NASSAU, BAHAMAS — Former Health Minister Dr Duane Sands says the time has come for The Bahamas to implement full catastrophic health coverage under the National Health Insurance (NHI) programme, warning that too many Bahamians continue to face financial ruin and emotional trauma when confronted with life-threatening illnesses.
“The horror stories we hear over and over about people with cancer, heart disease, kidney failure and other catastrophic illnesses unable to access safe, timely care is a big deal,” Sands said. “The promise of national health insurance was to start with primary care and then expand to cover catastrophic conditions so that Bahamians would not have to give up their dignity or watch loved ones die because they don’t have the funds.”
Sands, who served as Minister of Health under the Minnis administration, said comprehensive catastrophic coverage “is an idea whose time has come” and could be introduced without increasing government healthcare spending. He argued that the country’s annual healthcare budget already provides enough room to repurpose funds toward helping ordinary citizens.
“The government currently assigns around $10 million per year for catastrophic healthcare coverage, but that’s a drop in the bucket,” he said. “And the way it’s administered—it’s catch-as-catch-can. Some people can get it, some can’t, some don’t even know about it. That’s not how a modern health system should function.”
He also raised concern over the uneven distribution of healthcare professionals across the islands. “You can find a doctor in Nassau, but not in Acklins, Crooked Island, Long Island or San Salvador,” Sands said. “We have hundreds of physicians on the government payroll, but they are not strategically deployed.”
The former minister called for stronger incentives to encourage doctors and specialists to rotate through Family Island clinics and urged the government to fully activate hospitals in Exuma and Abaco as regional hubs.
Sands also warned that the country faces a deepening nursing shortage, with more than 400 nurses having already left the public system. “Our competent, capable nurses are leaving in droves because they don’t feel valued or respected and can’t survive in The Bahamas in 2025,” he said. “Every week another young nurse leaves for Florida, Atlanta, or elsewhere.”
He was sharply critical of the Davis administration’s plan to construct a $290 million secondary hospital outside the Princess Margaret Hospital (PMH) campus, calling the decision “stupidity at best.”
“Who in their right mind would decide to spend hundreds of millions on a new facility when PMH’s neonatal intensive care unit—the best in the region—has never been fully utilized?” Sands said. “It makes no sense to duplicate staff and services when we already have shortages of doctors, nurses, and critical equipment.”
He added that the existing PMH campus has ample space for redevelopment and warned that dividing limited medical staff between multiple sites would further weaken service delivery.
“This isn’t about sour grapes,” Sands said. “It’s about ensuring ordinary Bahamians don’t suffer indignity when seeking care. You go into the PMH emergency room and see people lined up without proper facilities, while the hospital kitchen has been down for 18 months. Yet, we’re talking about building a new hospital. Make it make sense.”
He concluded that for a country generating nearly $4 billion annually in revenue, the current state of healthcare “is not consistent with that level of national income.”
