After a meeting between the National Health Insurance Authority and the Parliamentary Team of The Progressive Liberal Party, the Opposition is proposing that the government consider a more gradual approach for National Health Insurance that would focus heavily on primary healthcare and selective catastrophic care to meet the demands in our public hospitals.
In a statement issued by Doctor Michael Darville, the PLP says, “as micro and macro economic indicators become more favourable, we can then move to implement the full healthcare package.”
The PLP representatives met with NHIA Chairman Dr. Robin Roberts and the Managing Director, Graham Whitmarsh and his team.
The Opposition spokesman on Health said, “In the NHIA presentation nothing was said about home care and the need to improve this arm of healthcare delivery in the country. If implemented properly home care would, in our view, shift the burden of attending to patients suffering from non-communicable diseases away from the accident and emergency and other wards and free up bed space at our hospitals ensuring that doctors and medical staff provide services for real emergencies.
“We in the PLP believe NHI is a must but once implemented it must be sustainable. It is our view that the proposal presented by the NHIA does not fully consider all facets of costs associated with the launch of the program and in the absence of an economic impact study by the Ministry of Finance we caution the government to consider a phased approach in order to reduce the potential for economic shocks. Their failure to do so could undermine the success of this very vital program and undermine economic growth into the future,” said Dr. Darville.
He said the PLP is convinced that a proper NHI programme will enhance the global growth of GDP ultimately but we must get it right.
“We in the Progressive Liberal Party understand the importance of universal health and the role national health insurance must play in order to deliver on this important mandate. NHI is our baby and we want it to succeed. Quality healthcare must be accessible to all Bahamians and we believe NHI is the way to accomplish this.
“We were pleased to learn that the NHIA accepts our position regarding the importance of universal primary healthcare. However, it appears that the NHIA is saying one thing and the Minister of Health another on NHI,” said the Senator.
“It is obvious that they are operating from different perspectives and that is creating confusion in the public domain. Who does one believe, the NHIA or the Minister of Health who has cabinet responsibility for relations with the Authority?
“For example, the NHIA is saying that there will be no cash exchanged by patients at the point of service. This was recommended by the Pan American Health Organization and the World Health Organization as a means of ensuring equity in the healthcare delivery system. The Minister of Health on the other hand is speaking about increasing the cost for services at the Public Hospitals Authority (PHA), the Department of Public Health (DPH) and the Ministry of Health. Have these increased costs been factored into the overall budget for delivery of NHI and if not who will bear this increased cost?
“Secondly, we have some difficulty with the NHIA proposal to establish a separate out-patient medical recording system while the PHA and the Ministry of Health are currently working with a reputable global software firm called Allscripts who won a multi-million dollar contract to administer hospital medical records and supplied flow chain in our tertiary institutions and public clinics. While in office we were assured by this group that this software package was capable of allowing doctors and medical staff to access the hospital records in the out-patient clinics. I am not certain if this important step was cancelled as part of the FNM’s stop review and cancel policy
But having two separate software systems for management of medical records would not only create confusion in the system but it will increase inefficiency and the cost of delivering healthcare in the Bahamas,” Dr. Darville said.
He said, “In the presentation, little was said about healthcare strengthening and the medical protocols necessary to ensure that services rendered in all our clinics are consistent from Inagua to Grand Cay, nor did they outline how we will sell NHI in the Family Islands whose medical infrastructure is failing because of a persistent lack of medical staff, medical supplies and life saving medication. Also, nothing was said about funding from the government prior to the launch in 2020 to hire trained staff and establish supply chains to ensure equity in the system.
“We are also concerned about the feedback from the business community, the Chamber of Commerce and the labour force. The business community and labour are saying that they will be forced to pay for this healthcare plan in a sluggish economy after the government increased value added tax from 7.5 per cent to 12 per cent in the last budget cycle.
“After reading the Response to the public consultation document from NHIA and listening to the stakeholders, we are of the view that this proposal is very ambitious and if implemented in the current economic environment could result in the contraction of business activity. There is also the added risk to the private sector of having to carry the burden of the shortfalls if the current figure of $130 million pegged to fund the next stage of NHI is underestimated,” said the PLP statement.
