What John Mahama said during his last digital conversation on health care and infrastructure in Ghana

Former President John Dramani Mahama took another turn to interact with Ghanaians via Facebook on Thursday, April 30, 2020.

In his latest Facebook Live session on Thursday, the flag bearer of the National Democratic Congress (NDC), said:

“The reaction of the public to the President’s promise to construct 94 new hospitals in one year is understandable, considering his rather tall list of unfulfilled or poorly-implemented promises from yesteryears.”

The former president also touched on the status of health care delivery in Ghana now.

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Below is John Dramani Mahama’s full statement:

Hello and welcome to another valuable opportunity to interact and share ideas on issues that will impact the growth of our country and economy.

For me, these sessions, which I started before these challenging COVID-19 times, have proven to be a great resource for generating ideas.

It has also created a platform for sharing useful thoughts for the development of our dear country.

Going through your emails, your reviews and suggestions sent via the LET’S TALK platform on my website, I cannot thank you enough for the interest and commitment we all have towards building a country that provides a just and equitable life for its citizens especially in times such as this.

I want to invite you to join this conversation from wherever you are now, watching across the various digital platforms and via television or listening on radio.

Use the hashtag #JohnMahamaLIVE and let’s have another exciting digital conversation.

From the outset, let me reiterate my advice, ladies and gentlemen that we must continue to observe the WHO preventive protocols of handwashing with soap under running water; use alcohol-based hand sanitizers; ensure physical distancing; and wear protective masks.

An update by the Ghana Health Service puts Ghana’s confirmed cases at 2,074, with 212 recoveries and 17 deaths.

The cases are spread across 12 of our 16 regions, with Greater Accra being the epicentre with 1,795 cases.

Clearly, we have passed the containment phase of the disease and are currently having to fight against a community spread.

While the official statistics are what we have to work with, it is clear that actual cases may be far more than have been captured because of constraints in testing capacity.

Unfortunately, government has still not come out with any comprehensive plan detailing its strategy in the Coronavirus response.

As the President implied in his last address, our destinies are in our own hands. He urged Ghanaians to exercise self-discipline by respecting the social and physical distancing guidelines, and wear masks to avoid infection.

Our healthcare workers are among those with the highest risk of contracting the virus.

There are continuous reports that basic protective gear, temperature readers and other essential items that the President says have been acquired to enable them fight the disease have not been made available to the health facilities.

Reports of health staff having to buy their own PPEs have been filtering through from various health facilities.

It is difficult to fathom the inaction of government in this respect considering the access it had to almost GH¢8 billion- within weeks of the pandemic.

I recently listened to the testimony of a patient who has recovered from the illness and it is obvious that social stigmatization of persons who are known to have been infected by the virus has begun.

Public education and awareness about the nature and transmission of the disease, in all the major languages of Ghana, has been unsatisfactory.

This is reflected in the lack of respect for social and physical distancing and other preventive protocols, despite the exhortations by the President.

The advent of the COVID-19 pandemic in Ghana has also provoked quite a useful debate about the need for a more robust and effective health system.

It has become obvious that the system must not only be responsive to the immediate and long-term health needs of our people, but also withstand emerging global public health challenges such as this novel infectious diseases.

It has been widely acknowledged that some of the critical investments we (and I am referring to the National Democratic Congress administration in which I was Vice President and later President), made in the health sector have proved extremely useful and enabled Ghana lessen the impact of this pandemic on our people and our nation.

My brothers and sisters, this acknowledgement bears out the vision and clear thinking that went into the massive investments we made in the health sector.

There were uninformed and snide attacks at the time, some questioning why many such health infrastructure facilities were being constructed.

We were acutely aware, however, that these investments were necessary to modernize a very fragile and weak healthcare system.

What we had at the end of 2016 was not the optimum but great gains had been made.

So, if government had diligently continued and added a few more beds and enhanced medical equipment, our situation would have been better than it is today.

The pressure on the existing facilities and our health personnel would have been much less.

We pumped in the needed resources to establish heath facilities at all levels– from Quaternary, Tertiary, Regional and District Hospitals to Polyclinics, Health Centres and CHPS compounds.

These had the effect of opening up the health system and making healthcare accessible to all including unserved and underserved communities in even the remotest parts of our country.

There were a number of these health facilities, which were not completed by the time we left office and only required a little more effort to complete.

The natural expectation was that the succeeding government would swing into action and have them completed and press on to make even further investments in the sector to make the goal of health for all a reality, sooner than later.

It was also thought that those that had just been completed, at the time, would be operationalized for use by the Ghanaian public in whose name and for whose benefit the facilities were established in the first place.

Government, citing very strange reasons, dithered in the operationalization of even those hospitals that were completed.

The government also failed or refused to complete several key projects that we undertook not just in the health sector – roads, education among others. A clear case of putting politics before the people.

