Statement
1 September 2015 - 5:15pm

REMARKS BY
MINISTER FOR HEALTH AND SOCIAL DEVELOPMENT
HONOURABLE RONNIE W. SKELTON
AT THE NATIONAL HEALTH INSURANCE REGISTRATION LAUNCH
TUESDAY, 1ST SEPTEMBER, 2015

Hounourable Dr. D. Orlando Smith, OBE, Premier and Minister of Finance, Hounourable Dr. Kedrick Pickering, Deputy Premier and Minister for Natural Resources and Labour, Hounourable Mark Vanterpool, Minister for Communications and Works, Honourable. Myron V Walwyn, Minister of Education, Youth Affairs and Sports, other members of the House of Assembly, Permanent Secretary of the Ministry of Health and Social Development and staff Director, BVI Social Security Board and staff, Deputy Director with responsibility for NHI and members of the NHI team, fellow residents of the Virgin Islands, members of the Media, Good Morning.

When I first became a Government Minister in 2003 one of the policies championed by then Chief Minister D. Orlando Smith now Premier D. Orlando Smith was his long-held aspiration of Universal Health Coverage for the people of the Virgin Islands. 

He envisioned a community where everyone would have access to quality healthcare and financial protection, and not just the rich, or lucky, or the well-connected but also the average citizen and resident. I must admit that, in the beginning, I was not completely sold on the idea that NHI was the best way to achieve this goal. We needed to examine the data and all the available evidence which we painstakingly did.

When the government changed in 2007 the new administration did the same thing. They commissioned new studies, and again carefully examined all the options.

We all arrived at the same conclusion after 12 years of study, that universal health coverage through pooled contributions was the logical solution from both an economic and a human rights perspective.

My conviction strengthened after serving as Minister for Health and Social Development for two terms.   I experienced first-hand the suffering of so many families year after year that could not raise the money to pay for their much needed treatment and care.

Several persons were struck with illnesses or injuries that caused them to use their entire life savings, or sell their land and or other hard earned assets to pay for the healthcare they needed to save their lives or their children’s lives.

In some instances private insurance deny the claims or their insurance ran out, and the Government would assist by providing financial guarantees to healthcare institutions here at home and overseas in order to protect our people from being denied care, or from impending financial disaster.

The BVI Health Services Authority has recorded over 24 million dollars in outstanding obligations. Millions of dollars were leaving our economy every year as demand increased for services that were not available here in the Virgin Islands,  posing a threat to our economy as a whole.

Families complained of the considerable inconvenience and expense of having to travel overseas for hospital services that, in many instances, could be provided right here at home with strategic partnerships and investments in our domestic health system. We also recognised that the diseases that were costing the most money to treat, and striking down our loved-ones in the prime of their lives, were lifestyle related diseases that were largely preventable.

Healthcare costs continued to escalate rapidly, and so did the rate of illnesses and injuries affecting our people; and diminishing the productivity of our labour force. Something had to be done. We recognized that this ‘health crisis’, is not unique to the Virgin Islands. Therefore, we investigated healthcare provision in other countries to see how they mitigated similar constraints. We found that the countries of the world with the healthiest populations and best health outcomes were the ones that provided universal access to healthcare for their citizens. Universal health coverage involves equal access to needed healthcare for all people where ever they live and work, in the formal or informal economy, poor or wealthy, Male or female, young or old. 

Investments in health not only promote social stability but also have multiplier effects for the growth of the wider economy. Simply put, investment in healthcare is good for our country.

And so, we set out to build a sustainable health system that would:

  • promote wellness and prevention;
  • revitalise Primary Health Care to promote early detection and intervention, and expand physical access to services;
  • bring more specialist doctors, equipment, and services to the Territory; and
  • provide health insurance coverage to the entire population regardless of age, gender, medical condition, employment or other status.

As our National Health Strategy began to take shape:

  • We established a Health and Wellness Advisory Council to guide the implementation of our national strategy for the prevention and control of Chronic Non-Communicable Diseases;
  • We form Strategic partnerships to recruit, train and retain quality healthcare professionals and improve the quality of clinical care to internationally recognised standards;
  • We build or we are building  infrastructure  that includes our new state-of-the-art Peebles Hospital, new Nurse Iris O’Neal Medical Centre on Virgin Gorda, an Emergency Call Handling and Dispatch Centre, and the development of polyclinics in strategic locations, one in EE/LL and the other in Capoons Bay;
  • And, we are now implementing, the long-awaited National Health Insurance System that we are here to launch today.

