The Tribune

By NEIL HARTNELL

Tribune Business Editor

nhartnell@tribunemedia.net

The “God-like powers” granted to the proposed National Health Insurance (NHI) Authority by draft legislation were yesterday criticised by a well-known doctor, who said it did not represent “a comprehensive National Health Plan”.

Dr Duane Sands told Tribune Business that the NHI Bill, as it currently stands, gives “unbelievably sweeping and intrusive powers” to the scheme’s governing body when it comes to requiring the protection and sharing of information.

In particular, he expressed disquiet over the Bill’s section 34, ‘Power to require information’, which allows the NHI Authority “at all reasonable times” to demand records from doctors and insurers without any seeming checks and balances.

“These are unbelievably sweeping powers that are so general,” Dr Sands told Tribune Business. “You are basically saying that the Authority has God-like powers over practitioners, and in the absence of schedules and regulations defining what they can ask for, and who can see it.”

He pointed out that registered physicians and insurers who withheld information, even though there may be valid grounds for doing so, could be exposed to a $250,000 fine.

Dr Sands contrasted this with the $10,000 fine that could be levied upon someone who breached data confidentiality, although he conceded that a prison sentence was also offered as punishment option here.

“I’m not sure that is a significant enough fine for a breach of confidentiality, given the harm that can come to a patient or practitioner,” he told Tribune Business of the $10,000 ‘cap’.

While the NHI Bill does provide for an appeals process to enable patients, providers and insurers to challenge the Authority’s decisions, Dr Sands said it was “not robust enough” to protect all parties.

“The overarching theme is that I don’t find this Bill is comprehensive enough to look at the entire delivery of healthcare, given the transformative intent of NHI,” Dr Sands told Tribune Business.

“It seems as if this is kind of thrown together to deal with the passage of NHI’s primary care phase, and when we get to the next phase we will talk a little more about the entitlement of individuals to advanced healthcare, and the difference in service provision between the Family Islands and Nassau, and speak to accessibility and transparency.

“This is not a comprehensive National Health Plan. It’s as if the Government have said we need a legal framework in place to do what we said we’re going to in the next year-and-a-half, throw that together and we’ll come back to it in 18 months.”

Dr Sands said the NHI Bill’s section 35, which spoke to the ‘maintenance of records’, gave no guidance on how these were to be kept.

And he questioned whether the NHI’s ability to inspect the scheme’s healthcare providers would conflict with the existing powers of the Hospitals and HealthCare Facilities Licensing Board, which currently performs this functions.