Debates of 13 Feb 2014

MR SPEAKER
PRAYERS 11:10 a.m.

VOTES AND PROCEEDINGS AND THE OFFICIAL REPORT 11:10 a.m.

Mr Speaker 11:10 a.m.
Hon Members, Question time --
Hon Majority Leader, is the Minister for Food and Agriculture here?
Dr Benjamin B. Kunbuor 11:10 a.m.
Mr Speaker, the Minister is at the Regional Ministers' Conference at Winneba. However, his deputy is available. We would ask for your indulgence to allow him to answer the Questions.
Mr Dominic B. A. Nitiwul 11:10 a.m.
Mr Speaker, fair enough.
Mr Speaker 11:10 a.m.
Very well.
ORAL ANSWERS TO QUESTIONS 11:10 a.m.

MINISTRY OF FOOD AND 11:10 a.m.

AGRICULTURE 11:10 a.m.

Mr Basoah 11:10 a.m.
Mr Speaker, I would like to ask the Deputy Minister for Food and Agriculture who were the beneficiaries of the facilities?
Dr Alhassan 11:10 a.m.
Mr Speaker, about 70 per cent of the tractors were used in the establishment of Agricultural Mechanisation Services Centres (AMSECs) across the country and the remaining 32 distributed to individuals who were interested in buying them.
Mr Basoah 11:10 a.m.
Mr Speaker, I would like to ask the Deputy Minister for Food and Agriculture when the facilities were distributed?
Mr Speaker 11:10 a.m.
The question again?
Mr Basoah 11:10 a.m.
Mr Speaker -- [Interruption]
Mr Speaker 11:10 a.m.
Hon Members, let us have order in the House.
Mr Basoah 11:10 a.m.
Mr Speaker, I would like to ask the Minister when the remaining 32 tractors were distributed.
Dr Alhassan 11:10 a.m.
Mr Speaker, I am not very clear. I do not know whether the question is “where” or “when”?
Mr Speaker 11:10 a.m.
When.
Dr Alhassan 11:10 a.m.
Mr Speaker, the 32 tractors were distributed as soon as the number for the AMSECs were taken out to individuals -- [Interruption] -- Oh, soon after the arrival of the tractors.
Indeed, all the 932 pieces did not come into the country on the same day. The distribution was done as they arrived and assembled.
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Mr Basoah 11:20 a.m.
Mr Speaker, it looks like I am not clear with the date that the tractors which were sent in were distributed. So, the Hon Member should give me the specific date or year of which the distr ibutions were made and the breakdown.
Dr Alhassan 11:20 a.m.
Mr Speaker, if I am given the appropriate notice, those details can be produced.
Mr Speaker 11:20 a.m.
Hon Member, you have exhausted your supplementary questions.
Mr Daniel Botwe 11:20 a.m.
Mr Speaker, I think what is of great interest to the House is for the Hon Deputy Minister to furnish the House with details of the distribution and that can be done on notice. But I am saying that, that is what is of interest. So, would he --
Mr Speaker 11:20 a.m.
Hon --
Mr Botwe 11:20 a.m.
I thought I would finish my question.
Mr Speaker 11:20 a.m.
Hon Minority Chief Whip, ask your supplementary question. Look at the principal Question that the Hon Member asked and ask your supplementary question.
Mr Botwe 11:20 a.m.
Mr Speaker, when would the Deputy Minister for Food and Agriculture furnish this House with the breakdown of when the tractors arrived and how they were distributed? How many centres received a particular number of tractors and the individuals who received the other 30 per cent? When would the Hon Deputy Minister furnish us with these details?[Country of origin was India and the funding was provided by the Government of Ghana.]
Dr Alhassan 11:20 a.m.
Mr Speaker, I said when given the appropriate notice, it would be within the power of the House to ask the Ministry to bring it to the House. But I would certainly have that information and I can make it available.
Mr Speaker 11:20 a.m.
Hon Members, the Question was, the number of tractors imported in the year 2008. That was the Question posed to the Hon Deputy Minister. There are supplementaries and he has provided them. You want certain specifics. He says that if given notice, he would make them available.
Mr Botwe 11:20 a.m.
Mr Speaker, I think my question was very simple. I said when would the Hon Minister furnish this House with that detail?
Mr Speaker 11:20 a.m.
The Question should be whether the Hon Deputy Minister would furnish the House with that information and then the House decides to give him the time to do so; and we would programme him for the Business Committee.
Mr Botwe 11:20 a.m.
Mr Speaker, the Deputy Minister answered the question. The Deputy Minister has answered the question. He said when the House gives him time, he would bring it. He has answered the question.
Mr Speaker 11:20 a.m.
Hon Chief Whip, I would want to say that because you are in Leadership in the House, the question you are asking, is str ictly non- supplementary. I have allowed that question because you are in Leadership.
Look at the Question that was posed?
Mr Botwe 11:20 a.m.
Mr Speaker, if you had allowed him, he would have answered --
Mr Speaker 11:20 a.m.
So, let us proceed. At the appropriate time, if there is any directive to give, I will give it.
Mr Botwe 11:20 a.m.
Mr Speaker, we are waiting for your directive.
Alhaji Ibrahim D. Abubakari 11:20 a.m.
Mr Speaker, may I know from the Hon Deputy Minister whether the number of tractors imported during the period was adequate for the country and its impact on agriculture?
Mr Speaker 11:20 a.m.
Hon Member, that is not supplementary.
Dr Anthony A. Osei 11:20 a.m.
Mr Speaker, in his Answer, the Deputy Minister for Food and Agriculture indicated on page 9 that, the funding source was Government of Ghana.
Mr Speaker, Government of Ghana bought the tractors but when he says the funding source is Government of Ghana, what exactly does he mean? There is money from the budget. There is money from loans. But this is very vague -- “Government of Ghana”.
So, can the Deputy Minister be more specific. This is because if Ghana buys it, it is Ghana that is going to pay for it. So, to say Government of Ghana --
Dr Alhassan 11:20 a.m.
What it means is that, all the tractors were bought with funds provided by the Government of Ghana, not any partnership with any donor.
Mr Dominic B. A. Nitiwul 11:20 a.m.
Mr Speaker, the Deputy Minister says in his Answer that the distribution of the tractors were done when the tractors came. But from the Answer he gave here, he said that all the 932 tractors arrived in
2008.
I would want to ask him whether the distribution was done in 2008 or beyond
2008?
How many of these tractors were distributed in 2008? This is because he said as they came and he is saying that all of them came in 2008. So, were they distributed in 2008 or beyond 2008?
Dr Alhassan 11:20 a.m.
Mr Speaker, I believe when you give your directive for us to provide the details of the distribution, the specific dates would also come along.
Dr Owusu A. Akoto 11:20 a.m.
Mr Speaker, may I know from the Deputy Minister for Food and Agriculture, subsequent to 2008, how many tractors have been imported each year till now? If he has the figures for 2008, obviously, he would have the figures for the latter years. So, he cannot tell us that he does --
Mr Speaker 11:20 a.m.
Hon Member for Kwadaso, that is not a supplementary question.
Hon Asiamah. Last person on this Question.
Mr Isaac K. Asiamah 11:20 a.m.
Mr Speaker, I would want to find out from the Hon Deputy Minister, how much it cost the Government of Ghana to import these tractors and accessories?
Dr Alhassan 11:20 a.m.
Mr Speaker, the purchase price for the Farmtrac-60 was GH¢24, 242.42. Then the Mahindra-705DI, 100 pieces of them, each one cost GH¢30, 678.50. The Mahindra-605DI cost GH¢22, 473.47. The John Deere cost GH¢26, 642.11. John Deere 5303 cost GH¢
24,408.77.
I must add, even though it has not been asked, that these prices were not passed onto the people who purchased the tractors. This is because Government had to introduce a 33 per cent subsidy on each of them.
Mr Osei Kyei-Mensah-Bonsu 11:20 a.m.
Mr Speaker, since the amounts quoted in Ghana cedis can only be relevant when it is matched against the dollar equivalent at the time, what was the dollar equivalent at the time? It can only be relevant. What was the dollar equivalent at the time?
Mr Speaker 11:30 a.m.
Hon Minority Leader, I thought you were in Ghana? [Laughter.]
Mr Kyei-Mensah-Bonsu 11:30 a.m.
Mr Speaker, yes, I know I am in Ghana but the loans that we approve in this House are dollar denominated. Can the Hon Deputy Minister give us the dollar equivalent? [Interruption.] He should not shake his head; he should give us the dollar equivalent.
Mr Speaker 11:30 a.m.
Hon Deputy Minister, if you have the information, provide it.
Dr Alhassan 11:30 a.m.
Mr Speaker, I do not have the figures in dollars. [Interruption.]
Dr A. A. Osei 11:30 a.m.
Mr Speaker, the figures the Hon Deputy Minister has given to us are the sales figures, not the purchase price; so, the purchase was not in cedis. This was what was sold to the people who bought them, but that was not the currency with which they bought them. Those were in foreign currency and that is the figure we are asking for, not the cedi equivalent.
Mr Speaker 11:30 a.m.
So, what is your question?
Dr A. A. Osei 11:30 a.m.
Mr Speaker, my question is; What is the purchase price of these tractors, not the sale price?
Mr Speaker 11:30 a.m.
Do you know the purchase price?
Dr Alhassan 11:30 a.m.
Mr Speaker, they asked how much each unit of tractor cost, which figures I have given. I did say that almost all of them were passed onto the people who bought the tractors. This is because there was a subsidy element. I thought the Hon Member would be asking for the subsidy price. Anyway, that would have been a bulk transaction between the Bank of Ghana and the country that was exporting, so, I would not have the figures in dollars.
Mr Speaker 11:30 a.m.
Hon Member for Old Tafo, you do not have the floor.
Dr A. A. Osei 11:30 a.m.
Mr Speaker, I have information for him, so he should see me.
Mr Speaker 11:30 a.m.
Very well, Hon Member for Old Tafo.
Mr Kyei-Mensah-Bonsu 11:30 a.m.
Mr Speaker, the Hon Deputy Minister has indicated to us that all these tractors, the entire number of 932 were purchased with funding provided by the Government of Ghana.
Mr Speaker, is the Hon Deputy Minister aware that Government sourced for some facility that was available in respect of the purchase of the John Deere tractors? Is the Hon Deputy Minister aware?
Mr Speaker 11:30 a.m.
I did not get that. Please, the question again?
Mr Kyei-Mensah-Bonsu 11:30 a.m.
Mr Speaker, I am asking the Hon Deputy Minister because he said he was emphatic, and the Answer he provided does not come with an equivocation. He said to us that all the 932 tractors were purchased with funding provided by the Government of Ghana. I am asking whether he is aware that there was an Indian Government facility in respect of the John Deere tractors.
Dr Alhassan 11:30 a.m.
Mr Speaker, I am not aware of that arrangement and the Hon Member may note that this Question is specific to tractors imported in 2008.
Mr Kyei-Mensah-Bonsu 11:30 a.m.
Mr Speaker, if the Hon Deputy Minister's attention is drawn to it, would he accordingly amend the Answer because he is specific? He said the 932 tractors were purchased with funding from the Government of Ghana.

