Barbuda Hospitals Board 1 ANTIGUA
Act, 1999. AND

BARBUDA

[ L.S. ]

I Assent,

James B. Carlisle,
Governor-General.

18th February, 1999.

ANTIGUA AND BARBUDA

No. 1 of 1999

AN ACT to establish the Antigua and Barbuda Hospitals Board to
be responsible for the administration, management and overall

I organization of the hospitals in an efficient manner, and for
connected purposes.

[ 25th February, 1999 ]

ENACTED by the Parliament of Antigua and Barbuda as
follows:

1. Thls Act may be cited as the Antigua and Barbuda Hospitals short title.
Board Act. 1999.

2. In this Act, unless the context otherwise requires, Interpretation.

"Board means the Antigua and Barbuda Hospitals Board
Established under section 3;

"Director of Finance" means the person appointed to be
Director of Finance under section 9;

"fees" includes any fees or charges prescribed to be paid by
patients in the hospitals whether in-patients or out-patients,
for treatment, nursing, accommodation, attendance, food,
dressings, drugs, medicines or other supplies or services of
whatever kind rendered to each patient by the hospitals, but

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AND Act, 1999.

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does not include fees payable to members of the medical staff
who are not officers or servants of the Board;

"financial year" means the financial year of the Board as
defined in section 20 (4);

"funds" includes monies, stocks, shares and other securities;

"Hospitals Director" means the person appointed to be
Hospitals Director under section 9;

"medical staff means the medical and dental practitioners
appointed under section 13 to practice their professions in the
hospitals;

"Minister" means the Minister responsible for the subject of
Health;

"premises" includes messuages, buildings, lands, easements
and heredtaments of any tenure;

"prescribed" means prescribed by regulations made under
the Act;

"public officer" has the same meaning as in section 127 of the
Antigua and Barbuda Constitution Order, 198 1;

"Secretary" means the Secretary appointed under section 4
(1);

"the general hospital" means the institution known as
HolbertonHospital and the institution, whencompleted, to be
known as the Mount St. John's Medical Centre and any
premises which may be declared by the Minister, by notice
published in the Gazette, to be a part of the general hospital;

"the hospitals" means the general hospital and the mental
hospital and includes any establishment for the care or relief
of the sick or infirm that the Minister may place under the
control of the Board.

No. 1 of 1999. Antigua and Barbuda Hospitals Board 3 ANTIGUA
Act, 1999. AND

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3. (1) There is established a Board to be known as the Antigua Establishment of the
and BarbudaHospitals Board (in this Actreferred to as the "Board) AntiguaandBabuh
having the powers and duties conferred or imposed upon it by this Board.

Act and any other statutory provision and in whlch all funds for the
management of the hospitals shall be vested.

(2) The Board established under subsection (1) is a body
corporate with perpetual succession and common seal and is
capable of suing and being sued in its corporate name.

(3) Subject to the provisions of this Act the Board shall have the
power to acquire, hold and dispose of movable and immovable
property of any kind, enter into contracts and of doing or perfomling
the Acts that bodies corporate may by law do or perform.

(4) The seal of the Board shall be kept in the custody of the
Secretary at all times and shall not be affixed to any instrument
except by the authority of a resolution of the Board; and the sealing
of any instrument shall be authenticated by thechairmanor Deputy
Chairman and the Secretary.

( 5 ) All documents, other than those required by law to be
under seal, made by the Board and all decisions of the Board may
be signed under the hand of the Chairman or the Secretary.

4. (1) The Board shall consist of

(a) a Chairman, a Deputy Chairman, a Secretary and six
other members, appointedby theMinisterby instrument
in writing; and

(b) the Hospitals Director and the Medical Chief of Staff
as ex-oficio non-voting members.

Composition of the
Board.

(2) Subject to subsection (8) a member of the Board shall hold
office for a period of three years from the date of his appointment,
and shall be eligible for re-appointment.

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AND Act, 1999.

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(3) If the Chairman, Deputy Chairman or any other member of
the Board is unable to act, the Mnister may, appoint aperson to act
in the place of the Chairman, Deputy Chairman or other member.

(4) A member of theBoard, other than the Chairman, may at any
time resign his office by instrument in writing addressed to the
Minister and transmitted through the Chairman.

(5) Thechairman may at any time resign his office by instrument
in writing addressed to the Minister.

(6) The Minister may, on the application of a member in writing
grant leave of absence to the member.

(7) The members of the Board shall be paid remuneration as may
be determined by the Cabinet.

