The Ghana Association of Certified Registered Anaesthetists (GACRA) has threatened to withdraw anaesthesia services nationwide from December 1, 2026, if the government fails to address outstanding concerns affecting its members.

The President of GACRA, James Nwinsagra, issued the warning during the Association's 8th Annual General Meeting and Scientific Session held in Accra, under the theme, "Enhancing Safe, Equitable Access to Anaesthesia and Surgery."

He said the association had exhausted several avenues of engagement with the relevant authorities and would have no option but to lay down its tools if its concerns were not addressed satisfactorily within the stipulated period.

Among the major issues raised were "restrictions contained in the Scope of Practice document for Certified Registered Anaesthetists (CRAs), inadequate conditions of service, the absence of a formal Scheme of Service, delays in approving job descriptions and limited opportunities for professional development."

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A major concern highlighted by Nwinsagra was the continued disagreement over the recognition and implementation of the Scope of Practice for CRAs.

He recalled that in January 2022, certified registered anaesthetists withdrew their services in protest against the regulator, citing concerns including the non-recognition of the designation "Certified Registered Anaesthetist" as provided for under the Health Professions Regulatory Bodies Act, 2013 (Act 857).

The intervention of the Christian Health Association of Ghana (CHAG), which was significantly affected by the withdrawal, led to the establishment of a Ministerial Task Force to examine the concerns.

Although the task force made recommendations, Nwinsagra said the Ministry of Health had yet to issue a definitive position to resolve the outstanding matters.

He stressed that GACRA was not opposed to having a Scope of Practice, describing it as an important document for defining the responsibilities of practitioners.

However, the association objects to restrictions preventing CRAs from administering anaesthesia to children under five years, managing cases involving significant bleeding or those likely to involve blood loss exceeding 1,000 millilitres, and undertaking major procedures expected to last more than four hours.

According to him, the Ministerial Task Force warned that implementing these restrictions could deny many Ghanaians access to essential anaesthesia and surgical services, particularly at peripheral health facilities, potentially undermining the country's efforts to achieve Universal Health Coverage by 2030.

He warned that if the restrictions were enforced without resolution, CRAs would be compelled to refer children under five and complex cases, including antepartum haemorrhage, postpartum haemorrhage, placenta praevia, placental abruption, ruptured ectopic pregnancies, major laparotomies and mass casualties, to teaching hospitals where anaesthesiologists are available.

He acknowledged the potentially serious consequences for patients, particularly women and children, but maintained that the association could not ignore the regulatory directives.

The GACRA President also raised concerns about the remuneration and working conditions of its members, despite the recent completion and signing of the association's maiden Collective Agreement with the Fair Wages and Salaries Commission.

He expressed appreciation for the achievement, which took approximately two years of negotiations, but argued that the conditions approved so far fell short of members' expectations.

Nwinsagra maintained that CRAs perform highly demanding and critical duties in the health sector and should not be placed in the same remuneration category as other employees whose responsibilities differ significantly.

He emphasised that the limited number of anaesthesia providers serving Ghana's population of more than 33 million places considerable pressure on existing practitioners.

The association further expressed frustration over the absence of a formal Scheme of Service for CRAs, an issue it had previously raised at its 6th Annual General Meeting in Takoradi.

Although efforts had been made by the employer to develop the document, Nwinsagra described the pace of progress as worrying.

He disclosed that GACRA had already initiated work on a draft Scheme of Service with the assistance of its labour consultant and was prepared to support the Ministry of Health to conclude the process.

He also indicated that the association had completed a reviewed Job Description document, which was awaiting the necessary action from the relevant authorities.

The GACRA President called for the Ghana Health Service Council and Board to expedite the process and circulate the approved document to enable members to understand their official position.

On professional development, Nwinsagra appealed to the Ministry of Health to provide scholarships and sponsorship opportunities for CRAs to participate in international conferences and pursue further academic programmes.

He described such opportunities as essential to improving the knowledge, technical competencies and professional skills of anaesthesia providers.

He condemned the destruction of forest reserves, rivers and other water bodies, describing the situation as an existential threat to the country.

He expressed concern about the potential health consequences of environmental pollution and called on the President to take decisive action against illegal mining.

While acknowledging the efforts of the National Anti-Illegal Mining Operations Secretariat (NAIMOS), he urged government to intensify interventions to protect the environment and public health.

He also raised alarm over the abuse of tramadol, non-steroidal anti-inflammatory drugs (NSAIDs), alcohol and cannabis among young people.

He called on government, the Food and Drugs Authority and other stakeholders to introduce stronger measures to regulate the practice, importation and use of drugs to curb substance abuse among the youth.

At the meeting, the Director of Technical Coordination at the Ministry of Health, Dr Hafez Adam Taher, addressed participants, while the Deputy Director of the Clinical Services Development Department of the Ghana Health Service, Dr Ebenezer Oduro-Mensah, also spoke on issues affecting the health workforce.

Dr Oduro-Mensah acknowledged the workforce challenges confronting the health sector, particularly the gap between the population's needs and the available number of skilled professionals.

He highlighted the importance of career advancement, professional development, improved support systems and training opportunities.

He also encouraged greater participation by certified registered anaesthetists in emergency care and resuscitation training, arguing that their skills and expertise should be more visible beyond their traditional areas of practice.

He indicated that the concerns raised would be taken up with the relevant authorities for further consideration.

AM

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