A classic case in point is the University of Ghana Medical Centre, which I inaugurated in December 2016 and which was ready for use at the time.

After an avoidable but protracted tussle with the University of Ghana over the management of the facility, and misleading claims by the Health Minister that the facility did not have a standby power system, it had to take a one-man-demonstration and the COVID-19 pandemic for only parts of the hospital to be opened to treat patients.

This is a 650-bed tier four hospital that can render cutting-edge services to our people.

Today, that facility’s ICU, left abandoned for more than three years, is saving lives – serving the very purpose for which it was built.

Because of the advanced nature of the equipment and facilities in the hospital, health staff were sent to Israel for specialized training to come and operate the hospital.

These staff have still not been put to work and are currently dispersed all across our health system. The training they received has unfortunately been under-utilised.

Similar delays have been experienced with the Municipal Hospital at Ofankor and the Kasoa Polyclinic both of which we constructed as part of the community development components of the Awoshie-Pokuase road and the Kasoa Interchange projects.

Two years after they were completed, it had to take intense media and public pressure to get them opened.

All this was as at a time when the no-bed syndrome had resulted in a sad situation where patients in need of urgent medical attention were turned away from hospitals because of congestion, resulting sometimes in avoidable deaths.

Ghanaians died when hospitals, completed and ready, with a combined capacity of 900 beds had been left standing idle.

But for the deliberate slowdown of operationalization of the University of Ghana Medical Centre and the Bank Hospital, the unacceptable ‘No Bed Syndrome’ would not have claimed these precious lives.

Talking about the Bank Hospital – the rather curious case of that hospital and the International Maritime hospital cannot escape mention.

These are ultramodern world-class hospitals built with public funds and yet have either remained shut or under-utilised.

Particularly worrying is the abandonment of some major health facilities that had reached an advanced stage of completion by the time we left office.

I refer specifically to the NMS project under which seven fully equipped 120-bed District Hospitals with staff accommodation commenced in 2013 at Dodowa, Kumawu, Fomena and Abetifi.

By early 2016, the Dodowa hospital had been completed and commissioned into use, while those at Kumawu, Abetifi and Fomena had reached advanced stages of construction by the time we left office in January 2017.

Whatever the challenges, these projects should not have been abandoned, and left at the mercy of invading weeds and reptiles and in some case destroyed by bush fires.

Chiefs, Queen mothers and residents of these communities have on many occasions begged and appealed to Government to allow the contractors to resume work, but to no avail.

And what has been the cause of the abandonment and stoppage of work, despite the availability of funds for the continuation and completion? Fruitless and malice-driven Value for Money audits that yielded virtually nothing.

Another case in point is the almost one-year delay of the Euroget de Invest hospital projects.

This project involved hospitals in Tepa, Nsawkaw, Twifo Praso, Salaga, Konongo, Kumasi Regional Hospital at Sewua and a new Military hospital at Afari in the Ashanti Region.

For one year after the new government came into office, these projects were stalled because the project managers were asked to pay duty and taxes on material and equipment at the port even though they had a valid exemption granted by Parliament.

This situation has robbed the people of Ghana of the timely opportunity to access quality healthcare, which would have been offered in the catchment areas of these facilities.

But for the inexplicable failure to continue these projects, we would have been in a much better position to tackle this COVID -19 pandemic across the country with a more robust health system.

In addition to more health workers being employed, they would also have had a more congenial environment to offer their critical service; and our people, more dignifying places to seek healthcare.

While even more investment is required to augment the existing health infrastructure, it is important that the plan to do so is credible and clearly thought- through.

What should be avoided are knee-jerk promises that appear reactive rather than the product of critical thinking and a well-coordinated response to an existing or emerging problem.

Ladies and Gentlemen, the reaction of the public to the President’s promise to construct 94 new hospitals in one year is understandable, considering his rather tall list of unfulfilled or poorly-implemented promises from yesteryears .

I believe in a well thought-out and forward-looking agenda, which ensures further strategic investments in our health sector meet contemporary and future challenges.

This must take into consideration the grave threat posed by global pandemics like COVID-19, SARS, MERS, EBOLA among others.

It is in furtherance of this vision that I announced on my visit to the Western North and Bono East Regions in July 2019 that if elected, God-willing in December 2020, I will establish a Regional Hospital in each of the six newly created regions.

I also indicated that I will ensure the provision of a modern health facility in each district that currently does not have one as part of my ‘’health for all agenda.’’

All districts would receive a modern health facility. These facilities would range from polyclinics to district hospitals.

Proper planning requires that we take into consideration location, demography, population and health needs of the area.

There are, for instance, currently districts with well-functioning hospitals owned by faith-based organizations. In such cases, we will partner with the organizations to upgrade their hospitals to improve their services rather than duplicate it with a public hospital.

