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Report to the Nation: TCI NHIP underfunded as lifestyle diseases costs soar, overdue report to reveal if contributions will increase

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Photo by Jean Sagesse

#Providenciales, Turks and Caicos Islands – April 24, 2018 – In a report due to be completed by the end of May is where the nation will find out if the cost of contributions to the National Health Insurance Board should or will be increased to help stymie the year on year shortfalls of the social health care plan.

The Premier and Finance Minister, Hon Sharlene Robinson on Monday led a delegation of officials from the Ministry of Health and the National Health Insurance Board in a nationally aired press conference which exposed progresses at the beleaguered entity.

Premier Sharlene Robinson, in opening said: “I have started the overdue actuarial review of the National Health Insurance Board, the results of which will form and inform key government decisions.  Our Government has ensured financial support of the National Health Insurance Board to the tune of $12m.  Ten million of which has already been dispersed in the recently passed supplementary budget.”

The NHIP has been running a deficit budget for the past three years and it is costing TCI tax payers $12m to bail out the health care plan.

“These funds have been used to significantly reduce the organization’s liabilities to its local and overseas providers.  At this point the National Health Insurance Board is 70 to 80% of clearing all outstanding liabilities for the financial year 2017-2018.  The remaining 20% should be completed by the end of April 2018.”

The reason for the overrun at the NHIB, which in the Statutory Board Review was recommended to be dismantled, is – among other things – the surging cost to the Plan of medical treatment overseas for thousands of patients; 70 to 80% of which are Turks and Caicos Islanders.

“The average total expenditure for the National Health Insurance Board over the last three years is $61 million.  Hospital related payments accounted for about 51% of the average NHIP expenditure, followed by Treatment Abroad with 35%, pharmaceutical and local provider costs averaged about six percent and two percent respectively,” said Delton Jones, Chairman of the NHIP Board, who added later that, “This is indicative of the persistent under funding of the NHIP at a time when there has been increasing health care costs.”

The National Health Insurance Plan is reviewed in the Stephen Turnbull report as unsustainable, that it should be absorbed into the Ministry of Health.  However, Cabinet Ministers rejected the idea and voted ‘no’ to the recommendation.  The Premier tried to quell the fears of the 30 staffers at the NHIP.

“Let us not for one minute think that nothing is happening at the National Health Insurance Board. Our government has been working alongside the Board to fix the issues and turn the organization around, we are fixing it and we are committed to fixing the National Health Insurance Board.  Premier Robinson said to the staff, with whom she plans to meet soon that “I personally wish to thank them for their dedication and  assure them that the National Health Insurance Board is here and that my government is committed to their well being.  We recognize that they have a pivotal role in turning the organization around and will be a part of all key decisions…”

The long overdue Actuarial Report is but one of the advancements currently underway to reveal the truest state of the NHIP; it was also announced that the Health Regulatory Agency (HRA) is nearing launch and Desiree Lewis, Permanent Secretary of the Ministry of Health shared that there is a roll out plan.

“We have in place the CEO, as the Minister mentioned… it (the HRA) should have been in place prior to the opening of the Hospitals, unfortunately that did not progress in the manner in which it should have but we are now closer – closer meaning we have established an implementation plan which we should be rolling out within the next four to six months, before December.”

P.S. Lewis explained that the HRA is currently seeking a location, will bring on staff and will eventually manage and monitor all health facilities within the Turks and Caicos Islands.  The HRA will also have auditing power over the National Health Insurance Plan.

The National Health Insurance Plan, as explained by Chairman of the Board, Delton Jones started collecting contributions in 2009 with a current enrolment of 33,218 members, which includes dependents.

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PNP Government not prepared for this work!

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#TurksandCaicos, September 16, 2021 – This is exactly what the PDM was warning the new PNP Administration about, hoping that this did not occur; COVID-19 being spread in our schools amongst our babies. My fears are from the positions of a Parent, a citizen, a Member of Parliament, a former Minister of Health, and a Scientist.

In my press release from a week ago I stated “And we know how critical it is to get our children back to school. It is especially critical for their mental health and their development. In achieving this, the Government must ensure that schools can open with confidence, both in capacity and in the broader public health indicators that exist. Safety of our children and our families should be driving the decisions of the Government every step of the way.”

I then went on to say “Our first job must be to care for our children, and provide a safe learning environment. However, the PNP Administration’s readiness for the reopening of Schools this week was frightening to observe. All occurrences showed that this PNP Administration was not adequately prepared, and did not provide the schools, through the Department of Education, the much-needed budgetary support in human resources, adequate safety materials, supplies and early provision of book-list. In addition, they did not provide the schools with any enhanced and improved health and safety guidelines.  They should not put your child and your family at risk.”

