Doctors across the Island are still complaining about late reimbursements from the Government's Health Insurance Plan (HIP) and five charge their patients up-front for treatment.

In one case, a doctor's practice said they had discussed with seniors about leaving HIP reimbursements in their wills to their children because they feared they would not see any reimbursements from Government before they died.

The problem emerged last year when former Health Minister Phillip Perinchief acknowledged there was a HIP backlog and patients were having to pay up front.

Additional staff were hired and an atomisation process for claims was initiated, according to Health Permanent Secretary Warren Jones.

In January this year, he promised these changes would improve doctor's payments, perhaps even returning them within two months of seeing a patient.

Then last week, the current Health Minister Nelson Bascome, said in the House of Assembly that a number of payments were only a month behind. A survey by this paper, however, revealed a different situation.

Five of the 28 doctors surveyed said they still had to ask patients to pay for services when they visited, 17 were still disappointed in the HIP payments and just six were satisfied saying there had been an improvement.

Asked for comment from Mr. Bascome, yesterday, Permanent Secretary Warren Jones replied and said if there were any doctors unhappy with the process to contact him.

He said: "If the physicians you spoke to have not experienced any improvement in their outstanding claims after I have publicly stated on numerous occasions that we have improved and set out the steps we are taking to get up-to-date, I invite them either to identify themselves to you or to call me so that their claims can be investigated and addressed."

The anonymous survey which included 17 practices, representing 28 doctors, began by asking each accounts department if they charged the patients for HIP.

If they did, the services were asked to explain why they charged the patients. Responses to this question were overwhelmingly: 'HIP does not reimburse us quickly enough.'

All of them, who did not wish to be identified for fear of retribution, were reluctant to ask for payments up front, but said they did not have a choice if they wanted to run their practices.

One office actually said senior patients talked about leaving HIP reimbursements in their wills for their children because they will not see the payment before they die.

And if during the survey physician's practice said they would submit claims on behalf of the patient, then the second question to them was: 'how long is it taking to receive any payment?'

The answers varied from nine months to only just receiving claims from 2004 to 2005. Many recognised the Ministry was trying to improve the turnaround time, but needed it to get better.

Only one office, representing three doctors, said they received payments within a month of seeing patients and two other practices said they were happy because their reimbursements were taking a couple of months.

A week ago Mr. Bascome threatened doctors asking for payments up-front with being reported to the Bermuda Health Council.

He said: "Now we've brought a number of those payments right up to being one month out and so what's happened is, a number of them (doctors) aren't doing that anymore (charging up front for HIP).

"And I would really like to know those that are, because I've challenged the Health Council to jump on those physicians and those persons practising that when indeed (HIP has) now caught up."

But last night Louise Jackson, Shadow Health Minister, said the problem was not with the doctors but with the system.

She said: "When we raise the issue (HIP being broken), the Government hits back with statements that suggest the fault lies with "offending doctors."

"It is important to understand that doctors are not the problem. The government-run HIP system is the problem. The solution will not be found in rounding up doctors, as the Health Minister indicates, but in bearing down hard on reforms that can speed up the claims process.

"We'll say it again: It is essential to move with speed to hire more staff and computerise the system for the speedier handling of claims.

"Some progress may have been made, but it is high time the problem was checked off Government's to-do list. Until then, the people least able to afford up-front payments will continue to be penalised for the slow pace of reforms."