Ladies and Gentlemen, sometimes the right path is not the easiest one. Permit me to say that health reform and social transformation are not for the faint of heart. The Social Security Board recently celebrated its 35th Anniversary.  Those of us who have been around long enough would remember the level of fear, propaganda and protests that seized the Territory when it was first introduced.

The Chief Minister at the time, the Late H.L Stoutt was even abandoned by his own Cabinet colleagues, and he famously relied on the Opposition to make the Social Security System a reality.  Here today, 35 years after, the situation is different, my colleagues and I unanimously agreed that the NHI is the right system for the Virgin Islands.

National Health Insurance is to healthcare, what Social Security is to our pensions and employment income protection.  We cannot build a great little nation without it. We anticipated that there would be many questions and concerns about the National Health Insurance system, and we will continue to diligently address them.

As I explained before, we sought expert advice and took our time in designing the NHI model that would best suit the Virgin Islands population as a whole. We have done the feasibility and actuarial studies; we have conducted thorough research and assessments; and we have developed a sustainable plan that fits our needs. The analysis and assessments will continue as we gain actual utilisation data during the implementation phase, and the system will be adjusted to iron out any kinks over time.

Some fear that persons earning minimum wage cannot afford to pay $24 per month for comprehensive health insurance – we say to them that they cannot afford not to. This is a peace of mind investment.  It must be seen as money in the bank to take care of health emergencies and peace of mind for our relatives and our wider community.

The private insurance industry claims that NHI will cost you more. but persons with private health insurance can do the maths  and see that entire families can be covered under NHI at a fraction of the cost of private insurance.

Others say that NHI is a good thing, but it should only apply to persons who don’t already have private insurance.  When we spoke to countries of similar size that have taken that approach they found it to be unsustainable; and they are in fact looking at ways to transition to our model.

We’ve even been accused of introducing NHI as a way to pay for the new Peebles Hospital and reduce government spending on healthcare.  The truth is that with the same level of Government health expenditure, the Government will now be able to provide comprehensive coverage for the entire population. Every resident will have access to our modern facilities and services, whether in the public or private sector, without having to choose between buying groceries and paying for their visit to the doctor. With NHI they will be able to do both and not have to gamble with their health.

Fellow Virgin Islanders and residents, let me say how grateful I am for your patience and support over the years as we’ve worked to make the National Health Insurance system a reality. I am especially grateful to the NHI Steering Committee and the many professionals who served in various capacities to guide this project to successful completion. Particular mention must be made of the University of the West Indies Health Economics Unit, under the leadership of Professor Karl Theodore for their expert advice and assistance. 

Thanks also to the Social Security Board and its NHI Division for leading the charge towards full implementation. Based on the stellar performance of the Social Security Board over the past 35 years, we are confident that the NHI administration is in very capable hands. As you’ve heard, my colleagues and I have gathered here this morning to commemorate this historic occasion by completing registration and receiving our NHI cards.

Over the next several months the NHI team will  be working diligently to do the same for every man, woman and child in the Territory. This is not an easy undertaking, but I encourage you to pay attention to the notices as the various phases of the registration process are announced.

My team from the Ministry of Health and Social Development, and the Social Security Board will remain on hand to address any particular questions you have about the registration process, and to further clarify the overall design and benefits of the National Health Insurance System.

I thank our media partners for attending today’s event; and for diligently seeking factual information in order to get the NHI message out to the public.  You serve a vital role in keeping the community informed, and affording us the opportunity to hear and consider a wide range of perspectives.

Despite our diversity, a common thread that binds us together in the Virgin Islands is the ambition and drives to achieve, and become the best that we can be. 

Our health system will achieve its fullest potential. The people of the Virgin Islands will achieve the highest attainable standards of health. The territory of the Virgin Islands will be a beacon in the Caribbean, and take its place on the world stage in health. 

This is our vision, this is our goal, and this is our commitment to you. May Jehovah continue to bless us all with wisdom, courage and good health.

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