Dr. Nana Ayew Afriyie
The Minority in Parliament yesterday voiced strong opposition to a key provision in the Ghana Medical Trust Fund Bill, which seeks to allocate 20% of the National Health Insurance Authority’s (NHIA) total resources to finance the newly established Fund under the Mahama Cares initiative.
During consideration of Clause 3A of the Bill, which outlines sources of funding for the Ghana Medical Trust Fund, Ranking Member on the Health Committee, Dr. Nana Ayew Afriyie, announced that the Minority would abstain from voting on the clause.
He noted that the Minority could not support the use of NHIA funds for the new initiative, citing legal and procedural concerns.
“With your guidance, the Minority, as far as this provision is concerned, ‘3(a)’, we abstain. Regardless of the position of my colleagues, we would want to progress by taking due notice that we don’t support monies being taken from the NHIA. That entire provision, 20% of total monies, we are opposed to,” Dr. Ayew Afriyie stated.
He further argued that there are inconsistencies between the proposed allocation and existing legislation, particularly Act 852, which governs the operations of the NHIA. According to the Ranking Member, the allocation risks violating provisions in the Act that define how NHIA funds should be utilised.
“We don’t also have clarity and until those [inconsistencies] are addressed, we are not supporting this clause. We are not,” he said.
Joining the Minority’s reservations, Ofoase-Ayirebi MP and former Minister for Works and Housing, Kojo Oppong Nkrumah, cautioned the House about potential breaches of the Public Financial Management Act (PFMA), 2016 (Act 921).
He raised concern that the bill was being pushed without the necessary fiscal impact assessment required under Section 100 of the PFMA.
“Any legislation to be laid before Parliament… shall be accompanied by a fiscal impact analysis stating the estimated effect on revenues and expenditures,” he quoted and added, “When you take out 20% of total monies allocated to the NHIA, that fund is now depleted by 20%, which they would have already programmed for in their medium-term framework.”
He stressed the need for Parliament to demand clarity from the NHIA on how it plans to fill the funding gap created by the redirection of resources to the new trust fund.
“Even as the Ranking Member says we will not participate in a vote on this clause, we provide this information to guide the House. What you are doing is leaving a number of holes that are unplugged,” Oppong Nkrumah said.
Despite the concerns raised, the Majority is pushing ahead with the Ghana Medical Trust Fund Bill, which seeks to establish a statutory fund to support the treatment of chronic diseases such as cancer, kidney failure, cardiovascular illnesses, stroke, and diabetes.
The Trust Fund is part of the broader Mahama Cares initiative aimed at addressing gaps in Ghana’s healthcare system, particularly in specialist care and financing for non-communicable diseases (NCDs). The government projects to invest over $59 million over three years and estimates an annual operational cost of GH¢3 billion for the Fund.
However, the Minority insists that while the objective of the initiative is commendable, diverting NHIA funds without a clear legal and financial framework could undermine the long-term sustainability of the country’s health financing system.
By Ernest Kofi Adu, Parliament House