07 July, 2007

Health Check

Health Authority of Anguilla. On Thursday night Ras B interviewed Minister of Health Evans Macneil Rogers. I did not hear the interview myself. One of my correspondents did. This is what she wrote about it.

Last night the Minister of Health held an interview with Ras B on Heart Beat Radio. Interestingly, he did it on the condition that no calls be accepted from listeners. What is disturbing is that the Minister went on to make statements regarding the outgoing Health Authority Board and the Health Authority that demonstrate either a shameful ignorance of the purpose, structure and operations of the Authority, or another deliberate attempt by a politician to mislead the people.

The Health Authority legislation was carefully constructed as a model for future legislation regarding statutory bodies. Gordon Carnegie had many sleepless nights. He made sure that Anguilla would not make the mistakes that others had made.

The Board is required to have 7 members – one representing medical, one nursing, one business, one finance, one human resources, and two representing the public interest. The Board also has four supporting committees to advise it.

Each Committee has two members of the board as chair and deputy chair, and includes executive managers of the Authority and other private and public sector persons with the particular expertise. All of those 4 committees meet every month and report to the board on a monthly basis. The four committees are: The Patient Care and Quality Services Committee – headed by the medical member of the board included doctors from the private sector (like Dr. Paige) and doctors and senior nursing personnel from within the authority. This committee looks at the medical and patient care issues, including complaints from the public. It also worked on the diagnostics – (the public should not be deceived by the Minister's attempt to indicate that this was being ignored.) This committee provided guidance for the board on all medical matters and was headed for the first 3 years of operation by Dr. Brett Hodge, with Nurse Yvonne Rey as co-chair until the end of their term in December. It was on the recommendations of this committee that the Board implemented the diagnostic changes in the Authority.

Nurse Rey was also chairperson of the Nursing committee which advised the board on all nursing matters. When Dr. Hodge and Nurse Rey ended their term, the Minister for six months failed to appoint their replacements. In essence, he "starved" the Board of this vital expertise. For six months a board which should have 7 members was forced to operate with only 4.

The other committees were the Finance and Audit and Human Resources committees, which were set up similarly to the other committees. The board also created a Dispute and Grievance Resolution committee to assist staff who may have issues that could not be solved within the system.

The Human Resources committee assisted the human resources department with policies, recruitment and training decisions. I am appalled that the Minister told the public on radio last night displayed that the human resources department needed restructuring. This is an insult to Mrs. Meridith Gumbs, the human resources manager who literally worked day and night to ensure that the department was one of the most professionally organized in the public and private sector. The minister seems to be judging or damning the authority based on the need for customer service training, but if the truth were to be told Meridith Gumbs had several training sessions for the staff. Coincidentally, the same person that Meridith had looking after the training needs of the Authority, was the person that the minister took to study the "customer service" needs of the authority.

The Health Authority was set up to allow for input from inside and outside the Authority. The Board does not arbitrarily or high handedly make decisions. All this is public knowledge as the Authority published all this information very early in its operations. All sectors of the authority had to give quarterly accounts - The minister, the ministry and public were kept informed.

The people should know, in fact someone should tell the Minister that there is a difference between governance and operations. The board governs, the CEO and the managers carry out the established policy. The CEO does not have to go to the Board to buy a light bulb for the Operating Theatre. The empowerment of the lower levels is to cut out bureaucracy and make sure that the service is efficient. This is why Mr. Eric Reid OBE worked so hard to establish a Health Authority.

People are tired of hearing the Minister claim to be such a health professional. As a minister of government he should be looking at governance and regulation of the authority – his experience as a med tech does not give him the knowledge or experience to run the health authority or override the national health plan which was developed by health experts, health professionals and the people of Anguilla. Please tell the Minister, it is not about him, there is no room in health for pretense and self-importance.

The government needs to pay serious attention to the social development. The recent events point to that. The government should be concerned that one of the most qualified health professionals in the region, Mr Foster Rogers, is working in the Chief Minister's office and not in health – the minister did not want him – Why did Orris Proctor resign? – the minister frustrated him. Why was it such a fight to get the well-qualified Dr. Bonnie Lake to be appointed as PS Health? Why is she now sidelined by the Minister? Why are there so many proposals or plans from the Health authority and other social development departments lying unattended on the Minister's desk for a year or more? The ministry of health needs a serious check up.

Well, what do you make of this situation?


