Government urged to inject efficiency in NHIS operations

Accra, May 31, GNA - The National Executive of the Ghana Medical Association has called on government to inject efficiency into the operations of the National Health Insurance Scheme (NHIS), to facilitate prompt payment of claims.

"We will like to urge government to introduce greater efficiency into the operations of the NHIS administration, and take prompt steps to reimburse health facilities owed many months in legitimate claims, to prevent health service delivery from grinding to a halt". The call was contained in a statement signed by Dr Emmanuel Adom Winful, President of the GMA, at the association's 3rd National Executive Council Meeting at the weekend, in the Volta Region.

The statement noted that, although the introduction of the scheme was an essential intervention in the nations' health care, it had been bedevilled with several challenges which could collapse its operations. "It is worth to note that many health care providers under the NHIS are owed many months arrears in legitimate outstanding claims, with a real threat of crippling these facilities," the statement said.

The statement said for example that, "The Scheme owes Korle-bu Teaching Hospital GHc 2.7 million and the Central Regional Hospital GHc 693,791.10. The Eastern Regional Hospital is owed a total of GHC 1, 089, 678.53 as six months outstanding claims, whiles the Tetteh Quarshie Memorial Hospital is owed GHc 432, 102.15 as four months claims".

It said more facilities owe substantial amounts in medicinal and consumables procured on credit due to none payments of claims as a result of which supplies were no longer willing to supply on credit. The statement said, in the mist of all the challenges, operators of the scheme had remained mute, adding, that "In recent past, the NHIS has taken up the responsibility of micro-managing the facilities and their providers on how to diagnose and institute treatments for their clients. "An instance is the NHIS directive that Medical Assistants in sub district should refrain from treating chronic conditions like diabetes and hypertension. Such cases are thus automatically being referred to the District Hospitals where they are seen by the same Medical Assistants complementing the work of the few doctors in the districts". The statement said, managers of the scheme appeared to be taking over the role of the Ghana Health Service (GHS) and the interest of the patient did not seem to be the foremost consideration.

It said the scheme had neglected the responsibility of assisting the facilities in capacity building and technical support. It said "Clinical Audits by the NHIS were necessary and the GMA had no qualms about auditing of facilities. It is important however that clinical audits should not be used to cow down facilities that complain about the indebtedness of the scheme to them," it said. The statement among other things expressed concerns about the partial implementation of the on-call duty facilitation allowance and none payment of doctors allowance as at the end of May.

It therefore called on the Ghana Health Service (and the Directors of the various hospitals to clarify the situation of doctors with special local accommodation and rent arrangement to enable all qualified doctors to benefit from the negotiated allowance. "The GMA is calling on the Ministry of Health and the Ministry of Finance and Economic Planning to speedily adopt measures to iron out the outstanding implementation bottlenecks to address the undercurrents of discontent and maintain industrial harmony", the statement said. 31 May 10