The Tribune

By ANNELIA NIXON

Tribune Business Reporter

anixon@tribunemedia.net

The Prime Minister has voiced frustration over delayed payments to doctors and others providing medical services to the National Health Insurance (NHI) scheme, and asserted he is “still trying to get my head wrapped around” what is causing the problem.

Philip Davis KC said there is “always some glitch in the bureaucratic process” as NHI providers continue to speak out about late payment frustrations as well as policy changes that impact their business with no notice of consultation. This has prompted a group of doctors to try and become a registered union to advocate and negotiate for themselves.

The Prime Minister, though, said there is no reason why payments should not be paid to physicians and laboratories in full and on time. “Well, I've just been hearing about this, so we're looking into it,” Mr Davis said. “I mean, I don't know why or what the reasons are for it, but we’re looking into it to see what it is.

“But these bureaucratic issues impacting issues of payment continue to plague the system. I'm still trying to get my head wrapped around it. It's frustrating why payments are not being made, and there's no reason for it not to be. It’s always some glitch in the bureaucratic process.”

Last month, Mr Davis said that while he did not have all the facts, the Ministry of Finance had found issues in the billing process leading to the launch of an accounting reconciliation exercise to identify and address the problems. On Friday, the Prime Minister said he was unable to provide an update on the matter because he had not yet been updated as “they're still working on it”.

The group of doctors once known as the National Health Insurance Providers Association (NHIPA), but now operating under the name Physicians Provider Association (NPA), in a letter shared with the media and addressed to the Prime Minister said they were concerned with his comments last month that the Government found irregularities in how some NHI providers billed the state.

“We were concerned, however, by recent public statements suggesting that physicians have billed the National Health Insurance programme inappropriately,” the letter read. “Respectfully, this characterisation does not reflect how the system operates.

“Physicians within the programme do not submit traditional billing claims. Instead, the Authority controls and issues capitation payments based on enrollment reports generated within the system. Situations such as these highlight the importance of direct dialogue so that accurate information can guide public understanding and policy decisions.”

The letter, dated March 9, 2026, also requested that a meeting be held between NHI providers and Mr Davis to discuss late payments, policy changes, operational inconsistencies and the sustainability of the NHI framework. They also asked that confirmation be giving within two weeks whether a meeting can be arranged.

Speaking to the delayed payments, Dr Cyprian Strachan explained that initially NHI would pay the doctor the month before a patient was seen. But, currently, NHI is two months delayed in paying physicians and three months late in paying the medical laboratories. 

“Our presence here now, the reason we are here now, is that over time the National Health Insurance, the Government, has been delinquent on paying the doctors,” Dr Strachan said. “And so instead of getting paid the month before for the patient, the Government is now two months behind in payments. 

“So we should have been paid on February 15 for March patients. We just getting paid for January. They just finished paying for January, so we're two months behind. The labs are three months behind. And so things have changed. We've signed contracts with them for this particular purpose, and now they want to make adjustments to whatever contracts we have. That's where the disagreement comes in now. We're not greedy doctors. We're not selfish.”

In the letter addressed to the Prime Minister, the group also sought formal recognition as a registered union, reiterating that they have been working towards that goal and going so far as changing the name of their group as requested by the Registrar of Trade Unions but have had no success.

Obie Ferguson, the Trade Union Congress (TUC) president, voiced his support for the group arguing that they have a constitutional right to form an association or a union.

“So don't let them come to you with all kind of garbage,” Mr Ferguson added. “I call it garbage because the constitution of The Bahamas is the principal document that governs this country. I don't care what legislation you pass… So why you want to come to the doctors and try to give the doctors the impression that they can't have a union?

“I'm here to support them. The TUC is supporting them. And I'm here in addition to support the president of this union, and even though they're trying to block us, we with her. And we, by extension, we with the doctors and the officers of this union.”

Dr Duane Sands, the Free National Movement’s (FNM) chairman, said yesterday of the NHI payment delays: “This is a pattern that has persisted for nearly two years, and it has one root cause: The Government did not budget enough money for NHI.

“The Government’s own National Health Strategy report, released just months ago, warned that the health system’s financing is on an ‘unsustainable track’ with a projected deficit of $24m by fiscal year 2026. And yet this administration responded by increasing NHI’s budget by a mere $2m to $48.2 million, a figure that was already being outpaced by demand before the fiscal year even began.

“What we are witnessing is fiscal gymnastics with real human consequences. The Government has been boasting of a bBudget surplus while allowing the doctors who serve NHI patients to go months without payment, forcing them to personally finance a scheme the Government is legally and morally responsible for funding,” Dr Sands added.

“When the Prime Minister responded to this crisis by suggesting ‘irregularities’ in provider billing, without evidence and without specificity, he threw the reputation of Bahamian doctors under the bus to deflect from his own government’s failure. It was unworthy of the office, and it was factually indefensible. Physicians in the NHI capitation model do not even submit individual billing claims. The anomalies, if any exist, are within a system the Government itself built and manages….

“Let me be direct about what this government’s record reveals. For four years, the Davis administration has expanded NHI’s enrollment and broadened its benefits without adequately funding the programme to sustain those expansions.”