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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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GOVERNMENT REVIEWING TENDER AFTER GRAND TURK–SOUTH CAICOS FLIGHTS STOP

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Turks and Caicos Islands – March 10, 2026 – Commercial flights between Grand Turk and South Caicos have been temporarily discontinued, leaving residents without a direct air link between the two islands since March 1.

The Turks and Caicos Islands Government confirmed the suspension in a statement Tuesday, explaining that the route — which operates under a government subsidy — is currently under review as officials reassess the tender process used to award the service.

The Ministry of Finance, Economic Development, Investment and Trade said the government is “working diligently to assess available options” to restore reliable air service between the islands as quickly as possible.

While the statement did not identify which airline had been operating the route, historically Caicos Express Airways and interCaribbean Airways have provided flights between South Caicos and Grand Turk using small twin-engine aircraft.

Officials acknowledged the disruption has caused concern among residents, noting that inter-island air travel is critical for access to essential services, business activity and government operations.

The government emphasized that the suspension does not affect flights between Grand Turk and Salt Cay, which continue to operate normally.

The review now underway will determine the next provider for the subsidized route. Authorities say the process must be conducted in a “fair, transparent and efficient manner” before service can resume.

For residents of the two islands, however, the immediate issue remains transportation — with many now forced to reroute through Providenciales or rely on limited sea travel until the air connection is restored.

Further updates are expected once the government completes its review and awards a new operating arrangement.

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

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Rights Without Justice: How Weak Enforcement Fails Women and Girls

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GLOBAL — Laws promising equality for women and girls exist in many countries around the world, yet millions still struggle to access justice when their rights are violated.

That stark reality is highlighted in a United Nations report titled “Ensuring and Strengthening Access to Justice for All Women and Girls,” released ahead of International Women’s Day and the 70th session of the Commission on the Status of Women, which begins March 9 in New York.

The report points to what experts call an “implementation gap” — the disconnect between laws that guarantee equality and the real-world ability of women and girls to enforce those rights.

While legal frameworks promoting gender equality have expanded globally, the report warns that many women continue to face significant barriers when seeking justice.

Among the most common obstacles are high legal costs, long distances to courts and services, language barriers, and low levels of legal literacy. Many women also face what researchers describe as “time poverty,” balancing work and caregiving responsibilities that make pursuing legal action difficult.

Bias and stigma within justice systems themselves can also discourage women from reporting abuse or seeking legal remedies.

The report notes that girls often face distinct and overlooked barriers. In many cases, justice systems lack child-centred procedures, making it difficult for girls to safely report harm or access legal protection. Issues such as child marriage and early pregnancy can further complicate their ability to assert their rights, particularly when they remain legally dependent on family members who may also be the source of harm.

Older women also face unique challenges, often shaped by lifelong patterns of discrimination and economic disadvantage. Gendered ageism can undermine their credibility, with complaints involving violence, neglect, health rights, pensions or property disputes sometimes dismissed or ignored.

The United Nations report also highlights structural weaknesses within justice systems, including limited budgets, shortages of trained personnel and poor coordination between institutions responsible for delivering justice services.

Another factor contributing to the enforcement gap is the continued male dominance within justice sector leadership, which researchers say can discourage women from engaging with institutions meant to protect them.

The findings come as the United Nations marks International Women’s Day under the theme “Rights. Justice. Action. For ALL Women and Girls,” a call for governments to move beyond commitments on paper and ensure that laws protecting women are fully enforced.

Global leaders say closing the gap between legislation and real-world outcomes remains one of the most urgent challenges in achieving gender equality and ensuring that women and girls everywhere can live safe, healthy and purposeful lives.

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

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Jamaica Joins Afreximbank Agreement, Strengthening Africa–Caribbean Partnership

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CARIBBEAN — Jamaica has become the 13th CARICOM member state to accede to the African Export-Import Bank Establishment Agreement, further strengthening economic ties between Africa and the Caribbean.

The development was confirmed during the 50th CARICOM Heads of Government Meeting, where an Afreximbank delegation led by George Elombi and Kanayo Awani met with Jamaica’s Prime Minister Andrew Holness to advance cooperation.

Prime Minister Holness thanked the bank for its support following Jamaica’s recent hurricane, noting that Afreximbank financing helped restore critical infrastructure including water, electricity, sewage systems and roads, while also assisting reconstruction efforts aimed at building stronger resilience to future disasters.

The meeting also focused on broader development opportunities tied to Jamaica’s membership in the agreement. Discussions included rebuilding and modernising infrastructure such as railways, hospitals and other public facilities, while strengthening regional transportation and trade networks to improve the movement of people and goods across the Caribbean.

Afreximbank has been expanding its presence in the Caribbean as part of its strategy to connect Africa with the region often referred to as “Global Africa.” The bank has already committed billions of dollars in financing and trade support to Caribbean economies in recent years, including funding for infrastructure, trade facilitation and private sector investment.

By joining the agreement, Jamaica gains expanded access to Afreximbank’s financial instruments, technical support and trade networks designed to promote commerce between Africa and CARICOM states.

Regional leaders say the growing partnership could unlock new opportunities in areas such as trade, logistics, tourism, manufacturing and cultural exchange, strengthening economic cooperation between the two regions with deep historical and diaspora ties.

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

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