Are you saying, no, to him?
Mr Speaker 11:30 a.m.
Please, address the Chair. Hon Minority Leader, both of you should address the Chair.
I will take the last person.
Papa Owusu-Ankomah 11:30 a.m.
Mr Speaker, is the Hon Deputy Minister aware that presently, the market price of Farmtrac-60 is in the region of US$25,000? As of now, the market price is US$25,000?
Dr Alhassan 11:30 a.m.
Mr Speaker, I have not done a market survey on the cost of tractors including Farmtrac-60. I believe that if he gives me sufficient notice, I can -- I am not aware of that price.
Mr Speaker 11:30 a.m.
Hon Member for Okere, file an Urgent Question; I would admit it as such for all the information that you want the Hon Deputy Minister to provide on the tractors. So, if you file an Urgent Question, I would admit it as such for the Hon Minister to make the information available.
Mr Botwe 11:30 a.m.
Mr Speaker, is it my understanding that, that is the directive?
Mr Speaker 11:30 a.m.
Absolutely.
Mr Botwe 11:30 a.m.
So, it is to me now, not the Hon Deputy Minister? [Laughter.]
Mr Speaker 11:30 a.m.
Hon Member for Okere --
Papa Owusu-Ankomah 11:30 a.m.
Mr Speaker, we have a lot of committees in this House; we have the Committee on Government Assurance. I am certain that the Committee can follow up on this information because the information is for the benefit of the
House. Once the Hon Deputy Minister has admitted that he can provide the information, I am sure the Committee on Government Assurance can follow it up.
Mr Speaker 11:30 a.m.
Hon Member for Sekondi, I am aware, but the nature of the Question and the information that Hon Members want -- the information far exceeds -- If you look at the Question that has been filed and admitted by the Speaker, you would see that they needed more than what is there and the Question would clarify exactly the information that they want the Hon Deputy Minister to provide.

Hon Members, we move to the next Question.

Asantekwaa Irrigation Project (Completion)

Q41. Mr Stephen Kunsu asked the Deputy Minister for Food and Agriculture when the Asantekwaa Irrigation Project in the Kintampo North Constituency would be completed.
Dr Ahmed Y. Alhassan 11:40 a.m.
1. Asantekwaa small scale irrigation scheme
Mr Speaker, the Asantekwa a Small Scale Irrigation Scheme was one of the schemes initiated under the Small Scale Irrigation Development Project (SSIDP). The scheme is designed to pump water from the Yoko River into a night storage reservoir (NSR) before releasing the water under gravity to irrigated fields for cultivation of vegetables such as tomato, okra, chilies, leafy vegetables and other exotic crops.
The scheme was not fully completed when the loan disbursement period finally elapsed on 31st March, 2010. Con- struction activities progressed very slowly between 2007 and March 2010.
Some of the components were completed while some were at various stages of completion prior to the closure of the Fund. The basic contract data and stages of completion of major com- ponents are presented below in Tables 1 and 2 respectively:
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Dr Ahmed Y. Alhassan 11:40 a.m.


The scope of contract:

1. Head works: Construction of intake for 5 submersible pumps and pump control house.

2. 400 mm diameter, 1010.6 m long high pressure PVC delivery line to night storage reservoir.

3. Night Storage Reservoir.

4. Distribution system comprising secondary canals SC1, SC2 and

SC3.

5. Development of 143 ha irrigable land which includes:

1.Construction of block lined tertiary canals, their takeoff structures, check gates and drop structures.

2. Clearing of vegetation on the 143ha irrigable area.

3. Construction of drainage system -- main, secondary drains and also including cut- off drains.

6. Seven (7) kilometre high tension line to pump Control house.

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SPACE FOR TABLE 2 CONT-

PAGE 3 - 11.40 A.M.
Mr Kunsu 11:40 a.m.
Mr Speaker, according to the Deputy Minister, the NRGP has taken over the completion of the scheme. Now, how would he ensure that the bottlenecks that impeded the progress of work until

the lapse of the loan disbursement period do not reappear?
Dr Alhassan 11:40 a.m.
Mr Speaker, what I have just finished reading has given a time table and it is expected that by August 2015, the project would be completed, barring any hitches that should be the case.
Mr Kunsu 11:40 a.m.
Mr Speaker, I would also like to find out from the Deputy Minister if he considers restoring the fish ponds component in order to cushion the effects of the high cost of electricity bills for the farmers, as the scheme would use electricity to operate.
Mr Speaker 11:40 a.m.
Your question again?
Mr Kunsu 11:40 a.m.
The question is, would the Deputy Minister consider restoring the fish ponds component of the scheme which has been taken away?
Dr Alhassan 11:40 a.m.
Mr Speaker, my information is that, the original designs did not include fish ponds and the evaluation of the project would not include fish ponds. However, the priority of the Ministry is to get the infrastructure in place and I believe fish ponds as an accessory project, can then come on. If they put priority on fish ponds and the water itself is not available, it would not be a worthwhile undertaking.
Mr Botwe 11:40 a.m.
Mr Speaker, I would want to know from the Hon Deputy Minister how he would concile that fact on page 12 of his Answer; it is going to take seven months for a consultant to re-evaluate a project which would be built in nine months; how does he reconcile that?
Dr Alhassan 11:40 a.m.
Mr Speaker, you can see that the different components are at different levels of completion and the minimum is 50 per cent. We have already engaged a consultant that was disqua-
lified. The process of procurement of a new consultant is going to take quite a while and the technical advice we have is that, once the programme kick-starts, he should take that period to complete the entire project.
Mr Seth K. Acheampong 11:40 a.m.
Mr Speaker, from the Answer in paragraph 4 on page 12, after the first consultant, SNC Lavalin, a Canadian consulting firm was disqualified by the funding agency, AfDB.
Mr Speaker, my worry is the beneficiary and the Ministry as a client. I am surprised how the funding agency is the deter- minant for this consulting firm. I would want to know where his powers are emanating from while he is dismissing the consultant?
Dr Alhassan 11:40 a.m.
Mr Speaker, the process for procuring a consultant is global and so, once it is a foreign firm, we may not have been privy to certain information. But when our attention was drawn to that by the donor, we had to comply, particularly when we agreed with the situation. So, it is not the donor having a say as such, but the donor providing the information leading to the disqualification of the consultant. Indeed, the letter terminating the contract was written by the Ministry and not the donor.
Mr Ignatius Baffuor Awuah 11:40 a.m.
Mr Speaker, I would want to refer the Deputy Minister to Table 1 on page 10. It says that the initial contract sum was GH¢964,198.03. Mr Speaker, this was revised to GH¢1,113, 579.43.
Mr Speaker, first, I would want to know when the revision was done and two, how much of this sum has been paid to date and what is outstanding to be paid for the rest of the 26 per cent of the work left.
Dr Alhassan 11:40 a.m.
Mr Speaker, I would require some work to get these figures
done. I do not want to speculate. So, if I get the necessary information, I can give it to you.
Mr Kofi Frimpong 11:40 a.m.
Mr Speaker, I would want to know from the Deputy Minister when exactly would he provide us with these answers?
Mr Speaker 11:40 a.m.
Hon DeputyMinister, you said that you do not have it, so when would you provide it?
Dr Alhassan 11:40 a.m.
At the business of the --
Mr Speaker 11:40 a.m.
No, you said you promised you would provide it; when would you provide it?
Dr Alhassan 11:40 a.m.
Mr Speaker, as soon as time would permit consultation between myself and the technical group.
Mr Speaker 11:40 a.m.
Provide the information next week.
Mr Frank Annoh-Dompreh 11:40 a.m.
Mr Speaker, the Hon Deputy Minister, in his Answer, rightly pointed out at page 12, that the NRGP had taken over nationally, all SSIDP projects. Can he tell the entire House what measures are being put in place to offset the occurrence of any undue delay in the completion of such projects?
Dr Alhassan 11:50 a.m.
Mr Speaker, it has never been the intention of the Ministry to delay the completion of any project. The Ministry functions in an entire country with rules and regulations and so, I do believe that the fact that we have repackaged those projects under another project without any prompting, clearly demonstrates the Ministry's resolve to get those pieces of infrastructure in place for the farmers.
Dr Alhassan 11:50 a.m.


So, I can assure my Hon Colleague that the Ministry would work as hard as possible to ensure that no obstacles really delay the project.
Mr Kyei-Mensah-Bonsu 11:50 a.m.
Mr Speaker, I would want to enquire from the Hon Deputy Minister, if there are some other uncompleted irrigation schemes under the sponsorship of the SSIDP in other regions other than the three northern regions?
Dr Alhassan 11:50 a.m.
Yes, there are many of them, some in the Western Region, Ashanti Region, Brong Ahafo Region. In fact, the particular one that we are discussing now is in the Brong Ahafo Region and not in the Northern Ghana.
Mr Kyei-Mensah-Bonsu 11:50 a.m.
Mr Speaker, that is sufficient. That being the case, why do you put all of them under the
NRGP?
Dr Alhassan 11:50 a.m.
The NRGP; this is because the infrastructure component of that programme is being extended to cover the entire country and not limit it to only northern Ghana.
Indeed, there are other components to fund other irrigation infrastructure, including collaboration with what used to be EDIF, but to our funding for other places of irrigation including the Kamba Dam that has been standing for a very long time.
Mr Kyei-Mensah-Bonsu 11:50 a.m.
Mr Speaker, the question is, why put all these uncompleted schemes under the NRGP when as you have admitted, there are some in the Western, Central Region and so on? Why that name, Northern Rural Growth Programme?
Dr Alhassan 11:50 a.m.
Mr Speaker, projects are conceived having certain objectives on board. As the project unfolds, the objectives can be reviewed to cover other areas that were not originally part of the mandate. In any case, northern Ghana can be flexible in definition.
Mr Speaker 11:50 a.m.
Hon Minority, your last question on this matter.
Mr Kyei-Mensah-Bonsu 11:50 a.m.
Mr Speaker, may I know from the Hon Deputy Minister what is the total acreage of the Asantekwaa Small Scale Irrigation Scheme?
Dr Alhassan 11:50 a.m.
It is 143 hectares.
Mr Speaker 11:50 a.m.
Hon Members, I was going to end the question before the Hon Minority Leader got up and I called him. I want us to move on to the next Question; we have a lot of things on the Order Paper for today.
Dr A. A. Osei 11:50 a.m.
Mr Speaker, I would want to know if the Ministry has received approval from Parliament, that it has changed the mandate to cover the whole country, because the original NRGP was specific for the Northern Region? So, I would want to know if Parliament has given approval for it to be extended throughout the country. If not, would you come back and correct that anomaly?
Dr Alhassan 11:50 a.m.
I am not sure I have an answer to this question. But what I do know is that, it is just a name of a project in Ghana. There is an infrastructure component of it; the same donor was funding the Social Infrastructural Development Project (SIDP), collaboration has come and the funding can extend to cover the uncompleted projects in the other regions.
Mr Speaker 11:50 a.m.
Hon Members, that brings us to the end of Question time under the Ministry of Food and Agriculture.
Hon Deputy Minister, we thank you very much for coming to the House to respond to Questions on behalf of your Minister.
Hon Members, the next and last Question stands in the name of the Hon Member for Jaman South.
Hon Minister for Transport.
MINISTRY OF TRANSPORT 11:50 a.m.

