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Health facilities in the Ashanti Region have been compelled to resort to the dreadful �Cash and Carry� system, following the ineffective implementation of the Capitation Programme, which has come to wipe out the National Health Insurance Scheme (NHIS) in the region. As a result, hospital attendance has dwindled since the inception of the Capitation Programme. Dr. Edward Prempeh of the St. Edward�s Clinic at Fante New-Town in Kumasi and former President of the Society of Private Medical Dental Practitioners (SPMDP) said his outfit was currently attending to those who can afford the cash and carry system. He expressed the fear that people would continue to suffer and die, because people who suffer from diseases such as hypertension, diabetes, and other chronic diseases, which were factored in the maiden edition of the NHIS, are at risk, since such illness are not prevented, but treated with drugs, which is not part of the Capitation Grant. The Chief Executive Officer (CEO) of County Hospital at Abrepo, Dr. Antwi, noted that the people of Ashanti were suffering under the Capitation Programme. Dr. Antwi, who is also Secretary of the SPMDP, urged the government to streamline things to bring the NHIS back to life. He said the Ghana-Diagnostic Related Groupings amount of GH�8.56 under the Capitation Grant was low, compared to GH�11.66 received by colleagues in other regions. In an interview with Mr. Kofi Akohene Mensah, Administrative Officer of the Aninwa Medical Centre at Emena, near Kumasi, he said the situation was disturbing, as many patients who cannot afford the cash and carry system had resorted to self-medication. �We (SPMDP) wrote a letter to the Health Ministry sometime 21 March, 2012 to negotiate about the G-DRG, but we have still not heard anything from them,� he said. He said the initial GH�8.56 G-DRG, and the revised per capital rate of GH�1.43, were not incentive enough for any health facility to indulge in the Capitation pilot project, adding, �We feel we are being exploited compared our colleagues in other regions.� Official sources at the Komfo Anokye Teaching hospital (KATH) in Kumasi would not comment on the situation, but it was obvious that the story was no different therem against available data relating to attendance and admissions over the years. Records at KATH indicated an attendance of 117,990 and 238,884 at the Out Patients Department at the Polyclinic and specialised clinics respectively in 2011, against that of 145,437 and 298,298 cases in the same period in 2010. Admissions also went down slightly from 43,282 in 2011, against 45,000 in 2010, with surgeries dropping from 28,000 in 2010, to about 24,000 in 2011. The CEO of KATH, Prof. Ohene Adjei, is on record to have said that the hospital, which derives about 85% of its revenue from the NHIS, had suffered a massive reduction in revenue. The Chronicle�s assessment of the situation indicates that Febrile Convulsion, which is associated with children, is on the increase, because many people prefer to stay in the house till the situation gets out of hand, before they rush to the hospital. Investigations conducted by the Ashanti Development Union (ADU) reveals that attendance at the hospitals had drastically come down to 50 percent, while registration for the NHIS had also dropped by 40 percent, meaning there was a total loss of confidence in the NHIS and capitation. Meanwhile, the ADU has reaffirmed its position for the suspension of the pilot capitation in the Ashanti Region. The Union said the capitation should be rolled out all over the country, if the government believed it was feasible, else it should be suspended until the right approach to its implementation is adopted. The Co-ordinator of ADU, Mr. Edmond Owusu Peprah, stated at a press conference in Kumasi recently, that the problems associated with the pilot scheme in the region had not been solved, despite efforts by the sector minister, Alban Bagbin, to meet stakeholders and subsequently adjust the capitation rate slightly upwards, which was still at a stalemate. Owusu Peprah indicated that investigations conducted by ADU reveal that people are still dying and suffering, and urged the government to be proactive, and not wait for the things to get out of hand before doing fire fighting. The Union suggested that the government gives priority to the provision of standard health services, by going the extra mile to ensure that adequate infrastructure and equipment are well provided for health care delivery in the region. The ADU Co-ordinator emphasised that the withdrawal of the private providers had not only resulted in losing precious lives, but also rendered many people jobless, as the private providers are unable to pay their employees in the region.