(8) The Minister may, at anytime, revoke the appointment of a
member of the Board if

(a) the member is incapable for any reason to perform his
functions as a member;

(b) the member has been absent from meetings of the
Board for three consecutiveregular monthly meetings,
other than by reason of subsection (6);

(c) the member fails to disclose his interest in accordance
with section 6; or

(d) theMinister on reasonable grounds thinks it expedient
so to do.

Meetings of the 5. (1) The Board shall meet at least ten times in any one year.
Board.

(2) Meetingsof theBoard shall be heldat theplace,day, and time
thechairman, or threeother members of the Board acting together,
determine, and due notice of the place, day and time shall be given

No. 1 of 1999. Antigua and Barbuda Hospitals Board 5 ANTIGUA
Act, 1999. AND

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to each member in writing at least forty-eight hours before the time
the meeting is to be held.

(3) At every meeting of the Board the Chairman or in the absence
of the Chairman, the Deputy Chairman shall preside and in the
absence of both the Chairman and the Deputy Chairman the
members present shall elect a member to preside at the meeting.

(4) The quorum for meetings of the Board shall be five voting
members, and if a quorum is present, the Board is not disqualified
for the transaction of business by reason of a vacancy among its
members.

(5) The decision of the Board shall be by a majority of votes, and
in the event of an equality of votes, the Chairman presiding at the
meeting shall have a casting vote.

(6) Wnutes of each meeting and transactions of the Board shall
be recorded by the Secretary and shall be confirmed by the Board
at its next meeting and signed by theChairmanorDeputy Chairman
as the case may be.

(7) Subject to the provisions of ths Act, the Board may regulate
its own procedure for meetings.

6. A member of the Board who is directly or indirectly interested Disclosure of
in a contract made or proposed to be made by the Board interest.

(a) shall disclose the nature of his interest at a meeting of
the Board, and

(b) shall not take part in any deliberation or decision of the
Board with respect to the contract.

7. (1) TheBoard shall beresponsible fortheoverall organisation Functions and
and management of the hospitals. duties of the Board.

(2) The Board shall consider and advise upon all matters which
may from time to time be referred to it by the Minister and shall

ANTIGUA 6 Antigua and Barbuda Hospitals Board No. 1 of 1999.
AND Act, 1999.

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furnish to the Minister information he may reasonably require
relating to the administration of the Act.

(3) The Board shall

(a) administerthe hospitals generally in anefficient manner
to promote the welfare of the patients of the hospitals;

(b) make available at the hospitals modem methods of
treatment of the sick and i n f m ;

(c) co-ordmate the administration and operation of the
hospitals;

(d) make recommendations to the Minister on the
development of the hospitals and the hospital service
in Antigua and Barbuda;

(e) establish and determine the duties of its Committees;

Cf) determine, subject to sections 9,10 and the duties of its
officers; and

(g) give effect to any directions given by the Minister
under section 8.

Policy directions by 8. The Minister may, after consultation with the Board, give
Minister. general directions as to the policy to be followed by the Board in the

performance of its functions as appear to the Minister to be
necessary in the public interest.

Appointment of 9. (1) The Board shall appoint, at the remuneration, terms and
hospitals conditions approved by the Cabinet, a Hospitals Director who shall
Director and be afull-time officer of the Board and the principal executive officer
Director of Finance.

of the Board.

(2) The Board shall appoint, at the remuneration, terms and
conditions approved by the Cabinet, a Director of Finance who shall
be a full-time officer of the Board and be responsible to the Board
through the Hospitals Director for the efficient management of the
financial administration of the hospitals.

No. 1 of 1999. Antigua and Barbuda Hospitals Board 7 ANTIGUA
Act, 1999. AND

BARBUDA

10. (1) The Board shall appoint, at the remuneration, terms and Appointment of
conditions approved by the Cabinet, a Medcal Chief of Staff for the Medical Chief of
general hospital, who shall be a medical practitioner registered Staff.

under the Medical Act and may or may not be a full-time officer of Cap. 269.
the Board.

(2) The Medical Chief of Staff shall be responsible to the Board
for the medical and dental organization of the general hospital and
for the supervision of the medical and dental care given to all
patients of the general hospital in accordance with the policies
established by the Board.

(3) The Medical Chief of Staff shall be Chairman of the Medical
Staff Committee at the general hospital.

11. (1) The Board shall appoint, at the remuneration, terms and Appoinfment of
conditions approved by the Cabinet, a Chief of Psychiatry for the Chief
mental hospital, who shall be a medical practitioner registered
under the Medical Act, and may or may not be a full-time officer of Cap. 269.
the Board.

(2) The Chief of Psychiatry shall be qualified to practise as a
Psychiatrist by virtue of a qualification recognized by the Antigua
and Barbuda Medical Council.

