President of the Pharmacy Board of T&T Andrew Rahaman claims the National Insurance Property Development Company Ltd (Nipdec) is owing 290 pharmacies millions of dollars for services rendered under the Chronic Disease Assistance Programme (CDAP).
The pharmacies, which have been awaiting payments for the past eight months, are now threatening to withhold services to thousands of CDAP patients until they are paid.
Yesterday, however, Health Minister Terrence Deyalsingh said the issue was never brought to his attention by Rahaman and that the Sunday Guardian was the first to raise the issue. He described the situation as “very disturbing.”
“I will get to the bottom of this issue. I do have a meeting with Nipdec’s chairman Michael Toney at 6 pm today, so I would certainly raise it with him,” Deyalsingh said.
Deyalsingh could not say how much the pharmacies were owed, however, since he needed to speak with the ministry’s permanent secretary, who would then have to obtain that information from the accounts department. He promised to do so tomorrow.
However, Deyalsingh complained, “He (Rahaman) just runs to the media for every little thing.”
Deyalsingh said that he found his ministry in a total mess and he had to fix things one by one.
“It’s a wreck. I am assuring that all matters in the Ministry of Health are sorted out, whether it is maternal deaths, H1N1, Zika. The ministry is just in shambles,” he said.
The minister gave the assurance he had received no formal request from the Pharmacy Board membership or its president on the matter.
“All stakeholders that have issues to be resolved have always found the ministry ready and willing to meet around the conference table, to enter into meaningful dialogue in an atmosphere geared toward problem solving based on mutual trust, understanding and confidentiality, the hallmarks of successful negotiation,” he said.
Deyalsingh said it was therefore not his intention to enter into a public media discussion with Rahaman or the board’s membership, but he appealed for dialogue on the issue so their concerns could be addressed.
Told that pharmacies have also been dispensing CDAP drugs without signing a 2016 contract with Nipdec, Deyalsingh responded, “All that is news to me.”
On Friday, Rahaman said collectively the pharmacies “are owed millions of dollars” but could not quantify the sum involved.
Asked what was causing the delay in payments, Rahaman said he believed that Nipdec was short of funds.
For months, Rahaman said, “some pharmacies have been clamouring to stop dispensing CDAP until they are paid.
“I have been pleading with them to act in good faith in the hope that the Government pays the money. However, some pharmacies have stopped dispensing CDAP until further notice, because eight months is a long time to be carrying the cost for the Government. I am not aware of any pharmacy that has been paid since June of last year for dispensing CDAP medication.”
In some instances, Rahaman said, “I am aware of pharmacies turning away CDAP patients because they are in somewhat of a protest, while others are on the verge of closure because of the quantity of monies being owed by Nipdec.
“They (pharmacies) cannot continue to pay their staff. They are dependent on CDAP in providing the service.” Rahaman said despite their making enquiries about the non-payments, answers have not been forthcoming from Nipdec, which recently appointed a new board.
“There was a time a board was in place and the pharmacies were still not being paid,” he claimed, adding that pharmacies were supposed to be paid on a monthly basis.
He said the pharmacies that are contracted by Nipdec provide an essential service to citizens. Nipdec provides the CDAP medication to the pharmacies, which in turn fill the prescriptions for patients. The pharmacies are paid on the basis of the number of prescriptions filled, he explained. Rahaman said Nipdec procures medication for the ministry.
Rahaman also complained that there was a scarcity of drugs at health centres and hospitals by as much as 30 to 40 per cent.
“The quantity the pharmacies have been receiving is not the usual amount. This is always the problem. They never have 100 per cent.”
He said pharmacies have also been absorbing the cost of labelling CDAP medication, which should be paid for by Nipdec.
Owners feel pinch
The owner of a Sangre Grande pharmacy, who requested anonymity, yesterday admitted that he was owed a tidy sum.
“Yes, Nipdec owes us money. It’s a lot of money. I have not been paid for the past seven months but we are still filling CDAP prescriptions for CDAP patients,” the owner told the Sunday Guardian.
On a monthly basis, the pharmacy fills between 300 and 400 prescriptions for patients who live in far-flung areas of Sans Souci, Matelot and Toco, the owner said.
The manager of a Couva-based pharmacy also disclosed that she too had not been paid. “I think Nipdec does not have the money to pay the pharmacies. That is the bottom line,” she said.
She also explained that pharmacies were contracted on a yearly basis by Nipdec, but for 2016 “there has been no binding agreement.”
Up to late yesterday, Nipdec had not responded to several questions the Sunday Guardian had emailed on Friday. Established in 2003, CDAP provides citizens with free prescription drugs and other pharmaceutical items to combat diabetes, asthma, cardiac diseases, arthritis, glaucoma, mental illness, high blood pressure, enlarged prostate, thyroid diseases, epilepsy, hypercholesterolemia and Parkinson’s disease.
The object of the programme was to reduce the burden on the pharmacies and patients’ waiting time at the public health institutions.
There are 47 drugs available through CDAP.