Empirically, it is no longer disputatious that in every organization, the administrative staff are the backbone to sustainable organizational success in terms of core business delivery. This holds true whether or not it is in media practice, healthcare delivery, academic institutions, manufacturing industry, politics, construction filed, film industry and many more.
Once again, the Hospital Administrators in Ghana have been confronted with the handling of a contagious disease outbreak (this time, the COVID-19 pandemic). The Hospital Administrators are not clinicians. They are Healthcare Management experts. However, their work environment exposes them to numerous nosocomial or hospital-acquired infections.
In the face of the COVID-19 outbreak, the Hospital Administrators in our public hospitals could have withdrawn themselves from the work environment since they are not clinicians. But no, they are at work. Their work is the backbone of effective clinical work or curative healthcare. Without the Hospital Administrators, the clinicians’ job will be extremely difficult if not impossible.
As managers, the Hospital Administrators perform the respective managerial roles Henry Mintzberg (1992) identified. These managerial roles are:
- Interpersonal Roles (figurehead, leader, liaison),
- Decisional Roles (entrepreneur, disturbance handler, resource allocator, negotiator) and
- Informational Roles (monitor, disseminator, spokesperson).
As professionally trained managers (Health Service Administrators), the Hospital Administrators are still at work at the public hospitals. They are still playing the various managerial roles necessary for the clinicians to treat the Covid-19 and other patients at the hospitals in Ghana. Yes, they still lead, they allocate healthcare resources, they monitor service delivery at the clinical units despite the possibility that they can contract the disease in line of duty just like their clinician counterparts. They still disseminate relevant information and they supervise myriad of activities necessary in these difficult times.
Knowing what prevails in other public sector organizations for Public Administrators, it is atypically surprising that the Ministry of Health (MOH) and the Ghana Health Service (GHS) fail to recognise the relevance of the Hospital Administrators in curative healthcare delivery. In one breath, the MOH and the GHS talk about multidisciplinary teamwork and in another, they discriminate against the administrative class especially the Health Service Administrators, some of whom serve as Hospital Administrators (they work as both managers and frontline workers at the hospitals).
The work of the Hospital Administrator takes him or her to various clinical areas for inspection and monitoring purposes as well as making sure the needed logistics are available for clinicians to work with. They also have the oversight responsibility for planned preventive maintenance and the repair of the medical equipment in use.
One may put it in mathematical phraseology that the Hospital Administrators’ job and the clinicians’ curative roles at the hospital are two simultaneous equations that must be solved to get the variables necessary for the patient to receive quality healthcare.
It is however discriminatory on the part of the MOH and the GHS that the clinicians have better and huger remunerations (salaries and other conditions of service) than what the Hospital Administrator receives. Seemingly, the MOH and GHS value the Hospital Administrators when it comes to work but ignores them entirely when it comes to benefits.
In the face of the war against Coronavirus, the Hospital Administrators have once again demonstrated professionalism and teamwork. It is trite knowledge that patient care is not the sole duty of only clinicians but a joint role of both the clinicians and the support staff. In other organizations, the employers value the administrative employees just as they value the core business staff. The reverse is the situation for the Health Service Administrators working for both the MOH and the GHS.
On the Single Spine Salary Structure (SSSS) for example, a Hospital Administrator who has worked for about 15 consecutive years is paid only about 35% of the net salary a trainee clinician receives. Despite his or her relevant managerial roles in patient care and the number of years served, the MOH and the GHS choose to pay the seasoned Hospital Administrator far less than the trainee clinician who is not yet employed. Which serious employer does such a thing? The salary administration in the MOH and GHS is run as though the government health institutions are established with funding from the parents of the clinicians.
Methinks the Hospital Administrators have always risen to numerous challenging disease outbreak occasions in this country and they are doing so again in this era of Coronavirus. As such, this is the time those at the pinnacle of the MOH and the GHS must recognise again that in order to make healthcare qualitatively accessible to the patient on time, it is not only the clinician who is needed. Even the clinicians themselves know that running the public hospitals cannot be the sole duty of the clinician.
Perhaps the Minister of Health, the Director-General of Ghana Health Service, Teaching Hospital CEOs and the CEO of Fair Wages and Salaries Commission (FWSC) must pause and ponder over fair placement of the Health Service Administrators on the SSSS. Health Service Administrators especially those working at the hospitals go on monitoring visits towards (isolation wards inclusive), operating theatres, emergency rooms, the medical labs and many other areas at the hospital. As such, their risk of contracting disease is high. This, therefore, calls for a higher market premium for them on the SSSS and not the current 14% market premium they are paid.
The Health Service Administrator is well trained in the management of the administrative aspects of healthcare delivery. On 27th March 2020 for example, the Association of Health Service Administrators, Ghana (AHSAG) issued a press statement and touched on a number of issues relevant to containing the COVID-19 pandemic. AHSAG stated inter alia that:
- Government should consider a partial lockdown of the country to slow down the movement of people in order to localize the spread of the virus.
- There should be mass testing, after the partial lockdown, for all persons within communities and institutions that have recorded or have been exposed to cases.
- Government should eschew the quarantine of Covid-19 infected foreign nationals in expensive hotels in order to cut cost since no none knows when the pandemic will end.
- Government should procure enough PPEs and healthcare managers should ensure judicious use of the PPEs to forestall wastage.
- Government should ensure the closure of unapproved routes into the country.
- All Health Service Administrators should continue to attend to duty for the proper organization and management of health resources in the fight against the pandemic and to ensure continuous and efficient functioning of all health facilities across the country in these difficult times.
Indeed, the Resource-Based View (RBV) Model holds that the allocation of productive resources to different users within the organization over time is determined by administrative decisions. It is, therefore, time again for the Hospital Administrator to strategize to mobilize relevant resources and ensure their prudent use as AHSAG noted under item 4.
The logical question is that if this is not the committed expert voice of a professional who matters in healthcare delivery, then what else should it be called? Must such a productive professional not be paid fairly to commensurate the workload?
The Health Service Administrators and for that matter the Hospital Administrators have demonstrated once again that despite the meagre salary and despite the fact that the MOH and the GHS do not value them as they value the clinicians, they (Administrators) will stay put and fight the COVID-19 war till the enemy is defeated. MOH and GHS, be fair and candid in your salary administration discretions because article 296 of the 1992 Constitution forbids capricious and bias exercise of discretionary power.
~Asante Sana ~
Philip Afeti Korto
Email: [email protected]