By NEIL HARTNELL
Tribune Business Editor
nhartnell@tribunemedia.net
The Government is proposing to eliminate the Public Hospitals Authority (PHA) by merging it with the Department of Public Health to create a “single governance regime” for National Health Insurance (NHI).
Details of its plans are contained in the draft Bahamas Health Services Authority Bill, which will be the organisation charged with delivering and administering all health services and programmes under the NHI scheme.
The Bill, which has just been released for healthcare industry consultation and feedback, stipulates that all the PHA’s assets, including the Princess Margaret Hospital, Rand Memorial Hospital and Sandilands Rehabilitation Centre, will be transferred to the new Authority.
Also transferred, according to the draft obtained by Tribune Business, are all “pensionable officers” of the PHA and Department of Public Health, apart from those working at the latter who are dealing with “population-based health”.
Those moved to the Bahamas Health Services Authority will be employed on the same salaries and terms as at the PHA and Department, with “existing union agreements continuing in force until” changed via industrial negotiations when they become due for renewal.
The PHA-Department of Public Health merger into the Bahamas Health Services Authority is designed to provide a single governance structure that will boost efficiency, quick decision-making and healthcare system governance, according to the Bill.
“The Bahamas Health Services Authority forms a part of the National Health Insurance regime of the Bahamas. The goal of NHI Bahamas is ‘to enable the progressive implementation of Universal Health Coverage’,” the Bill’s ‘objects and reasons’ section states.
“The Cabinet of the Bahamas has therefore approved a single governance model that will accelerate the implementation of Universal Health Coverage, while providing effective oversight of the programme.
“The structure of the single governance regime will provide for quick and effective decision-making with transparency and accountability, as well as the alignment of health systems, and will result in greater efficiency, continuity of care and the seamless delivery of patient-centred services in the Government health sector.”
Many observers, especially in the private healthcare sector, will likely question whether this Bill, which repeals the PHA Act and associated bye-laws, can help achieve those lofty goals.
The Bill, though, emphasises that the Bahamas Health Services Authority will have responsibility “for the delivery and administering of health services and health programmes in the Bahamas” once the legislation is enacted.
It confirms that the management and maintenance of the public health sector’s clinics and laboratories will be transferred from the Department of Public Health to the Bahamas Health Services Authority, representing a fundamental change in the system’s governance.
The Bill has likely been released for consultation now because the Christie administration is rapidly running out of time to launch the much-touted $100 million NHI primary care phase before the upcoming general election, which is likely to be held in late April or early May.
The structure proposed under the Bill mirrors that proposed in the September 2014 report by the National Health Systems Strengthening Committee, the contents of which were disclosed by Tribune Business last year.
That report called for politicians to “buy into” the healthcare system’s new governance structure and care delivery model, and “ensure standardisation and overall quality of care”.
Warning against political meddling and interference in NHI and the new Authority, the 2014 report urged: “The Public Health Authority must be outfitted with persons well versed in healthcare and management, particularly the latter.
“There must be full transfer of authority to the limits of our governmental system. In this way decisions can be made that will allow the health system to function unencumbered by specific external pressures. This central co-ordination will allow for equitable distribution of trained staff, equipment, etc.”
The 2014 report called for “a single governance structure to address the administrative operations of all healthcare services underpinned by quality.
“The committee proposed a Central Governance Board or Public Health Authority with regional bodies to oversee the administration, management and operations of health care facilities in the regional zone,” it said, outlining exactly what the Christie administration now appears to be adopting.
“These changes will diminish the fragmentation of government health services, provide greater autonomy and allow for seamless movement of clients across the care continuum (where the continuum of care is a concept that involves an integrated system of care that guides and follows an individual over time through a comprehensive range of health services across all levels and intensity of care).”
The National Health Systems Strengthening Committee also called for the Bahamas to be divided into four healthcare regions, namely the Northern, Central, Southern and Southeastern District Health Authorities.
The Bill, too, appears to reflect this, as it allows the Minister of Health via Order to “establish one or more health districts”, name them and set their boundaries.
However, no regulations accompanying the Bill have yet been disclosed, which will likely arouse industry concern given that these typically contain the enforcement ‘teeth’.
Comments
Well_mudda_take_sic 7 years ago
If only the grossly incompetent Frank Smith, Chairman of the PHA and Sir Snake's son-in-law, could be so easily eliminated!
truetruebahamian 7 years ago
Snake, Sebas and all of the sewer crowd can readjust their expectations, because war is coming for them.
sealice 7 years ago
this is starting to stink like the republican version of Obamacare.....who knows WTF you are gonna get when it's all over besides another Royal Screwing from the gubmint??
Sign in to comment
Or login with:
OpenID