Tufton announces major governance overhaul in public health sector from June 1

Health Minister Dr Christopher Tufton says all internal audit units across the public health system will be required to submit reports directly to the ministry from June 1 under new accountability measures being introduced across the sector.

The requirement forms part of a broader governance reform programme that will also impose stricter financial reporting, procurement oversight and performance management standards across regional health authorities and public health agencies.

In his Sectoral Debate presentation on Tuesday, Tufton said the measures were prompted by recent concerns surrounding administrative performance and accountability within the public health system. 

The ministry has been grappling with a procurement and governance scandal at the University Hospital of the West Indies (UHWI), the region's premier teaching hospital, which was exposed in an auditor general's report released in January. 

The reforms, Tufton said, will focus on three main areas - governance and oversight, financial and procurement accountability, and capacity and performance management across the health portfolio.

Effective June 1, reports submitted by internal audit units will inform quarterly oversight meetings between the minister and board chairpersons.

Tufton also announced that all regional health authorities will be required to bring their financial statements and reports tabled in Parliament fully up to date within 12 months.

Health professional councils are also to submit action plans aimed at regularising their financial reporting and clearing at least 10 per cent of outstanding reporting backlogs.

The Ministry of Health and Wellness itself is expected to become fully current with its appropriation accounts in keeping with the Financial Administration and Audit Act.

“We are fully mindful of the constitutional separation between policy, administration, and operations, and of the statutory roles of Boards under the PBMA Act,” Tufton told the House of Representatives.

“For the next 12 to 18 months, we will establish and monitor for implementation a series of steps to correct and improve our internal systems of governance oversight to ensure that accountability systems work as intended and deliver transparency, responsiveness, and lawful decision-making,” he added.

Tufton also announced that a comprehensive legislative review of the health governance framework, including the Health Services Act and the UHWI Act, will be undertaken this year.

The review, he said, will be guided by recommendations from the UHWI Institutional Review Committee Report and the ministry’s Vision for Health 2030 Plan.

The minister also pointed to concerns surrounding procurement practices, particularly the use of direct contracting arrangements.

“Overreliance on direct contracting presents a significant governance risk,” Tufton said.

He disclosed that from June 1, all direct contracting above statutory thresholds — except at the National Health Fund — will require independent validation for a 12-month period.

The ministry is also requiring all agencies to transition fully to the Performance Management and Appraisal System within a year, with at least 70 per cent of organisational functions assessed under the framework.

Additionally, health entities are to undertake coordinated recruitment efforts aimed at filling critical fiduciary and governance vacancies, with at least 70 per cent of identified posts to be filled within 12 months.

Tufton said the reforms are ultimately intended to improve patient experience and public confidence in the health system.

“Accountability has no meaning if it is not reflected in the patient experience,” he said.

“Therefore, a client-centred, rights-based approach to service delivery is being advanced, supported by measurable service standards and satisfaction metrics, and reinforced by transparent public reporting.”

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