In districts where there already exists Polyclinics or health centres that are overstretched by population growth, we will upgrade them to the status of hospitals.

I reiterated these in my Facebook Live sessions late last year.

Furthermore, I re-emphasised this commitment in two public engagements since the outbreak of COVID-19 in Ghana.

First, was when I donated PPEs and other medical supplies to several hospitals across the country in a bid to save health workers from being infected.

Similarly, I reiterated my vision to build a robust health system when I presented food items to 20,000 households during the lockdown period.

On these two occasions, I stated the need for greater investments in healthcare to ensure a total state of readiness at all times to respond to pandemics of the nature we currently face and other disaster situations.

And I promised to start and complete phase 2 of the Greater Accra Regional Hospital (Ridge); expand and double the capacity of the 37 Military Hospital; construct two (2) international-standard Infectious Diseases Centres; and establish two additional international research centres, with capacity like the Noguchi Memorial Institute for Medical Research and the Kumasi Centre for Collaborative Research in tropical Medicine.

I have also proposed to establish a National Infectious Disease Response Plan that will enable us prevent the entry of such diseases into our country as we did in the case of Ebola.

In all these, let us not forget the ultimate goal is to build a health system, which is ready and able to protect our citizens and health workers, against current and emerging threats.

This is the reason why protective equipment and related logistics will become a permanent feature of our response plan and will form a significant part of our strategic medical supply stock.

These projects will be carried out using contemporary financing models that bring down costs such as equipment leasing, which has proven cost effective and is in use in a number of advanced healthcare jurisdictions.

In his last broadcast, and indeed in previous ones, the President echoed many of the ideas and policies I have previously outlined. It is gratifying to note that he is listening.

Any addition to our health infrastructure is ordinarily welcome. But it is regrettable that it had to take COVID-19 to jolt him into reality about the importance of such critical investments in healthcare.

That said, the fundamental difference between our two respective positions is that I come to the table with an established track-record of actually delivering many of such projects with less resources than he has had in the last three and half years.

Fellow Ghanaians, the NDC comes to the table with a clear plan of modernization of our healthcare system.

This plan considers global best practices and will have features that guarantee equitable access to quality healthcare for all Ghanaians.

I have taken due notice of concerns expressed by the Ghana Medical Association about the availability of health personnel to man new health facilities.

Here too, the NDC has a plan. I announced in my interaction with you last December, that we have concluded a public sector Human Resource Gap analysis to guide our employment policy going forward.

The analysis shows that for Ghana to reach the universally accepted optimal levels of health delivery and bridge the yawning gap between health professionals and our population, the Ghana Health Service would require an additional 86,000 health personnel.

If we prioritize properly and reduce the large army of ministers and other political appointees, we could probably make more space to accommodate our nurses and doctors who are sitting idly at home.

We have done it before. With the limited resources available to us, my administration employed the largest number of health professionals in recent times.

Under my watch, forty-one thousand four hundred and eighty nurses were employed by the Ghana Health Service – we increased the number of nurses from 11,125 in 2012 to 52,605 in 2016.

This can be verified from the Facts and Figures publication on the website of the Ghana Health Service.

Let me assure health workers one more time. You deserve better because the gains of the single spine pay policy have been eroded.

My brothers and sisters, a major plank of our health plan will also be far-reaching reforms in health care financing.

We shall remove all obstacles, which prevent citizens from accessing primary health care, and relieve the NHIS of pressure from the recurring and widening financing gap, which threatens its sustainability going forward.

This only represents a snapshot of my vision of a modern and responsive health system for Ghana.

As I have said before, the next NDC government will prioritize government spending in favour of the wellbeing and welfare of Ghanaians as opposed to the comfort of the upper echelons of society.

Healthcare will be one of the major priorities of my government. Through health care, we shall employ more people both in the health sector and in the manufacturing sector – COVID-19 has proven that we cannot continue to rely on imports.

In addition to an improved health care system, the biggest concern in a post COVID-19 era will be how to rebuild our economy.

The pandemic has exposed the extent of inequality in our society and we must do something urgent to address it.

The economy has been projected to come under severe stress with very low growth, high deficits, unsustainable debt levels and a depreciating currency.

This means the excruciating financial emasculation that Ghanaians suffered before the Coronavirus pandemic is set to worsen.

In the light of this, it would be catastrophic if deliberate steps are not taken to grow the economy for the benefit of Ghanaians.

What is your assessment of where we are now? What is the Ghana you look forward to, post COVID-19? I do have good answer and ideas.

I have been meeting with my working group of experts and professionals on the economy; a group chaired by Professor Kwesi Botchwey.

Our next conversation, in due course, will discuss some of these options we have come up with.

I want to repeat that I cannot thank you enough for the interest and commitment we all have towards building a formidable country that provides equitably for its citizenry especially in times such as this.

Thank you.