Minister for Transport (Mrs Dzifa A. Attivor) 11:50 a.m.
Mr Speaker, the Sunyani Airport is one of the domestic airports in the country supporting domestic air travel. The current Sunyani Airport started as an airstrip for use by the Allied Forces during World War II. In 1969 however, construction work for a complete airport began and was officially opened in 1974.
The Airport is currently served by Antrak Air, one of the domestic carriers.
Rehabilitation works
With regard to rehabilitation works on the current airport, I must say that this forms part of the total programme to rehabilitate the regional/domestic airports to boost air travel in the country.
In the case of Sunyani Airport rehabilitation, works have been scheduled to start this year as captured in the 2014 Budget of the Ghana Airports Company Limited (GACL).
The rehabilitation works will include:
Remedial works on runway, taxi link and parking apron.
Repairs to Terminal roof leakages.
Other works include:
Installation of security screening equipment.
Construction of underground water storage tanks for Terminal use and fire-fighting.
The Ministry will ensure that the GACL carries out the rehabilitation works as planned under the 2014 Budget.
Mr Speaker 11:50 a.m.
Yes, Hon Member, your supplementary question.
Mr Afful 11:50 a.m.
Mr Speaker, I would want to find out from the Hon Minister what she means by ‘remedial works'. When she says remedial works on the runway, what does she mean by that.
Mrs Attivor 11:50 a.m.
Airport construction is undertaken in various phases. Rehabilitation of the Sunyani Ariport, as I have already indicated, would be carried out in phases. The first phase would consist of the strengthening of the current runway, so that many more commercial flights can travel to the Sunyani Airport.
Thank you.
Mr Afful 11:50 a.m.
Mr Speaker, I believe the problem that we are facing in Sunyani is not a remedial one. The reason we are having only Antrak Air flying in and out of Sunyani is because of the shortness of the runway.
So, Mr Speaker, I would want to know if the Hon Minister and her Ministry have any plans at all to extend the runway to attract a lot of carriers to the region.
Mrs Attivor noon
Mr Speaker, those who know Sunyani Airport would testify to the fact that the current runway is short; it is about 1,400 metres. It is not possible to extend the runway at Sunyani Airport. The reason being that, the nature of the landscape makes it impossible to extend it. What we intend to do in future, is to relocate the airport to a place called Nsuatere for which we have a signed lease for the land.
We would want to do these remedial works to enable Antrak Airlines, and other Airlines to be able to use the airport, while we work towards the development of the new airport at Nsuatere.
Mr Speaker noon
Yes, Hon Member, your last supplementary question.
Mr Afful noon
Mr Speaker, I would want to find out from the Hon Minister, since she is talking about relocating -- I would want to know if they have acquired the land, and if they have title to the land at Nsuatere.
Mrs Attivor noon
Mr Speaker, my information is that, the Ghana Airport Company Limited (GACL) has signed the lease; I am told it is a government land. So, I think we would have access to it and develop it.
Mr Kwaku Agyeman-Manu noon
Mr Speaker, I have two supplementary questions. I do not know if I can put them together. [Interruption.]
Mr Speaker, I would want to find out from the Hon Minister for Transport, when the Nsuatere project would actually
commence, and whether she would consider renaming the Sunyani Airport after the late Professor Busia.
Mr Speaker noon
Hon Member, the second part of your Question is disallowed. She will answer the first part of it.
Mrs Attivor noon
Mr Speaker, the Sunyani Airport is one of the regional airports that we are working on and I would want to assure the Hon Member that, work would start as soon as possible.
Mr Alex Kyeremeh noon
Mr Speaker, the Hon Minister says that rehabilitation works at the Sunyani Airport would start in 2014. I would want her to give us an exact date when the works would begin and the allocation made for the rehabilitation works.
Mr Speaker noon
Hon Minister, how much did you allocate in the budget this year as you have indicated in your Answer?
Mrs Attivor noon
Mr Speaker, under the GACL budget, we have made provision for about GH¢8 million to start the works at the Sunyani Airport runway.
Mr Kwame Anyimadu-Antwi noon
Mr Speaker, from the GACL Report, they have performance of some selected indicators at the Sunyani Airport 2012/2013 compared -- in 2012. We had 6,784 passengers going through the Sunyani Airport. In 2013, we had 30,936 persons, and that gives us an increase of 356 per cent.
For aircraft, we had 574 in 2012 and in 2013, we had 804; that gives us a percentage increase of 40.1.
Looking at the trend of increase of passengers and aircraft, how soon is the expansion of the Sunyani Airport going to take place?
Mrs Attivor noon
Mr Speaker, it is part of the plans of the GACL to do some remedial works on the runway of the Sunyani Airport. I would expect that the works would start as early as possible. [Interruption.]
Mr Ignatius B. Awuah noon
Mr Speaker, would the Hon Minister assure us that all stakeholders, especially from Brong Ahafo Region have the opportunity of being invited to the consultation process when the designs for the new airport at Nsuatere is ready?
Mrs Attivor noon
Mr Speaker, I would want to assure Hon Members from the Brong Ahafo Region and for that matter, the whole of Ghana that, when the design is completed, it would be subjected to a stakeholders' conference for various inputs to be captured before the implementation of the project.
Mr Speaker noon
Yes, the last question on this matter.
Ms Freda A. O. Prempeh noon
Mr Speaker, I have two quick questions to ask. The Hon Minister said work would start as soon as practicable. The good people of Brong Ahafo, and for that matter, Ghana, would like to know exactly when, whether in 2014, 2015 or 2016 and exactly when the designs would be ready.
Mrs Attivor noon
Mr Speaker, in my submission, I made it clear that the first phase of the project would start in 2014. [Interruption.] I do not have the date; I can come back and give that to her.
Mr Speaker noon
Hon Members, that brings us to the end of Question time.

Hon Members, at the presentation of Public Business, the Hon Majority Leader?
Dr Kunbuor noon
Mr Speaker, item number.
5.
Mr Speaker noon
Are the Papers ready to be laid?
Dr Kunbuor noon
No! Sorry Mr Speaker, it is an omission. We can go to item number
6.
Mr Speaker noon
Are we going to lay item number (5)?
Dr Kunbuor noon
No, Mr Speaker. My attention has been drawn to the fact that, there is some contingency between item numbers 5 and 6. So, I would prefer that we take item number 6 first, then we see whether it would become consequential to take 5.
Mr Speaker noon
Very well.
Hon Members, item number 6 on the Order Paper -- Motion. The Hon Dr Richard Winfred Anane.
rose
Mr Speaker noon
Oh, Hon Member, do you have a point of order against the Chair? Nobody is on his feet.
Dr Anthony A. Osei noon
Mr Speaker, I wanted to seek your guidance before the Majority Leader spoke. There is a matter that I wanted to ask the Majority Leader about. I was on my feet but I could not catch your eye. I needed to ask before we go into this business, if it is possible to request a meeting of the Committee of the Whole after today. It is very important.
Mr Speaker noon
Hon Member, discuss these matters with Leadership and then we -- [Interruption.]
Dr Kunbuor 12:10 p.m.
Mr Speaker, I would advise very strongly that the challenge we have is, when this request is made on the floor of the House, it creates challenges for Leadership. This is because, one can only make a proposal for Leadership to discuss outside of the floor of Parliament and we cannot take for granted that both Sides of the House, at any time, at the request of an Hon Member, would be amenable to a Closed Sitting.
Mr Speaker 12:10 p.m.
Hon Members, I would want this matter to be discussed at the Leadership level.
Dr Kunbuor 12:10 p.m.
I cannot even make a commitment when my Hon Colleague is not here.
Mr Speaker 12:10 p.m.
Hon Members, let the Hon Leaders consult and advise the Chair on this matter.
We move on to Motion number 6.
Hon Dr Anane?
Hon Members, we have a Motion and Hon Dr Anane is on his feet.
PRIVATE MEMBER'S MOTION
Termination of NHIA “Capitation” Programme in the
Ashanti Region
Dr Richard W. Anane (NPP -- Nhyiaeso) 12:10 p.m.
Mr Speaker, I beg to move, that this august House urges the Hon Minister for Health to terminate the on-going Health Insurance “Capitation” programme being implemented by the National Health Insurance Authority in the Ashanti Region.
Mr Speaker, health financing has been an area of major concern for all nations for centuries. The necessity for a solution to the health financing conundrum has always been underlined by the need for nations to make and facilitate financial access to healthcare to their citizenry.
Mr Speaker, the health insurance scheme originated under Kaizer I by his Chancellor, Otto Von Bismark in the 1890s in its various forms. Over the years, it has been recognised as one of the attempts of nations to facilitate health access to its citizens and thereby also reduce catastrophic out-of-pocket expenditure.
Mr Speaker, out-of-pocket payments are well documented as a major hindrance to accessing healthcare. Out-of-pocket expenditure is an important measure of financial protection. It is, therefore, not strange at the global level, that the World Health Assembly in Resolutions 58.33 of 2005 and 64.9 of 2011, urged member States to move towards pre-payment and pooled mechanism of financing health- care services in their jurisdictions.
Mr Speaker, Ghana had taken actions pre-dating the World Health Assembly's Resolutions.
Mr Speaker, after going through the various forms of health financing, Ghana finally heaved a sigh of relief, when under the leadership of H. E. President John Agyekum Kufuor, the nation took the unprecedented step of taking the path of a national health insurance scheme in 2001. In 2003, the legal instrument was finally ratified.
Mr Speaker, the relief of the Ghanaian was seen in a very palpable rise in assess, in hospital care, in the aftermath of the implementation of the Scheme.
The expected effect of the advent of the National Health Insurance Scheme, is a reduction in the out-of-pocket expenditure for seeking healthcare service in the country. That may also reflect an increase in general government expenditure as reflected in data that, Mr Speaker, I would want to put across, by which I would crave your indulgence to submit, so that it would be properly captured in the Hansard.
Mr Haruna Iddrisu 12:10 p.m.
Mr Speaker, we are religiously following the Motion, which highlights as he indicated, the “Capitation” grant. I believe that he is still laying his foundation, if he can go to “Capitation grant” as he indicated.
Mr Speaker, my point of order is the very percentages he mentioned. We would want to be guided, percentage of what and what? He cannot just say 44 per cent -- Forty-four per cent of what line of expenditure? We need to know, so that we can relate it properly.
Dr Anane 12:10 p.m.
Mr Speaker, I earlier said I would want to crave your indulgence to submit it for it to be properly captured.
Mr Speaker, what I mentioned were about the general government expenditure on health as a percentage of the total health expenditure.
Mr Speaker, the out-of-pocket expenditure as a percentage of the total health expenditure is as follows and it carries from 1995 through to 2013.
Mr Speaker, in 1995, the out-of-pocket expenditure in Ghana was 44 per cent of the total health expenditure. In 2000, it was 47 per cent, in 2005, it was 37 per cent; 2006, it was 35 per cent; 2007, 30 per cent; 2008, it was 33 per cent and 2009, 37 per cent; and 2013, 36 per cent.
Alhaji Mohammed-Mubarak Muntaka 12:10 p.m.
Mr Speaker, I would be one of the last to stop the Hon Ranking Member on Health on this issue: but our rules are very clear. The Motion is on “Capitation” and not on National Health Insurance.
Mr Speaker, we were all giving him time because we thought that he was laying foundation, but he is speaking on the National Health Insurance; and not on “Capitation”.
Mr Speaker, I would want to urge you to encourage him to start speaking on “Capitation” and stop talking about National Health Insurance. This is because all what he is doing is on the National Health Insurance and he is completely deviating from the rules of this House.
Thank you, Mr Speaker.
Mr Daniel Botwe 12:10 p.m.
Mr Speaker, I think our Hon Colleague has been given the chance to move his Motion and I would crave the indulgence of the House, that he should at least, be allowed to finish moving his Motion, after that Hon
Dr Kunbuor 12:10 p.m.
Mr Speaker, that is why we have rules of procedure in this House. When a Motion is being moved, there are two essential things one needs to do -- to indicate and formally move and to give some background justification in terms of the Motion.
So, we would want to, at least, hear after formally moving the Motion the justification on “Capitation”. I do not have a problem if what he is saying is just trying to put “Capitation” within the context of health insurance.
But if one hears the details, there is a difference between a background and details. That is my worry. This is because somebody would support the Motion, then the details would come in the debate. But as it stands now, the Motion is not yet ripe for the details we are getting into.
That is my worry, Mr Speaker.
Mr Speaker 12:10 p.m.
Hon Members, Standing Orders 92(4) states that the speech of a Member must have reference to the subject matter under discussion. The subject matter is “Capitation” but he is moving the Motion. So, I would give him some time to lay his foundation. If he is going too far, I would call him to order.
Dr Anane 12:20 p.m.
Mr Speaker, I have been doing this for my Hon Colleagues to appreciate that, this is a national matter and not a partisan one. I will eventually be calling on --
Mr Speaker 12:20 p.m.
Hon Member, the point being made is that, if we are not careful and we extend it to the National Health Insurance Scheme, the debate would lose track and the main issue of “capitation” would be lost in the debate.You are moving the Motion; that is why I say I would give you some time; let us see how far you are going and then -- otherwise, the debate would not be focused.
Dr Anane 12:20 p.m.
Mr Speaker, I have come up with the trend of “out-of-pocket expenditure” as a percentage of the total health expenditure. I would want us to take note that in 2013, when the National Health Insurance Authority (NHIA) itself did some work in the Ashanti and Eastern Regions as the control, and it was all based on the fact that of the capitation as introduced in the Ashanti Region.
Mr Speaker, the out-of-pocket expenditure for 2013 as per the work done by the NHIA was that, the out-of-pocket expenditure as a percentage of the total health expenditure in the Eastern Region was 36 per cent, whereas in the Ashanti Region, it was 64 per cent.
Mr Speaker, I am laying this for us to appreciate it.
The above data, Mr Speaker, shows a clear and consistent reduction in the out- of-pocket expenditure after the implementation of the NHIS generally. Whereas for citizens in a controlled population, out-of-pocket expenditure for healthcare is 36 per cent, citizens of Ashanti Region per capita have to expend 64 per cent. That is nearly double out- of-pocket for a similar venture.

