Accountability Measures Across Public Sector to Be Strengthened

A move is on to strengthen accountability measures across the public health sector, while advancing a broad legislative agenda aimed at improving governance, transparency and public health protection.

Making his contribution to the 2026/27 Sectoral Debate in the House of Representatives on May 12, Minister of Health and Wellness, Dr. the Hon. Christopher Tufton, said the Ministry is going through assessments of the Ministry and its agencies, including the widely discussed Auditor General’s report on the University Hospital of the West Indies (UHWI), which revealed serious shortcomings in administrative performance and accountability that require urgent corrective action.

He said the findings have prompted a targeted policy response focusing on governance and oversight, financial and procurement accountability, and improved capacity and performance management across the health portfolio.

Dr. Tufton said the Ministry will spend the next 12 to 18 months establishing stronger internal systems to address the weaknesses identified, while enforcing existing rules more rigorously and introducing timelines and sanctions for non-compliance.

He noted that all regional health authorities will be required to bring their financial statements and reports fully up to date and tabled in Parliament within 12 months, with boards and regional directors being held directly accountable for delivery. He added that health professional councils with outstanding reporting issues will be required to submit corrective action plans and clear at least 10 per cent of their reporting backlog during the same period.

The Minister also announced sweeping procurement reforms aimed at reducing governance risks associated with direct contracting. Effective June 1, 2026, all direct contracting above the statutory threshold, except in the case of the National Health Fund, will require independent validation for a 12-month period.

Boards will also be required to approve certified procurement plans, while no financial commitments outside approved plans will be supported. Dr. Tufton warned that a zero-tolerance approach will apply to breaches of the Government’s e-procurement requirements.

Addressing statutory deductions, Dr. Tufton said the misuse of income tax, education tax and National Housing Trust (NHT) deductions to finance operations is unlawful and will no longer be tolerated. Beginning June 1, executives authorising or facilitating such breaches will face disciplinary action, including possible statutory surcharges. He stressed that workers’ deductions must be paid over to the relevant authorities and disclosed that efforts will also be made to address legacy arrears while preventing the accumulation of new liabilities.

The Minister further indicated that all agencies will transition fully to the Performance Management and Appraisal System (PMAS) within the next 12 months, with at least 70 per cent of organisational functions assessed under the framework.

He said the Ministry has also directed regional authorities to accelerate recruitment efforts, with a target of filling 75 per cent of existing vacancies within a year. According to Dr. Tufton, staffing shortages have often been cited as a reason for delayed implementation of programmes and services.

On governance and oversight, Dr. Tufton announced that a comprehensive review of the health governance framework, including the Health Services Act and the UHWI Act, will be undertaken this year in keeping with recommendations under the Mitchell Report and Vision for Health 2030.

He said that from June 1, all internal audit units will submit reports directly to the Ministry to support quarterly oversight meetings with board chairpersons, warning that persistent non-compliance will attract decisive action.

The Minister also underscored the importance of improving compassion and accountability in patient care through a client-centred, rights-based approach, supported by measurable service standards and transparent public reporting.

Dr. Tufton also outlined an ambitious legislative agenda for the 2026/27 fiscal year, including the long-awaited Tobacco Control Bill, amendments to the Food and Drug Act to regulate nutraceuticals and natural health products, and changes to the Nurses and Midwives Act to grant advanced nursing practitioners greater authority in remote health centres.

Additional measures include new funeral home regulations and a comprehensive review of the Public Health Act. The Minister said the review became necessary after shortcomings in the legislation were exposed during the COVID-19 pandemic, noting that the process is expected to take approximately two years and will involve broad national consultation, including participation from the Opposition.