Mrs. Margaret Clarke-Kwesie, at different times Deputy Minister of Health and of Education and one time NDC MP for Ga South constituency, addressed the Annual Delegates' Conference of the Ghana Medical Association (GMA) on Sunday 13th November 2004 at Elmina on behalf of the NDC Presidential candidate, Professor John Evans Atta-Mills, whose previously scheduled campaign tours did not allow him to personally address the Conference.
Mrs. Clarke-Kwesie's address, which was on the thrust of the NDC Manifesto on Health, touched on the NDC legacy in the Health sector and the four major NDC Health objectives namely, support for Primary Health Care, the extension and equipping of hospital infrastructure and facilities, the localisation of medical treatment, and the provision of affordable health care.
The address also touched on the training of health personnel, the National Health Insurance Scheme (NHIS), HIV/AIDS, the Health sector brain drain, traditional medicine, and mental health care delivery.
Mrs. Clarke-Kwesie referred to the NDC's 2000 Manifesto, which stated that "a healthy people are a happy people" and concluded that between 2005 and 2009, the NDC under Professor Atta-Mills would seek to create the conditions to make Ghanaians healthier and therefore happier.
'Ghana Palaver' has learnt that President Kufuor, even though had accepted an invitation to address the Conference, and even though was in Cape Coast at the time, declined at the very last minute not to honour the invitation and was represented by the Minister of Health, Dr. Kwaku Afriyie.
Feeling slighted, most of the Conference participants in retaliation refused to attend a reception laid on for them at the Residency where they were expected to interact with the Regional Minister, Isaac Edumadze.
The full text of Mrs. Clarke-Kwesie's Address is reproduced on Page 4.
NDC ADDRESS TO THE GHANA MEDICAL ASSOCIATION HELD AT ELMINA
The National Democratic Congress is grateful to the Ghana Medical Association for the opportunity to make a presentation of our Health policy as contained in our Manifesto and of our approach to Health when voted into office in next month's elections. I am making this presentation on behalf of our Presidential candidate, Professor John Evans Atta-Mills, who very much wanted to be here personally to deliver this address but has had to be unavoidably absent.
The NDC Legacy in the Health Sector
Because of the constant refrain of the present administration, including from the highest levels of the Party, that the PNDC/NDC Governments did nothing and that we "left a mess behind", I would like to begin by briefly recollecting some of the legacies that we left behind and the state of the health sector that the NPP Government inherited.
The Health sector scene as at 7th January 2001 included the following:
(i) 60% of the population had access to health services, comprising 92% in urban areas and 45% in rural areas, representing an over 100% increase over the pre-PNDC era. This was defined to mean the proportion of the population living within one hour's travel time, by any available means, from the health facility;
(ii) 53% of the population lived within 30 minutes of a health facility;
(iii) In 1981, the country had 297 health facilities. This was increased to 745 in 1996 and over 960 in 2000, including 3 brand new, state-of-the-art Regional Hospitals at Cape Coast, Ho and Sunyani;
(iv) Major improvements in health infrastructure and facilities included the establishment of the Cardio-thoracic Unit, the Plastic and Reconstructive Surgery Units, the Non-Trauma Emergency Unit, the Central Sterilisation Unit, the Renal Analysis Unit and the Oxygen Plant, all at Korle Bu.
The NDC introduced the Additional Duty Hours facility, created the Ghana Health Service, and established the Traditional Medicine Directorate in the Ministry of Health.
On welfare, the NDC introduced the "cars for doctors" scheme, the housing scheme for doctors and health workers, and sought to expedite a review of new conditions of service for doctors and health workers as a response to the "Mustapha Syndrome".
All these were in fulfilment of our four major Health objectives of support for Primary Health Care (PHC), extension and equipment of hospital facilities, localisation of medical treatment, and the provision of affordable health care as contained in our 1996 and 2000 Manifestoes.
Primary Health Care (PHC)
Back in power in 2005, the NDC's continued support for PHC will see us emphasising the decentralisation of the health services. The District Health Management Teams (DHMTs), which we established, will be strengthened to establish and nurture lateral relationships with the decentralised Ministries and work very closely with the District Assemblies for accelerated implementation of Community-Based Planning and Services.
We will continue with the provision and rehabilitation of health infrastructure. We will construct new health centres and District Hospitals, rehabilitate and upgrade old ones and equip them to support community-based services.
We shall resume our programme for the establishment of a modern Regional Hospital for each region, with Koforidua, Bolgatanga and Wa being next in line. The Sekondi Effia Nkwanta Hospital, the Tamale Hospital and the Ridge Hospital in Accra will be rehabilitated and modernised.