Nii Lantey Vanderpuye -- rose --
Mr Speaker 12:20 p.m.
Hon Deputy Minister for Trade and Industry, do you have a point of order. What is your point of order?
Nii Lantey Vanderpuye: Mr Speaker, we are being given statistics and data and comparing two regions with different population statistics. So, he cannot just directly give us figures relating to the Ashanti and Eastern Regions without stating the average of population differences?
Mr Speaker, if he does that, he would be misleading the House.
Dr Anane 12:20 p.m.
Mr Speaker, I said the difference in the two environments, that is, the Eastern Region and the Ashanti Region, was about the implementation of the capitation policy in the Ashanti Region which was introduced in the region as a pilot in January, 2012.
Mr Speaker, I would want to draw attention to the fact that the national Constitution frowns on discrimination, therefore, as enshrined in article 17(1), (2) and (4d), which I would crave your indulgence to quote:
“All persons shall be equal before the law.”
Mr Speaker, in article 17(2), the Constitution of Ghana says 12:20 p.m.
“A person shall not be discriminated against on grounds of gender, race, colour, ethnic origin, religion, creed or social or economic status.”
Dr Kunbuor 12:20 p.m.
Mr Speaker, sorry that I have to take a point of order on this matter but it is very significant for the records of this House. I am not sure that a region of Ghana is a bearer of rights and so, as he
cites his human rights, there must be legal persons, corporate or natural who are the bearers of the rights. The Ashanti Region is not a legal person that is the bearer of rights, please.
rose
Mr Speaker 12:20 p.m.
Hon Members, let us listen to the mover of the Motion and then we can make our contributions later.
Mr Osei Kyei-Mensah-Bonsu 12:20 p.m.
Mr Speaker, I think the trajectory that the mover of the Motion has chosen, is to let us know that, the National Health Insurance Law is supposed to catch the entirety of the populace of this country in one loop, and if as he is relating to, some people are being taken out of that loop, it is discriminatory.
Mr Speaker, that is the purpose that he seeks to establish, and at this time, I shudder to think the relevance of the interventions that my Hon Colleagues are making.
Can we listen to him, after he has finished, if any Member has any contrary view, we can share it.
Mr Speaker, that is it.
Dr Kunbuor 12:20 p.m.
In fact, Mr Speaker, I did not want to go into the details of this matter.

So, I knew why I was drawing attention to that; it is because of what he used.
DrAnane 12:20 p.m.
Mr Speaker, as I was saying, article 17(3) also states:
Mr Murtla M. Ibrahim 12:20 p.m.
Mr Speaker, the Hon Member is completely reading and I thought that he could be making references to them. I have no problem at all against this consistent repetition of “Ashanti”. I do not know of any Ashanti. I know of Ashanti Region. He repeatedly mentioned “Ashanti”. I think that people are here watching. There are school children there. I think it is appropriate and proper that he tells us what he is referring to as “Ashanti”. This is because we have ten regions in Ghana and I know of Ashanti Region.
Mr Speaker 12:20 p.m.
Hon Members, order! Order!
All of you, resume your seats. All of you, take your seats.
Hon Members, by the terms of the Motion --
rose
Mr Speaker 12:20 p.m.
Hon Kofi Frimpong, take your seat.
Hon Members, by the terms of the Motion, the Hon Member is not referring to Ashanti, he is referring to Ashanti Region and it is there. So, all of us should be guided. He is referring to Ashanti Region.
Number two, Hon Anane, are you reading?
Dr Anane 12:20 p.m.
I am making references to my --
Mr Speaker 12:20 p.m.
Very well.
Dr Anane 12:20 p.m.
Mr Speaker, if you were a woman.
Mr Speaker, if I may continue.
Mr Speaker, what we have frowned upon all this time, with the implementation of the Capitation programme in Ashanti has always been that, it has been hurried and the implementation has been botched. It has left a soar taste in the mouths of all who have been experiencing it in Ghana.
Mr Speaker, you do know very well that the Capitation mechanism involves three major partners. The partners are the Scheme itself, the subscriber and the provider.
The Scheme should be able to forecast and that is the advantage of the Capitation. The provider should also have a very good cash flow, whereas in the case of the client, who is the subscriber, he is
Mr Mahama Ayariga 12:40 p.m.
Mr Speaker, as you can see very visibly, in the Hon Member's effort to respect your directive that he should be looking forward at you, he has lifted the script and he is now reading it in such a way that you can see his face.
On a more serious note, Mr Speaker, I think we need your guidance on this matter. He is using an opportunity to move a Motion to actually make a Statement on the floor of the House. Mr Speaker, he has not moved the Motion yet. He should move the Motion, so that we would all have the opportunity to debate it. He has not moved it and he is copiously reading a Statement on the floor of the House.
Mr Speaker 12:40 p.m.
Hon Members, the Hon Member has moved the Motion. What we should rather be calling for is for him to start winding up. He should wind up.
Mr Kyei-Mensah-Bonsu 12:40 p.m.
Mr Speaker, I believe that all of us should be educating ourselves regardless of the length of time that we have stayed in this Chamber.
Dr Kunbuor 12:40 p.m.
Mr Speaker, I can see the sense of the parallels in terms of procedure that the Hon Minority Leader has raised. But in the particular case of a budget, our Standing Orders require estimates and expenditure to be laid, and that is the length of time in laying the estimates and expenditure.
In the particular case of the concern raised by the Hon Member, the idea is that, sufficient background information on the substantive issue which is Capitation, has been laid and that other Hon Members would want to be part of the debate. I think this is just the concern. For us as Hon Members of the House, if we do not have some guidance when we can bring a Motion, somebody can come and take six hours in laying foundations. So, he was simply asking for guidance --
But I do not have a difficulty with the foundation that he has presented. This is because in my view, personally, the foundation has become very useful in terms of this Motion.
Mr Kyei-Mensah-Bonsu 12:40 p.m.
Mr Speaker, I think the principal point espoused by the Hon Member responsible for Information and Media Relations was the fact that, the Hon Member was reading the document. That was the point, and it was the central issue that he raised.
I was suggesting to him that it is necessary. Given the circumstances and the importance of the matter before us, he needs to back it with concrete statistics, which is what he is doing and he cannot be out of order.
Mr Speaker 12:40 p.m.
Hon Dr Anane, you should wind up now. I think that you have laid sufficient foundation and I have given you enough time. So, you should conclude, so that we can make progress. Depending on how the debate goes, you may even have the opportunity of winding up.
So, Hon Member, conclude.
Dr Anane 12:40 p.m.
I thank you Mr Speaker.
Mr Speaker, I was just giving data of two hospitals; one in the rural area and the other in the city for us to appreciate the impact of Capitation --
Mr Speaker 12:40 p.m.
Then after that, you will conclude.
Dr Anane 12:40 p.m.
Mr Speaker, I will. But as I crave your indulgence, I would submit my document for it to be fully captured. So, Mr Speaker, for Suntreso Hospital which took care of 73,259 patients of which 15,817 were children and 57,442 were adults, Suntreso under Capitation had GH¢452,-
292.78.
Mr Speaker, the counterpart of the Suntreso Hospital in another region, within that same period, seeing the same patients, would have GH¢577,522.39. Mr Speaker, this means that Suntreso lost
GH¢125,229.61.
Mr Speaker 12:40 p.m.
Hon Dr Anane, conclude.
Dr Anane 12:40 p.m.
Mr Speaker, the impact of Capitation is also relevant when it comes to the rate of --
Mr Speaker 12:40 p.m.
Hon Dr Anane conclude. This is because there are others who would speak. So, any other information, you can give it to others to --
Dr Anane 12:40 p.m.
Mr Speaker, I wish therefore, to conclude that, taking cognisance of the breach of our national Constitution as per the articles referred to above and the fact that instead of ameliorating the out-of-pocket expenditure for subscribers, the Capitation policy has rather increased the per capita out-of- pocket expenditure. Instead of improving the cash flow of providers and then the operational and service provision of the provider, the Government, through the Hon Minister for Health, be urged by this august House to immediately terminate the implementation of the Capitation policy in the Ashanti Region.
Mr Speaker, we would want to call on the august House to urge the Hon Minister to ensure that the National Health Insurance Authority collaborates with all stakeholders, to craft a compensatory mechanism for the subscribers and providers of the region, who have had to endure the experiment of robust capitation policy.
We thence caution all Hon Members to ensure that the good people of their various
constituencies are not exposed to the manner and form of the Capitation policy that has been pushed down the throat of the people in the Ashanti Region.
Mr Speaker, I beg to move and in so doing, table it for it to be fully captured in the Hansard.