  1. The writer is to be commended for an excellent and accurate report. I was hoping the Minister would give us information, not a lecture on the obvious. He has a lot of questions to answer.

  2. In July 2005 the Minister lectured us to "develop the qualities of leadership, commitment, dedication to service, integrity, conflict resolution skills and honesty”. Unfortunately he has failed to demonstrate any of these himself. He is an enormous disappointment.

  3. On 28 August 2005 the Minister said, "I think it is time that we put a lot more effort and money into our social services". Stupid me, I thought he was referring to education and health. What a failure this guy is.

  4. Two years ago the Minister had big plans to beautify the grounds of our schools. He said at the Stony Ground School, “It is an effort to enhance the environment of the school,” said Minister Evans Rogers. “For a long time we have had problems not only at this particular school, but other schools as well and we will be addressing all of these problems as we go forward. We will take them one at a time and deal with them.”

    Work on the first school has yet to be finished. The Minister's self-confidence is exceeded only by his lack of follow-through.

  5. I thought it was interesting that the Minister said that the members of the outgoing Board may not have understood what he meant by "reconfiguring/reconstituting the Board", and when he wrote to them asking whether they wanted to serve again they did not respond. It would seem to me that he went to the Executive Council to get what he is calling a new board while he had the old board, albeit a skeleton board still serving. Could it be that ExCo would ignore the legislation and approve whatever a Minister brings to them without checking the legality? Even when he got the so called "approval" from ExCo, he apparently did not communicate this to the Board. He still does not give an explanation why he waited six months to appoint any new members, especially when the new Members were medical expertise required by the Act.

  6. The Minister's interview clarified a lot of questions I had. I am satisfied with his explanation and look forward to the new Board addressing the serious concerns and complaints the public continue to have. Now that Mr. Reid era is out, lets hope this will improve the public impression of our health system. Thanks, to the last Board for serving and establishing the foundation. It would be good if the last Board can meet with the minister and review this break down in communication.

    As professionals I did not expect all these personal pronouns in a letter of resignation. This is our people health and Boards come and Boards go. Move on. The minister made a decision. The only question on our minds now is what next? WHat do you expect the new Board to foucs on? How can we improve the system so that more ANguillians will use our service and not go overseas for basic care. When it can be easily done in Anguilla. How can we make sure Anguillian health care professionals abroad re- enter our system? We need people who understand our language and culture in the medical profession. Should we stop incentives for foreign nurses and treat all nurses with the same brush? We are losing our own people because others come here and are giving more benefits. Bermuda use to do that and they stop. All nurses are paid the same regardless of where they come from. Is it worth losing our health professionals for foreign ones? Why the exodus? How can we motivate the folks to stay? These are the only questions I want answers to.

    Mr. Minister I suggest you set up an online database for recruiting of Anguillians overseas. This will enable Persons overseas to sign up or view what postions are needed. Similar to what the BVI has. Lets use technology wherever possible.

    We are paying these computers guys big bucks!

  7. If a small child plays little power games when he's feeling jealous and spiteful because the other children left him out of their game, we all see and understand immediately what this child is trying to do.

    When a Minister of government acts in the same identical manner we come up with complex explanations and legal analyses for his immature, childish behaviour. I think this little man just needs a good spanking.

  8. The minister clarified a lot of questions you had?
    He did? He clarified none I had.
    Imagine, I was looking forward to this interview from the night before. Silly me. I should have known better.

    My big question: Why did he not appoint new members in December.Or re-appoint the outgoing members when their term ended?

  9. The minister in my view did not defended the allegations that was in the letter, The phone lines should have been opened to the public so that people could have called in with their questions. Everything about Anguilla is so confrontational, if you have a difference in opinion then you do not have a right, if you have a deep emotion about a matter than you are different, where is the tolerance and the respect for others views. We need to grow up and know that we are big people and we are unique amd makes this world a beautiful place. I do not be around the minister, but just based on what he says he seems to be very arrogant. My opinion.

  10. The combination of the new board members are interesting, don't you think? family and friends.

  11. The minister should be watchful and see that his health section is run by almost foreign people. This is so sad. Encourage young people to join the noble profession of nursing. Try to keep your local staff, why should we pay so much more allowances to overseas nurses, and Anguillians do not get the same, that is wrong how long can we continue with this, if you want to join the service then you should be given the same as everyone else. It is your choice.

