94 Doctors now turn administrators (Back Page)

NINETY-FOUR experienced medical doctors who should have practised in hospitals in the public sector found themselves occupying administrative positions, the 2005 audit report currently before the Public Accounts Committee (PAC) of Parliament has revealed.
The report showed that the situation was different from mission-managed health facilities where qualified hospital administrators had been employed to perform the day-to-day running of the hospitals.
In that vein, the performance audit report of the Auditor-General on the Management of Human Resources for Effective Primary Healthcare Delivery by the Ghana Health Service (GHS) recommended that in addition to their administrative duties, health professionals in administrative positions should work for a minimum of two days per week in the nearest convenient health facilities.
The recommendation became necessary because the audit found out that it was not compulsory for doctors in the administrative positions to attend to the sick in the hospitals or in the clinics.
In addition, it was revealed that the doctors in administrative positions were those who had worked as consultants in the hospitals and had more than 15 years experience, which is considered valuable to the service.
According to the report, the consequences of using professionals for administrative work were revealed in the doctor-patient ratio, first because they did not reflect the reality on the ground and secondly, the calculated figures made it difficult for planning as they were not calculated as part of the shortfall.
A typical case was the Brong Ahafo, where in 2005 the region had 58 doctors instead of the 90 doctors required and out of the figure, 21 doctors were assigned the responsibilities of district health directors, two were sent to the regional health directorate (RHD) and five to research centres, leaving only 30 to work in the hospitals.
Another example was in the Upper East Region, where only 24 of the required 54 doctors were available in the region and out of the number, nine were posted to the Navrongo Health Centre, one at the RHD, while six worked as district health directors, with only eight left to work in the hospitals.
The report went further to reveal that in spite of these shortfalls, when the ratio of health professionals to the population was calculated, those who performed administrative work were included as doctors in the communities.
Another significant point raised by the report was that because the experienced doctors did not work in the hospitals, younger professionals were denied the opportunity to learn from the experiences acquired by their senior colleagues.
It that case, the country had to spend extra resources to give the younger ones further training abroad, something they could have received locally.
That problem, according to the report, was compounded by the brain drain, where an estimated 6,546 health professionals reportedly left the country to other countries in search of greener pastures between 2001 and 2006.
These professionals included 418 doctors, 1,155 pharmacists, 3,496 nurses, 296 medical laboratory technicians, 1,001 midwives and 180 community health nurses.
“In a service where brain drain has significant impact on capacity and replacement is very difficult to accomplish, using qualified doctors to undertake administrative task is a further drain on the already under-staffed sector. The effect is pressure and stress on the few medical professionals left to run the facilities,” it observed.
Giving reasons why it did not recommend that the doctors should completely stop working as administrators, the report stated that in the Ministry of Health (MoH) some of the directorates being headed by medical doctors were created in response to disease outbreak and, therefore, needed those experienced doctors with the requisite knowledge to head them.
They also represented the health sector on international bodies where colleagues within the medical profession converged to discuss issues, the report noted.