Mr Speaker, I beg to move,

That this August House urges the Honourable Minister of Health to terminate the on-going Health Insurance ‘Capitation' programe being implemented by the National Health Insurance Authority in the Ashanti Region.

Mr Speaker, Health financing has been an area of major concern for all nations for centuries. The gravamen of the necessity to a solution to the health financing conundrum has always been underlined by the need for nations to make and facilitate financial access to health care to their citizenry.

Mr Speaker, a Health Insurance Scheme, originated under Kaiser I by his Chancellor, Otto Von Bismark in the 1890s, in its various forms over the years, has been recognized as one of the attempts of nations to facilitate health access to its citizens and thereby also reduce ‘catastrophic out-of-pocket expenditure'.

Mr Speaker, Out-of-pocket payments are well documented as a major hindrance to accessing health care. Out-of-pocket expenditure is an important measure of financial protection. It is therefore not

strange that at the global level, the World Health Assembly (WHA) in Resolutions 58.33 of 2005 and 64.9 of 2011 urged Member States to move towards pre- payment and pooled mechanisms of financing health care services in their jurisdictions. Ghana, had taken actions pre-dating the WHA resolutions!

Mr Speaker, after going the various forms of health financing, Ghana finally heaved a sigh of relief, when under the leadership of H. E. John Agyekum Kufuor, the nation took the unprecedented step of Ghana going the way of a National Health Insurance Scheme in 2001. The legal instrument to that effect was finally ratified in 2003.

Mr Speaker, the relief of the Ghanaian was seen in the very palpable rise in access in hospital care in the aftermath of the implementation of the Scheme.

Mr Speaker, it is worthy of note that our national constitution frowns on discriminatory practices as enshrined in article 17 (1), (2), & (4:d).

Mr Speaker, it is of interest to note that the NHIA, under its own study is aware of the fact that instead of creating equality or an improvement in health access, the implementation of the ‘Capitation' programme in Ashanti has skewed ‘Out- of-Pocket' expenditure against the people of Ashanti.

Mr Speaker, the expected effect of the advent of the NHIS is a reduction in the Out-of-Pocket Expenditure for seeking healthcare services in the country. That may also reflect an increase in general government expenditure, as shown:

1995. 2000. 2005. 2006. 2007. 2008. 2009. 2013

General Government expenditure 44. 41. 53. 55. 62. 59. 53 on health as a % of Total Health Expenditure (THE), %

Out-of-Pocket Expenditure as a % of Total Health Expenditure 44. 47. 37. 35. 30. 33. 37. 36*

Out of Pocket Expenditure 64* For Ashanti as % THE after Capitation

The above data shows a clear and consistant reduction in Out of Pocket expenditure after the implementation of the National Health Insurance Scheme.

Whereas, for citizens in a control population out-of-pocket expenditure for healthcare is 36% of per capita health care expenditure, citizens of Ashanti, per caput, have to expend 64.%, nearly double, out- of-pocket for a similar venture.

Mr Speaker, the difference in the two environments is the implementation of a Capitation Policy in Ashanti!

Mr Speaker, by the implementation, first, through a ‘Pilot' and then a so-called ‘Phased Implementation' the issues of Discriminatory Treatment with respect to access to health care and Discriminatory Catastrophic Out-of-Pocket expenditure have been broought to the fore.

Several protestations, since the initation of the ‘pilot' in January 2012, have been directed to the NHIA and the Government. No comforting response apart from a policy of extension of the implementation to cover other areas of the country have been received by the ‘victims' of this ‘experimentation'.

Mr Speaker, if Ashanti is complaining, and given the clear evidence of an associated increase in Out-of-Pocket expenditure for the Client/Subscriber, should this be allowed to be spread across the nation? To defeat the purpose of improving financial access to health care for the good people of Ghana?

Mr Speaker, in very simple terms, Capitation is akin to a ‘Retainership' of the lawyer who is paid some agreed upon amount whether services are rendered or not. The lawyer may receive extra payment when called upon to render some

services. The difference, Mr Speaker, is that this arrangement is not made to the detriment of the lawyer!

Mr Speaker, we wish to clarify for all that, we are not averse to the concept of Capitation in Health insurance management as we understand it to mean. We supported it as a means of health financing operational and sanitizing mechanism under Acts 650 (2003) AND 852 (2012), viz., Act 852, Section 37(c).

What we have frowned upon, and indeed have been against, has been the continued, hurried and botched implementation which have rather left a sour taste in the mouths of all who are experiencing it in Ghana.

Mr Speaker, as you know very well, the Capitation Mechanism involves three major Partners or Players, the Scheme, the Provider, and the Subscriber or Client.

It is normally expected that Capitation should inure to the benefit of the components lof the tripod:

1. The Scheme should be able to forecast expenditure and in the case of the Ghana-plan-of-action, also sanitize the expenditure of the NHIS.

2. The Provider should have a very healthy cash-flow and thus be able to operate rationally.

3. The Subscriber should benefit from a more respectful, client- oriented service with options ofr choice!

Mr Speaker, can one ever anticipate anything worse than the scenario painted above?

Under the Capitation Policy, which has seen several modifications, a Medical Provider was paid an average of GH¢1.73 now revised to GH¢2.75 for each client registered per month, whether the client seeks or does NOT seek for primary healthcare.

When this Client seeks for primary care no matter the number of times, the Medical Provider is NOT PAID for any services, e.g. Clinical examinations and diagnostic tests such as Hb, MPs etc. rendered, apart from the cost of drugs provided, e.g. the Provider is NOT PAID for the treatment of Malaria.

Mr Speaker, His Colleague in the other parts of the country is paid GH¢13.50 for every client seen for primary care at EVERY visit, e.g. GH¢13.50 x 3 = 40.50 for three visits in a month! Then the cost of drugs is also paid.

The perceived logic is that the per cent caput payment for the Provider in Ashanti, for ALL the registered clients should make up for the difference! But, does it?

While the Provider is paid the current GH¢2.75 and hence finds un-conventional means to survive, the Subscriber has to make un-prescribed payments amounting to Co- Payments not prescribed by the Law in order to access healthcare and thus pushing financial protection to citizens of Ashanti into jeopardy.

OPD Cases Capitation G-DRG Difference or Facility Chr. Adults Total In GH¢ In GH¢ (Loss) in GH¢

Ankase 11,358 37,836 49,194 177,520.63 439,338.60 261,817.97 Hospital

Suntresu 15,817 57,442 73,259 452,292.78 577,522.39 125,229.61 Hospital

Credit: GHS, Kumasi Metro

Income of Government Facilities in Capitated Ashanti vrs. Similar facilities under G-DRG (G-DRG = Ghana Diagnosis Related Groupings)

Mr Speaker, in a similar analysis, the Manhyia Hospital lost GH¢644,015.08! And as we speaker, the Manhyia Hospital has barely GH¢20,000.00 in its coffers.

In the face of this jeopardy, the Subsriber may or may not renew membership.

Mr Speaker, Membership in Ashanti

slumped on the introduction of the Capitation Policy. Eventhough, for good reasons it may be picking up, the pick-up is very slow. This is inspite of the little advantage of a health insurance coverage as against none at all.

A comparision between Ashanti and the usually similar control Eastern Region belies the situation:

Registration Coverage Distribution by Regions (Ashanti vrs. Eastern) Region 2013 2014

Ashanti 5,087,202 1,767,680 34.7% 5,198,546 33.7% 1,753,915

Eastern 2,791,143 996,658 35.7% 2,846,965 42.0% 1,195,990 Region

Credit: NHIA, 2014

It is interesting to note that while there is a a marked optimism for an increase in the Membership for the Eastern and other Regions, in Ashanti the NHIA in pessimism, expects a reduction in the Membership!

The only significant change in the environment is the continued imple- mentation of the Capitation Policy.

Where the Subsriber renews Membership, she will wait till she is in dire heed of healthcare before seeking for care. The end result is the increased cases of in-patient admissions of clients in Ashanti.

Mr Speaker, in the scenario shown above, it is only the NHIA that appears to benefit. And that is from its own expenditure accounts. Yes, the Scheme, flexing its national and legal muscle appears to be benefitting from so-called savings.

Mr Speaker, when a people are put to a pilot it usually brings some advantages to them. The peoples, both PROVIDERS and SUBCRIBERS of Ashanti have had to endure a pilot which to say the least is Punitive. While the businesses of Providers have been negatively impacted upon, the Subscribers have had to endure an increased Catasrophic Out-of-Pocket expenditure.

It is only the citizens in the Ashanti Region who are enduring this pain. Compatriots in the other parts of Ghana may not even understand what Ashanti is going through.

Mr Speaker, the results of the implementation of the Capitation Policy has amply demonstrated that it is Discriminatory, and it has defeated the

purpose of increasing financial access to healthcare by reducing ‘Catastrophic Out- of-Pocket' expenditure.

Indeed, a Private Consultant who was contacted by the Authority concluded dthat he could neither recommend the continuation nor the extension of the policy in its current form!
Mr Speaker, we therefore wish, following from the above, to submit that 12:40 p.m.
1. taking cognizance of the breach of our national constitution as per the articles referred above, and the fact that,
2. instead of ameliorating the out-of- pocket expenditure for subscribers, the Capitation Policy has rather increased the per capita out-of-pocket expenditure.
3. instead of improving the cash-flow of Providers and thence the operational and service provision of the Provider, the Government, through the Honourable Minister for Health be urged by this August House, to immediately terminate the implementation of the Capitation Policy in Ashanti.
We also call on the august House, to urge the Minister to ensure the NHIA collaborate with all stakeholders to craft a compensatory mechanism for the Subscribers and Providers of Ashanti who have had to endure the experiment of a botched Capitation Policy.
We thence caution all Honourable Members, to ensure the good people of our various Constituencies are NOT exposed to the Manner and Form of a Capitation Policy that has been pushed down the throat of the people of the Ashanti Region.
Mr Speaker, I beg to move.
Mr Speaker 12:40 p.m.
Hon Members, I have given enough time to the Hon Member who moved the Motion. You have to be very brief. Go straight to the point.
Dr Kwabena Twum-Nuamah (NPP -- Berekum East) 12:40 p.m.
Mr Speaker, I beg to second the Motion on the floor by stating that any form of healthcare financing mechanism has a prime motive of increasing access to healthcare to the needy and the poor.