  12. I had not realised that the names of the new Board members had been published. Who are they?


  13. The Minister named them on the radio after being pressed by Ras B. But they have not been published anywhere. It is a measure of the Minister's public outreach that he hasn't otherwise bothered to issue a press release naming the new board members.

    But we don't like to call names.

  14. Appointment letters were sent to these persons. But they have not been gazzeted as yet.

    Chairman : Dr. Franklin Lloyd
    Vice Chair: Dr. Linda Banks - Owlewakemi (sp)

    Directors: Orris Hughes, Salome Lake

    Pastoral and Legal reps to be contracted out on as needed basis.

    And some others I forgot.

    If I would like to be considered to be on the Board in the future, anyone knows how to go about it.

  15. If you want to be appointed to the board in the future you need only convince the Minister that you would honour and glorify him forever and ever.

    Try it in the mirror first, to make sure you can do it without laughing.

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  17. I have learn a very long time ago not to assume what others are thinking or think of me. In my work I always ask questions what is expected of me and I make sure those are documented. The minister has done more in two years that what some has done in 15 years of office. We want miracles from one man. That is our problem in AXA. We think politicians are all encompassing and just need to wave a wand and our problems will go away. Do career civil servants have a role to play?

    The minister inherited a education system in need of 3 more high schools. He inherited a hospital system with systemic deficiencies. I will not call him a faliure until he has completeed one full term and see his progress. His interview was refreshing and I was happy it was Ras B doing the interview. Sometimes we need to listen to our elected representatives and not having one caller taking up the program with the same old complaints.

    However, the minister should have open it up for callers so that the "loud mouths" could have called in and spend 20 minutes ranting. And the minister would have had only 10 minutes explaining his point. But I was impress he was interviewed without interuption. He was very professional and showed restraint. If that was Hubert, he would have taken the criticism in the letter personally and leash out on the former Board. I hope more politicians exercise that level of calmness when faced with negative criticism. Last year Victor called the Lawyers stance against the planning bill, "chatter" and he was very condescending.

    Good interview minister. But now you have to be more visible and continue to inform the public on updates in your ministries. We need to hear from our politcians more. So lets be specific in what the minister is doing wrong. And forget about what he thinks of you? Or what you imagining he is thinking of himself.

  18. Annoymous at 8:29 a.m. commented on the need to provide incentives for local professionals and nurses to return or stay home. This is so important. I do see some Anguillian professionals coming back in the Health System, though. I also hear from good sources that the last Board had a Job or Manpower Audit done over a year ago, with a restructuring of compensation for nurses and other professionals to make the salaries more attractive. It is still sitting on the Minister's desk, I understand.

  19. 'The minister has done more in two years that what some has done in 15 years of office.'

    Who was in office 15 years and did LESS than this minister in 2 years?
    I do not believe this to be possible.

    Please, previous poster help me out here: Who?

  20. The minister inherited a hospital system with systemic deficiencies. And an honest and dedicated board and CEO who were succeeding in repairing these problems. He has destroyed the board, and his war with the CEO is unseemly and childish.

    I believed in him. I voted for him. I feel defrauded. He has failed the sick, the elderly and the children.

  21. It alleged that the Minister sidelines the PS Mrs Bonnie Lake, if that is true, that is wrong. As long as you are some sort of a threat you would be sidelined, but do not worry the public observes and they are the greatest judge. But in a lot of the departments people are sidelined, persons who suppose to be in the loop, but because you are not one of the favorites for the bosses, then you would continously be sidelined. When I see the roles that friends play that they are not suppose to be playing because of friendship I wonder what would the Deputy
    Governor say when he learns of these things. Things that are so wrong,
    I keep saying that the ministry of health and education must be separated, these ministries are too big for one minister, Mr Rogers can not fix both. The Minister should come out and inform the people more he is a much younger minister than the rest of them , this is information age. Mr Reid's era is out, but yes there were problems but it seems to be working at least when it came to the staff, when you look at Yuonne Rey's time, the procedural way had to be admired. We have to learn from the past and understand and respect persons who know, that is our problem in Anguilla.

  22. It is a good thing that the ministers of government does not have the power on their own to send you home or the heads of departments, what would be a thing, the way they treat you their hostility and manipulation, saying one thing and behaving another and thinking that they are so smart and you so foolish, BUT, when their turn comes they only whine and whine beause they forget what they do to their staff and the people and when they get a dose of their own wickedness they can not take it it will come back FULL CIRCLE.

