Connect with us

News

A Statement from the Premier and Minister of Health, Agriculture, and Human services, Dr. The Hon. Rufus W. Ewing on the National Health Insurance scheme

Published

on

Providenciales, TCI, November 28, 2016 -The National Health Insurance Plan (NHIP) was established in 2009 as a Social Health Insurance Plan based on contributions from employers and employees who were legally resident in the Turks and Caicos Islands.

The Turks and Caicos Islands Government is also mandated to make contributions to the plan in the following way:

  1. As an employer on behalf of its employees
  2. As a subscriber on behalf of the unemployed, indigent and ward of the state
  3. Transfer of funds for the management and payment of treatment abroad cost
  4. Transfer of funds for the payment of the monthly hospital infrastructure cost

The funds collected by the National Health Insurance Board (NHIB) from its employers and subscribers are utilized to purchase health care locally from the preferred provider (TCI Hospitals), the network of contracted private primary health care clinics and private pharmacies on behalf of and to the benefit of its registered subscribers.

The NHIB on behalf of TCIG manages the procurement of overseas treatment for the beneficiaries of the NHIP. From budget year to budget year this cost is unpredictable as it is a reflection of both the number of persons requiring tertiary level care in any given year as well as the magnitude of their problems.

The cost of healthcare by the end of April 2017 is expected to exceed the budgeted provision by $6 million dollars. It is against that background that a paper prepared by the management of the board with the full knowledge of the Board of Directors, the Ministry of Finance and the Ministry of Health was submitted to cabinet for its consideration – to conclude that there was a cover-up or misappropriation of funds discovered by the acting CEO is incorrect, irresponsible and should be dismissed as political mischief.

The facts are that the treatment abroad programme has skyrocketed in the first half of the financial year amounting to over $5 million of the cost over-run. On average four patients a day are being referred abroad of which five a week are urgent referral requiring medical evacuation via private charters and air-ambulances; at the same time the number of cancer patients has been noted to have increased significantly in the first half of the year, these factors together result in an average cost per patient of around $15,000 with some patients costing in excess of $100,000. Because the NHIB until recently operated a cash basis accounting system, costs were not booked until paid.  This has now been corrected, hence the reporting of the large accounts payable balance.

A number of the more serious cases referred abroad were Turks and Caicos Islanders that were not covered by the scheme. The government takes its responsibility for the provision of its people seriously and has recently introduced changes to the NHIB regulations that would result in healthcare coverage for a wider category of patients while at the same time restricting coverage for some categories of persons which it believes should help to stabilise cost while a comprehensive review of the system is being undertaken after five years of operation.

TCIG has asked for a review of the management and corporate governance of NHIP with respect to the rising cost of overseas treatment to develop cost reduction or mitigation measures where possible without compromising care to beneficiaries of the plan. The Ministry of Health in collaboration with NHIP has already implemented several initiatives to reduce the cost of care, such as:

  1. Establishment of a free extended hours government primary care clinic
  2. Development of a new Pharmaceutical policy which would significantly lower the cost of drugs to both patients and NHIP
  3. Introduced an eligibility waiting time of 6 months for all new work permit applicants to the plan (effective December 1)
  4. Introduced a capitation on overseas care expenditure for work permit holders

The Ministry of Health will continue to implement its cost reduction strategies as outlined in the National Health Strategic Plan, the main ones of which include:

  1. Implementation of the pharmaceutical policy and plan
  2. Implementation of the Chronic Disease Action Plan
  3. Primary Health Care Renewal Strategy
  4. Development of a long term hospice care facility
  5. Expansion of existing and the Introduction of new tertiary level services at the hospitals based of overseas treatment care demands.

Government

$94.1Mfor Health; Knowles Pushes to Keep Care at Home

Published

on

Turks and Caicos, April 25, 2026 – A major shift in how healthcare is delivered in the Turks and Caicos Islands is at the center of the Government’s latest budget, with a focus on reducing reliance on overseas treatment and strengthening services at home.

Presenting his contribution to the national debate, Kyle Knowles outlined a strategy aimed at building a more sustainable healthcare system—one that allows more residents to access quality care within the country.

The health sector has been allocated $94.1 million, making it one of the largest areas of public spending in the $550.8 million Budget passed on April 23.

Central to the Minister’s approach is a restructuring of the Treatment Abroad Programme (TAP), which has grown significantly in recent years as more patients are sent overseas for specialized care.

The Government now aims to reverse that trend.

“We are reforming healthcare to ensure long-term sustainability,” Knowles indicated, pointing to efforts to strengthen local services and reduce the need for travel.

The strategy includes improving healthcare infrastructure, expanding services available within the islands and increasing efficiency through the digitization of medical records.

Digitization is expected to support better coordination of care, reduce delays and allow for more accurate tracking of patient needs—part of a broader effort to modernize public services.

The Minister emphasized that the goal is not only cost control, but improved access.

