THE WEEK IN REVIEW BY ELCOTT COLEBY 18-22 JANUARY

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sovaldi times;”>National Health Insurance registration begins

treatment times;”>On Monday, 18th January of this week the government of The Bahamas began phase one or the registration of citizens and legal residents for the National Health Insurance Scheme.

The five phases to the scheme are as follow:

•   Phase 1: Registration

•   Phase 2: Enrollment

•   Phase 3: Primary Health Care Coverage

•   Phase 4: Select Catastrophic Coverage

•   Phase 5: Full Benefits Coverage

According to the statement, phase two or enrollment for NHI requires individuals to possess a bio-metrics encrypted National Insurance Board (NIB) Smart Card. The NIB has expanded the number of available registration centres to facilitate this exercise. The locations in New Providence are the NIB Headquarters on Baillou Hill Road, the Mall at Marathon and the Enoch Backford Auditorium on Carmichael Road. 

The Primary Health Care Phase or phase three of the health plan will be introduced in 2016 at no additional cost to Bahamians. There will be no increases in taxation to cover the cost of this phase and no exchange of money at the point of service will be necessary.

“The Primary Health Care Coverage phase includes visits to your doctor, prevention services, diagnostics (lab and imaging), and medication through a primary care provider” said the statement released by the NHI Secretariat.

“Primary care services will be made available to all legal residents of The Bahamas at no cost at point of service and with no new tax being imposed in this initial phase.

“In this phase, all health costs for primary care services will be paid for by the Government of The Bahamas through general revenue collected by the Ministry of Finance (commonly referred to as the Consolidated Fund).

“Full benefits, including catastrophic care for major illnesses, will be included in NHI as the programme progresses.”

The statement also pointed out ongoing upgrades to the country’s health infrastructure, including upgrades to the Princess Margaret Hospital in Nassau; expansion to the Rand Memorial Hospital in Freeport; and the opening of mini hospitals in Abaco and Exuma. Upgrades will continue as the various phases of the health plan are rolled out. 

Gibson: “Our plan is to carry on with universal healthcare”

Notwithstanding that the Consultant Physician Staff Association (CPSA) opted out of the Bahamas’ National Health Insurance (NHI) plan, Labour Minister the Hon. D. Shane Gibson insisted on Monday that the “(government’s) plan is to carry on with universal healthcare.”

The Minister was speaking with reporters at the Paul Farquharson Center after the opening ceremonies of the NIB sponsored compliance symposium on Monday of this week. He was responding to CPSA chief Dr. Locksley Munroe who accused the government of ‘ignoring’ and ‘marginalizing’ the views of the CPSA in the run up to the implementation of NHI.

Holding no ill will against the CPSA, Mr. Gibson told reporters that “for those persons who are not on board, that’s their right. If they think that making the mighty dollar is more important than saving lives, I can’t kill them for that,” said the Minister.

“Our plan is to carry on with universal healthcare. We know for a fact that we will never get everybody onboard, but this is the right thing to do and so we will be doing it.”

Registration commenced nationwide for NHI on Monday, 18th January 2016.       

Public Hospital Authority (PHA) announces more healthcare upgrades

In a press release on Tuesday of this week, the Public Hospital Authority (PHA) advised that the Authority will be hiring an additional 22 pharmacists, 22 doctors, 3 surgeons 2 radiologists, 9 biomedical engineers and a number of nurses; the team is expected to be in place by February 2016.

The radiologists, surgeons and pharmacists will be deployed at PHA hospitals and clinics in New Providence and Grand Bahama.

“The engagement of nine biomedical engineers for the Princess Margaret Hospital, the Rand and PHA community clinics is particularly essential at this time so as to ensure greater accountability in the maintenance of critical equipment at our three major hospitals and community clinics” the PHA statement said.  

This day in Parliament

The House met on Wednesday of this week (20th Jan 2016) to debate two borrowing resolutions under section 3.1 ‘LOANS’ of the Inter-American Development Bank Act (IDB Act). One was a $33 million loan to fund “a program of public financial management and performance monitoring reform” according to the bill’s sponsor, the State Minister for Finance the Hon. Michael Halkitis.

The second resolution will be a $20 million loan to fund an anti-crime and social intervention program called the Citizens Security Initiative. This initiative will lead to the establishment of a parole system for the orderly and managed reintegration of ex-convicts into society. There is a social re-engineering component to the program.

Minister Halkitis pointed out that the loan was not for budget support but for program development. In this instance the first government program being debated was called “Management for results.”

The highlights and background of the resolution are as follow:

The IDB approved an application for technical cooperation filed by The Bahamas government in June of 2010. A more efficient public administration was the government’s broad objective. Subsequent to that, a grant of $1.6 million was secured by the Bahamas government to study the entire financial landscape of the government. “The overall objective of the program was to introduce the principle of management for results in the various stages of public sector management and administration in The Bahamas” said Halkitis.  

The seven components of the financial assessment were as follow:

  1. Strategic planning: converting government priorities into plans.
  2. Budget by results: results oriented allocation of resources – not just to heads.
  3. Public financial management
  4. Project management
  5. Monitoring and evaluation of public administration
  6. Public procurement
  7. Audit

At the conclusion of the assessment, the consultants engaged delivered a report called the “Public Expenditure and Financial Accountability Assessment (PEFAA).” This was March 2012. With the exception of ‘budget versus outturn’ (where the government scored an ‘A’), the government scored a ‘D’ in most of the fiscal areas assessed; the government accepted the report. So in a nutshell, urgent action was needed to address institutional weaknesses and operational deficiencies in public administration that could lead to public waste.

With this resolution the government of The Bahamas has taken a quantum leap forward in reforming the public service, thereby saving tax payers millions of dollars and significantly improving on the delivery of public goods and services.

 The four components of the program loan and itemized direct costs are as follow:

  1. Performance monitoring: strengthening management capacity ($3.1 million.
  2. Strengthening the capacity of the Department of Statistics ($3.0 million).
  3. Strengthening the Public Financial Management regime ($18 million).
  4. Upgrade of the Public Procurement System ($6 million allocated).

As for indirect costs, $1.2 million are allocated to project management; $180,000 for evaluation and $1.3 million in contingencies for a total program cost of $33 million.

As for the features of the loan, it will be disbursed over five years and repayment begins six months after the last disbursement or in five and one half years from now. The loan will be amortized over 25 years with semi-annual payments. The loan’s interest rate is a floating one – three months LIBOR (London Inter-Bank Offer Rate) plus 150 bases points which works out to 1.77%.   

In other Parliamentary news, Central and South Eleuthera member the Hon. Damian Gomez notified the House that the Committee on Privilege will report on their findings stemming from claims of bribery made by Stellar Waste to Energy CEO Dr. Fabrizio Zanaboni by April Fool’s Day. In December 2015, Dr. Zanaboni revealed in an interview that both PLP and FNM members of Parliament asked him for “small” donations before the 2012 general elections. Mr. Grant characterized those claims as bribery and requested a House investigation. To date the committee has not been able to interview Dr. Zanaboni. 

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