The Management of Korle Bu Teaching Hospital (KBTH) has been compelled to respond to some allegations made against the Hospital by Prof. Kwabena Frimpong-Boateng in his recent press statement on the revocation of his appointment as Honorary Director of the National Cardiothoracic Centre (NCTC). The major allegations made against the Hospital by Prof. Frimpong-Boateng were:
• That some individuals in Korle Bu were orchestrating to revoke the independence of the NCTC so that they could access its finances “to improve the fortunes of the hospital as a whole”.
• That Korle Bu has taken over al l independent institutions with the exception of the NCTC
• That Korle Bu was interfering with the staffing of the NCTC • That Korle Bu generated more revenue than Komfo Anokye Teaching Hospital (KATH) when he was the CEO and which, he claimed, was not the case now and lastly, • That these individuals were presiding over and supervising the gradual decay of Korle Bu and tried to blame that on him. We first wish to state that neither the Board nor Management influenced the decision of the Ministry of Health to revoke his appointment. We also wish to state that the Board and Management have no plans or desire to revoke the autonomy on the NCTC. The Board does not even have power to put this into effect. All the ‘independent’ institutions or Centres of Excellence at Korle Bu namely the NCTC, the National Centre for Radiotherapy and Nuclear Medicine, the Reconstructive and Plastic Surgery and Burns Centre and the Centre for Clinical Genetics have a direct relationship with the Ministry of Health (MoH). The power to revoke or change the status of these Centres resides with the MoH. The statement that Korle Bu has already taken over all independent institutions with the exception of the NCTC is not true. None of the above Centres of Excellence is under the Board of the Hospital. Even though the National Centre for Radiotherapy and Nuclear Medicine and the Reconstructive and Plastic Surgery and Burns Centre have expressed interest in operating under the governance of the Korle Bu Board, no decisions have been made. The interest of the Board in these Centres had been to ensure governance and legal cover for them under ACT 525 that establishes the Ghana Health Service and Teaching Hospitals. The ACT, as it exists now, does not cover these autonomous Centres of Excellence. To further appreciate the intentions of the Board, it should be noted that the NCTC and the other Centres of Excellence at Korle Bu are Budget Management Centres (BMCs) and not Sub-BMCs or Departments. This means they have the same status as agencies under the MoH like the Ghana Health Service, KBTH, KATH and other service providing agencies. These Centres of Excellence, however, do not have governing Boards. Neither have they been established by a Legislative Instrument that recognizes them as public institutions under the 1992 Constitution. Moreover, the operations of such institutions would require an administrative structure to provide for efficient management in the areas of finance and budget, audit, procurement, human resource management etc. The Board has no interest in annexing and usurping the finances of these Centres. Its focus is on governance, to limit legal risks for the Hospital and for all institutions operating within it. Even for the Sub-BMCs, the Board and Management have been working towards decentralizing financial and administrative authority. The aim is to improve efficiency and effectiveness in their delivery of services to patients. In this arrangement, 60 per cent of revenue generated by the Sub-BMCs/Departments is released to them for their operations, whilst 40% covers expenses made by the central management on their behalf. This is the first time in the history of the Hospital that Sub-BMCs/Departments have been given such latitude and flexibility in running their own affairs. The Board and Management cannot therefore be accused of working towards ‘centralizing’ the management of the Hospital. The records show that rather than using resources of these autonomous Centres, it is the Hospital that supports them in many ways. For instance, KBTH had, until 2009, paid fuel and car maintenance allowances to doctors and other qualified staff of the NCTC from its Internally Generated Funds (IGF). The NCTC and the other Centres draw electricity and water from Korle Bu, payment for which is deducted at source from subventions of the Hospital by the Ministries of Health and Finance and Economic Planning. Korle Bu supplies medical gases to the NCTC without charge. In respect of human resource management, it is Korle Bu Teaching Hospital that recruits doctors, nurses, pharmacists and other professionals for the NCTC at its own cost. The NCTC also depends on Korle Bu for promotion interviews and for administrative arrangements for staff development programmes. Security at NCTC is from staff of the Hospital paid from the IGF of the Hospital. Prof. Frimpong-Boateng again claimed that in his tenure as Chief Executive, Korle Bu generated more revenue than Komfo Anokye Teaching Hospital (KATH) but this had since changed. We do not know the basis on which he made these claims to harm and denigrate the Board. It is on record that since the current Board assumed office in 2009, prudent financial management practices had been put in place to enable the hospital to mobilize more revenue. The table below of comparative IGF levels in the periods 2003– 2007 when Prof. Frimpong-Boateng was in office and 2008-2010 under the current management team vindicates Management and the Board. YEAR IGF (GHC) 2003 4,342,678.40 2 004 5,953,406.91 2005 7,048,843.22 2006 6,199,223.14 2007 10,195,855.26 2008 12,444,477.47 2009 16,530,694.24 2010 26,205,391.63
