PRESS RELEASE BY PROF. KWABENA Frimpong-Boateng On His “Dismissal” AS HONORARY DIRECTOR OF THE NATIONAL CARDIOTHORACIC CENTRE AT THE KORLE BU TEACHING HOSPITAL


It is my humble opinion that I owe it as duty to Ghanaians at home and abroad, international citizens in Ghana and all individuals, organizations, institutions and Governments that contributed to the establishment of the National Cardiothoracic Centre to present my side of the story regarding the recent problems at the National Cardiothoracic Centre. If there other reasons that prompted my dismissal by government apart from what I have presented in this release I do not know and I do not want to speculate.


I crave your indulgence to present a brief historical background.
In August 1981, whilst still on the staff at the Division for Thorax and Cardiovascular Surgery, Hannover Medical University in Germany, I proposed the establishment of a modern Cardiothoracic Centre in Ghana. Initially very few people in Ghana believed that the mission was possible and feasible.
Indeed the initial resistance to the proposals was formidable but against all odds the National Cardiothoracic Centre was started in 1989. It took three years of hard work and the official commissioning by the then Head of State, Chairman J.J. Rawlings, took place on 2nd April 1992. Over the years the modest centre has grown to become the foremost Cardiothoracic centre in Ghana and one of the few active centres in Africa. It has been accredited by the West African College of Surgeons as a centre of excellence to train heart surgeons, cardiothoracic anaesthetists, cardiologists, perfusionists (technologists who operate the heart-lung-machine) and nurses.


In this regard I would like to acknowledge the support given by the then Head of State, Chairman J.J. Rawlings, his wife, Nana Konadu Agyeman Rawlings and many other individuals including Ato Ahwoi, P.V. Obeng, Dr Mrs. Mary Grant, Nana Akuoko Sarpong, Air Commodore Klutse, Kwesi Botchway, Mr. Owusu Agyei.
I am forever grateful to Chairman Rawlings for his commitment and support to the establishment of the centre. The first time I ever saw him was when he came to Korle- Bu to commission the new National Cardiothoracic Centre (NCTC). I became convinced following his speech that his support was not based on political expediency but that he believed in the project and that really encouraged me.
The PNDC government secured suppliers credit from the German government for the core equipment for the centre to be purchased. The government, however, did not provide any suitable accommodation for the equipment so I took it upon myself to initiate and construct a block for the centre.


I sketched the distribution of spaces and flow within the block and gave the sketches to Engineer Danquah of Macdon’s Ltd. who provided all the structural and architectural drawings and helped with supervision of the construction without charging any fees whatsoever. Mr. Kwame Antwi Boasiako, a draftsman/ construction foreman also provided invaluable assistance with supervision. On the electrical works Mr. Akwasi Nti Addai offered his services free of charge.
We had to gather a group of artisans to do the actual construction work because we did not have the money to hire a contractor. We got a group of artisans mainly from Mamprobi, Korle Gonno and Chorkor who were supervised by a team including Eng. Danquah, Antwi Boasisko and my humble self.
The whole project took off with my personal seed contribution of five million Cedis. Subsequently, several individuals and institutions donated in cash and kind towards the project and the construction was completed in two years. The biggest donation came from Mr. R.G. Patel, who organized the Indian Community in Ghana to give us one hundred and twenty thousand US dollars (US$120,000.00). The engineers and other specialists estimated my “sweat equity” at two million US dollars.


As the only heart surgeon at the time I had to prepare for the day when I would retire from Korle Bu. Therefore right from 1992 I drew up a structured programme for human resource development to train personnel to man the Centre. Currently the centre can boast of highly talented, motivated and competent surgeons, cardiac anesthetists, peri-operative and intensive care nurses and perfusionists. Quite apart from these Ghanaians, an Ethiopian, a Togolese and about twenty five (25) Nigerian Doctors have received their training in Ghana and a large number of them are on the waiting list.


Transition Period


The cardiothoracic Centre is presently in a transition period which really started 5 years ago. I have been planning to leave structures and processes in place to ensure the survival, growth and sustainability of cardiothoracic care in Ghana so that, unlike most institutions in Ghana, the next generation will not become a pioneer generation and still be confronted with basic developmental challenges.
About five years ago I decided that when the Centre had a reasonable number of cardiothoracic surgeons, anaesthetists and other support personnel it should embark on a programme of sub-specialization. In other words it was not optimal to have only general cardiothoracic surgeons such that one person has to operate on the hearts of adults and children and also to be performing other surgeries on the lungs, blood vessels, the oesophagus (gullet) among others. For optimal patient care and to promote research and accelerated training there had to be sub-specialization.

Dr. Mark Tettey decided to specialize in Thoracic Surgery and so for about 5 years now he has become the foremost surgeon in thoracic surgery. The NCTC went ahead to purchase expensive equipment that enables Dr. Tettey and his team to perform keyhole surgeries in the chest.

