Money buying faster healthcare at Korle Bu Teaching Hospital - Reports

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TSITSURU 1 day ago

Ghana gas actually become a state where money has become the denominator for a good health care services. God have mercy.

Ghana gas actually become a state where money has become the denominator for a good health care services. God have mercy.
TSITSURU 1 day ago

Ghana has actually become a state where money has become the denominator for a good health care services. God have mercy.

Ghana has actually become a state where money has become the denominator for a good health care services. God have mercy.
Hanson K.K 1 day ago

With corruption, Ghana is just sitting on a timing BOMB.
" The Almighty "KALABULE" is still at play again.
Kalabule gave birth to 1st an 2nd revolution in Ghana.
Third revolution is just looming over the horizon.
But ...
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With corruption, Ghana is just sitting on a timing BOMB.
" The Almighty "KALABULE" is still at play again.
Kalabule gave birth to 1st an 2nd revolution in Ghana.
Third revolution is just looming over the horizon.
But should it happen it would be the worst in all revolutions in the world
A Professor at Korle-Bu 1 day ago

Intramural Practice at Korle Bu: The Other Side of the Story

The article, “Money Buying Faster Healthcare at Korle Bu Teaching Hospital,” raises legitimate questions about equity, transparency and access to specialist ...
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Intramural Practice at Korle Bu: The Other Side of the Story

The article, “Money Buying Faster Healthcare at Korle Bu Teaching Hospital,” raises legitimate questions about equity, transparency and access to specialist healthcare. These are matters that every public hospital should take seriously. However, the discussion would be incomplete without considering why intramural practice exists and the problem it was designed to address.

Korle Bu Teaching Hospital is home to some of Ghana’s most highly trained specialist and subspecialist teams. Their expertise is scarce, expensive to develop and increasingly sought after by private hospitals.

This creates a difficult problem for a major public teaching hospital.

Private hospitals can engage these specialists and pay them substantially for their services. The private institution benefits from expertise developed over many years, often through public investment in training and within the teaching hospital system.

If this continues without an appropriate response from the public sector, the eventual outcome is predictable. Specialists will spend increasing amounts of their professional time in private facilities or may leave the public hospital altogether.

Who suffers most when that happens?

It is not the wealthy patient. That patient can follow the specialist into private practice or, increasingly, seek treatment outside Ghana. International hospitals and medical tourism companies actively market specialist healthcare to patients who have the means to travel.

The person who suffers most is the patient who cannot afford private healthcare.

That is the central issue that must form part of any discussion about intramural practice.

Why intramural practice exists

Intramural practice provides a regulated mechanism through which specialists can offer additional paid services while remaining within the public hospital.

The objective should be threefold: retain highly trained specialists within the public institution, generate additional revenue for the hospital, and make specialist expertise available to patients who can pay for an additional service without removing that expertise from patients who depend entirely on the public system.

Seen from this perspective, intramural practice is not necessarily a competition between rich and poor patients. It can be a means by which the public hospital competes with the private sector for its own highly skilled workforce.

Without such a system, the alternative is not automatically that every patient receives the same service at the same speed. The alternative may be that specialists increasingly provide their additional services outside Korle Bu, with the income going to private hospitals while Korle Bu retains the workload, infrastructure costs and patients who cannot pay.

That outcome does little to promote equity.

The real question is how the system is regulated

This does not mean every concern raised about intramural practice should be dismissed.

No emergency patient should wait because another patient has paid an intramural fee. Clinical urgency must remain the basis for prioritising emergency and time-sensitive care. A patient should never be deliberately denied or delayed ordinary public care to create an incentive to pay for intramural treatment.

There should also be clear rules governing fees, theatre allocation, use of hospital equipment, staff participation, accounting for revenue and the relationship between regular and intramural services.

If individuals abuse the system, those abuses should be investigated and addressed.

But abuse of a system is different from the purpose of the system itself.

The appropriate response to weaknesses in intramural practice is therefore stronger governance, transparency and accountability, rather than dismantling a mechanism that may help public hospitals retain scarce expertise.

This is not peculiar to Ghana

The coexistence of public and private medical practice is not unusual internationally.

In the United Kingdom, for example, consultants working in the National Health Service may also undertake private practice. UK government guidance specifically provides for circumstances in which private care may take place within NHS facilities, with rules governing the use of NHS staff and resources and the separation of private and NHS care.

The important principle is not that every patient must use exactly the same pathway. It is that the existence of a private pathway must not deprive the public patient of the care to which he or she is entitled.

Ghana faces the same policy question, but under greater resource constraints.

Who benefits if the specialists leave?

This is perhaps the question missing from the current debate.

Suppose Korle Bu abolishes intramural practice tomorrow.

Will patients who can afford GH¢30,000 for specialist treatment suddenly join the ordinary queue?

Some will. Others will go to private hospitals. Some will travel abroad. The specialist may follow them into the private sector because that is where the opportunity to earn additional professional income now exists.

Korle Bu loses revenue. The specialist spends less time within the institution. The private sector gains the income. And the patient who cannot afford private care may have even less access to that specialist.

That would hardly be a victory for equity.

A better policy is to retain the specialist, retain part of the paying patient market within the public institution, generate revenue for the hospital and use the same specialist capacity to continue caring for patients who cannot afford additional fees.

The measure of success

The Herald asks an important question: Can a Ghanaian who cannot afford to pay extra still receive timely, dignified and quality care at Korle Bu?

The answer must be yes.

But there is another question that deserves equal attention:

How do we keep Ghana's highly trained specialists within public hospitals so that the Ghanaian who cannot afford private healthcare continues to have access to them?

