Newly Qualified Health Professionals are Allegedly Paying Bribes at Ministry of Health to have Postings Reviewed: Are Postings now for Sale?

Dr Kwaku Agyeman Manu - Health Minister

Is the Health Minister aware of the above caption? Every year, the Ministry of Health (MOH) posts many newly qualified health and allied health professionals to various parts of the country to work. In the distant past, the postings were decentralised to the Ghana Health Service (GHS) and other agencies under the MOH. Few years ago, however, the MOH centralised the postings with the justification of ensuring that all the regions have their equitable deployment of healthcare professionals. Perhaps to make the postings transparent in the name of ensuring equitable distribution of the healthcare human resources, the MOH introduced an e-posting portal, which has been used to post healthcare professionals.

The introduction of the e-posting portal has further solidified the centralisation of the posting of health professionals in the public sector. The MOH thus posts the professionals even directly to hospitals. In some cases, the newly posted workers’ salaries are processed by the MOH even before the workers assume duties at the hospitals. This same e-portal posting system is used to employ non-administrative professionals as Administrative Managers when the country has many newly qualified but unemployed Health Service Administrators awaiting financial clearance to be appointed.

Currently on the discussion table for social media users is the allegation that some officials at the MOH in charge of the e-postings are taking bribes ranging from GHC1000.00 to GHC4000.00 from newly qualified health professionals who want their postings reviewed to their preferred regions. The amount charged is regardless of the reason for the posting review.

This practice is depriving some regions their required number of health workers. This regrettable practice clearly defeats the purpose of the introducing the MOH e-posting portal. E-Governance platforms like the MOH e-posting portal are technological innovations meant to improve productivity, transparency and accountability in public service delivery. However, the transparency and accountability will occur only when the system has checks and balances. It means that the overall posting authority must be monitoring who authorises or reviews a posting in the system and for what reason.

It is true that for some genuine reasons (spousal, medical etc), some newly qualified health professionals request for a review of postings from a region of “inconvenience” to a preferred region of “convenience.”

A social media user alleged on Facebook, “I’m a health worker who has recently been posted but I’m married with a baby. Due to the distance of the hospital, I’ll have to be reposted in order to be close to my family but the cost involved is quite huge (about 4,000.00GHC). My husband, who is in a better position to help me, has refused to give me such an amount to work out the reposting and I don’t know what to do…”

To me, the above is a genuine request for reposting on marital grounds yet someone is charging the poor lactating mother such a huge amount before reviewing the posting. Yet some years ago, we were crying loud that there was brain drain of health workers to other countries. Now we have them in abundance but we are treating them unfairly?

Another victim wrote on social media, “I heard some people at MOH can change the region for me but at a cost of GHC3000.00…Finally, I paid the money and the posting was changed to my preferred region but another hurdle is how to get my preferred hospital. I am a nursing mother so going to a region faraway will affect me.” How much at all is a health worker paid a month, that she or he would be compelled by a posting officer to pay such huge amounts, not to the state but to an individual or a group of individuals?

Much as we are human and the employer must have the welfare of the employee at heart, review of postings on spousal or medical grounds should not have cost the newly qualified health workers a pesewa. There are also some situations where newly qualified health professionals do not want to accept postings to some parts of the country due to fear of abject hardships emanating from underdevelopment of those regions compared with Accra. One may not support this latter reason for a request for review of the posting but it is a reality and this is where some MOH officials are allegedly making huge amounts of money into their personal coffers. This is unjust and must be checked immediately.

It is alleged that because of the ulterior motives to make money for personal benefits, some MOH officials in charge of the e-posting portal intentionally block the system to indicate that the most preferred Regions (Greater Accra, Ashanti, Central and Eastern) are already full. This makes the health workers being posted to contact people for help to change the postings and in the process, monies allegedly change hands.

If indeed the portal indicates that those hotcake regions are full, then will the payments of say GHC3,000.00 open more posting spaces? It is proper that the Minister of Health cause an investigation of this and bring to book, those involved. We need to know those who are involved. Are they just the ICT professionals in charge of the e- posting portal or it is a syndicate of both ICT and other professionals responsible for the postings?

Perhaps the MOH must look at the centralisation of the postings again and consider decentralising it to the GHS and other MOH agencies. I do not seek to say that those working in the GHS are holier than those at MOH but GHS was handling the postings in the past and there was no such problem. Besides, most of the public health facilities in Ghana operate under the auspices of the GHS so making the GHS responsible for posting newly qualified health professionals to its facilities should not be out of place.

The legal creation of the GHS out of the MOH in 1996 with its operationalisation since 2001 was necessitated by the principles of the New Public Management (NPM). Apart from establishing the GHS out of the MOH, the organisational structure of the MOH itself was reviewed to deconcentrate service delivery from the centre. These were the days of the Medium Term Health Strategy (MTHS), which spun on the pivot of the lip-serviced and well politically trumpeted mirage vision 2020 for Ghana. We have now gone past 2020 and posting reviews are being sold at the MOH? Into what dangers are we leading ourselves?

The NPM was a global paradigm shift in Public Administration in the 1990s, pushed by the Bretton Woods institutions (the IMF and the Wold Bank). One of the issues at the core of the NPM agenda was to do away with centralised and bureaucratic administrative methods through decentralisation of various public sector functions. If the GHS was established by an Act of Parliament (Act 525 of 1996) as an autonomous Public Service Organisation and as the most conspicuous agency of the MOH, then should the GHS not have institutional autonomy to post newly qualified health professionals to its hospitals, directorates and other facilities?

I hope fervently that this article gets to the attention of the Minister of Health and other Managers in the health sector. The bribe collection for posting reviews may be happening at their blind sides. We need a solution. The MOH e- posting portal must have a posting review procedure. Otherwise, manual administrative procedures should be put in place to augment the electronic internal controls relating to the posting reviews.

~Asante Sana ~

Author: Philip Afeti Korto

Email: [email protected]