And now our worse fears are coming through. This new Government should immediately adjust protocols, execute their contingency plans, if any, and take all mitigating actions to prevent further spread. Immediate action is needed.

I had also stated that; “The Government had every opportunity to be more than ready to mitigate against all the known challenges that the Pandemic presents. It would have been in everyone’s best interest if the Government had budgeted for the hiring of more teachers, and more staff for the schools, which would enable decreasing class sizes, hence providing our students and teachers with a safer environment.”

It is not a bad thing to admit that you got something wrong, and then immediately correct the mistakes, especially when the lives at risk are our children.  It is bad when no immediate action or adjustments are made to correct the mistakes.  The Government has fell down in many areas while executing the re-opening of schools under a covid-19 environment.

The new PNP administration must take urgent actions, and after, immediately address the issues of overcrowding, class sizes, number of teachers, Cohort groups/school hours, and school health and surveillance systems.

Do not fail our children, our future, our parents, our families, and our country.

 

Hon. Edwin A. Astwood

Leader of the Opposition

 

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PDM’s Robert Been speaks out, calls Premier to forefront

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#TurksandCaicos, September 13, 2021 – The people are not getting what they voted for. The momentum initially shown by the Progressive National Party’s administration is slowing down day by day – and we are only seven months from February 2021 elections. In general, the PNP party is accused of being arrogant, inaccessible, untrustworthy, unresponsive and displaying clear favoritism to their party supporters first, and I am encouraging the PNP to stick to the promises made to the TCI people that you will not continue in this way. Elections are over.

The voters gave you another chance to prove that you can do what you promised – to serve the entire Turks and Caicos Islands, but sadly, I don’t see enough of the work going on like it was promised.

Education

While it is clear some work has gone into seeing better in our school system, Turks and Caicos Islands children are still being shared out of the spaces in their own country. We don’t want any child left behind, and definitely not our own children in their own land.

Why is this happening? With new schools, the Education Minister said these problems would be addressed, but the narrative continues. On behalf of the people of the Turks and Caicos Islands, I am calling for there to be an investigation into why our children cannot get into schools the government builds and staffs. We need real answers, progressive action, so that we understand what is going wrong and make it right… and this includes our special needs children.

Minister, you say you want the people to feel that you really do love them, well I call on you to immediately investigate every avenue to determine why many TCI families are still at the short end of the stick when it comes to securing sound education for all of our children – special needs or not, and enact productive plans that see a final end to these concerns.

Tourism

A major policy change came into force since September 1st 2021, which impacted our tourism industry and investors – domestic and foreign. The Minister of Health is leading on this, but we also need the Minister of Tourism to step out and thoroughly review all aspects of this decision to thoroughly address the valid concerns being expressed by our citizens. Ego should have no room in managing our economy in a way that is best for our economy.

There is integrity in reconsidering the negative effects of a decision, and moving forward with a better plan. Only God is perfect. Let us look around the world and learn from their mistakes, as well as glean from their wise decisions. There are other ways to achieve a desired goal – Minister of Health and Minister of Tourism, I appeal to you, before things get worse, work together and please explore this in other ways as well.

As a stakeholder, and someone whom you both are familiar with, I am happy to make myself available to put forth my ideas if it means the better of our nation. Finally about tourism, it has been since March 2020 that Grand Turk and Salt Cay have lost their tourism slice.

Plans to revive this industry always seem to get pushed back with no updates since June 2021. Millions of dollars sit in the joint infrastructure fund and even though they had a meeting with Carnival Cruise Line in June, we have not heard anything about projects, incentives, the new dock or the new cruise line company. Meanwhile Grand Turk people are leaving the island and businesses have to shut down, which makes job opportunities even harder to find there.

Providenciales is our pearl, but other islands exist in our Beautiful By Nature island chain. I am challenging you to speak to us about the future of our industry and any changes you are planning for our brand. What are you doing to soften the blow of this pandemic so it does not sink our tourism ship and what actual plans are in place to strengthen our tourism product?

Health

This is my final point. We cannot find spaces for our severely ill people at facilities in nearby countries due to the effect of surges of Covid-19 cases and the ongoing pandemic. We feel it for our regional health partners and are grateful for the open doors the NHIB was able to find.