Intramural practice is one attempt to answer that question.

The discussion should therefore move beyond the simple narrative of “paying to jump the queue.” We should examine the evidence: Has intramural practice increased or reduced overall waiting times? How much revenue does it generate for the hospital? How much of the specialist's time remains available to ordinary patients? Are emergencies and clinically urgent patients protected? What proportion of intramural income goes to the institution? Has the system helped retain specialists who might otherwise have moved substantially into private practice?

These are measurable questions.

If the evidence identifies abuse, correct it. If the governance framework has weaknesses, strengthen it. If fees or revenue-sharing arrangements require review, review them.

But Ghana should be careful not to solve one perceived inequality by creating a much greater one: a public health system that trains highly skilled specialists but cannot retain them, leaving their expertise increasingly available only to those who can afford private hospitals or treatment abroad.

The objective of a properly regulated intramural system should be simple: allow the public hospital to retain its specialists, generate additional institutional revenue and preserve specialist care for the patients who need the public system most.

That is the wider conversation Ghana needs to have.
Andrews Tete-Donkor 1 day ago

Brilliant submission to clarify the intramural issue. Please don't let the public patient lose out significantly.

Brilliant submission to clarify the intramural issue. Please don't let the public patient lose out significantly.
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Fixed all your credit score change school grades ... Pays off car loans pays of usa crefit card Loadin bank loading canada german usa UK Australia deal bank deal and alot mt103 Business bank flash Urdu flash email me hamzaben.d@hackermail.com all types pos dealss am Russian base in scortland vbvvvf
Pelicles 1 day ago

What is the meaning of this report? Ghanaians now have their "Angelic Political Party, NDC" with a "Saint president John Mahama" so, who is complaining about what?

Why can't everybody shut and live with what they voted for ...
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What is the meaning of this report? Ghanaians now have their "Angelic Political Party, NDC" with a "Saint president John Mahama" so, who is complaining about what?

Why can't everybody shut and live with what they voted for, why not?
Mensahoo988 1 day ago

My brother, every where in this damn world, if you have money, you get faster & better service, period. Even in old communist soviet union that is what it used to be. How mch more capitalist sysyems. It is a fact of life. It ...
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My brother, every where in this damn world, if you have money, you get faster & better service, period. Even in old communist soviet union that is what it used to be. How mch more capitalist sysyems. It is a fact of life. It will never change. All fingers are not equal.
.
Kweku 1 day ago

Korle Bu Teaching hospital should be decentralised to promote efficiency and effectiveness

Korle Bu Teaching hospital should be decentralised to promote efficiency and effectiveness
Samy 1 day ago

It looks like our leaders do not have clue . National health service payment shouldn’t be one time are we serious as a nation when a bottle of beer costs more than thad the one time premium we are asked to pay to keep o ...
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It looks like our leaders do not have clue . National health service payment shouldn’t be one time are we serious as a nation when a bottle of beer costs more than thad the one time premium we are asked to pay to keep our hea service running why .

Andy Korp 1 day ago

This is a very stupid article honestly
how do you raise issue with services intended to give more money to the hospital? Take up a non issue, create your own problem and additionally make a big untrue leap that the presence ...
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This is a very stupid article honestly
how do you raise issue with services intended to give more money to the hospital? Take up a non issue, create your own problem and additionally make a big untrue leap that the presence of intramural services means patients of less means are being turned away.
the first cure to your ignorance is, Triaging remains the universal standard for sorting out medical emergencies, to suggest otherwise is bad journalism an icing of unprofessionalismt.
No emergency patient should wait because another patient has paid an intramural fee and none waits. what happens is people who operate on time sensitive scales like CEOs or government officials, chiefs, other well to do individuals recognise the long queues from the high patient load and decide to avoid it. Avoid it means, they decide to meet which ever care giver outside his operating hours. in case you were blind to the point OUTSIDE HIS OPERATING HOURS... could be as EARLY as 5am before works starts at 8am/9am or after office hours. The benefit of these is whilst they could be seen at private facilities, they are seen in the public facilities and hence professionals are retained in the public sector shielded from the competitive rates gov't hospitals cannot compete with and cures the braindrain for specialists rampant in our communities. This also reflects in the profit margins of the hospitals as individuals also pay for services, utilize lab and imaging centres within the facility. No person pays for intramural during clinic hours or operating hours. Procedures to be done follow similar fashion as referenced in Capital letters above and not at the expense of an ordinary citizen without such means. Be comfortable with the idea that whilst you have time on your hands to be looking for useless news, others patients do not and want a faster way to resolve their issues.
You could have helped your wayward course if you had statistics of how much normal workflow is disrupted because of intramural services however you wont find any stats because there is nothing like any disruptions

PS. other public services do this, Passport and DVLA head offices, why havent you condemned that action or is it because you are been allowed to spew nonsense and others with more important matters to deal with sit in silence? not again.
Kojos 1 day ago

NDC you. Ghanaians prefer market than hospital.

NDC you. Ghanaians prefer market than hospital.
Keane 1 day ago

Even nurses charge for a pillow
Doctors break machines so you have to go to their private clinic
Stealing left right and center by staff
Ghana is a corrupt shit hole

Even nurses charge for a pillow
Doctors break machines so you have to go to their private clinic
Stealing left right and center by staff
Ghana is a corrupt shit hole
Truth 1 day ago

People who can pay more are also part of the public. Try not being poor if you want what money buys.

People who can pay more are also part of the public. Try not being poor if you want what money buys.
EASY TO LOVE 21 hours ago

Money Talks. Period.

Money Talks. Period.

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Money buying faster healthcare at Korle Bu Teaching Hospital - Reports

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