THE GHANA Medical Association (GMA) has accused the National Health Insurance Authority (NHIA) of neglecting its responsibility of assisting the health facilities in capacity building and technical support.
The GMA said though clinical audits by the scheme are necessary, it is important that the NHIA does not suppress facilities that complain about indebtedness of the scheme to them.
The doctors noted that although the introduction of the National Health Insurance Scheme (NHIS) is a very important intervention in healthcare financing in the country, several challenges and avoidable problems have bedevilled the scheme, with the potential of collapsing it.
They said instead of dealing with the challenges facing the scheme, the NHIS officials have rather taken up the responsibility of micro-managing the facilities and teaching providers how to diagnose and institute treatments for their clients.
They gave an example of an NHIS directive that Medical Assistants in sub-districts should refrain from treating chronic conditions like diabetes and hypertension, mentioning that such cases are thus automatically being referred to the District Hospitals where they are seen by the same Medical Assistants, thereby increasing the workload on the few doctors in the districts.
“It is worthy to note that many healthcare providers under the NHIS are owed many months arrears in legitimate outstanding claims, with a real threat of crippling the facilities,” they explained.
The doctors raised the concerns last Sunday in a press statement issued at the end of the Third National Executive Council Meeting of the GMA at Keta in the Volta Region, jointly signed by its President Dr. Emmanuel Adom Winful and Secretary Dr. Sodzi Sodzi-Tettey.
They noted for example that the Korle-Bu Teaching Hospital has GH¢2.7 million in outstanding claims; the Central Regional Hospital, GH¢693,791.10 in just four to nine months; Eastern Regional Hospital, GH¢1,089,678.53 in two to six months and the Tetteh Quashie Memorial Hospital at Mampong Akuapem, GH¢432,102.15 in four months of outstanding claims.
The situation is no different in other health facilities across the country and this has enormously affected the ability of these facilities to provide quality service to their clients, with daily problems including shortage of drugs and other essential supplies.
According to them, most facilities owe substantial amounts in medicines and consumables procured on credit, and as a result, suppliers are no longer willing to supply on credit.
They therefore asked the government to introduce greater efficiency into the administration of the scheme and also take steps to make the payment of outstanding claims more prompt to salvage the scheme from collapse.
The association asked for the full implementation of 'on-call duty facilitation allowance' and the payment of outstanding claims to doctors to cover May this year.
It also advised that issues concerning rent and accommodation allowances for doctors be addressed, while all bottlenecks inhibiting the implementation of all agreements be removed to ensure industrial harmony within the medical sector.
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