  23. Who would be the lucky candidate to be the next Principal Assistant in CM's office?. It is being advertised.

  24. Is it true that Dr. Lloyd and Dr. Banks are to be members of the new board?
    Did not the Minister go to ExCo and get $100,000.00 approved for these two to do "diagnostic" and "customer service" reviews of the Authority? All this without the courtesy of informing his PS (Dr. Lake). All this coming after the Canadian Council had just evaluated the health services and told the Authority what they needed to do to improve and the board committee responsible for medical services had recommended and had implemented diagnostic improvements?
    It seems that the Minister did not even trust the surveys that the Statistical department independently conducted on the health services, which said that the people were seeing some improvements. He hired the consultant to review the findings of the survey.
    How could this amount of money be thrown away, when social services is operating on welfare? When the Authority is out there persuading the private sector to help them to impprove the health services? The Board was paid pittance as I see on this blog, but the consultants were paid big time.

  25. I agree that the loudmouths are allowed to call in and give long lectures. But this can be easily controlled by announcing that there will only be questions, not lectures, and callers will be cut off after 30 seconds. Anyone who can't ask a question in 30 seconds has been listening to Hubert too much.

    I am sorry that the Minister can only be bothered to spend a half hour reporting to the people. The Minister has a lot to answer for and the people have a lot of questions because of his silence. When will he stop giving us lectures and answer our questions?

  26. The Minister has two Permanent Secretaries, two Special Assistants he chose himself and a whole entourage of secretaries, clerks and receptionists, all to help him with the workload and make recommendations to him. His inaction is intentional, not because of overload. He is, as Hubert called Eddie, a "lazy boy."

  27. Victor Banks, Osbourne Fleming, Hubert Hughes, Albert Fleming, Kenneth Harrigan and Edison Baird all have almost a 100 years of combine elected experience. Osbourne Fleming, Hubert Hughes and Victor Banks all have more than 15 years of Ministerial office. I think you can research the history of Eric Reid and others.

    All those in office for over 10 years need to go home. I will give the new Minister of Health 5 years to judge his progress. Just my opinion. Please, don't expect all of us to see things your way. Perhaps what ever he did to some folks haves blinded they objectivity of him. However, keep him on his toes, I hear he love critics.

    By the way he was not my choice but now that he is there, I see lots of changes.

  28. I support Mr Mcneil Rogers, as a new minister, he has a long road ahead of him, but he should be glad that he got the letter, yes it was a very strong letter and I do not know what the intentions are but it actual painted a gloomy picture. Written communications of any nature are most times done to convey a message and most times one's emotions, feelings, biasness uncaring and onesideness comes out in that communication. Most times it also characterises the persons as well, and sometimes it reverses the effect it was intended to inflict. Personally, I did not have any contact with any of the members, but it was vicious. I personally can not see where there could have been a relationship with these board members and the ministers after all was said or being thought about him. IT IS VERY SAD.

  29. I wonder if that was the general view of all the board members, in Anguilla some people are so weak that they can not stand on their own. They have to jump on any band wagon that have the crowd. I hope that this was not a matter of dominance. As regards the minister, take this as a lesson and do not trust no one. People are the greatest animals to be feared. Admonition, you need to come out and speak to the nation on matters regarding health, and take a good look at what is happening with the recruitment in health. I do not like what I see, it is too alienated. I am not sure based on what I have observed either that hiring these persons is more professional. Most of the lower level staff are non -Anguillians. Anguillians must be the first choice of these jobs, afterall, they are nor requiring a college degree to do these jobs, it is better that an Anguillian young man or woman get those jobs than a friend tell a friend to apply for these jobs leaving Anguillians out. While they still hold on to a part time job as well. BE VIGILANT MINISTER LOOK OUT FOR YOURSELF PLEASE. I WIS YOU ALL THE BEST.

  30. Why is it that people like to criticize people when they are in a position, and when they get to that same position they can not perform or they are guilty of the same crimes. Is it that they are driven by jealousy?. We need to be objective in out thinking.

  31. I become even more concerned with the plight of Anguilla when people makes such comments as "MINISTER LOOK OUT FOR YOURSELF PLEASE." When the role of the Minister is too look out for the interest of ALL Anguillians. This Minister is truly a disappointment but how can we expect any better when character is what is lacking here (who expected him back after taking government money and running).He has done NOTHING and in five years he would have done NOTHING!!!!


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