Mr Speaker, I thank you for the opportunity to contribute to the Motion for the adoption of the Report of the Committee of the Whole on the Proposed Formula for the Distribution of the National Health Insurance Fund for the year 2018.
Mr Speaker, in doing so, I would note that this, undoubtedly, remains a major policy intervention that has better served the needs of the Ghanaian people in terms of access to quality healthcare. It is an intervention that this House must take an interest in expanding its frontiers so that Ghanaians could continue to access medical care under the NHIS.
Mr Speaker, as has been intimated by earlier contributors, our advice to the Ministry of Finance is that, they should go to the parent Act of the NHIS and the Fund. Mr Speaker, while the Ministry on pages 183 and 184 of the Budget Statement has already taken a certain portion of the money to pay for nurses allowances, it has also denied the Scheme additional resources.
Mr Speaker, we would not support such an initiative next year. The payment of allowances should not be contingent on the NHIF because that is not part of the mandate or the core object of the Fund, especially, when they have a funding gap and funding differences.
The government must find other innovative ways to raise money to pay for those allowances but not to tie it to --
Mr Speaker, actuarial studies have been done and I would have referred to it but for want of time. Most part of the studies talked about the inadequacy of the funding regime. There are those who even propose that we should add two and a half (2½) per cent Value Added Tax (VAT) to an additional half (2½) per cent to make it three (3) per cent and dedicate it to the
NHIS.
We have others who have also said that we may also want to take a percentage of the revenues from oil, even if it is one (1) or two (2) per cent and dedicate it to the NHIS.
Mr Speaker, the Ministry and particularly, the head of the NHIS is engaged in some discussions with Organised Labour, the Trades Union Congress (TUC), so we encourage them to continue to do that. If they are able to get the support of Organised Labour to leverage even GH¢5 or GH¢10 per worker per month for 12 months, then that would rake in additional resources.
What Organised Labour and TUC have demanded is transparency and accountability. Mr Speaker, probably, on matters relating to age, if we look at the law where it says persons would benefit from the distress Scheme, I think that we have to look at the age issues again.
I raise this because many Ghanaian workers retire at the age of 60 and we are saying that they could only qualify for the NHIS when they are 70 years but that 10 years gap is when they mostly need the government's support and intervention.
Mr Speaker, many of the major illnessnes; cardio related, kidney-related, liver related and other major ones are not covered by the Scheme. So, workers during post-retirements would have problems in accessing medical care but that is the time that they need it most.
Mr Speaker, in concluding, I have looked at the Formula and I would like to refer you to page 4 of the Committee's Report. Mr Speaker, with your permission, it states:
“On accrual basis, the total budget expenditure for the year ending 31st
December, 2017 was GH¢1,719.85 million as against an annual budget of GH¢2,261.74 million.”
So, it means that there is a shortfall of GH¢541 million and apart from this shortfall, government is taking additional resources from NHIS to compensate for the allowances of nurses when we should be dealing with their core mandate and business. Mr Speaker, so, the Ministry of Finance should find innovative ways to raise money to pay the nurses but not to come and depend on the NHIF and burden it further.
If they have a difficulty, then they should say so but to take those additional resources -- how would they account for it within the remit of what is being approved? What they deserve is more than what is being allocated to them.
If the Ministry of Finance would want to cap, then they should cap other areas such as the District Assemblies Common Fund (DACF) and the Ghana Education Trust Fund (GETFund) as has been done but for the NHIF, it is a no.
Mr Speaker, with these few comments and as the Hon Minority Chief Whip said, many of these allocations are on IT infrastructure but every year, we dedicate moneys for IT infrastructure and its improvement.
We would need to see a stop. Sometimes, we see a particular value for, maybe, claims and processing and it would be GH¢41 million for this year but it would have been GH¢36 million for last year. So, we would need an explanation from the Hon Minister for Health on what accounted for the variance.
In terms of capitation, it has been said that there is zero allocation in respect of most of those issues. Mr Speaker, IT infrastructure is helpful and we would continue to need it.