Accra (Greater Accra) 2nd June ?99

The Ministry of Health is to explore the possibility of using people from both the formal and informal sectors, who are contributors to the SSNIT Pension Scheme as a nucleus of the National Health Insurance Scheme.

Mr Samuel Nuamah Donkor, Sector Minister, who disclosed this in Parliament on Tuesday, when he appeared before the House to answer members' questions, stated that the programme is on a pilot basis and that support would be provided for districts and communities, which have embarked upon such schemes.

A committee that would include members of the Parliamentary Select Committee on Health has been proposed to oversee its operation.

Mr Nuamah Donkor said collaboration between decentralised district health systems and the district assembly is paramount.

He was responding to a question that stood in the name of Dr. Kwame Addo-Kufuor, the Minority Spokesman on Health and asked on his behalf by Mr Joseph Henry Mensah, the Minority Leader.

Dr. Addo-Kufuor wanted to know from the Minister whether in a decentralised health service it is desirable that the district health service operates under the district assembly or the Ministry.

Continuing, the Minister pointed out that the point of divergence is the institutional arrangement within which this collaboration takes place, that is, whether district health service is part of the district assembly or the Ministry.

He declared, "we cannot ignore our immediate past regarding the problems that district assemblies are having with the environmental health division".

"We cannot also ignore a weakness in the management capacity at the district level where the health care delivery system needs a lot of technical support and supervision by the Ministry."

Mr Nuamah Donkor was asked whether it was in the national interest for medical specialists and consultants to retire at the age of 60.

He replied that health professionals, especially doctors, including consultants and specialists have in the past been offered the chance to re-apply to be engaged on contract till the age of 65 and beyond if their health permits.

The Ministry, he went on, has engaged and continues to engage retired consultant lecturers and retired professors of the two teaching hospitals when the universities have dispensed with their services.

He said the Ministry sought cabinet approval in the early half of 1998 to engage all retiring health professionals for an initial contract period of five years.

The Minister said many health professionals know the arrangement under which retired officers or those about to do so are engaged and have taken advantage of it.

Responding to a question on the provision of free medical treatment for the aged, pregnant women, and children, the Minister said the free medical care facility is limited to patients, who report for treatment at the hospitals, polyclinics, health centres and clinics in the districts, and especially at the local levels, where the majority of the rural poor live.

He explained that as soon as a patient is referred or transferred from that domain to a regional hospital, the facility ceases to apply.

On what steps the Ministry is taking to assist mission hospitals, which serve as district hospitals, to operate efficiently, Mr Nuamah Donkor said as providers of about 30 per cent of health services to the rural poor, their role in the overall health service delivery cannot be under-estimated.

He said since the role of the mission hospitals are indispensable in the provision of health services, government's policy is not to build new district hospitals in areas where mission hospitals operate as district hospitals.

Rather, he said, government would continue to improve upon both the infrastructure and the human resource base to enable them to provide the needed health services.

Mr Nuamah Donkor said, hitherto, these mission hospitals had no direct support from government, but at the moment, they are being given assistance in accordance with this policy, in the form of payment of salaries and wages of staff of mission hospitals throughout the country.

For example, he said in 1997, a total of 12.07 billion cedis were spent on salaries and wages of staff of mission hospitals countrywide.

Two billion cedis have been approved this year to meet the non-wage recurrent expenditure of mission hospitals as a way of strengthening their capacity to deliver services.

"We have also embarked upon a project to supply selected facilities with X-ray and Ultra-sound equipment to improve the quality of service in such institutions", the Minister said.

With particular reference to the Asankrangwa Catholic Hospital, which also serves as a district hospital, Mr Abraham Kofi Asante, NDC-Amenfi West, wanted an assurance from the Minister as to steps being taken to assist it to operate efficiently.

Mr Nuamah Donkor stated that an assessment of the hospital in September last year revealed that it had a weak financial management system, as a result of which the Ministry has instituted a training programme to build capacity.

Furthermore, he said, under the support programme, "we allocated some microscopes to the hospital, and as soon as the X-ray unit, which is at the roofing level, is completed, we shall install an X-ray equipment to improve the quality of service at the hospital.