However, if we are flown to the DR or Colombia, where we can find medical care and we die of the coronavirus – then the remains of our loved ones are cremated. This is a circumstance we cannot change and a heart-wrenching pill to swallow. I heard the Minister of Health say that it is out of his hands. And while that might be case, where is the plan to get Turks and Caicos out of this position? Let’s put our heads together to find a way around this.

No one wants the return of dear loved ones in a jar. We need a hospital which can cater to trauma emergencies. We need a hospital with a fully-functioning ICU. If it takes borrowing, if it takes strategy in finally developing medical tourism – let’s get the plan for it. Let’s get the public informed of that plan and with an agreed approach, let us finally fix healthcare in the Turks and Caicos Islands. Conclusion To the Hon Premier, your experience has earned you this prestigious title.

Your party’s theme was “We come for this wo’k”, and “this work” requires you to be occupied at the helm. Return to the forefront so your people do not feel abandoned in the midst of important health care concerns, the Covid-19 surge, cost of doing business, inflation and this recent mandate which lacked proper consultation by all levels of businesses in tourism and finance.

Your past experience, which you boasted has assisted in our country’s economic development and its thriving, is actively needed now. You have said many times, and I was happy to hear, that this is not about party politics, but about all of us as a people.

My call to you is the same. Turks and Caicos is a topclass destination and we demand top-class delivery on the Contract you wrote.

Just a reminder that the three (3) month stimulus plan is incomplete. The impact of the recent entry requirement is costing so many in hard-earned income – it’s time to deliver in full on this promise.

You wanted the work, you got the work, now do the work – for all of us!

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Bahamas News

Caribbean Wellness Day 2021

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#Caribbean, September 13, 2021 – Health, in every facet, is sought-after, at great expense, by all members of the global community. Though the success of our endeavours in health varies from region to region, it must be emphasised that in our Region, a healthy Caribbean is always the goal for which we strive.

Each year the Caribbean Region observes, Caribbean Wellness Day since it was established at the 2007 landmark summit, ‘Declaration of Port of Spain: Uniting to Stop the Epidemic of Chronic Non-communicable Diseases.’

This year’s commemoration focuses on equitable access to health; an all of society approach to health and well-being, and building healthy communities under the theme, “Power Through Collective Action: In it Together, Building Healthy Communities.”

As health care systems are being taxed by the devastating effects of the COVID-19 Pandemic, it is even more important now to advocate for equitable access to health. Too many of our Caribbean citizens face harsh realities, because of inequities in access – this should not be. Caribbean Wellness Day is the most opportune time for the members of our Caribbean community to ensure that the health of our people is indeed a priority through legislative change, health in all policies and all of society action.

Equitable access to health care in the Caribbean is one of CARPHA’s points of focus as can be seen through our work to ensure equitable access to PPE, equipment, supplies and vaccines through the COVAX facility, a mechanism whose primary function is to ensure the equitable distribution of COVID-19 vaccines and donations notably the US Government donation of 5.5 million doses of Pfizer BioNTech.

Without the power of voices in chorus, like with the COVAX facility; the Caribbean Cooperation in Health (CCH) and others – many more would be disadvantaged and unserved. Achieving health for all in the Caribbean also means attaining and sustaining healthy environments.

The built environment, which provides for sidewalks, bike lanes, community parks and green spaces, can influence lifestyles, body weight, and improve mental health. As these necessary frameworks are made reality and we avail ourselves of them, we exercise Power through Collective Action showing that we are truly in it together, Building Healthy Communities.

As we speak about the environment, we must mention the effects of climate change. The inaction in the past has set the world on a course of environmental destruction. We need to act now; it is the only way that we can protect the generations to come from even worse realities than those we face today.

As we seek to mitigate the damage done due to inaction on the recommended major climate change interventions, we need to address other pertinent issues. Vector-borne diseases remain a challenge in many Caribbean territories, and unlike the bleak outlook that is presented on climate change, simple adjustments in our behaviour can make the world of difference.

By eradicating breeding grounds of mosquitoes in our immediate environment and communities, we minimize the spread of many vector-borne diseases. Advocacy in health should be the standard operation of every Region, State, and organisation. Sustaining Health and well-being is one of the very few universal desires.

Regardless of creed, culture, or any other divisive line – all organised bodies have a responsibility to promote health. Further to this, we need to take the time to look after ourselves and our families and communities.

Simple actions – increasing our intake of local produce, reading labels of processed foods to make informed decisions, scheduling regular exercise – these actions will drastically improve the health and quality of life of our people.

Working together to this end, will lead to healthier minds, healthier bodies, and a Caribbean that exudes wellness.

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