With the Anguilla Health Authority just about three weeks into its work, its Chief Executive Officer, Dexter James, is assuring the public of a high level of medical and health services far beyond what was provided under the old system ran by the Government. All that he, his management team, the Board and other health-care providers are asking for is the cooperation and support of everyone as the new processes are put into action for the enhanced delivery of the services.

Appearing at a press briefing with Chairperson of the Board, Dr. Phyllis Fleming-Banks, on Monday, January 12, Mr. James spoke of plans to upgrade key areas of the health system. One of the longstanding complaints he addressed related to the Accidents and Emergency operations area at the Princess Alexandra Hospital. “We know of cases where persons would have come to the hospital after 4 o’clock and there is no one in the lobby area to meet or greet them,” he spoke about the past. “We know of cases where persons would come between 7 pm and 12 midnight and they would sit in the casualty area and nobody says anything to them…We know of all the inconveniences, the nuisances and, of course, the very customer unfriendly environment of the Accident and Emergency Department.”
He said the Board had mandated that immediate steps be taken to correct the situation. “We have committed ourselves by the end of this month to carry out a major upgrade to the Accident and Emergency Department which will see nursing support provided between the hours of 7 a.m. to 10 p.m.,” he promised. “We will have a cashing operative within the same hours and are installing a receptionist area… where patients are greeted by some one and re-directed.” After 10 p.m. the security guard will be in the lobby area to meet persons seeking assistance and will notify the nurse on duty behind the closed door of the emergency section. If he is not at his station, persons can press the bell at the entrance and it will ring in the casualty area alerting the nurse there. He explained that with no suitable accommodation at the hospital it was not possible to have a doctor in residence at night, but the matter was being looked into.
He said further information would be given later about the new improved arrangements in the Accident and Emergency Department. “We just want to assure the public that we have heard their woes… and this Board is committed to making a difference to resolving that area of first-line contact,” he stated. “We just ask that you bear with us while we get the capital works installed in that particular area.”
Mr. James spoke of plans to bring about the provision of a number of inherited outstanding projects including the completion of the maternity wing, the installation of an incinerator to dispose of bi-hazardous waste and a sewage treatment plant. He said there would be major improvements to the open wards in terms of privacy, amenities and colour coding. He also spoke about a patient satisfaction and customer feedback survey to be launched shortly on the wards. It will provide information on the views of patients with respect to nursing care, food service, the aesthetics and hygiene of the hospital environment and lead to corrective action. The survey will later be undertaken at the Accidents and Emergency Department later following the upgrading there.
“The gripe is not so much about the level of care provided at the facility,” the Chief Executive Officer of the Health Authority observed. “I think we have second to none practitioners at the hospital compared with other parts of the region,” he went on. “What has failed us tremendously over the years is the absence of effective and efficient hospital management information systems and processes. This is where a lot of our work will be hinged over the next two to three years. [It will include] the creation, development and implementation of new hospital systems to support the work that our medical staff provide at the facility. These systems have been deficient at all levels and therefore it is not surprising that the hospital been given a lot of negative goodwill over the past years.”
James, who appealed to the media to partner with the Health Authority to move the process forward, said the staff was quickly settling in. “I am heartened by the level of action, enthusiasm and sense of calm that persons at the hospital in particular have shown over the past two and a half weeks of our operation,” he said. “I think they really believe that we can make a difference in the way that we treat the issues and there is a genuine sense about it.”
He noted that with the transfer of staff from the Public Service to the Health Authority there was no loss in benefits which were either now equal or better. He said the staff members had been given one increment above what they ended the year with. “Because we are in a mode of being performance-driven, offices have the opportunity to earn a second increment in November,” he stated. “It is however going to be paid subject to each employee achieving his or her objectives set for them at the start of the year…Here is where we are creating a cultural transformation in the sense that if employees achieve their individual objectives then so too would the organisation because employees are part it. This was one of the areas of great challenge for us.”
He explained that he and the Board had met with the Civil Service Association (ACSA) in particular and legal representatives on the transfer arrangements. The result was an interim agreement in which the employees would continue to be governed under the General Orders of the Public Service until the Health Authority puts its own policies and procedures in place.
A Management Committee has been set up to complete a staff manual by February 15. The document, which Mr. James said would provide a level of comfort, will detail the rights, privileges and responsibilities of the employees of the Health Authority. The committee is chaired by the Acting Director of Nursing Services Serene Carter-Davis. The membership comprises two ACSA representatives, the Human Resources Manager, Meridith Gumbs , the Coordinator Health Promotion and Nutrition, (Vernice Battick) and Everette Duncan, a representative of the Diagnostic and Therapeutic Department.
Meanwhile Dr. Phyllis Fleming Banks said the manual had already afforded staff members and their representatives an opportunity to make their input to allay any concerns.

She joined Mr. James in calling on all persons, the media and Government to support the work of the autonomous Health Authority. She saluted and applauded the Hon. Minister of Social Development, Eric Reid, for his foresight and persistence in the establishment of the Authority. “I am still here because of what I perceived is his sincerity and wholehearted dedication to improving health-care services for Anguilla,” she said. “He realised that goal could not have been achieved within the context of the Public Service and he moved to ensure that there was a Board which could assist with a more efficient service.” She added that the Board was praying for his recovery.

Dr. Fleming-Banks spoke about the establishment of four Statutory Board Committees which will assist the Health Authority with its work. These are the Patient Care and Services Quality Committee; the Finance and Audit Committee; the Human Resources Committee; and the Nursing Committee.

She stated that the committees would assist the Health Authority in various areas of service and provide feedback. “We are looking for volunteers to help for even an hour a day to man a hotline where we can take suggestions and comments so that we can make the health services better for all of us,” she added.

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