Premier Andre Ebanks announced immediate governance reforms for the Health Services Authority board during the first Premier’s Question Time.
The move comes following criticism from MPs about excessive board meetings and remuneration that reportedly exceeded payments to some medical professionals.
The reforms include transitioning board remuneration from per-meeting stipends to a flat fee structure to discourage excessive payments and unnecessary meetings.
Board members had been receiving between CI$500 and $750 per meeting, with concerns raised that the frequency of meetings had increased significantly.
According to reports, the board held 190 meetings over 18 months – 126 in 2024 and 64 through June 2025 – with members receiving $490,850 in total compensation under their pay-per-meeting structure.
The Ministry of Health, Environment and Sustainability has requested HSA’s first half-yearly report covering 1 January to 30 June, marking the first such report presented to parliament since the Health Services Act 2003 revision began.
“It is essential to recognise that this report serves as a crucial step in improving the financial accountability of the HSA,” Ebanks told parliament.
The ministry is reviewing a recent Internal Audit Service report on HSA board remuneration and activity, with plans to implement its recommendations.
HSA has been asked to provide a proposed implementation plan and submit regular progress updates.
New accountability measures will include annual performance evaluations for HSA board members and reinforcement of the distinction between strategic oversight and operational management to prevent board overreach.
All board members will be required to undergo training in public sector governance, financial stewardship and healthcare ethics, with new members already registered for upcoming sessions.
The ministry is also considering equipping the board with tools to monitor patient safety and care quality metrics aligned with international standards.
Longer-term reforms will include a legislative and policy overhaul, with plans to revisit the HSA Act to ensure it adequately supports board accountability.
The health minister has implemented immediate transparency measures, with minutes from all HSA board and subcommittee meetings now being provided to the ministry regularly. Regular meetings between the minister, the recently appointed HSA board chair, the ministry chief officer and HSA chief executive officer are taking place to improve operational cohesion.
Ebanks emphasised the need for bipartisan cooperation on healthcare reform, stating the government would reach “across the aisle” for support on larger legislative and policy matters.
“We all want and need to have a high-functioning, effective, prudent public healthcare system. This has a far greater chance of success when we all pull together,” the premier said.
The Premier’s Question Time, introduced through the Parliament Standing Orders, 2025, represents a new mechanism for enhancing transparency.
