Ghana: NHIS Service Providers Happy With Mode of Payment

Edmond Gyebi

22 July 2011

Tamale — Some service providers of the National Health Insurance Scheme (NHIS) in the Northern Region have denied allegations by a section of the public that they always refuse to deliver some essential drugs to clients of the scheme because the National Health Insurance Authority (NHIA) owed them large sums of money.

According to them, the allegations were completely “untrue and baseless,” and that they were rather enjoying swift payment of their monthly claims under this current administration, than before.

The Chronicle, in trying to ascertain the truthfulness or otherwise of the much publicised allegation, visited the Tamale Teaching Hospital, which is the largest health centre in the whole of the three Northern regions and the Seventh Day Adventists (SDA) Hospital, which is also one of the best missionary health facilities in the region, to interact with the authorities and other patients who are card-bearing members of the NHIS.

Even though it was earlier reported on most of the local radio stations in Tamale by some serial callers, and on the TV Africa’s “Ghana Must Know” segment, that he majority of NHIS clients, who were issued with non-availability forms for essential drugs, had been turned away by service providers in the metropolis, the Director of Pharmacy at the Tamale Teaching Hospital, Mr. Nicholas T.K. Adjimani, debunked the assertion.

According to him, it was true that occasionally, the hospital experiences shortages of some of the drugs, but that did not mean it was a deliberate attempt by the hospital to deny them essential drugs.

He said the Tamale Teaching Hospital had created a Special Pharmacy Shop where clients could easily procure any prescribed, but unavailable, drug at low prices.

Mr. Adjimani disclosed that about 90 to 99 percent of the essential drugs needed for treatment under the NHIS were mostly available, but the problem, he indicated, was that the majority of the clients were highly impatient, and sometimes would want to challenge prescriptions by the doctors.

“Because some of the clients go to private pharmacies to buy drugs at their discretion for the treatment of different diseases, and it sometimes work for them, they are always expecting to be given the same kind of medicines when they come to the hospital. But, that is completely wrong, it is the duty of the doctor who has diagnosed you to determine the right medication for you, yet they will not agree, because they feel they also know better.”

On his part, the Public Relations Officer (PRO) of the Tamale Teaching Hospital, Mr. Nii Otoo Ankrah, also denied that claims were not being paid at all.

According to him, the Tamale Teaching Hospital could not have been operating, since it takes about 90% of its income or revenue from NHIS services, with the 10% accruing from the cash and carry.

He, however, complained about the certain deductions in the payment of claims by the NHIA, without explaining further as to why the deductions were effected.

Mr. Nii Otoo Ankrah maintained that NHIS holders receive absolutely equal treatment as those without.

Contrary to assertions in the media, about 13 patients the paper interviewed at the Tamale Teaching Hospital and the SDA Hospital maintained that the NHIS had helped them and their children enormously.

Some of them, however, complained that some people were abusing the scheme by visiting the hospitals with trivial cases, which they said, sometimes caused serious congestion at the facilities.

The Principal Accountant at the Tamale SDA Hospital in charge of the NHIS, Mr. Alex Osei Bonsu, in an interview with The Chronicle, also refuted the allegation that the scheme was not paying them regularly services they provide.

He told the paper that at the time of the interview, he had just submitted his May claim for vetting at the Tamale Metropolitan NHIS office.

He said the claims are paid within 60 days after submission, provided there are no anomalies in the report to cause further delay.

The Northern Regional Manager of the NHIS, Mr. Rashid Tanko Computer, also expressed disappointment at the way some people were trying to sabotage the scheme.

According to him, the NHIS, within the last two and half years, had seen massive transformation, which now makes it one of the best in Africa.

He said the current NHIA had been able to pay all the outstanding claims it inherited from the past government, and as of now, about 99% of the service providers nationwide had been paid.

He explained that what caused the little delays was because the claims had to undergo some vetting and considerations before payments are made, but that, he said, did not mean they were delayed.

Mr. Computer revealed that in the Northern Region alone, 1, 925,978 people had registered with the NHIS and issued with ID cards, representing 81.35%, while 390,000 people had also registered under the scheme in the Tamale metropolis, representing over 75%.

He, however, appealed to Ghanaians to support the NHIS, which is a very credible social policy by government to bring quality healthcare to the people.

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