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Isn’t it time to privatize the government hospitals?

Wed, 5 Aug 2015 Source: Bokor, Michael J. K.

By Dr. Michael J.K. Bokor

Monday, August 3, 2015

Folks, the perennial strike actions embarked on by Ghanaian doctors working in public health institutions should set the stage for the government to privatize public health institutions and enforce other measures aimed at curtailing the enormous pressure being put on it and the Consolidated Fund. The current strike action by members of the Ghana medical Association (GMA) should be the clarion call to change the existing paradigm so those who cannot fit in can go into private practice to stop harassing us all with their huge demands for improved service conditions. In private practice, they will get to know what it takes to function as doctors. No pampering of anybody!!

Interestingly, members of the Ghana Bar Association hardly go on strike, apparently because they will do so at their own risk. Their counterparts on the Bench (State Attorneys) are on strike, causing much headache for the system.

It is clear that recourse to strikes by civil or public servants paid from the Consolidated Fund is so attractive that it can easily be turned into a political tool to damage government's interests and image. Dirty politics is done this way. Of course, labour agitations and withdrawal of services are guaranteed, but in our part of the world, they have become too fashionable.

I blame the government for not being proactive enough to forestall such agitations and labour unrests. I think that the various officials at the Ministries, Departments, and Agencies could have done better in hob-nobbing with organized labour as soon as any contentious issue crops up so discussions at the formative stages could pre-empt an escalation of the situation.

More often than not, though, such officials harden their stance and either disregard the early warning signs or seek to twist arms. They fail to nip the issues in the bud and they simmer to boil over, leading to the withdrawal of services by organized labour. And when that happens, the citizens suffer needlessly and push the blame to the government of the day. And the government itself "suffers" all the more!!

Government officials appear to be too "stiff", insensitive, and intemperate in dealing with organized labour until the matter worsens when they seek to use ad hoc measures to solve problems. Such desperate moves only worsen matters. We see so in the case of the junior doctors!!

Government alone shouldn't take the blame, though. Organized labour, especially their leaders, are also culpable for various reasons. It is true that service conditions aren't as good as organized labour expect, but it doesn't mean that strike actions should be used to get their pound of flesh. But that is the norm, not the exception.

There is no doubt in my mind that some in organized labour have political interests and persuasions contrary and hostile to the those of the government, and they quickly manipulate the labour front to politicize issues in the hope that they can use strike actions to make the government unpopular. Such elements are all over the place; but they are only being mischievous because whatever negative backlash falls out from their strike actions will affect the country as well.

Using strike actions—as is the case of the Ghana Medical Association—will not solve systemic problems unless a miracle happens. In a democracy, better means should be used. No miracle will happen.

It is now clear that the Ghana Medical Association's reasons for going on strike are likely to cast the Association itself in a bad light, especially if we consider the demands made (See http://www.ghanaweb.com/GhanaHomePage/NewsArchive/Exclusive-GMA-s-list-of-demands-for-doctors-372584).

Outrageous as these demands may be regarded, they speak a lot about the flaws in our system. Just because those doctors are being supported by the Consolidated Fund—and from how everyone sees the politicians fleecing that Fund—isn't it a matter of course for the doctors to demand more than the government can grant them? But they will go this way because they have more to gain from their strike action than in remaining at post, at least, if we consider the political implications and the fact that some of the bigwigs in the GMA are politicians-in-disguise (just as it is in the case of the so-called Men-of-God).


There is no need for the government to continue "managing" the so-called hospitals where these GMA members are employed. The government shouldn't continue to pay these doctors or put itself and Ghanaians at their mercy now that we know how the situation has been politicized by self-seeking members of such an association or any other.

What should the government do, then? Privatize these hospitals and end direct management (in terms of funding and supply of equipment). The so-called government hospitals or polyclinics should be turned over to consortiums that can do a better job in managing those institutions.

It means that the other analogous issues such as professional training and recruitment of doctors and paramedical staff will not be the government's headache.

It also means that whoever seeks to become a doctor or whatever in the medical field should not depend anymore on "free tuition" or any other support net that depends on the Consolidated Fund. Elsewhere, financial aid is provided to the needy and they are required to repay such "student loans". In that sense, the government doesn't encumber itself with the financial needs of students hoping to become doctors.

If the government doesn't support those seeking to become lawyers, teachers, diplomats, etc. why should it do so for doctors? It should be the individual's own affair. Then, upon graduation, the individual must go through the rigours of job search before being recruited. In our case when everything seems to be automatically programmed to absorb those doctors, the situation isn't working well. Too much leeway has been given to these doctors, which is why they are over-extending themselves by laying down their tools at the least prompting.

In many countries that don't behave the way we do in Ghana, the regimen regarding the medical sector is rigid and strictly enforced. Why can't we do so in Ghana too?

I insist that the current strike action by the GMA should open the government's eyes to begin taking drastic measures to clean the stables so that the public hospitals, polyclinics, etc. can be better managed and the Consolidated Fund rescued.

Those hospitals, polyclinics, etc. should generate their own funds and pay staff thereby without recourse to the Consolidated Fund. The medical field is guided by principles that go beyond "incentives" and must be so appreciated. When self-acquisition and self-interests undermine the Hippocratic Oath, chaos results. The government has every opportunity to change the paradigm so those seeking conditions that it cannot meet can find their way out to be on their own. The days of Father Christmas are long gone!!

I shall return…

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Columnist: Bokor, Michael J. K.