Another accusation was that Korle Bu was interfering with the staffing of the NCTC and an example was given of a doctor who wanted to work with the Centre but was stampeded out of it. The doctor referred to is a Ghanaian undergoing postgraduate training in Paediatric Cardiology (children’s heart medicine specialty) in the UK. She had expressed desire to return home at the end of her programme in June 2012 to work at the NCTC. After interacting with the Director of Medical Affairs, she appreciated better the role she could play by being based in paediatric cardiology at Korle Bu and, at the same time, serving the NCTC. After an official interview, she was offered an appointment letter to take effect after completing her studies. She has duly accepted the appointment and had been in touch several times with the Head of the Children’s Department. It is not true that this doctor had been discouraged from returning home by the Korle Bu Management and from working at the NCTC. The last comment we wish to make is with reference to the statement that some individuals were presiding over and supervising the gradual decay of Korle Bu and were seeking to blame him. We give credit to Professor Frimpong-Boateng for his invaluable achievements in the establishment of the NCTC and for presiding as CEO of the Hospital for five years. In recognition of his significant contributions and invaluable services, the Board honoured him and others who had served the Hospital well in 2010. Taking over from where he and the immediate past Board had developed the Hospital, the present Board and Management had worked hard in the past two years to add to the growth of this great institution. Some developments under the current Board are noted below:- 1. The Building of a Reproductive Centre for women sponsored by Population Council through Professor E.Y. Kwawukume and his team. 2. Establishment of a DNA Lab, one of the firsts in West Africa. 3. Development of Site assessment Plan and Master Plan for the Hospital for future growth. This work was undertaken by Canadian Experts. This has become necessary for proper planning of the hospital and also to replace the 88-year old hospital with major infrastructural defects including aged electrical cables, plumbing systems, water pipes etc. We wish to place on record that HE the President John Evans Atta Mills had personally encouraged these developments, recognizing that the Hospital is operating beyond its life-span and needs a major face-lift at this time. 4. Feasibility report for funding of a new Emergency and Medical sub-specialty Departments. Funding has been secured from the Saudi Fund, the Kuwaiti Fund, the BADEA Fund and from OFID for the first phase of this major project that will make Korle Bu an ultra-modern Hospital. We are waiting for Cabinet and Parliamentary approvals for this project to begin – hopefully before the end of this year. 5. Plans to construct a Centre of Excellence for Eye care in Ghana and West Africa; this project is expected to commence before the end of the year. 6. Establishment of a national referral Gynaecology Centre for care of women with genital problems in Ghana and West Africa in response particularly to the desire of the President and the First lady to support women 7. Plans to rebuild the Children’s Emergency Centre to increase capacity from the original 17 beds to about 80 beds. The First Lady, Dr. Mrs. Ernestina Naadu Mills, had already cut the sod for this project and initial funding has been received from the National Health Insurance Authority. 8. Development of a Patient Bill of Rights for adults and children to ensure quality of practice by health professionals. 9. Establishment of an Ethics and Professionalism Committee to which patients could lodge complaints against staff of the Hospital. 10. Produced a document towards the promulgation of a law on use of human tissues such as kidneys, the heart, liver etc for transplantation. This document submitted by a Committee Chaired by Professor E.D. Yeboah has been sent to the Minister of Health for processing.
11. Collaboration with external institutions in the US and Canada in particular for in-service training courses for staff 12. Development of basic documents including those for Conditions of Service for Junior and Senior Staff and for Human Resource Policies 13. Development of a new strategic plan for the Hospital 14. Replacement of broken down lifts at the Hospital and plans for safe parking lots.
We shall continue to work hard to build upon the foundations laid for this premiere Hospital by great leaders such as Governor Gordon Guggisberg, Dr. Kwame Nkrumah, former President J.J. Rawlings and several other national leaders and managers after them.
FROM THE MANAGEMENT OF THE KORLE BU TEACHING HOSPITAL SEPTEMBER 10, 2011