Mr Speaker, the insurance authority itself in its own target for 2014, is envisaging that the active membership in the Ashanti Region is going to be reduced. Mr Speaker, I would crave your indulgence to compare the figures in the Ashanti Region with the Eastern Region --
Mr Speaker 12:40 p.m.
Is it different from the figures given to us by the Hon Member who moved the Motion? If it is the same, then --
Dr Twum-Nuamah 12:40 p.m.
Mr Speaker, it is different. The Hon Member gave cost, but I am giving the number of active members of the Health Insurance Authority in the various regions. [Hear! Hear!]
Mr Emmanuel K. Bedzrah 12:40 p.m.
Mr Speaker, the Hon Member is quoting from a paper. We would want to know where he is getting his quotation and all the figures from.
Dr Twum-Nuamah 12:40 p.m.
Mr Speaker, the source I am quoting is from the Insurance Authority -- [Interruption] -- National Health Insurance Authority, as part of their programme of works for 2014. This is the target the Authority is envisaging to achieve.
You remember in the Budget Statement, the Hon Minister for Finance stated that they would want to increase active membership by 10 per cent in 2014. These are the details, how that increment can be achieved and it is already before the House and I am quoting from it.
Mr Speaker, the Authority envisages to increase the membership in the Eastern Region to 1,195,990 in 2014 with the percentage increase of 42 per cent. However, in the Ashanti Region, the Authority envisages that the active membership would reduce from 1,757,680, thus a percentage of 34.7 per cent.
Mr Speaker 12:50 p.m.
What is the title of the document?
Dr Nuamah 12:50 p.m.
Mr Speaker, it is the Health Insurance Authority's programme of work for 2014. It is captured in the budget.
Mr Speaker 12:50 p.m.
Very well. He says the source is the budget. Is the source the Budget Statement? Let us get the point clear.
Dr A. A. Osei 12:50 p.m.
Mr Speaker, as you are aware, when estimates are given to us, the agency provides further particulars to the committee before the committee can report on the budget. So, that was provided to the Committee and it was captured in the budget.
Mr Speaker 12:50 p.m.
Have you looked at the budget of the National Health Insurance?
DrTwum-Nuamah 12:50 p.m.
Mr Speaker, the Committee is supposed to meet the Authority for them to conclude on their formula for 2014 and these pieces of information are captured in the formula for 2014 for the Authority. It is yet to be laid. I think the Hon Majority Leader made mention that this Motion may have an effect on the Papers to be laid.
Thank you, Mr Speaker.
I am saying the authority --
Mr Speaker 12:50 p.m.
Hon Members, I know as a fact that there is a working relationship between the Select Committee on Health and the National Health Insurance Authority. If the Hon Member says that is the source of his information, then I think we should allow him, unless somebody says that the document that he is referring to does not exist but he has told the House the source of his document.
Dr Twum-Nuamah 12:50 p.m.
Mr Speaker, I am saying that the Authority envisages that in 2014, the active membership in Ashanti will reduce from the present level of 1,767,680, thus a percentage of -- [Interruption]
Maj (Dr)(Alhaji) Mustapha Ahmed (retd): Mr Speaker, I am just seeking your guidance. The document that he is referring to has not been laid. So, as far as I am concerned, it is a draft.
Mr Speaker 12:50 p.m.
Hon Members, the person is not out of order. He comes and says that this is what he has been told and there is a document to back it. So, somebody rose on a point of order to give us the source and he has tried to explain the source of his information. Unless
members of the Committee can say that no meeting of that nature took place or no document of that nature has been supplied to them at the Committee level, we may have to proceed.
Mr Kyei-Mensah-Bonsu 12:50 p.m.
Mr Speaker, as you have noted, the Member is quoting from an official publication and an official publication needs not be tabled in this House. It needs not.
Mr Speaker 12:50 p.m.
Hon Minority Leader, I have already ruled on that matter -- [Interruptions.] Let the Hon Member continue.
Dr Twum-Nuamah 12:50 p.m.
Mr Speaker, the Authority envisages that in 2014, the active membership in Ashanti will reduce by 1 percentage point to 1,753,915. Mr Speaker, the question I ask is, if all forms of health care financing is targeted at increasing access and we have all agreed that health insurance has come to increase the access and the payment mechanism is going to rather reduce the active membership in the largest population in the country, I do not think such payment mechanism should be allowed or should be extended to the other regions.
Mr Speaker, the Authority itself contracted a consultant to go into the effects of the Capitation. As part of the conclusions from the consultant, he stated that he can neither recommend the continuation nor the extention of this policy in its current form.
Mr Speaker, the Authority is envisaging to extend the Capitation to three other regions in the country in 2014.
The question is, if piloting this in the Ashanti Region has brought these negative results and all these challenges, why is the Authority trying to extend this payment mechanism to other regions in the country?
Mr Speaker, I shudder to say that if this mechanism is extended to the other regions, then the target of the country increasing the level of active membership in 2014 will not be achieved.
If Capitation has reduced the active membership in Ashanti, it is going to do the same to any of the regions that is going to be enrolled -- [Interruption.]Mr Speaker, as has been stated by the Hon Member who moved the Motion, Capitation in itself is not a bad thing, but it is the way it has been implemented that has led to all these challenges.
Mr Speaker, a country like the State of Israel that has hundred per cent active membership rate also practises Capitation. But what they do is that, in coming out with the figure per capita, an appellate body is constituted and all interested parties will present their proposals how much should be charged for per capita.
This Committee meets once a year in the last quarter of the year and they meet for three weeks. After the deliberations, they are able to come out with an acceptable payment that is accepted by all sides.
Mr Speaker, what happened in Ghana? The Authority has now become the judge, the jury, the prosecutor and I would dare say that the accused. The Authority itself would come out with the per capita payment and also --
Mr Speaker 12:50 p.m.
Hon Member, conclude --
Mr Dominic A. Azumah 12:50 p.m.
Mr Speaker, listening to the Colleague, he made a certain statement and I think that it is not factually correct.
Mr Speaker, he was giving us active members from the Ashanti Region and creating the impression that it is the Ashanti Region alone that is suffering that kind of thing.
Mr Speaker, from the records available for the approval of the formula, Greater Accra Region has an active membership of 1,463, 349, that is about 34.4 per cent, but in 2014, the active membership is 1,397, 057. So, it cannot be that it is because of Ashanti Region, for that matter. That is not wholly correct,Mr Speaker. So, he should address the issue properly.
Mr Speaker 12:50 p.m.
Hon Member, conclude. I am not going to take a point of order on this matter. Conclude and let me open the floor.
Dr Twum-Nuamah 12:50 p.m.
Mr Speaker, from all the above information that have been extolled in the House, I would entreat Members of the House, we are all Hon Members of Parliament -- healthcare is the most important ingredient on everybody's table.
I would entreat Members to support this Motion, to ensure that the import of health insurance which has brought a lot of advantages to Ghanaians, especially the vulnerable, I mean women, children, the aged and disabled. We used to have the phenomenon where people who were rich would go to Korle bu and paid for the health cost of people who had been detained --
Mr Speaker 12:50 p.m.
Hon Member, conclude.
Dr Twum-Nuamah 1 p.m.
This phenomenon is no more in existence.
So, we should not allow out-of-pocket payment to come back into our body politic.
With this, I would entreat all Members to support this Motion to ensure that healthcare is improved.
With this, Mr Speaker, I thank you for the opportunity.

Question proposed.
Mr Speaker 1 p.m.
Hon Majority Leader, are we putting the vote on the Motion today? If we are putting the vote on the Motion, then I would exercise my discretion under Order 78(k) which you have drawn my attention to. But if we are not taking the vote today, we may have to wait till tomorrow and you come under Order 80 (2). It depends on whether we are taking the vote today.
Dr Kunbuor 1 p.m.
Mr Speaker, why I am alluding to the urgency of this matter is that, dependency of this Motion is what is holding back our consideration of the Formula of the National Health Insurance. This is because the substance of the issue before this House would determine whether the formula should be allowed to create an expenditure line on “Capitation”. I think it is in the interest of this House and this country that the Motion be taken today and that is why I intend to come with the amendment.
Dr Anane 1 p.m.
But before you do so --
Dr Kunbuor 1 p.m.
If Mr Speaker indulges me --
Dr Anane 1 p.m.
Mr Speaker, there is no bearing, no relationship between this Motion and the submission of the formula and therefore, the Hon Majority Leader should not --
Mr Speaker 1 p.m.
Hon Member, the issue of relationship was discussed at the Leadership level. Listening to the Hon Member who supported the Motion, he indicated that they wanted to extend it to other regions and so, if this Motion is carried, it means therefore, that we cannot extend it. Therefore, whatever allocation is made in the formula would have to be deleted. So, there is a relationship between this Motion and our final outcome.
Dr Kunbuor 1 p.m.
Mr Speaker, we should not be in a hurry; this is just one reason for the urgency. I am coming to another important matter. So, the Hon Member should be patient and listen to me.
The Motion as it stands, is inviting this House to come and do something illegal. Mr Speaker, it is a serious matter for a House to be seen two years down the line after the --
Mr Speaker 1 p.m.
Hon Member, that is a different point -- that does not touch on urgency. I would want you to find out whether I should admit the Motion under 78(k) by exercising my discretion under urgency. So, you need to convince me.
Dr Kunbuor 1 p.m.
Mr Speaker, all I am indicating is that, if we were to proceed and take this matter today, only to find that in substance, we should not have proceeded with the Motion in terms of the way it is worded, it is quite a serious matter and I believe an urgent matter also means a very important matter that goes
to the root of legal consideration. That is the context in which I am using urgency, Mr Speaker.
Mr Speaker, I am saying this to draw your attention to the legal position. Capitation is being presented here as if it were only a programme. Capitation is a payment system prescribed by law. If you go to section 37(c) of the National Health Insurance Act, 2012, which was passed in this House, that Act 852 that he himself mentioned, you would see clearly that Capitation is a recognised and legitimate payment system. [Hear! Hear!] Mr Speaker, that is not the only matter.

