By NATARIO McKENZIE

Tribune Business Reporter

nmckenzie@tribunemedia.net

THE Minister of Health yesterday reiterated that the Government is "between a rock and a hard place" over the legality of actions to establish National Health Insurance (NHI).

"With NHI we do not have the written report as yet," Dr Duane Sands said. "I have spoken to the verbal report. In order to action the next steps we need to have that written report. When we get that then we can mobilise the next step in terms of catastrophic care.

"I think it's basically looking retroactively at the decisions that have led to this point. We have spent millions of dollars. We have enrolled almost 30,000 patients and they are receiving care. There are contracts with primary care providers, with laboratories, and the question is whether those things were legal or not, and can the existing Board appointed after the decision was made ratify them as acceptable?

"You can't make them legal, but we're juggling the issues of healthcare and monies spent, and it has to be within a legal framework that is considered acceptable. We're between a rock and a hard place here."

The board of the National Health Insurance Authority (NHIA) sought a legal opinion on whether the actions of the NHI Secretariat - established by the previous Christie administration - were legal and potentially binding.

This was because even before the NHI board was established and key provisions of the NHI Act published in a gazette, the secretariat entered into numerous contracts with residents and healthcare providers.

The NHI Board cannot make significant changes to the programme without considering the legal and financial implications connected to the pre-existing arrangements the NHI Secretariat entered into.

The Bahamas Insurance Association (BIA) and leaders in the insurance community have argued that the Secretariat's actions were illegal, and should not be ratified by the board. They have called for the Board to restart the NHI programme from scratch.