Dr. Frank Edwin expressed his interest in paediatric heart surgery and the Cardiothoracic Centre in collaboration with the Walter Sisulu Foundation in South Africa sponsored him to specialize at the Walter Sisulu Heart Centre in South Africa. Dr. Edwin returned to assume active duties at the Centre just two weeks ago.
The Centre has dispatched Dr. Kow Entsua Mensah to South Africa to pursue studies also in paediatric Heart surgery. With him are a group of six nurses who will also specialize in the care of children undergoing heart surgery.
Dr. Martin Tamatey, another young specialist wants to sub-specialize in adult heart surgery and the cardiothoracic centre is sponsoring him to spend a year at a university in India from September 2011.
Dr. Kofi Gyan Baffoe, another young surgeon has expressed interest in transplantation and artificial heart support systems and he may go to Canada for a few years after Drs Tamatey and Entsua Mensah return to Ghana next year.
These and other programmes have been put in place and as is self-evident I have been planning to take a back seat and step aside some day since setting up the cardiothoracic centre.

Relocation

Since the establishment of the cardiothoracic centre the population of Ghana has increased from 15 million to over 24 million!! Obviously the number of patients with heart and cardiothoracic disorders has also increased.
Indeed during the 20th anniversary celebrations of the Cardiothoracic Centre in August 2009, I informed the staff of the Centre that I was retiring and handing over to the next generation of leaders. However, at a clinical morning meeting with all the senior staff, they requested that I stay on and lead them to complete the relocation project of the Center and finalize the autonomy status of the Centre.

The present facilities can no longer adequately meet the needs of the population. Therefore since 2009 the Centre has drawn up plans to relocate and has been looking for land outside Korle Bu for that purpose. The College of Health Sciences has 400 acres of land in Legon earmarked for a university hospital complex. In 2009, I made an official request to the University of Ghana for an allocation of 20 acres of the 400 acre property for the National Cardiothoracic Centre. The university has been lukewarm on this issue and has not given us any encouraging response.

Recently, I got to know that the individuals who are to take decisions that will facilitate the relocation of the Cardiothoracic Centre are the same people who want to absorb the centre into the Korle Bu system. It is therefore not surprising that the decision to allocate land to the Centre has delayed for two years.

The Hon. Minister of Health has been briefed about all these relocation plans and basically I was waiting for the land and autonomy issues to be resolved before leaving the centre.

Areas of Conflict with Korle Bu Hospital

When the centre was commissioned in 1992 there was no legal instrument establishing it as an independent entity. Nevertheless Chairman Rawlings, in his wisdom, stressed in the commissioning address that the centre should maintain its unique national status. I quote from his address given on Friday 10th April 1992: “Ladies and gentlemen, the Cardiothoracic Centre we are commissioning today is national in character and we all owe it a duty to accord it that status. I therefore charge the Ministry of Health, the Korle Bu Teaching Hospital Board and the Medical School to get together and draw up a plan that will ensure that the Centre's potentials are fully exploited to the benefit of Ghanaians and indeed the people of the sub-region”.
The understanding is that although the National Cardiothoracic Centre is located on the Korle compound it is a National Institution whose independence is to be maintained.
I very well remember that at the commissioning of the Reconstructive and Plastic Surgery Centre in 1997 and much later the Nuclear medicine and Radiotherapy Centre President Rawlings stressed the need to maintain the unique national character and independence of these facilities. These facilities operated efficiently for the benefit of Ghanaians under the dispensation of financial and administrative autonomy.

Over the past two years, however, the Korle Bu Hospital Authorities have been covertly trying to undermine the independence of the Cardiothoracic Centre, which is regarded as one of the Centres of Excellence on the Korle Bu grounds. The other Centres of Excellence are Reconstruction and Plastic Surgery, Radiotherapy and Nuclear Medicine Centre and the Centre for Clinical Genetics.
The present Korle Bu Management Team and the Board Chairman do not seem to believe in or accept the concept of decentralization. In spite of the many challenges facing the Korle Bu Teaching Hospital, they want to take over the administrative and financial management of these Centres of Excellence.
As at now the Korle Bu Management has succeeded in taking over the financial management of every facility in the hospital apart from the Cardiothoracic Centre. The irony of the situation is that the hospital authorities do not supply inputs for prompt management of patients in these centres with the result that major challenges are creeping into the operations of these centres with the attendant compromise in patient care. There are serious shortages of all medical inputs and infrastructural problems everywhere in the Korle Bu Teaching Hospital.

