Nhi ‘Simply Doesn’T Have Enough Doctors’


Tribune Business Editor


Doctors yesterday suggested National Health Insurance (NHI) was being “watered down” in the rush to implement it before the upcoming election, adding that less than 10 per cent of registered private physicians had signed-up to the scheme.

The NHI Secretariat on Wednesday said that 60 private sector doctors had registered to provide services under the $100 million primary care phase, with this number supplemented by public sector providers.

However, Dr Duane Sands, the FNM’s candidate for Elizabeth, told Tribune Business that the figure quoted by the NHI Secretariat represented less than 10 per cent of doctors on the medical register.

And, given the Bahamas’ 375,000-strong population, Dr Sands questioned how “patients wanting to participate in NHI can”, given that the draft contracts with doctors limit their patient populations to a maximum 2,000.

He implied that it was impossible to hit this ratio with just 60 private sector doctors signed up for the NHI primary care phase, and said: “We have almost 1,000 doctors on the medical register, and with that number and as many as 600 working in the private sector, my arithmetic’s not good but that’s 10 per cent.

“They simply don’t have enough doctors. Perhaps they’ll go back to the negotiating table. I would not be overjoyed if I were the Minister.”

Another private doctor, speaking on condition of anonymity, said of NHI’s first phase registration: “That’s very poor. You have about 800 physicians thereabouts in the specialist areas they require. You take that 60 out of that group; that’s a very small number.”

Tribune Business sources in the healthcare industry, speaking on condition of anonymity, said doctors who have signed on to NHI have yet to sign a full agreement to provide services.

This newspaper was informed that they have only signed a ‘Letter of Intent’, or agreement in principle’, to-date. And, in the meantime, some of those featured in NHI advertisements have enjoyed a substantial increase in patient volume and business at their practices via the free promotion.

The names of the 60 doctors who have signed up to provide services under NHI were not revealed, although the Secretariat said they included general practitioners, family doctors, internists, obstetricians, gynaecologists and paediatricians.

“We are pleased with the positive response from the provider community during the first round of Primary Care Provider registration for NHI Bahamas, and are looking forward to starting enrolment soon, so Bahamians can start selecting their preferred doctor,” said Peter Deveaux-Isaacs, the NHI Secretariat’s permanent secretary.

With the pace of implementation accelerating ahead of next month’s general election, the NHI Secretariat yesterday issued another release confirming that the NHI Act had come into force this Wednesday.

This, the NHI Secretariat said, will allow Prime Minister Perry Christie, who has taken ministerial responsibility for the scheme, to establish the NHI Authority that will oversee and govern the scheme.

It added that the Prime Minister will also now be able to hire staff for the Authority, plus start agreeing contracts with doctors and care providers.

However, as previously pointed out by Tribune Business, the NHI Authority (NHIA)- which is supposed to be created from a merger of the Public Hospitals Authority (PHA) and Department of Public Health - will have no legal basis for its existence.

This is because the Bill for its creation, which has been circulated for healthcare industry feedback, has yet to be brought to Parliament. And, with Parliament set to be dissolved next week, the chances of this happening before the next general election are virtually non-existent.

The Government has also yet to establish the public insurer for NHI, Bahama Care, and announce the identity of its private sector manager, while no agreements have been reached with Bahamian private health insurers to act as Regulated Health Administrators (RHAs) - as the scheme demands.

Thus NHI appears set to launch without key elements of its governance structure, doctor contracts and a mechanism to compensate them for services rendered, in place.

“The establishment of the NHIA highlights the continued commitment to the Bahamian people to make modern, affordable and accessible health care services a reality. Moreover, the legal establishment of the body that will usher in the provision of NHI Bahamas will move our country closer to achieving Universal Health Coverage,” said Dr Delon Brennen, NHI’s project manager.

The NHIA will now be making job offers for posts such as customer service representatives, finance officers, information technology staff, facilities management, benefits management and quality management following a “robust recruitment process”.

“The Act being brought into force marks another significant milestone for the continued implementation of NHI Bahamas,” said Mr Deveaux-Isaacs.

“We know the Bahamian people are eager to enrol, and we, too, are excited to launch phase two of enrolment this month. More details of when and how to enrol will come in short order.”


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