The Anguilla Progressive Movement (APM), through its leader Premier Ellis Lorenzo Webster, has repeatedly declared its intention to return Anguilla’s health services to direct management by the Government of Anguilla through the Ministry of Health. The plan is for the island’s health services, which have been managed by a statutory body, the Health Authority of Anguilla, since January 2004, to be returned to its earlier status, which essentially equated to a ‘department’ of Government.
While political parties often tout ideas on the path to election, and then reality causes them to revisit them, the idea that Anguilla’s health needs are best served by the return of the health services to the Government does not seem to be one such idea. This view is strengthened by the fact that the Premier, who has repeatedly referenced plans to return the health services to Government, also serves as the Minister of Health.
Persons who are familiar with the establishment of the Health Authority would be very aware of the extensive research and planning that went into rolling out the Health Authority. Even with such extensive planning it is apparent that certain matters were not fully considered. What is troubling about the plan, to return the health services to Government, is the apparent absence of any planning to effect the intended transition.
The APM Government prides itself on being transparent. Is it therefore fair to conclude that the absence of information about the intended transition is an indication that no concrete steps have been taken in relation to the purported return of the health services to Government? What is the basis for the return of the health services to Government? What evidence is there to support the legitimacy of that basis, if one exists? How was the evidence procured? Who is leading the change process? Reference has previously been made to the establishment of a committee. Has it been established? If it has, who is serving on the committee? Will the main stakeholders, the users of the health services, be consulted and, if yes, at what stage? Clearly, there are numerous questions that are yet to be answered.
The Health Authority of Anguilla is a legal entity having been established in accordance with the Health Authority of Anguilla Act. It is therefore expected that legislative action will be required to dismantle the Health Authority. A certain management structure has been established under the Health Authority, and staff appointed accordingly. What will be the implications for personnel of the Health Authority? Will the transition back to Government result in redundancies? How will redundancies be managed? Are the potential financial and legal implications being considered? What will be the potential implications for staffing in the Anguilla Public Service? Is the Public Service equipped to manage the finances and human resources associated with the provision of health services?
One of the primary reasons for the creation of certain statutory bodies in Anguilla, including the Health Authority of Anguilla, was to ensure that certain services were provided in a more efficient and effective manner. Has a comparative study been carried out to determine whether the desired improvements in health services have been achieved under the Health Authority, when compared to the level of service offered previously under the Government? There was a reason why the Health Authority was created. The APM would be doing an injustice to the people of Anguilla, if it transitioned Anguilla’s health services back to the Government without engaging in a thorough review of the pros and cons of doing so. If there is one ‘contemplated’ change that requires deliberate and extensive research and public engagement it is this one. We cannot play games with our health services.
