The Health Authority of Anguilla (HAA) was established in 2004,
transferring provision of services to a statutory authority, aiming to
allow service managers to operate free of public service constraints.
The sector review concludes that the HAA is not independent enough. The
government exerts unnecessary and partisan influence through the board
of management. The review also finds the HAA is not incentivised enough.
It receives government subvention regardless of its performance and, as
a result, continues to behave as if it were still part of the civil
service with few rewards or sanctions for staff related to their
The report recommends making the HAA completely independent, earning
income through performance. For this to work, public finance must be
channelled through a competent technical funding body with the ability
to ensure performance is achieved for the finance received by providers.
The recommended structure for the HAA is a company with shares all owned
by its staff but that cannot be traded.
England, R. Assignment Report: Anguilla Health Sector Review 2011. (2011) 39 pp.