I believe in the total financial and administrative independence of these centres of excellence for reasons of efficiency and effectiveness. I have always made it clear to the Korle Bu Management Team and the Hospital Board that it will be most unfortunate and unwise for the Hospital to take over the financial management of the Centres of Excellence and that as much as possible I will continue to advocate for the independence of these Centres of Excellence, especially the cardiothoracic centre and resist any takeover attempt by the Korle Bu administration that is already confronted with other pressing problems they seem helpless to solve.
As I stated earlier on not everybody in Korle Bu shares the view that the Centres of Excellence must be financially and administratively autonomous to foster their continuing growth and sustainability. Regrettably some key senior members in authority in Korle Bu think that Korle Bu is not doing well because of the independence of the Cardiothoracic Centre.

These senior members believe that the Cardiothoracic Centre is doing well and generating a lot of money, which when put at the disposal of the Korle Bu management will improve the fortunes of the hospital as a whole. They believe that Prof. Frimpong-Boateng is a tyrant and an obstacle to the progress of Korle Bu and that when I am gotten rid of not only will Korle Bu improve but also the personnel at the Cardiothoracic centre will rejoice.

When the Board Chairman met the Cardio doctors on Monday 29th August, 2011 he confirmed that when he took over as Board Chairman it was his intention to make sure that there were no autonomous or semi-autonomous departments or centres in Korle Bu. According to him all facilities should be placed under the Korle Bu Board. This is contrary to the Sub-Budget Management Committees Concept that sought to decentralize the hospital’s financial administration such that efficiency will be the entrenched policy of Korle Bu. These two individuals have also attempted to interfere with the staffing of the Cardiothoracic Centre.
A Ghanaian Paediatric Cardiologist now working in the United Kingdom applied to join the Cardiothoracic Centre. She worked as a medical officer at the Cardiothoracic Centre in 1996 and developed an interest in cardiology. The Cardiothoracic Centre mentored her and followed her development over the years. Therefore I thought it was only natural that she should rejoin the Cardiothoracic Centre with her new expertise, to complement the diagnostic and patient care efforts of the cardiothoracic surgeons. She applied for employment through me to the Ministry of Health and the Korle Bu Authorities were asked to conduct an interview. When the doctor arrived for the interview three weeks ago she was told by the Medical Director that she could not work at the Cardiothoracic Centre but rather in the Children’s block; well knowing that there are no facilities in the children block for any cardiologist to do any meaningful and useful work. She has since returned to the UK and I hope and pray that she will return to serve mother Ghana.

When I was CEO of Korle Bu Hospital a lot was achieved by the management team under the guidance of a very capable Board. We served Korle Bu well. Internal generation of funds was optimized and a lot was generated to bring about phenomenal changes in Korle Bu. During the period Korle Bu’s internally generated two times more money than Komfo Anokye Teaching Hospital. This enabled Korle Bu Teaching Hospital to pay its bills, maintain equipment, execute several infrastructural projects and also made sure that there was always adequate supply of drugs and other consumables.
Korle Bu has serious challenges. There are at least fourteen (14) private medical laboratories, ultrasound and other imaging units lined on the opposite side of the Guggisberg Avenue, all managed more efficiently than similar facilities in the Korle Bu Teaching Hospital and competing with Korle Bu Hospital for income.

If some individuals are presiding over and supervising the gradual decay of Korle Bu they should not blame it on me and should not be allowed to extend it to the Cardiothoracic Centre.

What is happening at the cardiothoracic centre has absolutely nothing to do with transfer of Prof. Frimpong-Boateng from the Medical School to the Ministry of Health or vice versa nor has it to do with my age. It has also nothing to do with any appointment, honorary or otherwise. It has everything to do with the inordinate ambition of certain individuals using their connections to take over the cardiothoracic centre in an attempt to get access to what they think is a pot of money. The cardiothoracic centre is where it is because of hard work and a conscious desire to succeed that has resulted in effective and efficient management.


Succession Planning and Handing over
Cardiothoracic Care is complex and its leadership should be handled with utmost care. This is a centre that operates at a level higher than the normal university hospital. To be able to head and manage the NCTC well we need a person with the following qualities:

1. Someone who can manage the human capital and communicate well at the centre
2. That person should demonstrate sound academic credentials especially in research and contribution to the world body of knowledge
3. Someone who is a good administrator and demonstrate leadership qualities
4. A person of integrity with sound moral and ethical standards
5. A role model for staff especially junior ones
6. Someone who will encourage others to advance academically and professionally
7. Someone who will have an ear for the social and other challenges facing members of staff.
8. Someone who will listen and consider the opinions of others, including subordinates.
So far so much has been achieved:
1. For about 4 years now a group of four manages the accounts of Cardio. I do not have to be at the Centre for a cheque to be signed.
2. I am not involved with requisition or procurement of anything. Those responsible do that. They only ask for my opinion or inputs.
3. I do not keep any files in my office.