(3) The Chief of Psychiatry shall be responsible to the Board for
the organization of the mental hospital and for the supervision of
the medical care given to all patients of the mental hospital as well
as theco-ordination and supervision of the care given to all patients
in the community psychiatric programme.

(4) The Chief of Psychiatry shall be Chairman of the Medical
Staff Committee at the mental hospital.

12. (I) The Board may, at theremuneration, terms and conditions Appointment of
approved by the Minister, appoint other officers and servants 0fficersof the
necessary for the due perfomlance of the functions of the Board. Board.

(2) The Public Service Commission may, subject to any
conditions that may be imposed, approve the secondment of a

ANTIGUA
AND

BARBUDA

Appointment of
medical Staff.

Clinical
departments and
services.

8 Antigua and Barbuda Hospitals Board No. 1 of 1999.
Act, 1999.

public officer in the service of the Government immediately
before the commencement of this Act to an office with the Board,
and a public officer so appointed shall, in relation to pension,
gratuity, other allowance, and any other rights or obligations as
a public officer, be treated as continuing in the service of the
Government.

(3) Where in this Act an officer is stated to be a full-time
officer of the Board, he shall not, except with the permission of
the Board, practise any profession or engage in any trade or
business or take any employment for gain, otherwise than in
pursuance of the duties of his office.

13. (1) The Board may, after consultation with the appropriate
Medical Staff Committee and on the terms and conditions
approved by theMinister, appoint medical staff for the hospitals,
but a person appointed to the medical staff shall not by reason of
that appointment be an officer, servant or agent of the Board.

(2) Subject to subsection (3) aperson appointed to the medical
staff shall hold office for a period of three years and shall be
eligible for reappointment.

(3) The Board may revoke the appointment of a person to the
medical staff for good cause (including any breach of the rules
of the Board).

14. (1) The Board may, after consultation with the appropriate
Medical Staff Committee, establish and maintain clinical
departments or services as it considers necessary for the proper
operation of the hospitals and without prejudice of the generality of
the foregoing, shall establish and maintain at the general hospital
the following departments or services:

(a) Medical;

(6) Surgical;

(c) Obstetrics and gynaecology;

(d) Pediatrics;

(e) Emergency medicine;

No. 1 of 1999. Antigua and Barbuda Hospitals Board 9 ANTIGUA
Act, 1999. AND

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Cf) Diagnostic medicine;

(g) Geriatric medicine;

(h) Dental;

( i ) Anaesthesiology;

Cjl Pathology and Laboratory services.

(k) Orthopaedics

(2) The Board may, after consultation with the appropriate
Medical Staff Committee and the Hospitals Director on the terms
and conditions approved by the Minister, appoint a member of the
medical staff to be the head of any department or service established
under subsection (1).

15. There shall be established Medical Staff
Committees.

(a) a Medical Staff Committee for the general hospital;
and

(b) a Medical Staff Committee for the mental hospital,

which shall bestanding committees and thecomposition, procedure
and functions of eachMedical Staff Committee shallbe asprescribed
by Regulations.

16. The funds and resources of the Board shall consist of Financial
provisions.

(a) monies appropriatedby theLegislature for the purposes
of the hospitals;

(b) monies from the M d c a l Benefits Scheme;

(c) monies received by the Board by way of rents, fees and
other charges for hospital services;

(d) monies borrowed by the Board under section 17 forthe
purposeof carryingout its functions underthe Act; and

ANTIGUA
AND

BARBUDA

Borrowing powers

Investment.

Iand tax exemption.

Accounts of the
Board.

10 Antigua and Barbuda Hospitals Board No. 1 of 1999.
Act, 1999.

( monies or other property real or personal received by
way of gifts or bequests given to the hospitals or to the
Government for the purposes of the hospitals.

17. (1) The Board may, with the prior approval of the Minister
of Finance borrow monies required by it for the purpose of canying
out its functions under the Act.

(2) The Minister of Finance is required to approve the amount
to be borrowed, the source of the borrowing, the terms on which the
borrowing may be effected and his approval may be either general
or limited to the particular borrowing and may be either conditional
or unconditional.

18. (1) The Board may invest monies in securities to be
determined by the Board and the investments shall include funds
that are given or bequeathed for the benefit of the hospitals.

(2) The Board may realise any funds that are in a state of
investment provided that any funds realised that were given or
bequeathed forthebenefit ofthe hospitals shall as soon as practicable
or expedient be re-invested by the Board.

(3) Funds received by the Board that are in an investment may
be retained by the Board in that investment.

19. All property real or personal appertaining to the hospitals
shall be exempt from land and other taxes of like nature.

20. (1) The Board shall cause proper accounts of its financial
affairs to be maintained.

