Exodus of Health Professionals - Any Solution?
AT THE 26th Annual General Congress of the Society of Private Medical and Dentists practitioners held in Kumasi recently, Dr. Kwame Addo Kufuor, himself a medical practitioner and Minister of Defence, told his fellows that the time had come to agree on practical solutions to halt the exodus.
He stated that in an attempt to curb the practice and persuade health professionals to stay, the Government had introduced a number of incentive initiatives for health sector including the establishment of a post-graduate College of Surgeons and Physicians, the payment of additional duty allowances and the setting up of a $5 million Revolving Fund for the purchase of vehicles, among others, but noted that the exodus still leave a sour taste in the mouth of even the most avowed optimist. He, therefore, called for a debate on whether health professionals should be bonded or whether they should pay some form of monetary compensation to the state if they decide to leave.
Dr. Addo Kufuor's observation that provision of incentive initiatives cannot effectively stem the tide of exodus is noteworthy though a shade late. During the late General Acheampong's regime, medical officers were provided with similar incentives but they still left the shores of Ghana in droves for greener pastures especially to Nigeria.
The mistake some of us continue to make is the thinking that exodus of professional health workers is peculiar to Ghana. No.
Not at all. In fact, almost all developing countries are bearing the brunt of this unfortunate exodus. Another mistake is the thinking that profusely providing incentives may extenuate the flow of exodus. Even worse is the attempt to appeal to the conscience of these professionals.
The CNN sometimes in the third week of August 2004, carried a news item in which the Italian Prime Minister, Silvio Berlusconi, met the Libyan leader, Colonel Al-Qadafi, at the Libyan Port of Sorte for talks on curbing illegal immigrants to Europe particularly Italy. The problem was highlighted by the arrival of 275 illegal migrants on the Italian Island of Lampedusa.
After the talks, the two leaders agreed to mount joint sea, air and land patrols. The inference is that the exodus issue can better be resolved at Government-to-Government levels than any unbridled flow of incentives and or any appeal to patriotism.
That is, Governments of developing countries must seriously discuss the matter with their developed partners who are the beneficiaries of this exodus.
The thinking is that the buck stops with America; that may, perhaps, explain why the recent discussions over the exodus of health professionals between president Kufuor and British Minister, Tony Blair, have not fully yielded the desired impact. The fact of the matter is that Britain is equally facing mass exodus of its health professionals to America thereby creating ready and lucrative vacancies for health professionals from developing countries.
The statement attributed to the British shadow health minister, John Baron, is worthy of note (Ref. The Chronicle of 28/8/04 - Crack down on Nurse poaching launched in UK). He reportedly stated that if the British government was serious about stoping the NHS recruiting from developing countries, then, it should ban the NHS from using agencies that had not signed up to its code of practice which restricts recruitment from over 150 developing countries including Ghana, other African and Asian countries. In other words, the British government appears to be echoing the long held view that love your neighbour but not more than thyself.
Obviously, no one can claim that health professionals in Britain are not handsomely paid. Or that hospitals in Britain are inadequately furnished or equipped. Neither can it also be claimed that health professionals have no cars or decent accommodation. And yet British health professionals flee to America making any appeal to the British government not highly recommended. The Caribbean islands even appear to to be worst hit giving its closeness to America. It may be recalled that sometime in the 1990s, the Jamaican government made an official request to the Ghana government for the release of a number of nurses. And for inexplicable reasons, the request was granted. It is not clear what was bartered for the release.
As a long term solution, therefore, the assistance and active support of America will be urgently needed to stop or, at least, mitigate this brain drain.
West Africa Labour Health and Medicine Ghana
The buck surely stops with America. The governments of developing countries must, therefore, urgently make a passionate appeal to President Bush and or the United Nations (UN). It would appear that an appeal to President Bush now might unfortunately not receive the required urgency in the light of continuing events in Iraq and especially the impending presidential elections in America. So what do we do?
In the light of the realities on the ground, Hon. Mr. Addo Kufuor's call for a debate on whether health professionals should pay some form of monetary compensation to the state or be bonded would appear to be a call in the right direction. No incentive of any kind would stop the exodus as long as vacancies exist in the developing countries or the governments of developing countries remain apathetic to our plights. But that is not to say that nothing must be done about the genuine complaints of these professionals. After all, not all of them are joining the exodus.