In the Government Press Conference on Monday, January 15th, it was disclosed that patients who had been treated at medical institutions overseas under Government’s aid, owe the Government some EC$18 Million.
While Government expects to be repaid, there are some patients who have benefitted from Government assistance but have not honoured their commitment to repay. Still, there are others who cannot legally afford to repay.
However, Government is seeking to recoup as much of this outstanding amount as possible, for it is now saddled with the responsibility of having to remit multiple millions which it owes to overseas medical institutions.
Permanent Secretary in the Ministry of Social Development, Mrs. Bonnie Richardson-Lake, was present at Monday’s press conference to explain how Government’s assistance for medical treatment overseas actually works:
“Every year, we are given a budget for overseas medical assistance,” she said, “but as one can appreciate, the demand on that budget is very high. We carefully screen who we would provide assistance to, so that we render assistance to those needing it most.”
She said that assistance for medical care overseas is granted only when such care is not available locally. She also noted that a comprehensive assessment of the patient or his or her close relatives is conducted by a social worker. This assessment includes a review of bank statements, land registry, and the patient’s personal income and expenditure.
She emphasized that even a well-paid person who may have insurance can still stand in need of Government assistance due to substantially high costs, and so the Ministry of Social Development tries to assist wherever it can.
“For patients and their families who are able to repay the government in installments,” Mrs. Richardson-Lake said, “a repayment agreement is signed and monthly payments are made to the treasury. The problem we have had with that, however, is that not everybody who signs this agreement honours it, and so right now we have got EC$18 Million ‘on the road’ owed by people who will not pay.”
She stated that this outstanding amount owed to Government dates back to 2016 when the agreements first started. “This is a major concern for us,” she said, “because when we lend out money, and it is not paid back, it means that there would be less money left for the people who would later need it.”
Mrs. Richardson-Lake emphasized that at the end of 2023, the Government were in receipt of bills sent by overseas medical institutions. The total of the bills now on hand exceed the 2024 budget of EC$1.4 Million. This means that this year’s Overseas Medical Assistance budget is ALREADY overrun by outstanding bills.
The Account General, Mr. Vonlee Harris, was also on hand during the conference to report on the astronomical expenses which Government has been incurring on an annual basis, in contrast to the amounts budgeted.
“The issue we are having is that medical bills are very high and the current medical assistance is unsustainable,” he said. “One patient’s medical bill can be as much as EC$1 Million. One can understand how burdensome it would be for a person to have to payback this kind of money to the treasury, even if EC$500 is paid back monthly. It can take ‘a lifetime’.”
He explained that the Law, via auditing regulations, prohibits spending in excess of EC$500,000 per annum for medical assistance. But if one patient’s expenses amount to say EC$300,000, then that poses a problem. “So something better has to be done,” he said. “It may not be a good thing to introduce thresholds, but it is something that we may just have to do. Realistically, we cannot keep expending public funds on overseas medical expenses. ‘At the end of the day’, the public can inquire how the Government will recuperate that money.”
Mr. Harris then gave a synopsis of overseas medical expenses over recent years: “For 2019 the budget for Medical Treatment Overseas was EC$2.8 Million, and the Ministry spent EC$1.5 Million; for 2020 the budget was EC$1 Million, and the Ministry spent EC$900,000; for 2021 the budget was EC$945,000, and EC$794,000 was spent; for 2022 with a budget of EC$468,000, the Ministry spent EC$1.3 Million. In this case, a supplementary budget had to be enacted.”
“As far as medical loans are concerned,” he said, “in 2015 loans amounted to EC$177,000; in 2016 they were EC$500,000; in 2017 they amounted to EC$1.5 Million; in 2018 they amounted to EC$3.2 Million; in 2019 total loans were EC$5.3 Million; in 2020 they were EC$7.9 Million; in 2021 loans amounted to EC$9.9 Million; in 2022 the figure was EC$11.9 Million. To date, patients owe EC$18 Million to Government for these loans.”
The Honourable Minister of Social Development, Ms. Dee-Ann Kentish-Rogers, mare reference to the cuts that were made on social programmes in 2021, pending the introduction of GST. She said “the programs had to be staggered or cut back due to delays in Government’s revenues, for the pending GST was delayed at that time. Government’s current finances would not have been able, at that point in time, to cover those expenditures.”
“I do not want people to have the idea that the Government cut back on those social programmes just because it was our intention to do so,” she said. “It was not like we did not care about our people and their needs.
“At that time we were ‘between a rock and a hard place’ and we were asked [by the authorities] if we delay the implementation of GST how we were going to pay for these social programmes. We could not finance all the programmes, without implementing the Goods and Services Tax.”
“So, it turned out that we could not pay for medical treatment overseas without implementing the Goods and Services Tax,” the Minister indicated. “It is important for us to understand that. And I think this situation that we are in now, with these high medical bills, which are outstanding, is a good example of the things that must be taken in consideration around the implementation of the GST.”
