Dominica Hospitals Authority Act
The Dominica Hospitals Authority Act (Act No. 8 of 2021) is a legislative authority establishing the administrative and regulatory framework for managing public hospitals in Dominica. It governs institutions like Dominica China Friendship Hospital and sets standards for operations, accountability, and patient care within the healthcare system.
Legal Framework and Amendment
Initially enacted in 2021, this law created the Dominica Hospitals Authority, a statutory body tasked with oversight of public hospital operations, financing, and service delivery. Key features include governance by a board, executive leadership, and defined responsibilities for hospital administration.
On December 24, 2024, Parliament passed Act No. 13 of 2024, the Dominica Hospitals Authority (Amendment) Act, 2024, formalizing updates to the original framework. It was assented to shortly thereafter and gazetted for public record.
Notably, Section 49 of the Act emphasizes the confidentiality obligations of every member and officer of the Authority. In January 2024, a breach of patient confidentiality at Dominica China Friendship Hospital led to disciplinary action, reinforcing the importance of this provision.
Structure and Governance
The Act established the Dominica Hospitals Authority, a corporate body with perpetual succession and the power to enter contracts, manage finances, and employ staff. The Authority is governed by a board of directors appointed by the Minister responsible for health. Members of the board are selected for their expertise in medicine, finance, law, and community service.
A Chief Executive Officer manages day-to-day operations under the oversight of the board. The Authority is also required to submit annual reports to Parliament through the Minister for Health, ensuring legislative accountability.
Functions and Services
The responsibilities of the Hospitals Authority as set out in the Act include:
- Managing all public hospitals and selected community health centres.
- Establishing policies for patient care, administration, and service delivery.
- Recruiting, supervising, and disciplining medical and administrative staff.
- Implementing financial controls, including budgetary management and procurement in compliance with the Procurement and Disposal of Public Property Act.
- Maintaining patient confidentiality and protecting sensitive health data.
- Coordinating with the Ministry of Health, Wellness and Social Services on policy implementation.
- Ensuring that hospital services align with national disaster response and resilience planning, particularly under frameworks like the National Disaster Plan of Dominica.
The Act also provides the Authority with powers to collaborate with international partners, including health agencies, donor organisations, and foreign governments, for technical and financial support.
Confidentiality and Discipline
One of the most notable provisions of the Act is Section 49, which mandates strict confidentiality for board members, officers, and employees of the Authority. This clause became particularly relevant in January 2024 when a breach of patient confidentiality at the Dominica China Friendship Hospital led to the resignation of a staff member. The incident was highlighted as a test of the Authority’s capacity to enforce its legal mandate, highlighting the balance between transparency and patient rights.
The disciplinary powers granted to the Authority allow it to investigate misconduct, enforce penalties, and recommend dismissal where appropriate. These provisions ensure professional accountability and reinforce public trust in the healthcare system.
Relationship to Other Health Laws
The Hospitals Authority Act is one component of Dominica’s broader legal framework for health services. Other key statutes include:
- The Health Services Act, which regulates professional licensing, standards of practice, and public health administration.
- The Public Health Act (1968), covering disease control, sanitation, and environmental health.
- The Pharmacy Act, which governs the sale and distribution of pharmaceuticals.
Together with the Hospitals Authority Act, these laws establish a comprehensive system for healthcare governance, balancing hospital administration with public health, regulation, and safety.
Impact on National Development
The Act is aligned with the National Resilience Development Strategy 2030 (NRDS), which identifies health care as a priority sector for resilience building. By creating a statutory authority with financial and administrative autonomy, the legislation aims to strengthen Dominica’s capacity to deliver high-quality care, respond to disasters, and integrate health services into national development planning.
The Authority has played an important role in rebuilding after Hurricane Maria (2017), ensuring that hospitals were upgraded to withstand future climate impacts. Funds from the Citizenship By Investment Unit (CBIU) and the Economic Diversification Fund (EDF) have been channeled into hospital projects, linking the law directly with wider economic strategies.
Significance
The Dominica Hospitals Authority Act represents a major reform in the governance of health institutions, balancing efficiency with accountability. Its establishment of the Dominica Hospitals Authority ensures that hospitals operate with professional oversight, modern financial systems, and strict legal standards. As health challenges evolve, whether through pandemics, chronic diseases, or natural disasters, the Act provides the foundation for sustainable, resilient, and transparent hospital administration in Dominica.