The Tribune

By NEIL HARTNELL

Tribune Business Editor

nhartnell@tribunemedia.net

The Medical Association of the Bahamas (MAB) president yesterday said he had been informed that junior doctors in the public clinics were signed-up for National Health Insurance (NHI) without their permission, with the scheme’s development thrown into doubt by yesterday’s general election.

Dr Sy Pierre told Tribune Business he had been informed by Dr Macumba Miller, acting president of the Bahamas Doctors Union (BDU), that his members were signed-up as NHI providers without their knowledge by the public health clinics.

“A lot of them, their names were put there without permission,” Dr Pierre disclosed. “That’s what the head of the junior doctors union was saying. He was saying a lot of them were signed up by the clinics, and it did not have their permission.”

Dr Pierre said the issue was likely to be raised and discussed at the MAB’s upcoming annual general meeting (AGM) later this month, although those most impacted were junior public sector doctors, who are BDU members.

“I received a list of available physicians, but a lot of them on that list didn’t give their permission, and didn’t actually sign up,” he added.

Dr Pierre said “very few” doctors confirmed they had signed on to NHI in response to his and the MAB’s request for information on those agreeing to be providers.

Dr Delon Brennen, the NHI’s project manager, sidestepped the issue when questioned last week by Tribune Business as to whether doctors had been placed on the scheme’s provider list without their knowledge.

However, private sector doctors showed Tribune Business where some physicians had been listed twice on the NHI provider list as at May 3, 2017. One doctor was even listed three times, and at clinics on two separate islands - New Providence and Grand Bahama.

Meanwhile, the election of an FNM administration throws NHI’s future evolution and development into uncertainty, given the party’s scepticism over whether the model was right for the Bahamas and its affordability.

Dr Duane Sands, the FNM’s newly-elected MP for Elizabeth, recently told Tribune Business that there was “a fundamental flaw in this [NHI] model”, based on the fact that outgoing minister of health, Dr Perry Gomez, was unable to say how much the scheme will ultimately cost at full roll-out, and who will pay for it.

The FNM has pledged to retain the NHI scheme and make it better, and Dr Sands said the party “wants to focus more on a catastrophic model for the insurance aspect of NHI”.

This implies a switch from the $100 million primary care phase launched under the Christie administration to a model designed to ‘end cook outs’, helping to cover the costs of major operations and surgical treatments for Bahamians.

“I think that what we’re going to have to do is continue the development of the capacity in the public sector, and encourage and strengthen the private sector,” Dr Sands said.

“Build on the capacity in the private sector, but using it in a way so that it’s not an outrageous cost to the public purse. Simultaneously improve, in bite size nuggets, the health infrastructure.

“We can’t afford $800-$900 million in one go. We can afford chunks of $50-$70 million at a time. That way you minimise disruption but have continual improvement in healthcare delivery.”

Dr Sands said an FNM administration needed to “maximise the return the Bahamian people get from what they actually pay” in tax dollars for healthcare in the public system.

He added that it would seek to reduce the 25 per cent funds wastage rate in the Public Hospitals Authority to “an irreducible minimum”, improve efficiency and ensure staff resources are maximised to boost healthcare services and delivery to the Bahamian public.

Dr Sands said an FNM government would also upgrade both the public health clinics and the Princess Margaret and Rand Memorial hospitals, introducing new emergency rooms, a national blood bank, medical examiner’s facility and mortuary, and child maternity wings.