(2) The accounts prepared forthe purposes of subsection (1) shall
set out

(a) the accounts for each hospital separately;

(b) the income andexpenditureofeach hospital and where
an activity can be shown separately for accounting

No. 1 of 1999. Antigua and Barbuda Hospitals Board 11 ANTIGUA
Act, 1999. AND

BARBUDA

purposes, the income and expenditure arising from the
activity;

(c) any other matters the Minister may specify.

(3) Without prejudice to the generality of subsection (2) the
Minister may give general or special directions with respect to the
accounting procedures of the Board and the Board shall act in
accordance with those directions.

(4) For the purposes of this Act, the financial year of the Board
shall end on the date the Board, with the approval of the Minister,
may determine.

21. (1) The accounts of the Board shall be prepared in the form Audit of accounts
and at the time the Minister may direct, and shall be audited
annually by theDirectorof Audit oraperson appointedby theBoard
with the approval of the Minister of Finance.

(2) The Board shall grant, to the Director of Audit or the Auditor
appointed under subsection (1) to audit the accounts, access to all
books, documents, cash and securities of the Board and shall give
to him on request any information in relation to the operations of
the Board.

(3) The Board shall submit to the Minister every account,
certified by the Director of Audit or the Auditor appointed under
subsection (1) to audit the accounts, within thirty days of the date
of the certificate.

(4) The Minister shall, as soon as possible after receipt of an
account in accordance with subsection (3) lay a copy of the account
before the House.

22. At the request of the Minister, the Permanent Secretary, Inspectionof
Ministry of Public Works or an officer of that Ministry authorised hospital
by him in that behalf, may at all reasonable times and upon premises.
reasonable notice being given to the Board, enter into and inspect
all premises within the control and management of the Board, and

ANTIGUA
AND

BARBUDA

Vesting and
divesting of

property.

Power to make
regulations.

12 Antigua and Barbuda Hospitals Board NO. 1 of 1999.
Act, 1999.

the Permanent Secretary, Ministry of Public Works or an officer of
that Ministry authorised by him in that behalf, shall report to the
Mnister upon the state of the premises and the Minister shall
forward a copy of each report to the Board.

23. (1) All property of the hospitals whether movable or
immovable shall become the property of the Board.

(2) No property vested in the Board under subsection (1) shall
be divested without fist obtaining the written approval of the
Cabinet.

24. (1) The Minister shall, after consultation with the Board
make regulations

(a) to fix the sums to be charged by way of hospital fees;

(b) prescribing anythmg whichmay beor is to be prescribed
under the Act;

(c) prescribing professional and other qualifications
required by officers of the Board;

(d) prescribing the conditions under which medical and
dental and other practitioners shall be admitted to the
hospitals to practise their professions;

(e) prescribing the conditions under which students shall
be admitted to the hospitals to study their profession;

(f) prescribing the duties to be performed by the various
officers and Committees of the Board

(g) prescribing the composition, procedure and functions
of each Medical Staff Committee;

(k) generally for the purpose of giving effect to this Act.

No. 1 of 1999. Antigua and Barbuda Hospitals Board 13 ANTIGUA
Act, 1999. AND

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(2) Regulations made under this Act shall be subject to negative
resolution of the House.

25. (1) The Board shall, in consultation with theMinister, make power to make
hospital rules rules.

(a) governing the professional conduct of the medical
staff,

(b) as to investigations i ~ t o allegations of misconduct by
the medical staff;

(c) as tothedisciplinary action thatmaybe takenfollowing
a finding of misconduct;

(d) to establish and institute policies for the efficiency,
good order and management of the hospitals;

(e) to make provision for

(i) the admission and dischargeof patients, patients
identification and protection of the rights of
patients;

(ii) the conduct and control of patients;

(iii) the conduct of visitors; and

(iv) the control and supervision of clinical work and
the use of the facilities of the hospitals in the
course of that work.

(2) A handbook of the policies and rules of the Board shall be
supplied by the Board to medical and dental practitioners and made
available for inspection by other persons on request being made to
the Hospitals Director.

ANTIGUA 14 Antigua and Barbuda Hospitals Board No. 1 of 1999.
AND Act, 1999.

BARBUDA

Passed theHouse ofRepresentatives *hs 18th Passed the Senate ths I lth
day of January, 1999. day of February, 1999.

B. Harris,
Speaker.

M. Percival,
President.

S. Walker, S. Walker,
Clerk of the House of Representatives. Clerk of the Senate.

Printed at the Government Printing Office, Antigua and Barbuda,
by Rupert Charity, Government Printer

- By Authority, 1999.
800 - 2.99 [ Price $5.75 1