McKeeva Bush was first elected to the Cayman Islands legislature for West Bay in 1984 and held the seat continuously for more than 40 years. He served as Minister for Health and Human Services (1992-1994) and Minister of Community Development, Sports, Women's and Youth Affairs and Culture (1994-1997), before becoming Leader of Government Business and Minister of Tourism, Environment, Development and Commerce (2001-2005). He co-founded the United Democratic Party in 2001, later sitting as an Independent.
Bush led the Opposition from 2005 to 2009 and was elected Premier of the Cayman Islands in 2009, holding the post until 2012. He later served as Speaker of Parliament from 2017 to 2022, and lost his West Bay seat in the 2025 general election.
He spoke as a panellist at the 2nd, 3rd and 4th Cayman Islands Shipping Summits (2014-2016).