The Tribune

By FAY SIMMONS

Tribune Business Reporter

jsimmons@tribunemedia.net

A Cabinet minister yesterday asserted that combining National Health Insurance (NHI) with the National Prescription Drug Plan will help to curb healthcare waste and inefficiency in the public sector.

Dr Michael Darville, minister of health and wellness, told the House of Assembly during his 2023-2024 Budget debate contribution that merging the two initiatives will progress The Bahamas' universal health coverage ambitions as he confirmed the NHI Authority has a $46m budget for the next fiscal year.

He said: “The Budget allocation for the National Health Insurance Authority (NHIA) remained unchanged at $46.2m. With the passing of the new NHI Bill that would replace the 2016 NHI Act, my ministry will finally address the vexing reality of duplication and wastage across the board in healthcare delivery systems, and begin the important steps to move the NIB prescription drug plan to the Nation Health Insurance Authority.

“This move is part of my ministry’s healthcare strengthening strategy outlined in the initial Sanigest report that foreshadowed NHI as the funding engine for the country’s universal health coverage model.” The minister added that the NHI and drug plan merger will eliminate delays in getting medication to the Family Islands and create savings that will be funnelled into the Authority for screening and diagnostic programmes.

He said: “We in health believe this new policy decision will end the need for two pharmacies co-existing at our public clinics. This change would help decentralise pharmacy services and eliminate the delays we are currently experiencing in getting drugs and medical supplies to our Family Islands on a timely basis.

“There will be cost savings associated with this move that would be channelled to NHI [along with] additional screening and diagnostics programmes outlined in the new NHI Bill.”

Dr Darville said the Bill will be debated in the House of Assembly shortly, and will detail how primary care, catastrophic healthcare and universal healthcare are implemented.

He added: “On the path to universal health coverage, the NHI programme continues to experience rapid growth, warranting the need for legislative amendments and expansion of the current NHI Act 2016. The National Health Insurance (NHI) draft Bill 2023 builds upon the solid foundation set for the programme for primary care, and outlines details for the future implementation of catastrophic healthcare and progression to universal health coverage for all.

“Extensive stakeholder consultations on the new legislation have taken place, and will continue as the Bill progresses through the legislative process. Debate on this Bill is expected to occur shortly.”

Dr Darville said the Public Hospitals Authority (PHA) will receive almost 64 percent of total healthcare funding in the 2023-2024 Budget. Its allocation has been lowered by $10.3m due to reduced COVID-19 spending and healthcare upgrades. He added that $48.68m was budgeted for Family Island clinics, excluding Grand Bahama and Grand Cay, in the new fiscal year,

Dr Darville said: “My Ministry has a total recurrent budget allocation of $348.049m. Of this sum, the Public Hospitals Authority (PHA) received $222.156m, demonstrating a $10.3m reduction compared to the last Budget cycle due to the projected decreases in COVID-19 spending and other initiatives aimed at enhancing efficiencies across the board at all state-owned enterprises.

“The Department of Public Health, which manages our clinics in New Providence and all of the Family Islands, with the exception of Grand Bahama and Grand Cay, was allocated a budgetary sum of $48.683m. It is noted that due to the shift in COVID-19 status in the country, the hiring of additional staff and the completion of many capital works projects at all major clinics, the Princess Margaret and Rand Memorial Hospitals in the current budget cycle, allocations in the 2023-2024 budget saw a decrease by some 13 percent compared to last year.”

Dr Darville added that once the 2023-2024 Budget has been passed, his ministry will begin negotiations on the NHI and drug plan transition. The latter will include new medications, including anti rejection drugs that are necessary for transplant patients that will participate in the National Organ Donor Programme expected to launch by the end of the year.

He said: “The negotiations with NIB, my ministry, NHI and the Ministry of Finance will begin shortly after the passing of this Budget. As part of this change, we will also add new drugs to the current drug list of the National Prescription Plan to facilitate improvements in clinical outcomes of patients suffering from non-communicable diseases and anti-rejection drugs for renal transplant patients.”