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TCI: Opinion Piece – NHIB Spending

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#TurksandCaicos, February 3, 2018 – Providenciales – Who is the Man?  As a lawyer, I regularly read the Gazette when published on Fridays as it contains valuable information for my legal practice.  Last week I read with great interest the changes in portfolios of Ministers specifically the Minister of Finance and Premier, and the Minister of Health, Human Services and Agriculture, which are to commence on February 1st 2018.

Delio Photo Studio - Business Head Shot Photography in MiamiReader, I urge that you walk with me as we take a trip down memory lane.  Some 13 months ago, the first Female Premier and Minister of Finance was sworn in, and during her speech she said “I’m the Man for the Job”.  While we chuckled at that colorful expression coming from a woman, who should be proud to be “the woman for the job”, we understood where the Minister of Finance was coming from.  Now some 3 months ago, the Minister of Health, beat his chest proudly in the House of Assembly and said “He is the Man, the Man for health.  No one knows more about health than me.  I am the Man”.  Now, with serious eye-rolling that I find happening more and more often whilst I am sitting in the Chamber due to the various colorful exchanges and expressions coming from the Government side, I was intrigued by the Minister of Health’s extensive reminder that he is the Health Man!  This proclamation of his manliness was in response to his Amendment to the NHIB Ordinance which he said was the first step in fixing what some deem a real drain on tax-payers dollars.  The amendment largely related to the make-up of the NHIB Board.

So, imagine my confusion last week Friday when I reviewed the Gazette and noticed that the self-proclaimed Health Man, lost the biggest expenditure in Health from his portfolio, that being responsibility for the National Health Insurance Board.  For the sake of completeness, the National Health Insurance Board is the oversight body for the Treatment Aboard Program in the Ministry of Health and Human Services.  Our contributions to NHIB not only provide funding for treatment overseas but also payment to TCI Hospitals on our behalf along with our US$10.00 co-pay we’d pay when we utilize services at one of their locations.

Caicos Express Airways

So, my questions today is WHO IS THE MAN?; and why is it that the NHIB spending is well over the projected budget amount of US$23,274,067.00.  When we were in the Budget Debate last year, I specially asked the Minister of Health on three occasions was the budget of US$23,000.00 enough for the work of NHIB in covering the Treatment of Aboard Program, and ancillary costs of the NHIB.   At each stage he said yes with gusto, and assured us that new structures would be in place to ensure NHIB would operate within their budget.

So, my second question is simply this, Did the Health Man fail? Is that why the Minister of Finance has come to save the day, and replace the Health Man, with the Finance Woman-Man?

What makes me ponder these questions is the response to my parliamentary question which was submitted in September (answered this week in the HOA) to the Minister of Health as to what are the costs of the Treatment Aboard Program from July 1st 2017 to October 31st 2017.   How is it that in just the period of July 1st 2017 to October 31st 2017 some 4 months the NHIB has spent US$8,659.170.00, which is US$7,131,783.00 in medical costs, US$1,000,000.00 in airfare, and US$238,000.00 in subsistence.   At this rate the total expenditure for the 2017/2018 Financial Year would be US$21,395,349.00 in just overseas medical costs. During this period a total of 418 referrals were processed resulting in the following big ticket medical costs of: US$3.3M for 80 patients to the Bahamas, US$2.2M for 183 patients to Jamaica, US$300k for 2 patients to Canada, US$391K for 19 patients to Cayman and US$153k for 1 patient to Colombia.

To say I was flabbergasted is an understatement of the amount that was spent in 4 months by the NHIB, but nonetheless we press on.   As the Minister of Health wrapped up his answer to my question, he mumbled something about primary health care being important.   So my next question is what is the plan to curb this rapid unsustainable expenditure?

To make matters even more interesting, there is a Supplementary Budget for 2017/2018 that will be debated next week, and on review of this yesterday, I note that NHIB has requested additional funds in the sum of US$12,000,000.00 increase for this financial year which ends on March 30th 2018.  Um, that is just 8 weeks from now. US$12,000,000.00!!!! Taking the NHIB estimated budget for this Financial Year to the grand total of US$35,885.000.00!!!!   Now, that is when I noticed my heart rate began to escalate in the HOA.   Where are we going to have US$12,000,000.00 found from in the current revenue streams that we have, and further what is being cut from the Budget to make up this difference.

cairsea INSERT FIX

So in the end the forecasted outturn for this financial year 2017/2018 for NHIB expenses is US$35,885,000.00, and not US$23,000,000.00 that the Minister of Health assured the people of this Country was sufficient for their potential medical costs overseas.   While, I am here, let us also remember the Budget was debated and passed in April.   Further, the Minister of Health had ample time to prepare a practical budget, but further to that from April to October 2017, wasn’t the Minister of Health monitoring the rapid expenditure of the NHIB.   Oh wait, will they blame the former Government for this rapid expenditure to date, or let me guess Hurricanes Irma and Maria?   Remember this is the Minister of Health’s Budget, that was deemed by the Government as the People’s Budget.

