Health Minister Dr Duane Sands.
By NEIL HARTNELL
Tribune Business Editor
nhartnell@tribunemedia.net
The Minister of Health yesterday pledged to "maximise value for the Bahamian public" after revealing the former administration's planned $11 million investment in new Cat Island clinics would benefit just six patients per day.
Dr Duane Sands told Tribune Business that the "soundness" of such a multi-million dollar outlay was called into question by healthcare usage rates in the Family Islands.
"We have entered into tens of millions of commitments under the premise these new clinics would modernise the infrastructure for NHI," he said. "The question is whether or not they are predicated on sound principles.
"It is challenging when you look at the buildings proposed for Cat Island. We are spending so much money in Cat Island. Based on the utilisation studies for the last three years, if we were to build those clinics in Cat Island, on average they would see six patients per day."
Dr Sands had criticised the Cat Island clinics contracts during his 2017-2018 Budget presentation, but his revelation of the likely patient usage rates explains why he - and the Minnis administration - fear the investment will not provide taxpayers with value for money at a time of fiscal crisis.
The Christie government had awarded three clinic construction contracts pre-election that were valued at $2.349 million for Old Bight; $2.1 million for Orange Creek Clinic; and $6.6 million for Smith's Bay.
But Dr Sands argued that, beyond the construction contract's worth, the Government would also have to staff and equip all three clinics, plus pay for the likes of janitorial and security services, to serve a patient population numbering in the single digits daily.
"The average number of patients seen in the Family Islands, the number of visits to healthcare facilities, is around three visits per patient per year," the Minister of Health told Tribune Business.
While acknowledging that this frequency was slightly higher for Cat Island residents, Dr Sands added: "When you look at the projected utilisation of those clinics over the next five to 10 years, each of those clinics, costing $10 million, will see less than 10 patients per day."
Based on the 1,200-strong Cat Island population cited by Dr Sands in his Budget debate, and the three annual patient clinic visits average, the three proposed clinics would see a combined 3,600 patients annually.
This translates into a total 9.86 patients per day visiting the three government clinics on Cat Island, a figure in line with the estimates provided by the Minister.
"Underlying the premise of those buildings is NHI readiness," Dr Sands told Tribune Business. "As we look at the decisions made in the name of NHI, the commitments entered into in the name of NHI, the new NHI Authority is going to have to look a number of things.
"Ultimately, a sense of prudence and equanimity ought to apply so we end up maximising value for the Bahamian public."
Dr Sands's comments illustrate the difficulties in delivering a universal health coverage (UHC) system that matches equity with efficiency, and value for money, in an archipelagic nation with numerous sparsely populated islands.
His Budget debate address also noted that the Christie administration issued clinic construction contracts worth $1.6 million for Rum Cay, an island with a 70-strong population, and $300,000 for San Salvador.
"I have directed the National Health Insurance administration to revisit some of the decisions that have been made," the Minister said at the time. "We are going to review these contracts and if we can cancel some, we will cancel some, but we are going to set this right for the Bahamian people."
His remarks sparked an immediate riposte from Opposition leader Philip Davis, MP for Cat Island, Rum Cay and San Salvador, who said Bahamians in the Family Islands should enjoy the same rights and facilities as those living on New Providence.
"What amazes me is that this posturing, this flippant referral to these islands, comes from the Government that committed to the 'Back-To-The-Island' campaign which is anticipated to become the largest migration of Bahamians back to the Family Islands," Mr Davis responded.
"Why did they move in the first place? What incentive is there for them to return when something as basic as the construction of facilities to provide essential services becomes the subject of debate?"
Comments
TalRussell 7 years, 4 months ago
Comrade Dr. Duane reads from the same blame script as "KP." Listen-up doc. Why is it challenging when if you honestly think the funds would be better deployed for the greater benefit healthcare seekers - don't complain, don't explain - when you can just pull the damn plug.
jujutreeclub 7 years, 4 months ago
Tal. You're the PR officer for the PLP aye? You are worst than birdie strachan or you are birdie.
OMG 7 years, 4 months ago
Why not centralize specialist medical facilities in Nassau and establish a reliable flight transportation service . For all this talk about mini hospitals most serious/complicated procedures will still have to be carried out in Nassau.
athlete12 7 years, 4 months ago
"Reliable flights" that's a stretch, imagine the added cost. They need to build a major facility like PMH in the southern island. The country has become too reliant on Nassau and it's obvious they can't handle the load.
TalRussell 7 years, 4 months ago
Comrades! The first order business red government towards bringing online access to BahamaCARE to islanders - should be to switch over all our Lighthouses to cell phone towers.
Well_mudda_take_sic 7 years, 4 months ago
Christie was the Minister of Finance and had a duty as the responsible cabinet minister to ensure that such foolish squandering of public funds did not occur. Yet we are hearing about numerous instances of mega millions of dollars of the taxpayers funds having been blatantly flushed down the proverbial toilet by Christie, Halkitis, Simones and others like them (right under their noses without the slightest care) as a result of their dereliction of duty and gross negligence in administering the people's affairs and their outright repeated failures to uphold the fiduciary duties impressed upon them by their respective public offices in callous disregard of the public trust. Carl Bethel should not even need a sharp pencil to bring serious charges against these former government officials for misfeasance, malfeasance and/or nonfeasance as appropriate......the evidence is all too glaring and our country must demonstrate to the rest of the world, as well as current and future generations of Bahamians, that we are not a 'banana republic' well on its way to becoming a failed state. This is the overriding mandate that was given by the vast majority of voters to Minnis and the new FNM government...and they had better respect it for the sake of our country going forward. We, the people, are watching most carefully!
