Feature Article of Saturday, 26 January 2013
Columnist: Quaye, Emmanuel
On November 24, 2004, Ghanaweb reported a call from the Minister of Defense for a medical school to be established on the campus of the University of Ghana (UofG) at Legon. (1) On November 25, 2012, Ghanaweb reported that the UofG has started construction of a 600 bed hospital on the campus of the university at Legon. (2) Eight years after the initial announcement, work has finally started on the project, a very welcome development. As indication that this government is serious about the project, the current president has announced a number of presidential priority projects that include health care development. (3) It took eight years from the initial announcement by an NPP minister, to beginning of the project by an NDC government. In those eight years, a lot has happened; a Ghanaian president has died in office after much publicized foreign trips for health care. In the process, the inability of the Ghanaian health system to cater to the needs of its most honorable citizens is exposed. In like manner, the inability of our neighbors to cater to the health needs of their leaders has been exposed.
Even though the wealth and political leaders can travel abroad for health care, some illnesses require that services be available locally. In 2005, when President Eyadema died, he was on a plane to Europe for health care after an apparent heart attack. (4) The availability of adequate cardiac emergency services, in Togo or even in Ghana, might have saved his life. Thus the responsibility of a medical center and teaching hospital at University of Ghana has been clearly defined, and it will no longer be just to teach medical students, and treat patients, but to provide the highest quality and scope of health care that would meet standards of quality anywhere in the world, and make it unnecessary for Ghanaian leaders, or any Ghanaian, to travel to other countries for health care. The benefits of a project like this go beyond the health and well being of Ghanaians. With savings from travels abroad for health care, and income from medical tourism, the impact on the national economy will be positive, and long lasting. This is the message to health policy makers, and the leaders of the medical school.
Because it took 8 years from the initial announcement to breaking ground for the project, I am concerned about timeline for this project. Is there an urgency regarding the project? What type of timeline are the contractors for the project operating under? Would this project take so long that, by the time it is completed, it would be obsolete? What would it take to open the hospital complex for operation once completed?
In this regard, the most important consideration would be manpower. How many physicians would it take to operate a 600 bed major medical center? Does the University of Ghana, or the Government of Ghana have any plans to have adequate staff (physicians and surgeons, nurses, medical and nursing aids, non-physician medical professionals such as radiology, respiratory technicians) trained to operate equipment, and provide service once the complex opens? How about non-clinical service personnel to ensure that the equipment run smoothly? Timeline is important when one considers the time it would take to start a training program that would produce the needed professionals to make sure that everyone is in place to work on day one, when the medical center opens. I am quite sure the medical administrators and policy makers have already thought about these concerns. However, it is good to let them know that others are thinking about these same issues.
The report said: ?When completed all the University's constituent institutions would be relocated from the Korle Bu Teaching Hospital at Mamprobi to the new hospital.?
This is an alarming development if the plans are to relocate the medical school completely from Korle Bu to the university campus. Most, if not all academic medical centers in the US operate their clinical programs from more than one hospital. Some of the hospitals are wholly owned by the university, as I suppose this new hospital will be. Some of the hospitals are public institutions, often belonging to the city or the county that the university is based in, and some belong to the federal government or its agencies, such as the Veteran Affairs medical centers. If ?all the University?s constituent institutions? are relocated to the new hospital, or as Prof Aryeetey noted, ?the project marked the beginning of relocating the Korle Bu of the University,? what becomes of the rich patient resources at Korle Bu? What becomes of the buildings and the hundreds of acres of land that is Korle Bu? Perhaps, the Ministry of Health and the University of Ghana need to explain this further. A major cosmopolitan center such as Accra, with over 2 million people needs more than one major medical center in order to provide adequate health care to its people.
Again, the policy makers have probably thought through this issue already. Yet, it is important to let them know Ghanaians care about the future of Korle Bu. ?The Deputy Minister expressed the hope that when completed it would be self-financing and be opened to the public and citizens from the West African sub-region and beyond.? Eight years ago, a statement like this might have sounded like an impossible dream. Today, such a project would be incomplete unless it has the scope and quality to attract patients from neighboring states, and keep Ghanaians at home for health care. Such a project would be successful only if it has provisions for growth and expansion in its scope of services. That means this project should not only be designed to provide quality care, but must be research based. Such a project, to grow and expand, must exist and thrive in an environment in which there are other institutions competing and collaborating. Such a project, to grow and expand, must exist in an environment in which there are ancillary industries to support its mission.
In other words, the University of Ghana Medical Center must be created in an environment of a Medical Industrial Complex with other hospitals, a variety of ownership: academic institutions such as UofG, public institutions such as Korle Bu, and a variety of private institutions spanning the spectrum of non-profit and for profit institutions. Such a complex of hospitals will depend on ancillary businesses to carry out their missions. Supporting ancillary businesses will be in the hospitality industry, manufacturing in the health care industry, service companies, and training institutions to provide a pipeline of employees, goods and services to support this medical industrial complex. All that I am proposing does not have to be housed on one campus, nor even in one city. For example, a company that produces solutions for intravenous infusions can be located anywhere in Ghana, so long as its products can reach destination in a timely manner to be used. However, a hotel that caters to family members of foreign patients must of necessity be located close by. All of this can be coordinated by policy makers from various related ministries, with a common goal. That is why I am happy that the president has included health care among his priority concerns. It shows that he means business.
I am proud of the series of developments in Ghanaian health care, and I remain hopeful that this government will transform Ghana?s health system into something all Ghanaians can be proud of.