My advice to the new Minister of NHIB is to be open and honest with those registered with NHIB, as this current trend is unsustainable with the 30,000 persons who are contributing to NHIB and some 39,000 users.  Where is the extra money going to come from?  We need to know and we need to know soon.  Oh, and if you’re reading this and think I got the requested figures incorrect, it is in black and white in the documents that were laid on the table yesterday, and as a Millennial, I include the screenshot for your review.

I am deeply concerned about NHIB, as there is still no Chief Financial Officer recruited, and it is bleeding funding with what seems to be no oversight, and something drastic needs to occur to severe the infected limb (pun intended).

 

Release:

Hon. Akierra Mary Deanne Missick

Member for Leeward & Long Bay Hills

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Mother’s Pride Headlines Bahamian Takeover at Sixers-Heat Clash in Miami

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The Bahamas, March 30, 2026 – The voice of a proud mother captured the spirit of a nation Monday night, as Bendra Rolle shared heartfelt reflections on the overwhelming Bahamian support for her son, VJ Edgecombe, during the Philadelphia 76ers matchup against the Miami Heat in Miami.

“The patriotic support and scenery at my son, VJ Edgecombe’s NBA game… was overwhelming,” Rolle said in a statement issued following the game. “The arena in Miami was lit. Bimini and the Bahamas showed up and showed out.”

Her words come amid what has already been widely described as a remarkable showing of national pride, with Bahamians traveling in large numbers to South Florida to witness the young guard’s continued rise. For Rolle, however, the moment extended far beyond basketball.

“Beyond VJ’s basketball talents, I’m so moved by his magnetic personality and personal journey to inspire and excite an entire nation—our beloved Bahamas,” she said. “I thank God for VJ’s humility and for his hunger for greatness. He never forgets how far God has brought us.”

While the Sixers did not secure the win on the night, Edgecombe delivered a solid individual performance, finishing with 13 points and five assists. He made an early impact on the game, showing confidence and poise before foul trouble disrupted his rhythm, but still managed to leave his mark in meaningful minutes.

The game itself evolved into a cultural showcase, with Bahamian flags waving throughout the arena and chants ringing out in support of Edgecombe. Much of that presence was bolstered by a coordinated travel push from Bahamasair, which helped facilitate fan travel and added to the electric atmosphere in Miami.

Rolle said the emotional weight of the moment was deeply felt by her family, as they witnessed firsthand the unity and pride of the Bahamian people.

“Thanks and love for the tears and overwhelming joy on Monday, Bahamas,” she expressed. “The Bahamian flags were love, loud, and proud. On my own behalf, VJ, and the entire family, I am ever grateful for the indescribable experience.”

Her closing words underscored what many have described as the true victory of the night—not the final score, but the powerful display of national pride and support surrounding one of The Bahamas’ rising stars.

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50 Years of Ministerial Government: Cabinet Moves to Mark Milestone Rooted in 1976 Constitution

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Turks and Caicos, March 30, 2026 – The Turks and Caicos Islands is preparing to mark a major political milestone, with Cabinet approving the establishment of a National Commemorative Committee to celebrate 50 years of ministerial government, a system first introduced under the 1976 Constitution.

The decision, confirmed in the February 10 Post Cabinet statement, signals a year of reflection on a governance model that fundamentally reshaped how the country is run — shifting from direct colonial administration toward locally led political leadership.

That shift was formalized in the Turks and Caicos Islands Constitution Order 1976, which laid the legal foundation for ministerial government and introduced a structured Executive and Legislative system.

At its core, the 1976 Constitution established an Executive Council, bringing together:

  • a Governor,
  • a Chief Minister elected by members of the Legislative Council,
  • and Ministers appointed to assist in governing the Islands.

A Very Different Government Back Then

If today’s Cabinet feels crowded, the 1976 version would have seemed almost unbelievable. There were just three Ministers serving alongside the Chief Minister — a tight, compact leadership team responsible for the affairs of an entire country. No sprawling list of ministries, no long roster of portfolios — just a handful of individuals carrying the weight of governance.

