Opposition PDM Issues Statement on the Recent Changes to the National Health Insurance Board

Turks and Caicos, March 15, 2025 – While we acknowledge the concerns raised by Governor Dileeni Daniel-Selvaratnam regarding the financial viability of the National Health Insurance Board (NHIB), we question the necessity and effectiveness of the measures being implemented, particularly the selective removal of only non-governmental members from the Board (Chairperson- Minister Appointment, Deputy Chairperson and Opposition Appointed Member), and the removal of the newly hired Chief Executive Officer.

The decision to appoint an Examiner and to revoke the appointments of certain Board members seems to imply that the issues at hand are solely the responsibility of those outside of government. This raises critical questions about accountability and systemic problems within the governance of the NHIB, particularly regarding how government-appointed officials, who remain in their positions, have or have not contributed to the organization’s management challenges. Shouldn’t a comprehensive overhaul include a thorough review of all Board members, including those linked to government, to ensure a balanced approach to accountability?

Furthermore, it is crucial to recognize that the NHIB serves primarily as a facilitator of the Treatment Abroad Program. The actual decisions regarding who receives treatment and for what conditions are determined by healthcare providers, InterHealth, while the Turks and Caicos Islands Government (TCIG) is responsible for funding these services. With TCIG currently owing the NHIB approximately $45 million, the financial strain on the NHIB is not solely due to its operational practices but also reflects broader fiscal challenges within the government itself. NHIP received $10 in November 2024 Government Supplementary, and is now expecting to receive $16M in the current March 2025 Government Supplementary. This reality underscores the need for a more holistic examination of the funding and operational dynamics at play.

Additionally, the reliance on Interpath (BVI) Ltd, a firm with no local presence, to oversee such a vital aspect of public health raises concerns about the effectiveness of external oversight. Will they truly understand the unique challenges faced by the NHIB, or will their recommendations reflect a one-size-fits-all approach that may not resonate with our community’s specific needs?

It is also important to consider the message this sends to the public. By retaining government representatives on the interim Board while removing non-governmental appointed members and the CEO, we risk perpetuating a cycle of mistrust. How can the community have confidence in the NHIB’s governance if it only appears that the non-governmental appointed members and the staff of NHIP are the individuals who may have contributed to its current challenges?

In light of these concerns, we urge the Governor, the Premier, and the Cabinet to consider a more inclusive and thorough examination of the NHIB’s governance structure. A holistic approach that evaluates all members and incorporates community input may not only restore confidence but also ensure the long-term sustainability of the NHIB.

In conclusion, while action is necessary to address the challenges at the NHIB, the current measures may not adequately address the root causes of the problems, many being outside of the NHIB. A commitment to transparency, accountability, and comprehensive reform is essential to safeguard the health and well-being of the people of the Turks and Caicos Islands.