Samuel Dowuona, Adom FM
This article or letter is a sequel to a previous one addressed to the Minister of health, titled “Bureaucratic bottlenecks to health sector brain gain”, published widely on and off line.
Much more has unfolded since the first letter. Whiles we wait to see what would be done to tap the expertise of our sons and daughters in the Diaspora to save the lives of our people in the homeland, it has become necessary to call the attention of His Excellency President John Evans Ata Mills to this all important matter.
Two reasons make it necessary for the president to come into this matter; one, because the new information unfolding makes the members of the Ghana Medical and Dental Council (GMDC) look like a bunch of contentious dinosaurs defending some entrenched bureaucratic clause to the detriment of the masses, and secondly because His Excellency is a social democrat, which means his priority is the people, and he believes in ‘the law is made for man and not man for the law.’
I have been speaking with the outgoing President of the Ghana Doctors and Dentists Association (GDDA) of the UK, Professor Samuel Debrah, who now works as the head of the Cape Coast University Medical School. He recounts the history of their voluntary service programme to Ghana, and how the GMDC came into the picture and mounted the stumbling blocks in the way of their noble course.
In 2007, the then Minister of Health, the late Major Courage Qaurshigah of blessed memories asked the GDDA to play a key role in the health delivery aspect of the Ghana@50 celebration. His deputy, Dr. Gladys Ashitey followed up on her boss’ directive to assist the GDDA members to start a voluntary service programme to Ghana in 2008, under the joint auspices of the ministry and the Ghana High Commission in UK.
Originally, the doctors asked the Ministry of Health (MOH) to pay for their travel from the UK to Ghana, then to the priority areas where their services are needed most and they will come in a go anywhere and offer health care service and training for free, even in the medical schools.
But God being so good, the UN International Organization on Migration (IOM), through their Migration for International Development Assistance (MIDA) offered to fund the travels of the doctors from UK to Ghana and throughout Ghana to offer their voluntary service.
The GDDA, MOH and IOM-MIDA had a tripartite agreement which took off in 2008 and has worked fine until this year when the GMDC came into the picture to insist on the Ghanaian doctors in the Diaspora coming in to offer voluntary medical service and training for free, to register with the council at $400 per head every time they come into the country to serve between one day to three months.
It is international practice, that any health professional going to work in another country must register with the regulator at a fee, but two things are worth considering in this matter; one, these doctors are Ghanaians and they are coming in to work for free, at no cost to government, GMDC or the people of Ghana; secondly, an international organization, which has no obligation to sponsor their trip to Ghana, has offered to foot the travel bills, but the GMDC cannot wave the registration fee of $400 per head, and would rather let poor Ghanaians die because the specialist doctors are not willing to pay and register.
If IOM-MIDA could bank roll the travel expenses of the doctors, couldn’t the GMDC or the ministry of health, for that matter, wave the registration cost, which is not money they are losing because they did not have in the first place?
Your Excellency, as we speak now, the IOM-MIDA have had to hold on with sponsorship for the doctors to come in because all efforts to get the GMDC to see the simple wisdom in waving the registration fee to allow the doctors to come and help Ghanaians has proved futile.
It is as if the intent is to prevent the doctors from coming, and not just about the registration fee. This clearly runs contrary to His Excellency’s clamouring for Ghanaian health professionals abroad to come and help the country’s health delivery system. The GMDC is not creating an enabling environment for that to happen.
Last year, Dr. George Ajah Sipa Yankey met the GDDA and the GMDC in London and announced that the registration fee has been abolished for the sake of ‘our people’, but not long after that the minister resigned; then Dr. Benjamin Kumbuor took over and also pledged his commitment to the position of his predecessor.
According to Prof. Samuel Debrah, Dr. Kumbuor immediately saw the wisdom in waving the registration fee and promised to get the GMDC to do that, but for some reason, things have rather gotten more complicated.
Dr. Kumbuor had promised to go to the UK last September, meet the GDDA members and officially announce the abolishment of the registration fee for those coming to do voluntary work, but the minister had to be with His Excellency the President in China so he asked the Director-General of the Ghana Health Service (GHS), Dr. Elias Sory to represent him.
Prof. Samuel Debrah said Dr. Sory sprung a surprise on them in Manchester when he announced that the previous health minister, Dr. Sipa Yankey, overstepped his boundaries when he announced the abolishment of the registration fee, insisting that, that duty lied solely with the GMDC.
Dr. Sory made complete nonsense of the assurances of his boss, the minister of health and as a result, there is a stalemate, for which the doctors could not make their big trip to the country this year to offer voluntary services.
According to Prof. Samuel Debrah, it was so embarrassing for him to go tell the IOM-MIDA to hold on with the financial support because the very people they were going to help are putting stumbling blocks in their way.
Prof. Debrah said the Ghanaian health specialists in the UK are more than willing and in fact waiting to come help, and they are ready to go to the deprived communities, where the homeland doctors refuse to go, but the GMDC and now the GHS is just putting avoidable stumbling blocks in their way.
He insisted, and rightly so, that the Diasporan doctors are not ready to pay $400 every time they come in to help for free, particularly when an international organization is paying for their travel, they do not see why the GMDC/GHS cannot wave the registration fee as their passive contribution to health for the people of Ghana.
The hard facts about Ghana’s health sector is that 37 per cent of doctors trained in Ghana live and work abroad and currently the doctor/citizen ratio is one doctor is to over 20,000 patients. This is why doctors are frustrated and they sometimes take their frustration out on their patients.
It is mind boggling, annoying and ridiculous that the GMDC has made this whole issue about some standards and procedures that has to be followed, without the least consideration that the service of these specialists are very much needed, and that they rather deserve a handshake from the government and not the other way round.
The GMDC does not seem to consider that if the doctors do not come in it is Ghana which loses on two fronts; one, the masses who cannot afford to travel abroad for specialist surgeries and care are dying slowly, and secondly, they are jeopardizing the opportunity for IOM-MIDA sponsoring more of such assistance to Ghana.
It would not be surprising that the staff of IOM-MIDA might be ridiculing us because it is only c**** people who see help coming and say “pay me money before you come and help me, otherwise forget about helping me.”
The other side of this story is that Mr. Eli Atikpui, Registrar of the GMDC, insists that the registration is standard practice and the council will not, for any reason, wave it; not even when Ghanaian health specialists are coming in to give millions of dollars worth of healthcare and training for free.
The council also puts forward a very weak argument about verifying the background and qualification of the doctors; something they can easily do if they really and honestly want to because they have been traveling to the UK to hold conferences and dinners with these doctors every year, and they know exactly what to do and where to look for the information they need. As a matter of fact, every ordinary Ghanaian looking for that information can find it because it is in the public domain, on the website of the British Health Sector Regulator.
What audacity the GMDC has to take the destiny of Ghanaians into their hands and hold all Ghanaians to ransom in the name of some avoidable standard practice. Rules are one thing, but there is also the moral responsibility to let go of something small in order to get something big. The GMDC has completely lost sight of that moral responsibility so there is need for a higher intervention.
A higher intervention to tell the GMDC that if the doctors pay and register, they might be forced to also charge for their services, and the majority of people in Ghana cannot pay for that kind of service.
With all respect Mr. President, over to you.
ENDS