Mr Speaker, let me read the provision for you --
Mr Speaker 1 p.m.
Hon Majority Leader, let us take the issues one by one. You would want to amend the Motion --
Dr Kunbuor 1 p.m.
A slight amendment to the Motion --
Mr Speaker 1 p.m.
Yes.
Dr Kunbuor 1 p.m.
I am presenting a justification as a preliminary for Mr Speaker to give me that indulgence. So, when that indulgence is granted me and the amendment is brought, then the details would be indicated. So, I was actually seeking Mr Speaker's leave, so that I could even indicate the proposed amendment for consideration of the House.
I am saying it is important, because it goes to even enrich the Motion as it
stands. I did hear the Hon Member who moved the Motion says he wants this matter to be considered at a national level and indeed, the amendment I am proposing lifts it to that national level for national consideration.
Mr Speaker 1 p.m.
Let me listen to your amendment.
Dr Kunbuor 1 p.m.
Thank you, Mr Speaker.
Mr Speaker, I am only seeking to say that as the Motion stands, let us simply delete the word “terminate” and add the word “extent” and then we come to the “end of Ashanti Region” and add “to other regions of Ghana”.
Mr Speaker, I beg to move, that the proposed amendment should read;
“That this august House urges the Hon Minister for Health to extend the ongoing Health Insurance “Capitation” programme being implemented by the National Health Insurance Authority in the Ashanti Region to other regions of Ghana.”
Mr Speaker, this automatically takes away the discrimination that is anticipated by the Hon Member who moved the Motion of either residents of Ashanti or citizens of Ashanti, it will not arise and in that, we are also keeping faith with the fact that it is a legitimate legal requirement. And the only reason you can terminate its implementation, is to amend the law. Inasmuch as it remains part of the law and the Authority thinks it is implementing it, it is not doing anything wrong for this House to urge the Minister to get a termination, Mr Speaker.
Mr Speaker, I would like the Table Office to have the version of this proposed amendment and if you grant me the opportunity, I would indicate why I think this amendment is useful.
Dr A. A. Osei 1 p.m.
Mr Speaker, I am waiting for the amendment to be properly read and seconded, then I would comment on it. This is because it has not been seconded yet.
Mr Speaker 1 p.m.
Hon Members, I asked a question earlier whether we intended to take the vote on this matter today. If we intend to take the vote on this matter today, then I will admit it, especially, when it is linked to the consideration of the National Health Insurance formula. So, for those two reasons, I intend to admit the Motion, so that we can have all of them debated, and then the House can take a decision. I am doing so under Standing Order 78(k).
Papa Owusu-Ankomah 1:10 p.m.
Mr Speaker, I am not sure that the text as read is what the Hon Majority Leader sought to propose -- because -- [Interruption] - -That is what I said, Hon Majority Leader. I said the Hon Member for Madina -- Mr Speaker, I thought I heard the Hon Majority Leader say that he wanted the word “terminate” to be substituted for “review.” [Interruption.] Oh! I see.
Dr Kunbuor 1:10 p.m.
Mr Speaker, I am much obliged; the substantive text is here before the Table Office and I respectfully want to move an amendment to item number 6, that:
“This House urges the Hon Minister for Health to extend the on- going Health Insurance Capitation programme being implemented by the National Health Insurance Authority in the Ashanti Region to other regions.”
Mr Speaker, my amendment is to other regions and if the capacity of the Authority is to cover the rest of the nine regions, it is still other regions. If their capacity is for five, it is still other regions.
So, Mr Speaker, under Order 83, the basis of what we seek to do is just to delete the word “terminate” and insert the word “extend” and then to add at the end of “Ashanti Region”, the words: “to other regions”.
Mr Speaker, as I have indicated, a house that makes law -- [Interruption.] Is he on a point of order? [Pause.] Mr Speaker, as Leader, at least, once I see Hon Members standing, I would resume my seat.
Mr Speaker 1:10 p.m.
The Hon Member is moving his Motion. Yes, I have admitted the Motion under 78 (k); he is moving the Motion.
Mr William O. Boafo 1:10 p.m.
Mr Speaker, I would want to seek your guidance.
Mr Speaker, Order 78 (k) mentions “Motions”, -- Urgency relating to Motions. But this is amendment to a Motion and I am wondering whether --
Mr Speaker 1:10 p.m.
Motion includes an amendment to Motion. This is because if his Motion is accepted, it becomes the Motion. So, his amendment is also a Motion.
Mr Boafo 1:10 p.m.
Mr Speaker, in this case, the rules expressly mention Motions. And earlier, (d), we have amendment to Motions, which is exempt but not -- (d), we have amendment to Motions --
Mr Speaker 1:10 p.m.
But you have seen that the (k) is an omnibus provision in the Standing Orders vesting discretion in the Chair and that is why I posed the Question to make a case whether it is urgent and he gave two reasons. One of the reasons is because of the issue of the fact that the House has programmed on the Order Paper today to take the formula.
The outcome of this Motion would determine what happens in the formula
that would be approved and the fact that we want to take the vote on this matter today and dispose of it.
So, it is on that basis that I have admitted it; it has been admitted. It is for the House to decide at the end of the day where we need to go.
Mr Boafo 1:10 p.m.
Mr Speaker, I thought you were going to apply the rule relating to expressio unius exclusio alterius in this particular case. I was just looking whether you would apply that rule of interpretation, expressly providing for consideration of Urgent Motion and excluding urgency of amendment to Motion, especially when the Hon Member moving the Motion has given sufficient notice and he is being taken unawares by this amendment. [Hear! Hear!]
Mr Speaker 1:10 p.m.
Hon Member, that is why I started by saying, if the vote would be taken tomorrow, then I would go by Order 80 (2). That is why I posed the Question to the House and nobody has objected to the vote taken; nobody has spoken. Please, Hon Members, I posed the Question to the House and a copy of the Hansard is there.
That is why I posed the question, that if the vote is going to be taken today, then I would come under Order 78 (k); if it is not going to be taken today, then I would come under Order 80 (2) and nobody has raised any serious objection to this matter. And then I went further to ask the Majority Leader to convince me why it should be taken under Order 78 (k), and he gave certain reasons. Now, I went on to admit it and you are taking an objection to it.
Hon Members, you see, the rules are very clear. I was expecting somebody to oppose it when I posed the question to you. Nobody opposed it; the record is there. Even the Hon Member for Old
Tafo, Dr A. A. Osei said that he wanted somebody to second the Motion, so that he would contribute. So, Hon Members, it is not the best way to handle these matters.
Mr Kyei-Mensah-Bonsu 1:10 p.m.
Mr Speaker, having listened to the Hon Member who moved, the prime Motion, if maybe, the issues involved cannot be settled today and maybe, it has to go to tomorrow and the days after, it rests with you, taking the sense of the House to so direct. But in reality, if a Motion comes by notice and is so admitted, an amendment Motion to it should also come by notice.
Mr Speaker, that is so. The rules are clear and you just mentioned it -- Order 80 (2) provides -- and indeed, Order 79 (6) provides that no notice shall be given orally as the Majority Leader sought to do. Mr Speaker, no notice shall be given orally in the House. Then Order 80 (2) provides and Mr Speaker, with your permission, I beg to quote:
“A motion of which notice is required proposed by a Member . . .”
This is what the Hon Anane did,
“. . . or a motion to amend a motion of which notice is required or an amendment to a Bill may be debated twenty-four hours after notice has been given.”
It cannot be orally given. If Mr Speaker, you are going by the fact that in urgent circumstances, you may consider this as an Urgent Motion, I am not too sure that the Order 78 provides for an amendment Motion. It talks about a Motion -- a substantive Motion. An amendment Motion is not covered by Order 78 at all.
So, if the Majority Leader seeks to amend a Motion which has been properly
Mr Haruna Iddrisu 1:20 p.m.
Mr Speaker, I believe that when you posed the question whether the debate and conclusion on this subject was to be taken today or extended for 24 hours, we ignored it at a cost, which ignorance is what is motivating the opposition to your ruling.
Mr Speaker, with your permission, let me quote Standing Order 78 for emphasis 1:20 p.m.
“Unless any Order otherwise provides, notice shall be given of any motion which it is proposed to make, except the following --
So, Order 78 provides exceptional provisions that one may proceed further -- Except under the circumstance mentioned. And the circumstance is provided for in Order 78 (d):
“a Motion to amend a Motion...”
Mr Speaker, the headnote of this Standing Order -- Part thirteen is important. It reads;
“MOTIONS AND AMENDMENTS”.
So, it says, and I beg to continue:
“a motion to amend a motion of which no notice is required --”
There is another “or”. So, do not ignore the “or” that “or” is for any purpose of interpretation, it has a meaning:
“. . . or which is debated twenty- four hours after notice has been given,”
It for this reason that, Mr Speaker, you posed your earlier question, which was ignored by them -- because if they wanted the debate after 24 hours, that would have guided your ruling on this particular matter.
Dr A. A.Osei 1:20 p.m.
Mr Speaker, on the floor of this House generally, when you pose the kind of question you posed, it is not up to the ordinary questions to move forward. We leave that to Leadership. The question was whether we were going to vote on this. We were waiting for Leadership to consult. Under normal circumstances, Hon Members do not get up and say, yes. That is the practice.
So, it is not up to some of us. I got up, but I was hoping that Leadership will consult. They did not consult. So, it is not that we were ignoring you. I think that point should be noted.
Mr Alban S. K. Bagbin 1:20 p.m.
Mr Speaker, the subject under consideration is so critical to the health and wellbeing of Ghanaians. And I believe that is why you admitted the Motion.
But Mr Speaker, I think the way we are going about it, we are unlikely to come to a conclusion that could assist this country in improving upon the payment system that has serious challenges.
So, Mr Speaker, I am going to humbly suggest that we postpone debate on this Motion and Leadership should put their heads together to get the Motion properly worded for us to debate.
Mr Speaker, as a former Hon Minister for Health, I know very well that the “Capitation system” that is being implemented has a lot of challenges. Luckily, the Hon Majority Leader was also an Hon Minister for Health. And there have been studies to try to see how we could improve upon the system before extending it to other regions.
Mr Speaker, when I was in office, I did make a Statement that when that is done, the Ashanti Region has to be compensated in a way. This is because the Ashanti Region being used as a pilot region, has suffered some consequences.
So, I believe that, Mr Speaker, it is a Motion that is worthy of consideration of this House but not in its current form.
Mr Speaker, I also thought my good Friend, Hon Dr Anane, would have allowed somebody else to move such a Motion in view of the fact that by his profession and his practice, it might be bordering on conflict of interest. I am not certain; I am just raising it. This is because when one reads the article, it talks about “perceive”.