“No family should have to leave home to get quality care,” he said, underscoring the Government’s intention to refocus healthcare delivery on local capacity.

The shift comes as rising healthcare costs continue to place pressure on public finances, with overseas treatment representing one of the most expensive components of the system.

By investing more heavily in domestic services, the Government is seeking to reduce that burden while improving outcomes for residents.

While the direction is clear, details on timelines and the pace of expansion for local services were not fully outlined in the presentation.

Still, the emphasis on sustainability, access and modernization signals a strategic pivot in how healthcare is expected to evolve in the Turks and Caicos Islands.

Angle by Deandrea Hamilton. Built with ChatGPT (AI). Magnetic Media — CAPTURING LIFE.

Continue Reading

Government

Premier Defends Budget Strategy, Rejects Claims of Inefficiency

Published

on

Turks and Caicos, April 25, 2026 – Premier Charles Washington Misick has pushed back against criticism of the Government’s newly passed budget, defending both its direction and execution as deliberate and necessary for national development.

Wrapping up debate on the $550.8 million Budget, passed on April 23, the Premier dismissed concerns raised by the Opposition about inefficiency, rising costs and gaps in delivery, insisting the Government’s approach is measured and focused on long-term growth.

“This budget is about delivering for our people,” Misick said, as he reinforced the administration’s commitment to infrastructure, healthcare expansion and broader economic development.

Opposition Leader Edwin Astwood had earlier challenged the Government’s performance, pointing to unfilled posts, delayed projects and what he described as weak execution despite increasing allocations.

In response, the Premier rejected the notion that the Government is failing to deliver, instead arguing that building national capacity takes time and sustained investment.

He maintained that staffing challenges are being addressed and that improvements across ministries are ongoing, even as demand for public services grows.

The Premier also defended the scale of spending, framing it as a necessary step to support development across the islands, rather than unchecked expansion.

“We are investing in the future of this country,” he said, pointing to continued funding for infrastructure, community development and public services.

On the question of equitable growth, Misick reiterated his administration’s focus on balanced development, including ongoing investments in the Family Islands.

He argued that progress is being made, even if transformation is not occurring as rapidly as some would like.

Throughout his closing remarks, the Premier leaned on the country’s economic fundamentals—highlighting strong cash reserves, stable growth projections and international confidence in the Turks and Caicos Islands’ fiscal management.

While the rebuttal addressed criticism head-on, it did not significantly alter the structure of the budget or introduce major new measures in response to concerns raised during the debate.

Instead, the Government’s position remained consistent: the plan is in place, the investments are targeted, and delivery will continue.

The exchange underscores a clear divide—between an Opposition pressing for faster, more measurable results, and a Government maintaining that its strategy is already on course.

Angle by Deandrea Hamilton. Built with ChatGPT (AI). Magnetic Media — CAPTURING LIFE.

PHOTO COURTESY OF THE OFFICE OF THE PREMIER

Continue Reading

Government

Digital Government Push Advances, but Reliability and Security Details Remain Unclear

Published

on

Turks and Caicos, April 25, 2026 – There was no mistaking the enthusiasm of the Minister of Finance, Investment and Trade, E. Jay Saunders, as he laid out his vision for a more digitally driven Turks and Caicos Islands—one where services are faster, systems are connected, and doing business is easier.

But within that forward-looking presentation, what remained notably absent were clear timelines and defined measures to ensure data security and system reliability.

“We are moving toward a fully integrated digital government,” Saunders told the House, as he outlined a future where public services are delivered seamlessly through technology.

With responsibility for the country’s economic and digital transformation, Saunders pointed to several areas expected to be reshaped by the rollout of e-government systems, including revenue collection, business licensing, customs processing and access to public services—all designed to reduce delays, improve compliance and streamline transactions.

The vision is one of convenience and efficiency: fewer lines, faster approvals, and systems that communicate across departments rather than operate in silos.

Within the framework of the Government’s $550.8 million Budget, passed on April 23, the digital push is positioned as a key driver of modernization and improved service delivery.

However, for many users, the experience of government systems today remains inconsistent.

Periodic outages, payment disruptions and service downtime continue to affect daily transactions, raising practical concerns about how quickly the country can transition to a fully digital model.

Despite the scale of the ambition, the Minister’s presentation did not directly address how system reliability will be strengthened or how data will be protected as more services move online.

Those elements—uptime, security and resilience—are critical to public confidence, particularly as businesses and residents become increasingly dependent on digital platforms to access government services.

The direction is clear, and the potential impact is significant.

But as the country moves closer to greater digital dependence, the success of that transformation will ultimately rest not just on what is promised—but on whether the systems can be relied upon when they are needed most.

Angle by Deandrea Hamilton. Built with ChatGPT (AI). Magnetic Media — CAPTURING LIFE.

Continue Reading

FIND US ON FACEBOOK

TRENDING