The following is the first of a series of articles on the National Health Board. They are being published by The Anguillian as a community service.
The National Health Fund (NHF) had a “soft launch” in September 2007. Since this time, there have been a series of information sessions for the public about what to expect under the NHF.

L-R: Mrs. Rhonda Connor, Mr. Timothy Hodge, Dr. Bonnie Richardson-Lake, Mr. Ian Ferguson and Ms. Gecheal Richardson

The implementation of the NHF has been delayed several times in order to ensure that all of the elements required to run the NHF efficiently are in place. While there has not been a public consultation on the National Health Fund since August 2008, the NHF Shadow Board has been busy working toward the implementation of the Fund.

The Board has been assisted by the new Consultant Medical Director to the NHF, Dr. Figueroa of Belize. Dr. Ramon Figueroa, who is the Director of the National Health Insurance in Belize, was instrumental in implementing a comprehensive national health care package in his country. Dr. Figueroa joined the team in August of 2008 and has had four visits to Anguilla since this time. The Board is also in the process of recruiting a Chief Executive Officer to the NHF whose primary focus will be on the financial management of the Fund.

In October 2008, the Chair of the Board, and the Social Security representative on the Board, attended a Health Financing meeting in Trinidad where several variations of national health financing mechanisms were presented. Many important contacts were made and valuable information was obtained at this meeting.

Dr. Figuero

The Board, in consultation with stakeholders, has spent a great deal of time reviewing, updating and revising the Manual of Intentions which guides the operations of the NHF. These revisions aim to make the health coverage package as comprehensive as possible.

In addition, the Manual of Intentions now makes special provisions for those suffering from chronic diseases such as hypertension, diabetes and heart disease. Work also continues on the regulations to the NHF Act which will address collections procedures, medical services covered, financing and accounting, and registration of employers and employees.
In order to manage and organize the NHF system a fit for purpose software package is required. The Head of the Department of Information Technology worked with the Board and the Consultant Medical Director to develop the software specifications required for the running of the NHF. A Request for Proposals was sent to several companies and recommendations from the NHF evaluation team will be forwarded to the Tender’s Board once bids are received.

The Board and the Consultant Medical Director have been working with Health Authority of Anguilla (HAA) and private doctors on developing standards and protocols to be utilized under the NHF. The protocols will guide the way physicians manage disease conditions such as Diabetes, Hypertension, and Asthma so that everyone is using the same procedures for identification and treatment of these diseases based on the best scientific information available. The standards will outline minimum requirements for clinic and hospital facilities under the NHF. Compliance with the protocols and standards will be very closely monitored by the NHF and the Ministry of Health. Training for the medical providers in the protocols and standards will begin later this year.

Ms. Nicole Alleyne

The Board has begun to look at how persons will be able to access overseas medical treatment under the NHF. A team visited Jackson Memorial Hospital and Baptiste Hospital in Miami as well as HUMA San Pablo Hospital in Puerto Rico. These meetings were useful in that they started the ball rolling on future negotiations with potential overseas providers.

While much has been accomplished in recent months, there is still much more to do before the NHF can be launched. Over the next several months the Board plans to work with the pharmacist in developing a list of drugs that will be covered under the NHF, to work with eye care specialist in determining a package of eye care to be covered under the NHF, and to continue work with primary care doctors and specialists to agree upon a package of services to be provided.

The Social Security Board will play a major role in the implementation of the NHF. Social Security will have responsibility for the collection of contributions and the dispersing of payments. They will continue to work closely with the NHF Board to finalize collection and payment processes. Because proper financial management of the Fund is key to the success of the NHF, the Board will work to develop stringent financial controls and electronic monitoring systems.

As the Board continues to work toward the implementation of the National Health Fund, we welcome the public’s questions and feedback. Comments can be directed to Dr. Bonnie Richardson-Lake, Chair of the NHF Shadow Board at bonnie.lake@gov.ai

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