribbean, Bermuda and the Mediterranean and focuses on identifying best practice. I caught up with Russell Kelly, Head of Advisory for KPMG Islands Group and Dr Ed Fitzgerald, Head of Healthcare and Life Sciences for the KPMG Islands Group, who are attending an event in Miami. I started by asking Mr Kelly to explain the rationale behind the launch. Yes, I'll briefly set that out then, hand over to Ed. We operate as a single business across a group of islands, so the Crown Dependencies, Bermuda, Cayman, BVI, the Harmers and down to the Caribbean. All of those islands we see face similar but not identical healthcare challenges. A few years ago we invested in a team led by Ed and that team has done quite a lot of work across those islands and brought to bear experiences of similar challenges to the local governments and healthcare providers. Thanks Russell. Yes, I guess one of my interesting reflections is healthcare is challenged wherever you are in the world. It's complex, it's difficult, it's sometimes messy and I think healthcare in island settings, in small island settings particularly, really brings a magnifying class to that. So our team is really working to make that a specialism, to be able to work with professionals who are based living in islands across the region, to bring that focus, to recognise some of those complexities, to adapt and adopt unique solutions for island settings and to really try and facilitate a little bit more collaboration and partnership between islands, many of whom are facing similar challenges and looking for solutions to be able to deal with some of these challenges. I think it's particularly important in island settings because we really have to support island communities themselves because it's the right thing to do but also because there is a wider economic benefit to islands from a strong healthcare system and a healthy population. Talking of unique challenges and looking at particularly the Isle of Man's issues, the problems here are well documented of late, another whopping multi-million pound overspend this year, also issues recruiting staff to name just two of the problems faced. How could the kind of initiative that you have now launched maybe help an island like us? Well, I think it's fair to say Simon that those issues are faced in all of the territories that we're operating in. It is difficult to attract people into those islands in some cases because of the degree of specialism of a medical practitioner can engage in in a small jurisdiction and I think it's fair to say that they all have financial pressures and that is normally in the form of healthcare becoming sort of more expensive on a per capita basis and also a greater share therefore of the budgets of all of these economies. Do you find a great interest among the islands, among the smaller islands in this initiative that you've launched are they keen to get involved? They really are actually and it's been really pleasing to see. I think islands do appreciate there is an opportunity in healthcare to share learning more than is taking place currently and I think from from the financial perspective it's on the record we've been helping support the financial recovery plan in Jersey last year and prior to that we helped support Bermuda Hospital Board's financial recovery and I think there are lessons learned from this that can be applied to other island healthcare systems comparing an island healthcare system to the mainland it's a different beast and I think islands do recognise that that different situation sometimes means that the learning is more applicable and there's better comparators from other island jurisdictions. And what is the knowledge base that you will glean your information from how has it been developed? So it's a good question because actually one of the shortages in many islands and there isn't the same level necessarily of health data provided in many jurisdictions so whereas you might look at be that everything from OEC data down to local population health data in mainland settings often in islands that isn't always there as much and so we are having to do a lot of work both helping support territories and jurisdictions on understanding that as the baseline starting point but once that's established it's actually really a huge interest to other islands to be able to see how comparators are made for example just having a conversation last week with the team in Bermuda about levels of diabetes which are roughly at least two times the prevalence you might find in the in the crown dependencies and understanding some of those differences it means you really think slightly differently slightly more nuanced about allocation of funding the resources that are needed so actually getting to understand some of that context behind the numbers in the different island settings is really important. I assume as well that running a health service in a place like the Isle of Man where it operates if you like a national health service akin to that in the UK is very different to islands that offer private health systems through maybe insurance. That's right and I think that is one of the really interesting things about islands there are some very different models for running healthcare systems and some very different population health needs and really being able to understand those in the local context is key. Bermuda where I'm based is an entirely US insurance style health system for example with a minimum level of provision for those unable to access health insurance but no universal health coverage, no national health service despite being a British overseas territory, compare that say to Jersey and other crown dependencies where access to hospital care is covered but you will pay to access primary health care. There are some really important differences in the way that different island health models are set up. Now you already have a track record you've got a couple of successful projects under your belt already but as with all things in life I expect this kind of support will come at a cost. Are you confident that the advice and support you can give balanced against that cost of the services itself will be cost effective for the islands concerned? Well certainly where we've done specific directed financial recovery type programs to identify cost savings you know we do it on the basis and our fees will be covered by the cost savings and some more you know quite substantially more and we've certainly seen that born out in other territories where we've done what. And I suppose the proof of the pudding is that you've already clearly established a successful track record ahead of the launch. Yes yeah that's something we've been working up to we've been building out the team we bring people in on the sort of western side of our business if you like from Canada to to assist and you know when we're working in the crown dependencies and to some extent in the west as well we do use some of our UK teams because having an understanding of that NHS backbone and an NHS system is quite important because you know as you look even across the Caribbean a number of those islands are looking to ensure there is a base level of universal healthcare becoming available for their populations. And finally I suppose Russell looking purely at the Isle of Man situation which of course you're aware of is the is the Isle of Man government is the health service here actually in dialogue with you about these kind of this kind of help. We've certainly spoken to the Isle of Man government about healthcare and healthcare transformation and you know we have had teams working in there in some areas of sort of healthcare process and healthcare provision although not overtly involved in cost-saving exercises. Thank you for making it to the end of the Manx Radio newscast you are obviously someone with exquisite taste may I politely suggest you might want to subscribe to this and a wide range of Manx Radio podcasts at your favourite podcast provider so our best bits will magically appear on your smartphone. Thank you. [music] [BLANK_AUDIO]