By Otchere Darko

Ref: "Doctors threaten mass resignation: Medical doctors across the country are threatening to resign en-masse if their service conditions are not improved in seven months.

The doctors say the only benefit they are enjoying now is a two-week mortuary service.

They have given government an ultimatum of 30th June 2015 to comprehensively review their service conditions, or they leave the health profession entirely." [Curbed from Ghanaweb General News of Monday, 10 November 2014, which was sourced from: Starrfmonline.com ]

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While reading through the above Ghanaweb news report, my memory went back to 1981, which was a year that saw a massive nurses and paramedical staff demonstration against what, at that time, was rightly or wrongly referred to as "illegal hospital consultation charges by Doctors".

*I will give the background to this massive demonstration that started at Koforidua Regional Hospital where I was then working as a Senior Hospital Administrator, a position that, in those days, was referred to as Senior Hospital Secretary. The then head of the nursing staff of the hospital (the Matron) came to my office to report to me that her nurses were threatening to go on demonstration because the doctors at the hospital had started charging "private consultation fees", which they were "pocketing". The nursing head wanted me to accompany her to see the Medical Superintendent of the hospital. In those days, the organisation of hospitals in Ghana followed a system that was literally described as "the tripartite system", which divided the system of the hospital's organisational structure into three functional parts 'the medical section', which was headed by a 'medical head' who in our hospital was referred to as Medical Superintendent; 'the nursing section ', which was headed by a 'nursing head' who at the hospital level in those days used to be called Matron; and the 'lay and supporting section', which was usually headed by a lay or business administrator who in those days was called Hospital Secretary.

The meeting of the pair of us (Matron) and myself with the Medical Superintendent failed to end amicably. That failure led to the demonstration by the nurses and staff of the lay and supporting sections of the main government hospital in Koforidua. The demonstration quickly spread to other hospitals in the Eastern Region; and from that region, it later spread nationwide, leading to a virtual paralysis of the entire health services in Ghana. The then Limann government was forced by the 'looming calamity' to meet the doctors of Ghana to demand explanation for charging patients who reported to them at OPD consultation fees, even though they were working in government hospitals. After hearing their explanation, the government ordered the doctors to immediately end the "illegal hospital consultation charges".

The Limann government succeeded in ending the nurses and hospital supporting staff demonstration by removing what caused it, BUT it failed to solve the shortages in hospitals that were making the work of doctors impossible...... shortages that formed the main reason why doctors resorted to the charging of the private consultation fees. Being a Hospital Administrator at that time enabled me to know what was happening in all hospitals in Ghana between the late nineteen-seventies and early nineteen-eighties, Thus, I did feel that the doctors had a case, except that they used a unilateral and wrong way to handle the case of acute shortages of almost everything in the hospitals. The failure of the government to assist doctors to resolve the problem of acute shortages that had paralysed the health system in Ghana by the beginning of the nineteen eighties, and which forced doctor to resort to the charging of private consultation fees, which the government had forced them to stop collecting, angered several doctors in Ghana at that time and forced many of them to resign and leave the country for the Diaspora. That mass exodus of doctors led to the worsening of the already bad health service situation in Ghana in 1981.

The way the Limann administration handled the concerns of doctors and other medical personnel in Ghana in those days was one of the causes of "the messy situation" that developed in Ghana" in 1981, which gave 'opportunity-hunters' of those days a reason to jump-in and take power from the inexperienced and cool 'proxy-President' brought in by PNP gurus at a time when all the experienced politicians in Ghana had had their hands literally tied to their backs by the three previous coup makers whose regime serialisation ended with Rawlings' three-month AFRC that 'managed' the polls that saw the election of the 'professional diplomat' (Dr Limann) as the third civilian Head of State of Ghana.

If Ghana will develop in the real sense of the term, certain professionals, services, 'talents' and other 'vital groups' of Ghanaian workers must be mobilised and effectively used. These people must include doctors, nurses, and other vital supporting health personnel without whom effective health care delivery is an illusion. Other groups are the army, the police, the universities and other research centres, students and other youth, and finally but not exclusively, entrepreneurs who create businesses and employment in every country.

To mobilise and effectively use these important 'human tools for development', Ghana government must learn and know how to handle 'these geese that lay the golden eggs'. One cannot expect one's donkey to be able to carry one's heavy load for one, without one feeding and properly caring for it. If even donkeys need proper care and attention from their masters, so do doctors in Ghana who, like 'desert donkeys', work for and serve their country under very difficult situations. Doctors must be provided with the right working conditions and the necessary professional 'tools' and 'gears' they need to enable them to serve their nation. They must not be put in situations that compel them to leave Ghana to other countries; neither must we force doctors to resort to illicit decisions and actions or unorthodox practices that run counter to the ethics of their profession.

Of course, no government can spend money it has not got. And money does not come by out of the blues, like the "manna" that dropped from the heavens to feed the Israelites fleeing from Pharaoh. Money must be 'made' through wealth creation. It is the duty of every government to create, or help the private sector to create wealth for its country; and to use the wealth so created judiciously, for sustenance and for further future wealth creation. Where governments fail to create enough wealth in their countries, citizens of such countries suffer.

*In countries where governments have failed, suffering citizens must not, however, allow their predicaments to crumble them up. They must pull themselves up, despite the suffering they go through, and strategise to turn things round. *Our 'suffering doctors' and all Ghanaians, including the government itself, must avoid using ultimatums and other coercive strategies to demand 'what is not there'. An Akans proverb literally says "nobody goes to the grave of [poor] 'Father Ananse' to hunt for treasure". *We must elect dedicated, wise, visionary and selfless Ghanaians into government and work with the governments we create to solve problems facing the nation. *Nearly hundred percent of Ghanaians are corrupt and selfish. You and I are as corrupt and selfish as the governments we elect. Thus, solving the several problems facing us and causing the suffering we are going through must begin with eschewing corruption and other negative behavioural tendencies that negatively impact on our developmental efforts. *Please, doctors and other Ghanaians, let us all change and look for ways to move away from the 'mess' we ourselves have created for ourselves ever since we attained independence in 1957.