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The Ghana Medical Association (GMA) has called on the government and the National Health Insurance Authority (NHIA) to urgently pay all money owed both public and private health facilities for services rendered from September 2018 to May 2019.

It said failure to honour the obligation would force the facilities to initiate cash and carry as a mode of payment in their quest to ensure continued service delivery, as well as forestall their collapse.

Addressing a press conference in Cape Coast yesterday after the two-day meeting of its National Executive Council (NEC), the President of the GMA, Dr Frank Ankobea, said in spite of a series of reminders and follow-ups, the situation remained unchanged, leaving the association with no option but the decision to revert to cash and carry.

NHIA responds

The Chief Executive Officer (CEO) of the NHIA, Dr Lydia Dsane-Selby, said the authority had been consistent in paying for the services rendered by health facilities.

She, however, explained that competing national interests and low tax revenue performance, which financed 70 per cent of the scheme, accounted for the months of arrears that the authority was working around the clock to get settled.

She said she had held a series of meetings with the Finance Minister and other duty bearers for the release of funds to retire the arrears.

“The premiums are very low, accounting for about 30 per cent, and so if tax is not collected and released in time to us, it becomes difficult to remit the facilities,” she said, and expressed empathy with the affected service providers.

She explained that for the bigger facilities, a chunk of their arrears had been paid for up to September, with those at the lower tier being in arrears of up to four months.

Dr Dsane-Selby said since it took the service providers between two and three months to present their claims, those for May this year could not be paid now.

She also explained that an actuarial model developed by the authority which took cognisance of expected inflows and costs, as well as other additions into the scheme, showed that the scheme was sustainable into the future, with the only challenge being the timely collection of what was due it and its release.

The CEO, therefore, called on all Ghanaians to contribute to make the scheme what each one wanted it to be, saying that sections of the public continued to call for one item or another to be included in the insurance scheme, while premiums remained low and heavily funded with tax money.

“Everybody is calling for this or that to be included in the scheme, but as we grow and our gross domestic product (GDP) increases, we need to decide, as a people, what we want and what we can pay for,” Dr Dsane-Selby said.

She called on all to put their shoulders to the wheel to plug the loopholes in the tax system, especially the National Health Insurance Levy (NHIL), so that the NHIA would get what was due it in time to settle such obligations, which was its mandate.

Updates on negotiation

On conditions of service (CoS) for medical doctors and dentists, Dr Ankobea said the government had not reached any agreement with the GMA following the December 31, 2018 expiration of the document for practitioners working for the Ministry of Health and its agencies.

He said the GMA informed the employer of the need for commencement of negotiations last year prior to the expiration of the document to ensure that a new CoS would be ready before the old one expired.

He said in spite of several reminders and calls on the employer by the GMA on the subject matter and the need for completion of same, the only real activity so far concluded was the ground rules for negotiations and the subsequent receipt of the GMA’s proposals by the employer on June 4, this year and a hurriedly arranged meeting on July 24, at which the government asked for additional time to prepare for negotiations.

“The NEC would like to place on record that the GMA is not happy with the way and manner the employer is handling the negotiations. 

The GMA is reluctantly granting the request of the government for the extension,” he said.

Dr Ankobea warned that if the government failed to adhere to the rules of engagement, including timelines, the GMA reserved the right to take the necessary steps to ensure that closure was brought to the subject matter of CoS.