The medical laboratory space

The recent strike action by the Medical Laboratory Scientist of the Komfo Anokye Teaching Hospital raises fundamental issues of misunderstanding about what happens in the laboratory space.

There is no Medical Laboratory Scientist trained in Ghana or elsewhere who since time immemorial did not appreciate the plurality of persons working and teaching in the laboratory space.

There were different categories of Medical Laboratory Technologist, Technicians, Biomedical Scientists and Doctors including categories of trainees at different stages of their respective programmmes. All worked amicably to provide results and reports for good patient outcome. Lest we all forget, we are in that space to provide the best for the patients.

So what has led to this strike action. The Management of Komfo Anokye Teaching Hospital posts two Haematologists, both with Membership of the Ghana College of Physicians and Surgeons and there is an outcry; when their role is to strengthen the link between the laboratory and the clinicians, offering confidence to the clinicians about quality of results and offering advice to the clinician on what further investigations may be necessary to unravel the clinical conundrum.

Interestingly these Haematologists, after full medical training and two year house jobs in all the four major disciplines of Internal Medicine, Surgery, Obstetrics and Gynaecology and Paediatrics, would have spent a minimum of three years training in Laboratory Medicine doing six months rotation in all the four major disciplines in Pathology or Laboratory Medicine: Anatomical or Cellular Pathology, Chemical Pathology, Microbiology and Haematology, before settling on the choice of discipline.

During my rotations in all the laboratories in Korke Bu Teaching Hospital in 1981 and 1982, I formed some of the my best enduring relationships with Medical Laboratory Scientists and Biomedical Scientists from whom I learnt a lot. You will have to know how the tests are done, know what the possible challenges that are likely and how to rectify them, and if you get abnormal results what else can be done to provide better incite into the diagnostic challenge. This is how we were trained in the medical laboratory space and I do not believe things would have changed for my two colleague Haematologists.

It would appear that the formation of the Ghana Association of Medical Laboratory Scientists (GAMLS) and the edging out the Biomedical Scientists, some of whom have been at the helm of training the members of the GAMLS was the first ominous sign. A letter to the Ministry of Health and its agencies not to appoint any Biomedical Scientist was a real shot in the dark. It would appear this was the beginning of their endeavor to be the only professional group within the laboratory space and then came the Allied Health Professional Council (APHC).

The APHC is a professional regulatory body that accredits Professionals within the body of Professions Allied to Medicine or Allied Health Science and has the twelve Allied Heath Professions listed in Act 857 page 70. Under Medical Laboratory Science, it has Medical Laboratory Technician, Medical Laboratory Technologist and Medical Laboratory Scientist. APHC only accredits and regulates the underlisted professional groups and not the laboratory space. It is therefore wrong for any member of GAMLS to indicate that only APHC accredited members can work in the laboratory space. In Ghana, the premesis is regulated by the Health Facilities Regulatory Agency (HEFRA).

GAMLS must first of all accept that they have no control of who works in the laboratory and that it has always been a team of different professionals working ultimately to improve health outcomes.

The issue of the Headship of the laboratory can only be the most experienced and competent professional with all the requisite qualifications. For many years it has tended to be the Laboratory Physicians (Doctors) who would have had second and third degrees but we all recognize that some specialist laboratories have Biomedical Scientists and Medical Laboratory Scientists, distinction not mine, who have earned advanced qualifications and management experience who can compete for Headship. It cannot be guaranteed for any profession necessarily.

From the forgoing, there is really no need for this messy strike action that unjustly target the ill and the poor. In advanced countries with best practices, many professionals work in the laboratory space just as many other professionals work in the imaging and radiation space.

The APHC superintends six different professionals in that space, and there are Radiologists, who are doctors, who also operate in that space as well. There appears to be better team work than there is in the medical laboratory space and the same can be said for the dental space and ophthalmology space.

There must be an immediate truce. The Ministry of Health must resolve this once and for all.

The author is Prof. Agyeman Badu Akosa, a Pathologist.

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