The Tribune

By ANNELIA NIXON

Tribune Business Reporter

anixon@tribunemedia.net

THE Government’s record $469m healthcare spending in the upcoming 2026-2027 fiscal year will only translate into better patient care and outcomes if the funding addresses staff shortages, infrastructure gaps and access to care, a leading doctor is warning.

Dr Gemma Rolle, owner of Bahamas Digestive Health and Wellness, and former president of the Medical Association of the Bahamas (MAB), said the increased healthcare budget creates significant opportunities for system-wide improvements but warned that the real measure of success will be how the funds are spent.

“Having $469m allocated, a record allocation for healthcare, it sounds exciting. It sounds promising,” Dr Rolle said. “As a physician, what we will be paying attention to is how these funds are allocated.”

She said key questions remain over the balance between preventive and hospital-based care, funding for the National Health Insurance (NHI) programme, physician reimbursement, infrastructure upgrades, operational costs medication supplies and medical equipment.

“How will this translate to how we will deliver healthcare? How are the funds being allocated?” Dr Rolle asked. The healthcare allocation became one of the largest spending priorities in thBudget, with Simon Wilson, the Ministry of Finance’s financial secretary, revealing that the Government’s projected $223m fiscal surplus would have been significantly larger had it not chosen to increase investment in healthcare.

Mr Wilson said the Government expects to record a surplus of approximately $120m for the 2025-2026 fiscal year ending next week, rising to a projected $330m in the upcoming fiscal year and increasing further thereafter.

Dr Rolle said the spending should be viewed as an investment rather than a cost. “We have to remember and hold fast to the fact that the health of the nation is the wealth of the nation,” she said. “So maintaining our people’s health, we would have economic stability and increase the workforce and maintain a workforce. So it is an investment that the country is making.”

Dr Rolle pointed to findings from the recent Bahamas National Health Strategy consultation process, which identified shorter waiting times, and improved access to specialists, emergency care, medications, surgeries and diagnostic imaging among the public’s top priorities.

“If utilising the surplus would answer all of those concerns, then I think it’s a great thing to utilise that surplus and focus on investing in the health of the nation,” she added.

Dr Rolle said achieving the Budget’s revenue and economic projections could help address several long-standing healthcare challenges, including infrastructure upgrades and workforce retention.

“If the opportunities are met, it’s great. We can improve on our infrastructure, we can recruit and maintain or retain healthcare professionals, physicians, nurses, allied healthcare workers, particularly in the public space,” Dr Rolle said. “We can ensure that perhaps NHI is sustainable if we meet them.”

However, she warned that falling short of those projections could place pressure on critical services and capital projects. “If we miss these marks, are we still going to meet our goals for improvements in the infrastructure to ensure that we have enough medications to give to patients in the hospitals and not have to ration?” Dr Rolle challenged.

“Will we be able to provide life-sustaining measures for patients, provide procedures and essential life-sustaining surgical interventions?” Her comments came as the Government advances several major healthcare projects, including the $268m New Providence hospital project, the expansion of healthcare facilities in Freeport and the acquisition of Harbourside Hospital.

While acknowledging the potential benefits of modern facilities, Dr Rolle questioned whether the healthcare system currently has sufficient personnel and resources to fully utilise them.

“In theory it sounds and seems really great where we’re having a state-of-the-art facility constructed, the advancement in Freeport, the Harbourside hospital,” she said. “The concern amongst many physicians is how will this be filled with staff with our staff shortages that we have at the Princess Margaret Hospital currently.”

Dr Rolle also raised concerns about funding for equipment, pharmaceuticals and medical supplies. “Medical devices, supplies, pharmaceuticals, what budget is allocated for that as patients are suffering, as patients are dying?” she said. “How will we fill these hospitals to provide patients with what they require?”

Dr Rolle argued that while new facilities could help reduce bed shortages and waiting times, improvements in primary care, preventative medicine and healthcare access throughout the Family Islands may ultimately have a greater impact on national health outcomes.

“Focusing on primary care, preventative medicine, focusing on health equity for all patients throughout the archipelago, that is what would truly speak to improvement in healthcare, I believe, in the country,” she said.

Mr Wilson acknowledged many of the concerns raised by healthcare professionals, and argued that the Government’s healthcare reforms are aimed at strengthening the sector’s long-term financing model rather than simply increasing spending.

“I think what she’s saying is quite correct,” the Mr Wilson said. He highlighted the Government’s decision to introduce employer-sponsored health insurance for public sector workers as a key reform designed to inject additional resources into the healthcare system.

“The Government is the largest employer in the economy and we didn’t offer universal healthcare to our employees,” Mr Wilson said. “So our employees were, in essence, utilising the system without compensating the system.”

The reform will also extend insurance access to public sector pensioners, including retired police officers, defence force personnel and corrections officers, many of whom retire relatively young and often lose employer-sponsored coverage.

“The key for us for the healthcare sector is we have to get more resources into the sector,” Mr Wilson said. “I think the insurance is an important step.” He also signalled broader reforms aimed at ensuring public healthcare providers receive reimbursement from private insurers when insured patients access public facilities.

Under provisions contained in the National Health Insurance Authority legislation, which are expected to come into force this fall, insured patients using public healthcare services will be required to use their coverage, allowing funds to flow back into the system.

“The insurance will actually provide funds back into the system,” Mr Wilson said. He argued that while insurance reforms alone will not solve the sector’s challenges, they represent a necessary step toward creating a more sustainable healthcare financing model while improving efficiency in resource allocation.

“We accept the fact tha, as a government, we may not be the most efficient in terms of how we allocate resources in the sector,” Mr Wilson said. “And we are discussing with our partners in the economy how we could do that.”