Mr Speaker, that is not the main issue I am raising. The main issue is that, I think we should postpone the debate, reconsider the wording of the Motion and truly debate this issue of “Capitation” and the National Health Insurance Authority to do the right thing for the country. It is very important.
Dr Anane 1:20 p.m.
Mr Speaker, ordinarily, I would not have responded to my Colleague “Wiseman”. But Mr Speaker, it appears that, maybe, there may have been some misunderstanding.
Mr Speaker, I am a doctor, no doubt about that. I practise in the teaching hospital and I have a private facility.
But Mr Speaker, you would notice that in my presentation, what I said was that, I am not going to the private sector; I am only making a presentation on the public sector and not even going to the regional or teaching hospitals but to the relatively smaller hospitals.
Mr Speaker, in addition to that, you do know very well that I have played a very, important role in the evolution of health insurance in this country. Therefore, if anything is going to cause it to be destroyed, Mr Speaker, I think as a representative of the people of this country, it is my right to get up and make sure that it is righted.
Mr Speaker, the appeal was not about just Ashanti Region, but I was using Ashanti and the experience of Ashanti to advise us, so that we here will help the National Health Insurance Authority in decisions that they make. That was why I said they were calling for a national bi- partisan approach to this measure.
Papa Owusu-Ankomah 1:20 p.m.
Mr Speaker, if Hon Colleagues observed when the Hon Majority Leader was moving his Motion, I went and consulted my Hon Colleague the Hon Member for Nhyiaeso (Dr Anane) and it was along the same lines as the Hon Member for Nadowli/Kaleo suggested to this House.
Mr Speaker, some of us are really not familiar with this “Capitation”, But having listened to the submission, I thought that it was a matter that we needed to try and build a consensus on , if possible, and debate it. Really, if the argument being advanced is that, there are major challenges and it should not be extended and there is a view that it should be extended, they must also have some very good reasons.
So, I was thinking that despite the urgency of the matter, we should try and put our heads together and see how we can advance the cause of the people of this country. Certainly, I do not want to bring you into this debate but sometimes, agencies say that they have the right to do something. They may be doing something. They may have the legal right but it may be problematic.
So, if the Hon Member for Nadowli/ Kaleo is suggesting that we take some time off and then reflect while having discussions, I believe that it would be in the interest of the country and this House, if we followed that course and then returned and debated it. We may not all agree, but then, we will be debating in a manner that will enable the NHIA take on board concerns that have been expressed on the floor of this House.
Dr Kunbuor 1:30 p.m.
Mr Speaker, definitely, we have been having a lot of consultations on this matter and the Hon Member for Nadowli/Kaleo did make a proposal to my amendment, which in my opinion, is acceptable. It only needed another word added, that we should review and extend, and I have no objection to that. My objection was to take the Motion in the form in which it was made and that was why I was seeking my amendment.
Mr Speaker, you see why it is important to subject the Motion as it is to -- The Hon Member who moved the Motion has just introduced another dimension, that the Motion is about the public sector Capitation and not the private sector -- [Uproar] -- And that Mr Speaker --
Mr Speaker 1:30 p.m.
Hon Majority Leader, he was responding to the point raised by the Hon Member for Nadowli/Kaleo who said that he limited himself to the public sector. He had a facility in Kumasi and to avoid the perceived conflict of interest, he was responding to it.
Dr Kunbuor 1:30 p.m.
Mr Speaker, I know exactly why I was putting that in context. He equally, in his submission, was already making comparison among doctors in other regions in terms of their fortunes and how much they earn where Capitation is prepared. He did not make a distinction between the public and the private. When he mentioned GH¢1.00 something and GH¢13.00, he never made a distinction between public and private.
So, all that I am saying is that, the Motion is pregnant with a lot of interpretations and that is why it is significant for us to re-work it, which I am
Dr Anane 1:30 p.m.
Mr Speaker, just to make a correction. I am not sure the Hon Majority Leader did listen. Mr Speaker, what I said was that, I was comparing facilities, I was not comparing doctors, and I wish the Hon Majority Leader would take note of it -- [Interruption.]
Dr Kunbuor 1:30 p.m.
Mr Speaker, he said “fees”; he mentioned “fees”.
Dr Anane 1:30 p.m.
Facilities collect fees, Mr Speaker.
Mr H. Iddrisu 1:30 p.m.
Mr Speaker, I would want an opportunity to second the amended Motion and make a comment on only one major issue to tie it up with the brilliant submissions by Hon Bagbin and Hon Papa Owusu-Ankomah, and that is what our rules require to have the Motion seconded.
Mr Kyei-Mensah-Bonsu 1:30 p.m.
Mr Speaker, I believe we are at a critical junction, to proceed or not to proceed. Mr Speaker, if it is that as the Majority Leader has sounded, that he is determined to present his Motion and we see a Minister of State warming up to second the Motion, we are equally ready to debate it.
But we should look at what we intend to achieve. The Motion indicates that the Minister for Health should terminate the ongoing Health Insurance Capitation
Programme in Ashanti. What the Majority Leader has also indicated is to have the word “terminate” substituted for the word “extend”.
I think the issue raised by the mover of the Motion was that in its current form, that programme is not the best. If it is not the best and it has to be extended, it would rather impose additional hardships on the entire populace. That is why the Majority Leader is admitting that he would be amenable to including the words “reviewed” and “extended”. I think that would capture the sense.
So, I guess that where we are, we may have to suspend it for the proper thing to be done, for the new amendment to be properly proposed, so that everybody can speak to it and we would be very clear in our minds.
So, Mr Speaker, I would urge that at this juncture, we suspend the debate on the matter pending the time when the Majority Leader would submit --
I would want, to plead with the Majority Leader to be looking at me and be listening because every now and then, he is turning and he is listening to his backbench and he may make some interventions that may not perhaps, be in line with what we are saying.
May I suggest to him that he comes properly with his amendment -- [Interruption] -- Mr Speaker, may I take it that he is coming up on a point of order? If it is a point of order, I would concede.
So, I would want to plead that he comes with a better rendition of his amendment, then we suspend and debate it tomorrow or anytime that the Business Committee in consultation with the Speaker, may agree on.
Dr Kunbuor 1:30 p.m.
Mr Speaker, I intend to proceed with the leave that you have granted me but I would seek further slight indulgence to incorporate the suggestion that has been made by the former Leader of this House. If indulgence is granted, I would simply insert the word “review and extend”, so that the Motion as amended would read the way that is acceptable, I guess, to the Hon Member for Sekondi and to the Minority Leader; and to proceed to move it because the justification for that does not even go beyond five points.
Mr Speaker, the foundation alone that was laid in relation to this Motion in its present form that I strongly object to was quite detailed. That is why the response and justification why it should not be taken, should be allowed and be taken, Mr Speaker.
So, Mr Speaker, I understand that you have granted me the first level of leave to move my amendment --
Mr Speaker 1:30 p.m.
Hon Members, the point is being canvassed on the floor of the House, that in the interest of the people of this country, we should try to work out a certain compromise on this matter. It appears that compromise has been endorsed virtually by the two Leaders and indeed, by necessary implication by both sides of the House.
Now, you have raised another matter that because of the issues raised by the mover of the Motion, you would want to be offered an opportunity to clarify them before you go for the consultation. Is that what you are saying?
Dr Kunbuor 1:30 p.m.
In fact, Mr Speaker, that was what I intended to do while I was moving the Motion. But I have taken a
cue from you, that as Leadership, we should be seen to be the first in line for understanding. I would have another opportunity to engage the substantive issues that he has raised, Mr Speaker.
So, I would not pursue that matter of a response now. But there are very serious inaccuracies that were actually raised in his submission and I intend to engage him if not for nothing at all ,as a former Minister for Health, who has worked in that Ministry before.
Mr H. Iddrisu 1:30 p.m.
Mr Speaker, I take guidance from you and the earlier submission, but I would want to further seek an amendment to what has been proposed by the Majority Leader, by the deletion of the word in the third line “implemented” by the National Health Insurance Authority; “implemented” be substituted for “piloted”.
Mr Speaker, I do so relying on the very words of the mover of the Motion, and with your permission, I am quoting his second but last paragraph, where he said:
“We had to endure the experiment of a botched Capitation policy.”
So, he himself appreciates the fact that it is a piloted programme, a piloted project.Therefore, I would want the word be “implemented” substituted for “piloted”. If you would permit me as a further amendment to the Leader's Motion, then I would respond to one other issue of discrimination he raised.
Prof . George Yaw Gyan-Baffour 1:30 p.m.
Mr Speaker, I think from the mood in the House, maybe, we need to suspend this Motion until some other time. The main reason is this. It looks like the substantive issue is being swallowed by procedures. But Mr Speaker, what the mover of the Motion is alleging is that, this being a pilot, is not serving the people of Ashanti Region any good.
Mr Speaker 1:40 p.m.
Hon Member for Wenchi, you should take the cue from your Leaders. When you do that, you create problems for the Chair.
Dr Kunbuor 1:40 p.m.
Mr Speaker, I do not like this principle in which an individual's subjectivity is raised to the standard for the entire House. This is a House of debate and as much as he is entitled to raise his point, other people are entitled to disagree. Why is it that people think when one person raises an issue, nobody should counter it?
That is not what democracy is about. I would not take away his right to raise the statement but do not take away my right to say “I disagree with him”. That is what we are doing here.
Mr Speaker 1:40 p.m.
Let me take Dr Akoto Osei and the Chairman of the Health Committee.
Dr A. A. Osei 1:40 p.m.
Mr Speaker, I would want to plead with the Leadership of the House. Earlier, my Hon Senior Colleague has suggested that it looks like we want to come to a situation where the entire House is looking at a very serious policy. In my view, if you try to agree on an amendment now, we are going to run into difficulties.
So, I plead with the Leadership, let us suspend, Leadership get together, take
your time, you are relaxed, come up with an amendment and let us continue tomorrow. We do not want to spend time disagreeing on amendments on a very major policy. So, I plead with the Leadership, let us go in that direction.
Mr Joseph Y. Chireh 1:40 p.m.
Mr Speaker, you listened to our Leaders and the suggestion that we have all been listening to is, we suspend the debate, whether to amend or to carry on with the original one and allow Leadership with those who have interest in this matter to go behind and bring something that will encourage debate without the passions.
So, I think that virtually, you have made a decision and from what has been said by other people, we should not continue with the debate.
Alhaji Mohammed-Mubarak Muntaka 1:40 p.m.
Mr Speaker, I would not want to prolong it. I think the crux of what I wanted to say is what was said, that if we could all be patient to allow the issues to be suspended while we take our time to look at an amendment that will serve the interest of this House and that of this country, it would do us a lot of good. Even if it means extending that beyond tomorrow to next week to be able to debate it very well, I think that would be most laudable.
Mr Kyei-Mensah-Bonsu 1:40 p.m.
Mr Speaker, we have come to some broad consensus on this. First, we all agree that in its current form, the Capitation Scheme is not the best. If it is not the best, it cannot be extended to other regions. It must be reviewed and improved in order for it to be stretched to the other regions.
Mr Speaker, having agreed to the principle, I think we can get together and do the formulation of the Motion and that will prevent others from, when it has come to the floor after it has been advertised on
Mr Speaker 1:40 p.m.
Hon Members, thank you very much.
Hon Members, in admitting this Motion, a lot of things happened behind the scenes, that are not known to the generality of Hon Members of the House. I was pretty aware, in admitting this Motion, that “Capitation” has been provided for by section 37 (c) -- indeed, the National Health Insurance Regulations, 2004 and then the National Health Insurance Act provides for “Capitation”.
I was very much aware. Behind the scenes, between the Clerks-at-the-Table and I and then the mover of the Motion, there had been a number of discussions.
The essence -- I would want to say it for the records, so that when you go back to consult among yourselves, you will have this at the back of your minds-- Reality of the Motion, in my understanding and why I admitted it, was whether it was discriminatory because that was the point that was raised in the draft that came to my Office.
So, I will give you the opportunity to go and consult, build a consensus round this matter, because I share the sentiments and press on the floor of the House that we cannot politicise our people.
This Motion touches on the health of our people and the politicisation should be the last resort, when discussions and consensus building have failed. So, I will defer the matter for now. If you are not able to build consensus, then we proceed. But I pray and plead with the Leadership of both sides and indeed, the generality of the whole House, that in the interest of the people, we should try and work out something acceptable to both sides of the House.
Dr Kunbuor 1:40 p.m.
Mr Speaker, if we could get some clarification on your directive, if I understood, where we reached before we got to this direction for consensus was that an amendment was proposed. In fact, leave for an amendment was made and leave was granted and we were in the process of moving the substantive Motion for the amendment. So, we have reached a point when you indicated that we will see whether we will come back to the original one.
I would want to draw your attention that Mr Speaker has already granted leave for an amendment. The form in which the amendment will take will be the subject of the discussion between both sides.
Mr Speaker 1:40 p.m.
Hon Majority Leader?
Dr Benjamin B. Kunbuor 1:40 p.m.
Mr Speaker, in the light of developments on the floor up to this point, I would humbly like to move, that the House do adjourn to tomorrow, Friday, the 14th of February, 2014 in the forenoon.
Mr Kyei-Mensah-Bonsu 1:40 p.m.
Mr Speaker, I am well informed that in my absence, a major issue cropped up in respect of a proposed meeting of the Committee of the

Whole. I was not here but I am told the Majority Leader signalled that he wanted to have some consultations with me before we can come to some determination of the matter. I was not in the Chamber. So, maybe, we may have to firm our thoughts up on that.
Mr Speaker 1:40 p.m.
The issue was raised and I said Leadership should consult on this matter. That was what I directed, that we should consult when we should hold the Committee of the Whole. It was raised by the Hon Member for Old Tafo and I said that Leadership should consult when to hold the Committee of the Whole meeting.
Mr Osei Kyei-Mensah-Bonsu 1:40 p.m.
Mr Speaker, I had some initial discussions with the Chairman of the Legal, Constitutional and Parliamentary Affairs Committee in respect of the Anti-Money Laundering (Amendment) Bill. So, if we may recline to do some winnowing on it after adjournment.
Mr Speaker, on that note, I beg to second the Motion moved by the Majority Leader.
Question put and Motion agreed to.
ADJOURNMENT 1:40 p.m.

  • The House was accordingly adjourned at 1.50 p.m. till Friday, 14th February, 2014 at 10.00 a.m.