Autonomy And Scope Of Practice Of Physician Assistants, And The Attainment Of Universal Health Coverage Through Primary Healthcare Threatened By The Health Professions Regulatory Bodies (part Two) Amendment Bill, 2019
A Physician Assistant is a highly skilled and specially trained healthcare professional who undertakes clinical, public health (both preventive and promotive) and administrative services at the over one thousand health centres across the length and breadth of this country without supervision from any section of healthcare professionals. They could also be seen in the Consulting Rooms at District/Municipal Hospitals attending the health needs of our clients. They are the sub district heads/leaders in the healthcare delivery machinery and the pivot of primary healthcare.
Physician Assistant training has evolved over the years. It started in Ghana as a Certificate programme and later became a diploma and advanced diploma. Currently, Physician Assistantship training is a 1st Degree programme. Some Physician Assistants have done Master’s Degrees in Public Health and some have done medicine, among others as additional qualifications. They are versatile.
The autonomy of practice of the Physician Assistants cannot be overemphasized as they have worked independently over the years to render quality, accessible and affordable healthcare services to the rural population which constitutes about 70% of Ghana’s population. As sub district leaders, they spearhead the CHPS policy, a tool to achieve universal health coverage for all.
It has therefore come as a surprise to the leadership of the Ghana Physician Assistants Association that the Medical and Dental Council, Ghana sponsored by the Ministry of Health has deliberately decided to take away the autonomy of practice of the Physician by clandestinely and speedily pushing for Amendments to the Health Professions Regulatory Bodies Act 857 (2013) through the Amendment Bill (2019). The association wishes to remind the Medical and Dental Council and other stakeholders that health service delivery is a collaborative and team work.
Since Physician Assistants and Certified Registered Anaesthetics have been put under the regulation of the Medical and Dental Council, Ghana by the enactment of the Health Professions Regulatory Bodies Act 857 (2013), we have never known peace. There have been attempts by a section of health professionals who think it was a favour done us by the Act, to ridicule, subdue and obliterate the autonomy of practice of the Physician Assistant.
In the proposed amendments to Section 43 (subsections 1-3) of the Amendment Bill (2019), we notice with concern the following:
- It is very unjust and discriminatory to equate a registered practicing physician assistant (irrespective of his/her grade and experience) to a house officer (a student under training) and exempt all from the rights conferred by registration
- In subsection ‘c’ of the above section, the Medical and Dental Council sought to replace “practitioner” in the parent act with “medical and dental practitioner” to conveniently exclude other professions regulated by the Council and we find it discriminatory as physician assistants attend to some cases that need certificates or documents required by law to be signed. It is expected that whatever legal document or certificate a physician assistant signs, he or she shall also be entitled to recover charges or fees
- Subsections 2 and 3 are orchestrated attempts by the Council, dominated and controlled by Medical Doctors to gag physician assistants and obliterate our scope of practice in the healthcare delivery machinery
- Out of the over one thousand Health Centres nationwide manned by physician assistants, how many of these physician assistants are directly supervised in their daily clinical services to their clients?
- If this Bill is passed into Law, does a physician assistant has to consult and seek approval from the so called supervising medical and dental practitioner in absentia before he or she can attend to a client in the rural areas?
- Supervision is never done in absentia so these insertions are flawed and should be expunged from the Bill
- The attainment of Universal Health Coverage through Primary Health Care will be a mirage if physician assistants are not granted that autonomy of practice at the primary healthcare level
Also, in the proposed amendments to section 50 of the Amendment Bill, we have the following concerns;
a. Subsection “c” of the Amendment Bill defined a physician assistant as “specially- trained middle healthcare professional who practices medicine and dentistry within the scope of practice of that health professional under the supervision of a designated licensed medical or dental practitioner and may be in the nature of a middle level health professional formerly referred to as medical assistant, nurse anaesthetist or community oral health officer.
The word under supervision of a designated licensed medical and dental practitioner should be expunged from the document as all physician assistants who work in the health centres are not supervised unless MDC wants to say supervision is synonymous to monitoring. As long as the physician assistant acts within his/her scope of practice, he or she is practicing within the ambits of the Law.
We are by this press conference calling on the Minister of Health and the Medical and Dental Council to withdraw the Bill as a matter of urgency.
The association should be engaged in all deliberations/discussions in relation to the amendment of the provisions of the Act 857 (2013)
The Association is also calling on the Minister of Health to initiate a Bill to create another Regulatory Council to regulate the practice of Physician Assistants and Certified Registered Anaesthetists as we feel disrespected and discriminated against in this current Council we belong to.
We shall fight with our blood and strength the oppressors rule and machinations till we are liberated. Thank you all for your attention
EMMANUEL YAW APPIAH PETER EYRAM KUENYEFU
PRESIDENT (0244 779518) GENERAL SECRETARY (0249883933)
DAVID KOJO DONKOH NATIONAL PRO (0243683988)