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Subscribers of the National Health Insurance Scheme (NHIS) now have to pay for essential drugs needed in times of emergency because of government�s indebtedness to service providers. Between January and now, government is indebted to members of the Health Insurance Service Providers Association of Ghana (HISPAG) to the tune of GH₵79,065,630. As a result of the indebtedness, service providers could also not pay pharmaceutical companies that supply them drugs. Consequently, the Ghana Chamber of Pharmacy has suspended the supply of medicines to hospitals on credit basis from August 1, 2014. Mr Frank Richard Thorblu, Executive Secretary of HISPAG, told The Finder that NHIS hospitals now offer essential drugs on �cash and carry� basis because the Ghana Chamber of Pharmacy no longer supplies medicines on credit. According to him, hospitals, as part of their mandate, are required to always have in stock essential medicines to attend to emergencies. He explained that it is for this reason that HISPAG members have decided to offer essential medicines on �cash and carry� basis in order to have continuous supply of essential medicines. He stated that the close to GH₵80 million that government owes HISPAG members has created a serious cash flow crisis for them. Mr Thorblu said the situation is so serious that some service providers cannot even pay their utility bills. According to him, the situation has hit maternity homes so hard that some of them have folded up and their premises turned into sachet water production companies. The Ghana Chamber of Pharmacy is the umbrella body of key pharmaceutical manufacturing, importing, distributing, wholesale and retailing companies in Ghana. The Ghana Chamber of Pharmacy has stopped the supply of medicines on credit to all health facilities under the National Health Insurance Scheme (NHIS), effective August 1. This is because all the health facilities owe members of the Chamber for more than two months. This signifies possible medicine shortage in the affected hospitals, and patients risk not being supplied medicines when they seek medical care at various hospitals across the country. According to the Chamber, supply of medicines to any health facility shall be on cash basis only, except where the facility/institution is in arrears not exceeding two months. A letter from the Chamber copied to nine institutions associated with the health sector, including the Ministry of Health, said: �We wish to state that pursuant to an earlier notice issued through the media and agreement arrived between members at a regular meeting, effective August 1, 2014, all members of the Chamber shall not supply any medicines on credit to any facility or health institution that is in arrears beyond two months.� The statement said the Chamber noted with grave worry the consistent delays in re-imbursement for medicines supplied by members and has on a number of occasions drawn the attention of government, stakeholders and Ghanaians to the potential risk these delays have on the liquidity and survival of members of the Chamber. It noted that the rather long delay in health insurance re-imbursement has made it difficult for many facilities and institutions across the country to honour their medicine payment obligations. According to the statement, �this regrettable decision has been taken to forestall further loss of capital in the wake of rising operational costs, unstable forex fluctuations and the dire consequences these could have if nothing is done to reverse the situation.� The Chamber called on the government to immediately impress upon the requisite agencies and stakeholders to intervene to avert any further serious or untoward impact on the health system in the country.