By NEIL HARTNELL

Tribune Business Editor

nhartnell@tribunemedia.net

A Cabinet minister last night branded the latest payment delays suffered by doctors and other National Health Insurance (NHI) providers as “regrettable” with several complaining they are now owed for two months’ work.

Dr Michael Darville, minister of health and wellness, in a messaged response to Tribune Business inquiries, confirmed that compensation for September and October has been held-up due to the need for the Ministry of Finance to release funding for the Bahamian taxpayer-financed scheme.

He added that “a partial payment” of what is owed is due to be released by “the end of this week”, which should mean today, and pledged to work with the Ministry of Finance to “expedite the release” of the required financing.

“The Ministry of Health and Wellness acknowledges the concerns raised by National Health Insurance (NHI) providers regarding delays in the payments for the months of September and October,” Dr Darville told this newspaper.

“These delays are indeed regrettable, and are primarily due to the timing of funding released to the National Health Insurance Authority (NHIA). The NHI is scheduled to release a partial payment to providers by the end of this week, and we will continue to actively work with our partners at the Ministry of Finance to expedite the release of the necessary funds and ensure that providers are fully compensated as soon as possible.

“We understand the critical role our physicians and healthcare professionals play in delivering essential services to Bahamians, and we deeply appreciate their continued patience and commitment to patient care during this time.”

Dr Darville spoke out after several doctors, speaking on condition of anonymity, revealed to Tribune Business that the last payment received from the NHI Authority - made in early October - was a partial payment for August. They added that the scheme is two months behind on compensating them, which is now the longest wait for payment in its existence.

The consistent payment delays, which have persisted for around a year now, have meant that doctors and other NHI providers are financially carrying, and effectively underwriting, the scheme at their own expense, which is likely causing cash flow, liquidity and other financial strains for their own companies. Some may even have been forced to take out loans and credit to bridge the gap.

One physician told this newspaper that, as a result of NHI non-payment, they are “down to a very little amount in my account” after being forced to cover daily expenses such as staff payroll, utilities, office supplies, VAT payments, National Insurance Board (NIB) contributions and medical malpractice insurance.

Noting that the $12.50 per patient capitation payment compensation rate has not changed since 2017, despite surging cost of living and inflationary pressures, they added: “There’s a lot of people that won’t say anything. They’re afraid to put their head above the block; whatever you call it. They just say nothing but the ones that talk, they’re all pissed off.

“They [the Government] want to put their money in other places that benefit them more. They probably think we’re people who won’t kick up too much of a fuss because we haven’t done so in the past. But it can’t continue like this.”

The Davis administration expanded the NHI Authority's annual funding by $2m in the Budget, increasing it from $46.2m to $48.2m for the 2025-2026 fiscal year - an amount projected to remain the same for the following two fiscal years. For 2024-2025, NHI had used up $36.135m - some 78.2 percent of its full-year $46.2m allocation - by end-March, which marked the fiscal year's three-quarter mark.

This suggested the remaining $10m was likely to be inadequate to see the NHI Authority through to the June 30 year-end. The Government and NHI Authority have since indicated they plan to expand the taxpayer-funded healthcare scheme and the number of providers, which has left the Opposition and other critics questioning how they plan to achieve this with no significant expansion in budget and an inability to pay bills coming due now in timely fashion.

Dr Duane Sands, the Opposition’s chairman and a former minister of health, having confirmed the payment delays for himself, told Tribune Business yesterday: “We continue to receive significant signs that the funding of healthcare is not a top priority.”

He pointed to the children’s and gynaecology wards at Princess Margaret Hospital (PMH), both of which he said are now closed, plus the absence of “significant progress on repairs in the operating rooms” at both PMH and the Rand in Freeport.

“When we see that here with providers, who are supposed to stand in the gap to prevent persons suffering from the ravages of non-communicable diseases, which is the model of primary care we have adopted, clearly there is a serious problem with the Government’s priorities in spending,” Dr Sands argued.

“I was in Golden Isles today, and they are paving the roads and doing all manner of capital works. Clearly they have money… What is the potential fall-out? I have heard families complain some clinicians are postponing NHI visits, saying they don’t do those on certain days. I’m sure that, if you are not being paid, how can you provide a service at the same level carrying a certain amount of receivables.

“It’s beyond a shadow of a doubt that the Government has a serious cash flow problem, and is using the accounts receivables approach to keep NHI providers dangling on a fiscal hook. I suspect physicians are not going to tolerate this indefinitely. I’d like the Government to say just how significant are the arrears in NHI or in insurance payments to Colina on behalf of civil servants. Clearly, there are challenges with outstanding bills.”