Health Service Administrators are professionals solely trained to manage health institutions especially from the business perspective even though their work permeates the clinical areas as well. In Ghana, Health Service Administrators (H.S.As) work at various echelons of the health system and they contribute largely to policy and managerial decision-making. They are referred to as Hospital Administrators whenever they work at hospitals. Some people also refer to the HSAs as “surgeons” who hold the scalpel or surgical blade indirectly or invincibly because their work has significant impacts on the works of the clinicians including the surgeons.
In Ghana, the HSAs occupy other significant positions that are not health-related while others hold health-related positions. For example, some H.S.As are working as university registrars and assistant registrars; some work with the National Blood Service and some work with printing presses. The Executive Director of Christian Health Association of Ghana (CHAG), Mr. Peter Yebaoh is a Health Service Administrator. There are HSAs who are also in traditional leadership positions. Examples are Nana Kwaku Duah III, Nifahene of Offinso Traditional Area in Ashanti Region, Nana Odeneho Kwafo Akoto III (Akwamuhene) and Nana Tabonu Bonsu III of Asante Akyem Achiase. Some H.S.As are equally astute Human Resource Management Practitioners. The National Labour Commission has just constituted a three-member committee to oversee issues relating to labour and industrial disputes in the northern sector of the country and therein that committee is a Health Service Administrator, Ms. Georgina Yeboah is a Human Resource Management expert. To add to the non-exhaustive list of H.S.As in key positions is to say that Mr. Ebo Hammond, the current Director of Health Administration and Support Services of the Ghana Health Service (GHS) dovetails as the substantive President of Chartered Institute of Logistics and Transport (CILT), Ghana. There are some HSAs working with the Mental Health Authority and some with regulatory bodies. Paradoxically, other institutions value the role of the Health Service Administrator but Government of Ghana and for that matter, the Ministry of Health seemingly does not. Currently, there are some HSAs who are District Directors of Health Service in the GHS. By this and many other examples, the HSAs have demonstrated beyond measure that they have the potential and ability to deliver effectively at any level in the health sector when given the nod yet government pays them very meagre salaries.
Besides the foregoing, there are HSAs who are lawyers or legal practitioners and a significant number of them hold PhD in other fields of study and even in healthcare management.
It is obvious from the foregoing that the H.S.A. is not only qualified but he or she is capable of working with meaningful results at the managerial level of various institutions and there are evidences to show.
Within the public sector healthcare delivery system of Ghana, the H.S.A. is very instrumental in running institutional affairs as he or she is the Head of Health Administration and Support Services hence he or she has oversight responsibilities for most departments, programmes and activities within the health sector. In fact, the H.S.As working at the public hospitals are called at any time to handle emergency situations that call for managerial interventions. Notable among the duties of the H.S.A in healthcare delivery in the public sector of Ghana are:
- Day-to-day general administration of the health institution
- Ensuring the provision of all support services necessary for quality healthcare delivery.
- Coordinating the planning and budgeting processes in accordance with the approved guidelines.
- Monitoring the efficient use of health resources and reporting on them
- Supporting resource mobilization for the health facility.
- Ensuring regular provision of utility services such as water, electricity, telecommunication and waste management services.
- Planning, implementing and reviewing processes, procedures and structures for disaster preparedness, health and safety, and general security of the health institution. Indeed, Health Service Administrators have been instrumental in handling disease outbreaks in the country. A key example is that during the cholera outbreak in most parts of Ghana in 2014, Health Service Administrators were active at the frontline level in curbing the situation.
- Ensuring maintenance of a healthy and aesthetic environment for the personnel and clients of the institution.
- Developing systems to ensure adequate physical security and safeguarding of assets including protection of patients and staff in the facility.
- Devising systems to ensure the attainment of set performance objectives for administrative and support service units in the health institution.
- Contributing significantly to the development of relevant policies and programmes and ensure their dissemination.
Even though the H.S.A. is well equipped, works in stressful situations just like his or her clinical counterparts and achieves many results in healthcare delivery and other areas of public life, the public health sector pays the H.S.A so poorly. In fact, at the management level in a public hospital, the H.S.A.is instrumental but he or she is the worst paid compared to other management members whose oversight responsibilities are nowhere near the Hospital Administrator.
Given the opportunity to apportion blames for this unfortunate and unfair situation, the Ministry of Health, Fair Wages and Salaries Commission (FWSC), the Ghana Health Service Council, and Teaching Hospital Boards will not be spared. All these institutions sat unconcerned while the FWSC placed the Health Service Administrator so low on the Single Spine Salary Structure (SSSS) with meagre market premiums. It is as if there are frantic efforts being made to make the kitchen hot for the Health Service Administrators to leave the public health sector.
Ultimately, the Health Service Administrators themselves are to blame for their poor conditions of service. This is because they hold hot pepper in their mouths with the attendant burning sensations yet they do not shout enough for the employer and the general public to know that all is not well with the Administrator who seems to be holding sugar or honey in his or her mouth.
The pitiful plight of the Health Service Administrator working in the public sector of Ghana is to the extent that even interns in some clinical grades take more salary home than the Health Service Administrator who has been on the job for 15 years or more. The public health sector values the Health Service Administrator when it comes to work but he or she is virtually neglected when it comes to salaries and other conditions of service.
Therefore, it is high time employers in the public sector paid the Health Service Administrators salaries and let them enjoy other conditions of service that commensurate the herculean roles they play in bringing quality healthcare to our people. How can the Government of Ghana treat such well-equipped and result-oriented professionals unfairly? By their training, Health Service Administrators can just be described as thinkers outside the box, especially when it comes to finding lasting solutions for thorny problems in the health sector.
~ Asante Sana ~
Author: Philip Afeti Korto.
Email: [email protected]