DDK 7 years, 4 months ago
Right on Mudda!
John 7 years, 4 months ago
Remember when Pindling use to plant light poles and run miles and miles of electrical wire to settlements in the family islands and do the same with water pipes and phone lines. Just before elections But after the elections and the people did not vote for his party (or in some cases they did vote PLP) the equipment would sit there for years and years. Nothing new under the sun. Leopards do not change ways. In fact one time the PLP put up traffic lights in some family islands in the over the hill areas in Nassau and after the elections they eased those lights down. Then remember how they (PLP) would have the Defense Force guarding the water tanks on Blue Hill Road and the pumping station just off JFK as well as BEC switching stations. All a mind game. And, for the most part it worked.
Well_mudda_take_sic 7 years, 4 months ago
BJ Nottage certainly did not have to worry about the serious problems involving our country's public healthcare system. Unlike most Bahamians he was very privileged to receive the best available private medical care in both the Bahamas and the U.S. at the expense of Bahamian taxpayers. Minnis was dead wrong in allowing in excess of $250,000 of U.S. medical costs and $50,000 of funeral costs to be added to our country's national debt for the benefit of the family of a former cabinet member (and long serving insider) in the most corrupt government we have ever had...to date. We will now have to pay interest to lenders for these borrowed amounts at a compound annual rate for untold years to come. Just like his corrupt brother Kendal Nottage, who was a long serving cabinet minister under past Pindling-led governments, BJ served for many years as cabinet minister (an insider) in corrupt Christie-led governments. BJ chose to play the role of loyal soldier to Christie and the PLP party notwithstanding his inside knowledge of all the corruption that was going on around him and that no doubt he too personally benefitted from. He therefore had no loyalty to the Bahamian people and it is the height of hypocrisy for Minnis to have saddled the taxpayers with these significant costs. One must ask why did Minnis do this? Is it because Minnis's own OBG medical practice, that is presumably being cared for by other medical practitioners in Minnis's absence as PM, stands to benefit from picking up a sizable portion of the medical business that BJ and his younger partners have enjoyed over the years? Who knows? But something does not smell right here. BJ's estate surely had the means to pay his U.S. medical costs and his funeral costs. The $300,000 plus dollars should have been spent towards fixing water fountains and restroom facilities that are in a deplorable (often non-functioning) state in so many of our public schools. Minnis and his cabinet members need to get a grip on the reality of our country's situation and stop throwing "feel good" money around that our country does not have to spend and must borrow at the end of the day!
242concerned 7 years, 4 months ago
Mudda these people are lucky enough to have health insurance paid by the government. Dr. Nottage's health costs should have been covered by his insurer except for a small copayment. If only the coverage government ministers had was the same as the proposed NHI coverage for all Bahamian. Sadly, as in the USA, MPs always get the best coverage.
Well_mudda_take_sic 7 years, 4 months ago
If most of the NHI expenditures under the corrupt Christie-led PLP government had no grounding or basis in law, it can only be assumed these expenditures were unlawful. This means the accounting firm KPMG was paid millions of dollars by a government known to be corrupt and they (KPMG) as part of their due diligence turned a blind eye to all of the global and local KYC laws applicable to them in dealing with politically exposed corrupt government officials whom they should have known (just by virtue of the information in the public domain) were acting unlawfully in engaging their services. Rather than do the right thing, KPMG simply chose to jump onto the gravy train of corruption at the expense of Bahamian taxpayers. Here we once again see the abuses of public office and the public trust by key cabinet ministers in the former corrupt Christie-led PLP government as well as greedy private sector consultants like KPMG. Are you listening Carl Bethel?
Reality_Check 7 years, 4 months ago
@Mudda: It would be the height of lunacy and insanity for the new FNM government to have engaged KPMG to investigate any aspect of the previous Christie-led government's wide spread corruption. Minnis hopefully realizes KPMG should not be given an opportunity to cover up any of the wrong that they have done in allowing themselves to be engaged by a known corrupt government for exceptionally lucrative fees!
sheeprunner12 7 years, 4 months ago
Right sizing our Family Island infrastructure should be a MAJOR priority for this government:
Why does Eleuthera need THREE international airports, while Long Island has none?
Why does Abaco have TWO major port facilities while many islands do not have ONE functional dock?
Why do many islands have primary schools with less than 20 students and high schools with less than 100 students???? Amalgamation should become mandatory where these exist.
Why are there so many islands with government services scattered all over the place in private rental spaces instead on one central plaza for simple logistical service??
Why is there not a Class 1, 2, or 3 health facility on each island or region of the country? Class 1 is PMH or Rand ..... Class 2 is a regional mini-hospital (Abaco, Exuma or Inagua) .... Class 3 is a local clinic
Why is there not island specific agricultural, fisheries, poultry, and pork facilities available to provide niche value-added industries for food security???????
THIS IS WHAT I WANT TO HEAR BEING DISCUSSED BY THIS FNM GOVERNMENT
tell_it_like_it_is 7 years, 4 months ago
Salient points, sheeprunner.
Chucky 4 years, 10 months ago
11 million, not so bad.
If we borrow that at 5% , interest would be 550k per year.
6 patients a day x 365 days a year is 2190 patient visits/ year.
Equals $250.00 per patient in interest payment alone. Maybe another $150 per to cover doctors fees.
Maybe 100 per patient to run building
Surely some healthcare money already being spent on these people
Is 500 per patient per year really that bad
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