The President of the Republic in his update No. 5 to the nation on Sunday, the 5th day of April 2020 in respect of the measures taken against the spread of COVID 19 pandemic, stated that all health workers will be exempted from tax on their monthly emoluments for the next three months, i.e., April, May and June 2020.
His Excellency also added that ‘frontline health staff’ were to be paid 50% of their basic salaries for the months of March, April, May and June 2020 as an allowance in recognition of their efforts in fighting the battle against COVID 19.
These are very welcoming interventions to alleviate the challenges that health workers face in the battle against the COVID 19 pandemic. I join several health workers who have commended the President for these interventions. Mr. President, we are grateful.
Subsequent to the announcement by His Excellency, the Ministry of Health (MOH) via letter No. MOH/CD dated the 7th day of April 2020 to the Hon. Minister for Finance informed the Minister for Finance that as of January 2020 the staff strength on the Ministry of Health’s payroll stood at 130,345.
The letter added that the tax exemption will be applicable to all the 130,345 staff of the MOH. What this letter did not do was to state the number of temporary health workers on the payroll of various public hospitals across the country.
The letter which was signed by the Chief Director of the Ministry of Health on behalf of the Hon. Minister for Health further stated that the Ministry had identified 56 COVID 19 treatment centres in various facilities within the Ghana Health Service (GHS) and Teaching Hospitals, including the University of Ghana Medical Centre (UGMC) and the Bank of Ghana Hospital. It added that the three testing centres; Noguchi Memorial Institute for Medical Research (NMIMR), Kumasi Centre for Collaborative Research (KCCR) and the National Public Reference Laboratory (NPRL) and some staff of the National Ambulance Service were also involved in the process of managing COVID 19 cases.
The letter further stated that all categories of health workers involved in the service delivery activities for COVID 19 cases will be regarded as ‘frontline’ workers and hence benefit from the 50% of basic pay as an allowance for the four months specified by the President of the Republic in his update No. 5 to the nation.
Following this letter, the Ghana Health Service (GHS) has proceeded to request for a list of staff who are involved in the management of COVID 19 to be compiled by facilities and submitted to it for onward submission to the Ministry of Health and finally Ministry of Finance to give effect to the 50% of basic pay incentive for frontline health workers.
In giving effect to the directives contained in the president’s update No. 5 on the incentives for health workers, what has become very apparent is that the Ministry of Health and its implementing agencies have not taken into consideration the critical role being played by temporary workers in our health sector.
The Labour Act provides under Section 75 that temporary workers employed for a continuous period of 6 months and more shall be treated as permanent workers. Most facilities rely on the services of these temporary workers to complement the efforts of the permanent workers in delivering health service to our cherished clients. Their roles can therefore not be overlooked when the directive was clearly meant to cover all health workers. Ignoring their critical roles at this very material time may lead to demoralization on their part and hence affect their productivity thereby constraining our quest to win this battle together as a team in the health sector.
These temporary workers are being paid by facilities using the Internally Generated Fund (IGF) of those facilities. As a requirement under the Income Tax Act, 2015 (Act 896), the income from the employment of these temporary workers in the health sector is chargeable to tax. Managers of our health institutions, therefore, deduct income tax from their emoluments and pay same to the Ghana Revenue Authority at the end of every month.
The MOH at regular intervals requests for the list of temporary workers from various facilities with the intention of mechanizing them to become permanent in the health sector. This is a step that has yielded some results in the past for some of these temporary staff. However, in a long while now mechanization has not been effected for them, although the last request was as recent as last quarter of 2019. An expeditious mechanization of these temporary staff will afford them some relief, considering how long some of them have worked as temporary staff.
The question being asked by managers of our health facilities at this time is how our temporary health workers are going to benefit from these incentives. Clearly, most managers of institutions recognize and appreciate the role these temporary health workers play and will therefore wish that they are equally made to benefit from these incentives.
However, do the managers of health institutions have the power to suo motu decide to grant tax relief on the emoluments of these temporary workers for the months of April, May and June, and also provide them 50% of their basic salaries for four months as directed by the president in his Update No. 5 to the nation?
In answering this question, managers are mindful of the fact that they work with directives from their superiors. For those of us in Ghana Health Service facilities, we receive directives from the MOH through our Director General and our respective Regional Directors. Managers are also not oblivious of the fact that under Section 7(2) of Act 896, it is the Honourable Minister responsible for Finance who may by Legislative Instrument make regulations to exempt a person, class of persons or income from tax. Against this backdrop, managers may not proceed on their own to implement this tax relief directive for temporary health workers without clear regulations having been made by the Honourable Minister responsible for Finance to cover these temporary workers in the health sector.
Temporary workers in our various health institutions qualify as health workers with all the intent and purpose meant by His Excellency in his update No. 5 to the nation. It is therefore my considered view that just as the Ministry of Health has written to the Minister for Finance on the tax exemption for 130,345 permanent health workers, the Ministry of Health should also write to the Ministry of Finance requesting that the LI on this tax exemption on emoluments of health workers for the three specified months should equally cover temporary health workers.
When this is done, health facility managers can proceed to exempt the incomes of these temporary health workers from tax for the specified months in the president’s update No. 5 without being worried of tax audit queries. It will also bring about uniformity across the country in the implementation of this directive for all temporary health workers.
On the 50% of basic pay for four months as allowance to ‘frontline’ health workers, several options should be considered by the MOH in ensuring that these temporary health workers also benefit.
The first option, although may not be very pleasant to most health facility managers, will be for the MOH to issue a directive to all facilities to pay the temporary health workers this incentive using their IGF, just as they are paying them their emoluments from IGF.
The challenge with this option is that most health facilities are already finding it difficult to meet most expenses during this pandemic which has given suppliers an upper hand to demand for cash before delivering medical consumables to hospitals. However, the temporary workers also deserve this incentive and must be provided same.
The second option, which is linked to the first option above, will be for the MOH to make funding available to hospitals to specifically take care of this 50% on basic pay incentives for temporary health workers. This can be done by the Ministry of Health ensuring that in the next four months health providers are paid at least two months of their outstanding submitted claims by the NHIA every month effective April 2020. When this is done, the health facilities will have funds available to be able to take care of this 50% of basic pay incentives to the temporary health workers without difficulties.
The third option, which in my thoughtful view should be highly considered by the Ministry of Health, is to mechanize these temporary health workers as part of efforts in tackling the COVID 19 pandemic. Most of these temporary health workers have been with us for years and are playing very key roles in our hospitals. We have seen a request for financial clearance from the MOH to the MOF for some category of health staff. The MOH already has the list of these temporary staff from previous submissions to it by facilities.
Indeed, if we are requested to submit again, we can do so within minutes because we already have the data. The MOH should please use that list and secure financial clearance for the mechanization of these temporary staff on the payroll.
In conclusion, I humbly pray that the Honourable Minister for Health will consider the critical roles being played by temporary health workers and ensure that he does everything within his power to make them benefit from these incentives announced by His Excellency to health workers.