Becoming a Minister wasn’t a direct vote of the people either. You first had to win a seat in the Legislative Council, and from there, the Chief Minister would recommend who should serve. The Governor then made the appointments. In other words, political trust and alignment mattered just as much as public support — and ultimate authority still rested above the local leadership.

And as for job security? There wasn’t much of it. Ministers served without fixed terms and could be removed if they lost their seat, resigned, or if the Governor revoked their appointment. Even the Chief Minister could be ousted through a vote of no confidence. Add to that the basic requirements — being at least 21, a British subject, and meeting residency rules — and it’s clear that ministerial government in 1976 was not only smaller, but far more tightly controlled.

This marked the first time elected representatives were formally given defined roles in the administration of national affairs.

Under the Constitution, the Governor retained overarching authority, but was required in many instances to act on the advice of the Executive Council, particularly in shaping policy and overseeing government operations.

The Chief Minister, meanwhile, was positioned as the central political leader, responsible for directing government business and advising on the appointment of Ministers.

Importantly, the Constitution also allowed for the assignment of responsibilities to Ministers, giving them oversight of specific areas of government — a structure that remains at the heart of today’s Cabinet system.

Section 13 of the Order made clear that Ministers could be assigned responsibility for the administration of departments or government business, embedding accountability and functional governance into the system.

The Legislative Council, established alongside the Executive, provided the law-making body, with elected and appointed members participating in debates, passing legislation, and representing the interests of the Islands.

Together, these provisions created the framework for what is now recognized as ministerial government — a hybrid system balancing local political leadership with constitutional oversight by the Governor.

The explanatory note of the 1976 Order describes it as introducing “new provisions for the Government of the Turks and Caicos Islands,” including the creation of a Legislative Council with elected members and Ministers appointed on the advice of the Chief Minister.

Fifty years on, that structure has evolved through subsequent constitutional changes, but its foundation remains rooted in the 1976 framework.

Cabinet’s decision to establish a commemorative committee suggests that the anniversary will not only celebrate political progress, but also invite reflection on how effectively the system has delivered on its promise of representation, accountability, and governance.

As the Islands approach this Golden Jubilee, attention is likely to turn not only to the achievements of ministerial government, but also to the ongoing question of how the system continues to serve a modern and rapidly developing Turks and Caicos Islands.

Developed by Deandrea Hamilton • with ChatGPT (AI) • edited by Magnetic Media.

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Government Moves to Amend Destination Management Fee Law

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Turks and Caicos, March 30, 2026 – The Turks and Caicos Islands Government has signaled changes to its tourism funding framework, with Cabinet approving draft amendments to the Destination Management Fee Act 2023.

The decision was confirmed in the Post Cabinet statement following the February 5 meeting, chaired by Governor Dileeni Daniel-Selvaratnam, where members agreed to move forward with revisions to the law governing the collection and administration of the fee.

The Destination Management Fee, introduced in 2023, is applied to travelers entering the country and is embedded within the cost of travel. The charge was designed to support tourism-related development, including marketing, infrastructure, and sustainability initiatives.

At the time of its introduction, the fee was linked to the establishment of a Destination Management and Marketing Organisation (DMMO), which was expected to coordinate tourism strategy and enhance the visitor experience.

However, recent developments have shifted that landscape.

The DMMO has since been discontinued, raising new questions about how funds generated through the fee are being managed and what structure will now guide tourism development efforts.

The Cabinet note does not outline what specific changes are being proposed under the amended legislation.

It also does not indicate whether adjustments will be made to:

  • who pays the fee,
  • how it is collected, or
  • how the revenue is allocated and overseen.

The move to amend the law comes amid broader government efforts to strengthen revenue collection and compliance, including updates provided to Cabinet on the work of the Drag-Net Steering Committee — a multi-agency initiative focused on improving government revenue systems.

The lack of detail surrounding the amendments leaves several key questions unanswered, particularly given the fee’s direct impact on both visitors and residents and its role in supporting the country’s tourism economy.

Any changes to the Act would require further legislative steps, including presentation to the House of Assembly, before taking effect.

For now, the Cabinet’s approval signals that the government is moving to revise a policy that is already in force — but without yet disclosing how those revisions will alter the current system.

As tourism remains the backbone of the Turks and Caicos Islands economy, clarity on the future of the Destination Management Fee — and the framework it supports — is expected to be closely watched in the weeks ahead.

Developed by Deandrea Hamilton • with ChatGPT (AI) • edited by Magnetic Media.

Photo Credit: TCIAA

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