Training of Health Personnel
In consultation with existing Medical Schools, all Regional Hospitals will become extensions of existing Teaching Hospitals. The proposed new Regional Hospitals for Koforidua, Bolgatanga and Wa will be equipped to be able to function as such. The ongoing rehabilitation works at the Tamale Teaching Hospital will be accelerated and appropriate accommodation for students and housemen at the Regional Hospitals will be provided. In this way, the regions will benefit from the expertise of teachers of our Medical Schools, the teachers will have rich teaching materials, and the students will be exposed to the problems of the regions even before they qualify since they will be doing their clerkship in the regions.
Strengthened Regional Hospitals will be in a better position to support District Hospitals and the structures below them.
The Teaching Hospitals will be refurbished and some Departments upgraded and an equipment replacement programme drawn up and strictly followed.
The newly established College of Physicians and Surgeons whose blueprint was drawn up during our time will be supported. Accommodation for residents, library and Internet facilities and other logistics at the various training sites will be provided.
We will accelerate the ongoing programme for the establishment of the new School of Allied Health Professionals promised in our 2000 Manifesto. Products of the School will include Laboratory Technicians and Technologists, X-Ray Technicians, Radiographers, Physiotherapists and Dieticians.
When all the existing Nursing Schools become Diploma-awarding institutions, additional midwifery schools will be accredited to run the 3-year midwifery programme. The post-basic midwifery course for Enrolled and Community Health nurses will however be maintained.
We will support the proposal to establish one auxiliary Community Health Nursing Schools in the regions with an accelerated annual intake out of the two different auxiliary nurses namely the Enrolled nurse and the Community Health nurse.
We will also undertake the rehabilitation and refurbishment of existing Nursing Training Schools.
National Health Insurance Scheme (NHIS)
Now let me explain briefly the problems we have with the NPP Government's National Health Insurance Scheme, a Scheme that the NDC initiated and piloted in 5 districts with a view to their replication nationwide:
(i) The 2.5% National Health Insurance Levy is a disguised increase in the VAT rate from 12.5% to 15%, a tax that the NPP rejected as regressive while in opposition;
(ii) Whilst the 2.5% VAT increase for health is being collected, the minimum health benefits under the Scheme are still not known, unless they are contained in the recently passed Regulations;
(iii) The compulsory deduction of 2.5% of workers' SSNIT contributions for the purpose of funding the NHIS could be illegal, and possibly unconstitutional;
(iv) The excessive bureaucracy involved in establishing Health Insurance Districts coterminous with political/administrative districts will result in money meant for health being diverted to service the Health Insurance bureaucracy;
(v) Every Ghanaian resident is a contributor to the NHIS by virtue of the 2.5% National Health Insurance Levy that he pays as a consumption tax or VAT and is therefore legally and morally entitled to a certain minimum of free medical care. To restrict the benefit of health insurance to only members of the District Mutual Health Insurance Scheme means that some members of the society are contributing to the NHIS without enjoying any benefits under it, and that is unconscionable.
That is why we have explained in our Manifesto that we shall sit down with the stakeholders to fully revise the NHIS Act as well as the framework for the operation of the Scheme and a review of the funding mechanism.
The fight against HIV/AIDS requires a multi-sectoral approach and the next NDC Government will support each sector to develop its control programme. Similarly, districts will be supported to design their own strategies to fight the pandemic. At least one 'Centre for Voluntary Counselling and Testing' will be opened in each Health District, preferably outside of hospitals.
We will also support the ongoing programme of selective treatment of people with HIV/AIDS with generic anti-retroviral drugs. The long-term objective will be to produce the drugs locally.
Health Sector Brain Drain
The exodus of Health personnel has now changed from a deluge into an avalanche and has become a major constraint to the effective delivery of health care. We shall consider a proposal to take the remuneration and conditions of service of doctors and health personnel as well as teachers out of the 'Ghana Universal Salaries Structure' (GUSS) and treat theirs as a unique case in order to encourage them to stay.
We shall hold an Act 575+5 Review Conference to review the Traditional Medicine Practice Act, 2000, 5 years after its passage, to determine its effectiveness and provide the necessary support to traditional medicine practitioners.
It is a crying shame that diseases such as guinea worm, yaws, TB and leprosy which had all but been wiped out during the era of the NDC Government should resurface in today's Ghana, to the extent that the country is now second only to war-torn Sudan in global guinea-worm infestation, with buruli ulcer still spreading and new diseases such as leishmaniasis being unearthed.
As we stated in our 2000 Manifesto, "a healthy people are a happy people", and so between 2005 and 2009, the NDC under Professor John Evans Atta-Mills will seek to create the conditions to make Ghanaians healthier and therefore happier.
Once again, Professor Mills thanks you very much for this opportunity, reminds you to vote NDC on 7th December 2004, and wishes you a very "Merry Christmas" in advance.