Found at: http://www.anguillaguide.com/article/articleprint/8356/-1/135/
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BAIRD AWAITS REPORT ON HAA DISMANTLEMENT
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Anguilla’s Deputy Chief Minister and Minister of Social Development, the Hon. Edison Baird, is awaiting a report from an Advisory Committee on how to dismantle the Health Authority and what mechanism can be used to effectively place it under the administration of the Government.
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Hon. Edison Baird
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“I charged the Advisory Committee with two things: to advise me on how to efficiently dismantle the Anguilla Health Authority; and to advise me with respect to a replacement managerial system suitable to Anguilla,” Mr. Baird said. He noted that the Committee was given four weeks in which to report to him.
“I have not in any way interfered with or tried to influence the operations of the Health Authority. The Board that I met is still in place,” he stated. “My intent is that when I get the report from this Advisory Committee, we will look at it and then spring into action to dismantle the Anguilla Health Authority.”
The Minister said the Advisory Committee was made up of Anguillian professionals, headed by Perin Bradley from the Ministry of Finance, and included Dr. Lowell Hughes, Dr. Paul Webster, Dr. Trevor Connor, the private Dental Surgeon; representatives of the Health Authority, Public Administration and the Attorney General’s Chambers, along with Health Planner, Lynrod Brooks, representing the Ministry of Social Development. “The point I am making is that the composition of this Advisory Committee is well-suited to critically examine the health system,” he said.
Mr. Baird stressed that the decision to dismantle the Health Authority was an election pledge by the governing Anguilla United Movement of which he is Deputy Leader. “We said we would dismantle the Health Authority for several reasons, one of them being that it was a financial burden around the neck of the Government of Anguilla,” he recalled. “In theory, it should be a self-financing entity. In reality, it gets 20 million dollars a year in subsidy from the Government of Anguilla and a lot of that money is trapped in the form of emoluments for the persons at the top and very little of it trickles down to where it is really needed – to patients, equipment, supplies and so on.
“A 100 percent of its capital budget comes from the Government and about 75 or 76 percent of its recurrent budget is also from the Government so it is financially dependent upon the Government. It was supposed to be financially, practically and legally independent of the Government whose role was only to set policy while the Authority would implement it. But it had never operated separately and distinctly from the Government so it is only technically an independent entity; and if something is financially dependent on the Government, it means that it puts the Government in a position to direct its operations… And even with regard to the people they hire, Government has a say because it is providing the subsidy in relation to expenditure, so it is only a fiction that the Anguilla Health Authority enjoys a statutory position.”
Mr. Baird continued: “We are dissatisfied with such an arrangement. We see that St. Kitts does not have a Health Authority system. We spend more money per capita on health than St. Kitts, but the level of service is inferior to that in St. Kitts…We are not getting value for money. We are spending too much of money on the Anguilla Health Authority in relation to its product which is a very low level of medical service and we intend to cure that difficulty by getting rid of the Anguilla Health Authority.
“You will recall that I was Minister of Education and Health from 1994 - 2000. When we came to power I made it clear that we would not implement the Health Authority. We had a Mr. Pool who was the Hospital Manager-designate and we sent him back. We did not implement it. When we left office the new Government implemented it. On the campaign trail, and in our manifesto, we made it clear that if the people put us in we would dismantle the system so we are fulfilling that pledge to the people of Anguilla.
“I do not attend the meetings of the Advisory Committee. It is not my intention to influence the committee in any way. They must examine the situation and come to their own conclusions in an unimpeded way. I have also been very careful not to hold any discussions with Mr. Brooks [the Ministry’s representative] in relation to the meetings. I want to operate not on what I hear, but on the basis of the report. His input will be at the meetings but I will never hold any discussions with him or any of the members while they are carrying out their deliberations.”
Mr. Baird was certain that under the new arrangement the health services would not be a burden to Government. “I don’t foresee it as a burden. Of course there are people who are on contracts and we will have to honour those contracts,” he continued. “This is why we were careful to have someone with a legal mind on the Committee and so we have a person from the Attorney General’s Chambers, as I said. We were also careful to have someone with a financial background, so that’s why we have someone from the Ministry of Finance. We were also careful to have someone from Public Administration. We were careful to put Dr. Paul Webster who functions in the United States as a medical doctor on the Committee because we are looking for scope and experience, and that’s why we also have Dr. Hughes there. We have people who know medical systems and I don’t pretend to be an expert on various medical systems. This is why I want the experts to recommend to me what the best system is, given Anguilla’s size and limitation. I have an open mind as to the replacement system but it will come back under Government control.
“The Health Authority was given provisional accreditation but it was quickly withdrawn. So the system couldn’t sustain itself. The major problem with the Anguilla Health Authority is not the people in the system. It’s a systemic problem. Even if you get rid of all the people in the system, and replace them with new people, we will still have these difficulties because the problem is systemic in nature. It is top heavy. Too much of money is trapped at the top. We are paying all these people hundreds of thousands of dollars a year to manage an average of nine patients in the hospital on a daily basis…”
Mr. Baird concluded by assuring the people of Anguilla that his Ministry would do all in its power to improve the health services of the island.