The recommendation of my successor was the only thing left to be done. The challenge is that you cannot hand over a complex institution like the Cardiothoracic Centre to just any one. A suitable successor as Director of the Centre is the person who fulfills the characteristics listed above. I believe that very soon Ghanaians will come to appreciate and understand this very well.
My tasks over the last 2 years, as defined by senior members of the team, were to secure the autonomy of the centre and other Centres of Excellence and to negotiate with University of Ghana’s land allocation committee to get land for the relocation of the new Cardiothoracic Centre.
I will still work for the Ghana Heart Foundation. Those well-wishers who have been calling me and also sending messages indicating that you are considering stopping your contributions to the Heart Foundation please continue with your much needed and appreciated support.
I want to say a few words about the dismissal letter from the Hon. Minister of Health who has never visited the Cardiothoracic Centre before. If only someone had called me for a little chat we would have spared all the embarrassment not only to me but also to the Minister and Ghana as a whole. He was ill advised and those who did it and drafted the letter for his signature must be carefully watched, for they may do it again.
Essentially the letter says my appointment as Honorary-Director has been terminated with immediate effect. The question is how do you even terminate an unremunerated honorary appointment?
The letter then goes on to thank me for services rendered to the cardiothoracic centre. The least he could have done was to thank me for setting up the centre against near insurmountable odds.
The Press Statement released by the Government made reference to the retirement age, giving the impression that it was my wish to stay on indefinitely. I am not over 62 as the Government Statement wanted the world to know. I am sixty one (61) and strong, by God’s grace. I am not the person who wants to overstay his welcome.

His Excellency the President may also recall that almost exactly 11 years ago, when he was the Vice President I had a similar problem with some detractors in Korle Bu and the Ministry of Health. At the time I wanted to tender my resignation to President Rawlings. Dr. Mrs. Mary Grant accompanied me to the Castle. The President had travelled so I was ushered in to see Vice President J.E.A Mills. I believe that His Excellency President Mills will recall the conversation that we had. After listening to me he said: “Doctor you came to Ghana to help the people of this country. You are not here because of a few detractors. In God’s name please go back and do your work”.
The kind words of the then Vice President encouraged me and I was very thankful and went back to the Cardiothoracic Centre. I was all the more determined to work hard and also train the next generation of heart surgeons. It is therefore wrong for anyone to suggest that I am afraid to go on retirement and link the “dismissal” letter to my age.
I believe that His Excellency the President will recall that shortly before he left for Canada in 2001, I believe, to lecture in one of their Universities, he visited the Cardiothoracic Centre and I had a rare and privileged opportunity of hosting him in my office. The two of us discussed a host of issues and I took the opportunity to tell him about the structure of the Cardiothoracic Centre and my vision for cardiovascular medicine in Ghana. We got to know and appreciate each other better and I can assure the President that just as he encouraged me I will continue to serve Ghana the more.
My wish now is that the next generation of workers at the National Cardiothoracic Centre will be successful and that the autonomy and independence of the Centre will be guaranteed.
I also recommend that the independence and autonomy of the other Centres of Excellence namely: Reconstructive and Plastic Surgery, Radiotherapy and Nuclear Medicine, and the Institute for Clinical Genetics should be restored and guaranteed.
I want appeal to Ghanaians, especially those in the Diaspora, who because of what has happened to me have been calling me and sending messages that Ghana is not worth dying for and for that reason are not encouraged to return home and serve to rethink their position.
Yes, I agree that, on the surface, one may say that Ghana is a country not worth dying for but I believe it is precisely for that reason that we should die for Ghana. Because If you die for a country worth dying for, it is no longer a sacrifice but it is a big sacrifice if you die for a country not worth dying for.
I wish to thank Ghanaians for their support and encouragement all these years. Please continue to have confidence in the National Cardiothoracic Centre.
I wish to appeal, once again, to the German Government that put in so much to get the Cardiothoracic Centre started not to be dismayed at what has happened. Please do not take a decision that will affect the development of such high-tech medicine in Ghana or any other developing country.
I want to reiterate my appeal to our international partners such as USAID, the American Embassy, SOS International and West African Rescue Association to still have confidence in the Cardiothoracic Centre.
I thank former President J.J. Rawlings for the extraordinary support he, his wife and key members of his administration gave me during the early years that enabled me, 39 years old at the time, to establish and lead the cardiothoracic team to the success evident today.
I thank former President J. A. Kufuor for the trust and confidence he had in me and allowed me to serve Ghana both as CEO of Korle Bu and Director of the National Cardiothoracic Centre, a period which witnessed the transformation of Korle Bu to a hospital of excellence worthy of health tourism.
I thank His Excellency President J.E.A Mills for giving me the opportunity to serve the Cardiothoracic Centre during the two and half years of his administration.
Finally, I thank my dear wife, Agnes and our children for their love, support and encouragement.
I want to end by reminding Ghanaians that: Great Institutions are difficult to build, easy to destroy and impossible to restore.

Accra, 5th September, 2011