NHIA Sued Over Capitation

The Pharmaceutical Society of Ghana (PSG) has dragged the National Health Insurance Authority (NHIA) to court seeking an injunction to stop the implementation of the capitation mode of payment currently being piloted in the Ashanti region.

The body for pharmacists wants the court to restrain the NHIS through a perpetual injunction from implementing the capitation policy or any other policy contrary to any law anywhere in Ghana.

The capitation procedure, they pointed out in their statement of claim, poses grave danger to patients given among other factors the recognition it gives to persons outside the pharmacy profession.

If allowed to operate, the PSG observed, there could be fatalities as a result of the handling of the pharmaceutical segment of the health care delivery system.

The PSG noted that as the Pharmacy Council mandated by statute to regulate the practice of the profession and ensure the maintenance of the highest standards, they were not involved in the accreditation of facilities and premises for the provision of pharmaceutical services under the capitation scheme.

They revealed that the action of the NHIS undermines the quality of pharmaceutical service, which allows unlicensed persons and facilities to function under the capitation policy and 'providing pharmaceutical services to the detriment of patients and the general public and compromising public health standards.'

Without an appropriate intervention, they posited, the capitation scheme would lead to 'fraudulent claims, irrational drug use and even fatalities resulting from the misuse of medicines.'

Continuing they maintained that 'the defendants action could lead to the collapse of several pharmacies across the nation with the accompanying huge loss of employment,' adding 'regulated pharmacists and pharmaceutical skills and knowledge are critical for the promotion of rational, safe and efficacious drug dispensation and the use of same in the best interest of the scheme and the nation's health as a whole.'

In the light of the foregone, they are praying an Accra Fast Track High Court to declare as unlawful the procedure of the implementation of the capitation exercise.

They are also demanding that the court outlaws the accreditation of unlicensed premises as part of the implementation of the piloting of the capitation in the Ashanti region.

The NHIS is piloting a new mode of payment in the Ashanti region through the accreditation of persons retailing drugs but not necessarily registered pharmacists, one of the issues being raised by the PSG.

By A.R. Gomda