Clouds are forming in the major hospitals, notably the Korle-Bu Teaching Hospital and the Ridge Hospital both in Accra on delayed fuel allowance to doctors and I should not be seen as a pessimist if I say this situation will trickle down to every public health institution if the situation is not addressed dispassionately and quickly. As an African proverb says, ''If you say little things are unimportant, you imagine how a lion feels when a fly enters its nostrils".
Fuel allowance is an allowance paid to all medical doctors in the Ministry of Health, whether the person works in a hospital or not. As at now, it ranges from 20 gallons of petrol for the medical officers (newly appointed doctors) to 40 gallons for Principal Medical Officers, Specialists and Consultants per month irrespective of whether the doctor has a car or not.
The allowance is paid to the beneficiary whether or not there has been a certified purchase of fuel and use by the doctor in the month for official duties. It is supposed to cater for fuel expenses a doctor incurs shuttling between his house and the hospital to care for patients. But is it efficient, prudent and fair to pay such allowances to doctors?
An activity or transaction is said to be efficient if it is carried out at the least cost. Imagine that there are 350 doctors in a hospital like Korle-Bu because there are a lot of consultants and specialists let us again assume the monthly rate is 30 gallons per doctor. It is expected that (367,500,000 cedis or 10,500 gallons) would be paid to these doctors per month with an annual expenditure of 4,410,000,000 cedis.
From the above, there is no evidence of whether all the 350 doctors would actually purchase fuel and use their vehicles in the month or year for official or call duties. This annual amount could have bought at least 19 pick-ups for Korle-Bu Teaching Hospital, assuming a pick-up costs $25,000.00.
If the same amount were to be used to fuel a vehicle that uses one litre of diesel per 10 kilometres, this would cover a distance of 5,836,765 kilometres. Meanwhile, the hospital (Korle-Bu) would also spend not less than 40 percent of this amount in respect of fuel to pick up doctors from their homes.
Is it therefore prudent to pay an uncertified amount to a doctor in a month whether or not he/she has even commuted to the hospital to care for a patient? Would that be more cost effective? In any case, are they not being picked from their homes with hospital vehicles?
Fairness is the quality of treating people equally or in a way that is reasonable and acceptable. Imagine a doctor in Akuse Hospital who is the only one there and is expected to be called more often than any of his colleagues at Korle-Bu.
Is it fair to pay a lump sum or the same allowance to these two doctors? Is it only a doctor in a hospital who is called to the hospital for official duties?
What about the anaesthetist, pharmacist, administrator, accountant or laboratory technician? Do these other professionals not deserve to be paid the fuel allowance? Indeed, some of these professionals are even called more often than an average doctor in a hospital.
A doctor may be the captain in the team, but he cannot score a goal without the others. If a Senior Medical Officer is given a 1.8 litre Toyota Corolla just like a Specialist, why should the Specialist receive 40 gallons and the Senior Medical, Officer 30 gallons for a vehicle that consumes the same amount of fuel?
My candid views on the issue are; first, the hospital's vehicles should be made use of as much as possible to convey staff needed to the hospitals. It is for such trips that vehicles are provided.
Where hospital vehicles are not available, any authorised use of a private vehicle by an officer (doctor or the orderly) to perform call duties in the hospital should be logged. The allowance should be related to the number of kilometres or miles travelled by the officer to and from the hospital for official duties. Therefore, a doctor at Akuse Hospital would be rewarded or reimbursed more than his colleague at Korle-Bu.
Second, it should not only be doctors who are in a hospital and are called to the hospital for duties. The other professionals should equally be paid the advocated fuel allowance. This is efficiency and fairness. Any inefficient organisation will collapse.
There has been a directive to freeze allowances like fuel allowance by the Ghana Health Service. I would not recommend stoppage but it should be administered fairly and justly for all in the public service by relating payment to kilometres travelled. I would advocate the same for car maintenance allowance too. The threats to reduce working hours would not work. Let us sit down and talk, because it's not even fair amongst the doctors themselves.
Written by Julius Bekkorwair Kuusaalesuo, (Hospital Administrator) Nsawam Government Hospital, Nsawam.
Credit: Daily Graphic