The Tribune

By NEIL HARTNELL

Tribune Business Editor

nhartnell@tribunemedia.net

The Medical Association of the Bahamas (MAB) president yesterday urged the new government to be “more honest and open” over healthcare reform than its predecessor, which he accused of “ramming NHI down our throats”.

Dr Sy Pierre told Tribune Business he was “hoping for better” from the Dr Hubert Minnis-led administration, with both NHI and the use of doctors’ names without their permission set to be addressed at last night’s MAB annual meeting.

While the new government has yet to fully detail its policies, especially its approach to the NHI scheme inherited from the Christie administration, Dr Pierre called for it to focus on sustainable solutions that the Bahamas can afford.

“I’ve got to sit down and see what they’re saying,” the MAB president said of the new government and its healthcare approach.

Asked what he wanted to see from the FNM administration, Dr Pierre replied: “Obviously, that things are transparent and truthful, and that they let people know what the country can and can’t afford, because nothing’s for free.

“We just want more honest and open discussion as opposed to ramming things down our throats. Dr Sands, he was always saying what was wrong with the NHI plan of the previous government, so hopefully he’ll make positive changes.”

Dr Duane Sands, a leading critic of the Christie administration’s NHI plan, was sworn in as minister of health yesterday evening.

“I’m hoping for better,” Dr Pierre added. “People are talking about should it be primary care, should it be catastrophic care, should it be specialty care.... There’s a lot of things to sit down and discuss.”

Dr Minnis suggested during the election campaign that an FNM government would re-focus NHI on catastrophic health insurance, providing coverage for Bahamians afflicted by ‘life or death’ illnesses and injuries that require immediate, but extremely expensive, treatment.

Such occurrences frequently force Bahamians into situations that “destroy a family’s finances” or require them to fund-raise through cook-outs and the like.

The FNM has been contemplating a catastrophic health insurance scheme for longer than Perry Christie’s NHI plan, having first examined such an undertaking during the waning years of the 1997-2002 Ingraham administration.

Dr Sands gave Tribune Business an insight into the new government’s likely approach just before the election, when he said it “wants to focus more on a catastrophic model for the insurance aspect of NHI”.

The Christie administration instead focused on primary care, allocating $100 million to the roll-out of this initial NHI phase. While around $40 million of this came from existing healthcare spending that was ‘re-purposed’, the $60 million came from other taxes - likely Value-Added Tax (VAT).

The new government’s efforts to reform and refocus NHI will likely be complicated by the fact that more than 10,000 Bahamians have already enrolled as patients/beneficiaries, including some 9,000 in New Providence and 2,600 in Grand Bahama.

The NHI Secretariat, a creation of the former government, continued enrolling Bahamians, and matching them to primary care doctors, even following last Wednesday’s general election, holding sign-up drives in Freeport on Friday and Saturday.

Dr Sands’ appointment as minister of health was largely applauded by private sector healthcare professionals yesterday, one doctor describing him as “certainly on our side as it relates to health”.

The doctor, speaking on condition of anonymity, added: “He’ll be a good person to represent both sides, the Government and then all the providers, physicians, pharmacists, physiotherapists and administrative staff in the healthcare system.”

Many healthcare industry players have welcomed the general election result, after growing increasingly resentful of the Christie administration’s efforts to impose a ‘one-size fits all’, government-run system on the Bahamas via NHI.

“Let’s come up with a sustainable plan that’s affordable, sustainable and able to improve the overall health of the country,” the doctor told Tribune Business.

They pointed out that NHI, as it exists, would not alleviate the two-three day wait for a bed that many patients at the Princess Margaret Hospital presently endure.

“I hope this will be an opportunity for us to craft something that will be sustainable, affordable and can have an impact on catastrophic care and also chronic disease management,” the doctor added.

“I have no desire, as do many of my colleagues, to be involved in the current [NHI] model as is. We need change, we need reform to be able to have a positive net result on every aspect of our country.”

They said of the new government: “It’s up to them to do it. They have the ability to do it. It’s a matter of stepping up and making it happen. They need to come out hard and heavy, and take the opportunity while people are receptive to them being leaders of the country.”

The FNM has pledged to retain the NHI scheme and make it better, and Dr Sands indicated in a pre-election interview with Tribune Business that the new government will focus on upgrading the quality of care and infrastructure in the public sector - both at the clinics and hospitals.

Health infrastructure improvements will occur in “bite size nuggets”, Dr Sands said, adding: “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.”

He also pledged to reduce wastage and inefficiency, and ensure the Bahamian people get ‘value for money’ on healthcare, while also delivering improved treatment and quality outcomes.