NHIS Solid (Front Page)

Story: Lucy Adoma Yeboah (Thursday, July 24, 2008)

THE National Health Insurance Scheme is financially solid to meet the increasing demand for health delivery in the country.
This assurance was given by Mr Ras Boateng, Chief Executive of the National Health Insurance Council (NHIC) when he met the Editorial team of the Daily Graphic in Accra yesterday.
He explained “actuarial studies conducted by the International Labour Organisation (ILO) concluded that the scheme is financially sound”.
Mr Boateng said the scheme is the the most liquid insurance entity in the country with savings and investments worth more than GH¢200 million.
The Chief Executive was responding to questions on allegations of corruption made against the NHIC in a 2005 report by the Auditor General, worker agitation and threats of industrial action by the Association of District Mutual Health Insurance staff.
He said the NHIC has put in place structures, such as internal audit department, procurement unit an entity tender committee and a research department to deal with the challenges facing the scheme in order to plug the loopholes in the system.
Some of the measures, Mr Boateng said, include the development of operational, financial and governance manual as well as an internal audit charter to guide the operations of the scheme as well as the usage of public resources.
On the data front, Mr Boateng the technology platform was also to help the council to integrate all the schemes in a network environment to ensure transparency and the reduction of fraud.
He noted that if the scheme was not integrated it was easy for any person to use the SSNIT number to register more than once and open up the scheme to abuse.
He said the new tariff structure was also intended to standardise the tariffs the schemes pay to service providers and to prevent service schemes from negotiating one on one with individual service providers, which could be a key source of corruption and fraud.
The CEO disclosed that in a significant move, a former Executive Secretary of the NHIC, Dr Sam Akor, has refunded the money which the Auditor-General accused him of misappropriating between 2004 and 2005.
The order for the refund was part of the recommendations made by the Public Accounts Committee (PAC) of Parliament after its public hearing on some aspects of reports by the Auditor-General on a number of public institutions, including the NHIC.
The PAC ordered Dr Akor to pay GH¢1,660 out of the millions of Ghana cedis which the Auditor-General accused some individuals and companies of illegally taking from the NHIC during the initial stages of the implementation of the insurance scheme.
Mr Boateng pointed out that to get things right, he had personally appeared before the PAC on four occasions to offer explanations to certain issues, although he was not employed at the time the anomalies occurred.
He said when he took over the running of the scheme in 2006, there were no structures to promote the effective management of the place, hence those lapses which created the problems the audit report touched on.
According to Mr Boateng, since the scheme was new, a lot of mistakes were made which the current management was trying to correct, adding that the present opposition he faced from some of the personnel in the districts stemmed from the fact that he wanted to effect changes that would further improve upon the operations of the scheme.
The CEO has of late been accused by some workers of the District Mutual Health Insurance Schemes (DMHIS) of being “a corporate dictator” who took actions without consulting other members of staff, filling positions with his relatives, adopting ways to dismiss accounting staff within the DMHIS with the introduction of an aptitude test, among others.
He denied all the allegations, stating that “since they could not accuse me of corruption, they tried to call me a dictator”.
He said series of malpractices were going on within the individual schemes, including the adoption of fraudulent methods to cheat the system, adding that the security agencies were working on some of the complaints.
He added that the accusations against him came about when he tried to introduce measures to check fraud and incompetence which had existed within the various schemes because no such measures existed to serve as checks.
“Were they not the same people who, a year ago, made statements to the effect that I was good for the place?” he queried.
He explained that the NHIA was mandated by law to set standards and enforce their adherence within the NHIS, with the aim of ensuring the efficiency, accountability and sustainability of the NHIS.
On the issue of the aptitude test, the CEO said the authority recently invited accounting staff of the DMHIS to participate in an aptitude test to determine their competencies to help them to improve on their skills, but in spite of the adequate notice given them, the accountants refused to take the test and rather resorted to making statements in the media reading motives into the decision.
He explained that the tests became necessary because although some training programmes had been organised for the accountants, later reports by internal auditors and external auditors of the Audit Service indicated serious challenges in accounting practices within the schemes.
“The test was intended to comprehensively identify competency gaps with a view to designing a tailor-made training programme for the accountants. The goal is to equip them to account more professionally for public funds entrusted to the schemes but not to dismiss anyone,” he explained.
He stressed that his sole interest was to see to the success of the scheme so that many people, especially the poor, would benefit, but not to allow a few individuals to run it down.
He said he was determined with his new team of administrators to open up the scheme for public scrutiny to ensure its success.
Mr Boateng said part of the strategy include the provision of a hotline at the NHIA secretariat which premium holders who have grievances can call to seek redress.
He said apart from the diseases on the exclusion list such as prostrate cancer, dentures, cosmetic plastic surgery, chronic renal treatment, hearing aid, mortuary fees and designer frames for spectacles.
Mr Boateng said anti-retroviral drugs are also not covered under the scheme because they are subsidised but opportunistic diseases such as malaria, diarrhoea and TB are covered.
He said the scheme had made strides beyond the government’s expectation as the scheme had registered 55 per cent of the registrable population.
He said more strides would be made from next academic year when all children under 18 years in school would be registered.