Ghana: Corruption rife in health sector

By Charles Takyi-Boadu and Lisa Boeckers 02.02.2006
Transparency International’s 2006 Global Corruption report has identified the health sector as a corruption prone area with evidence of bribery and fraud across the breadth of medical services.
This is said to have emanated from petty thievery and extortion, to massive distortions of health policy and funding, fed by payoffs to officials in the sector.
The report shines a strong light on the US$3trillion global industry, exposing a maze of complex and opaque systems that are a fertile field for corruption.
The global anti-corruption institution also identified certain characteristics that make all health systems, whether public or private funded and whether located in rich or poor countries, vulnerable to corruption.
In Ghana, for instance, it noted that there is corruption at various stages of the health care process, which is manifested in delivery and access to proper healthcare.
Mr. Daniel Batidam, Executive Secretary of the Ghana Integrity Initiative (GII), a local chapter of Transparency Internal, who outdoored the report in Accra, wondered why health officials sometimes give patients wrong information in order to line their pockets.
According to him, the situation has led to instances where it has become easy for a patient to be told there are no drugs at a hospitals dispensary, but upon payment of informal fees (bribes), drugs are provided.
He noted that at other times, patients are referred to dispensary of pharmaceutical shops owned by the same doctors and pharmacists who refer them.
Also, he identified the poor management; supervision and fraudulent manipulation of excess hours of work payment, which he said, end up causing huge financial losses to the hospital or public purse.
He cited the instance of health workers registering the time they wait at the hospital to be picked home as extra hours for overtime payment, and that of some workers dodging regular working hours, with excuses, for their personal assignments outside the clinic or hospital and yet registering extra working hours for overtime payments, as typical examples.
He further indicated that top officials overemphasize and over-indulge in construction works in order to generate opportunities to attract contractors, often resulting in kickbacks, praises and favours at the expense of providing optimum hospital requirements and facilities for efficient and effective maintenance of health service delivery.
Often, he noted, a couple of corrupt health suppliers bribe public authorities, such as the Standards Board and the Food and Drugs Board, to enable them to sell fake drugs to hospitals and unsuspecting consumers.
As TI Chief Executive David Nussbaum rightly pointed, “Corruption eats away the public trust in medical community. People have a right to expect that the drugs they depend on are real; they have the right to think that the doctors place a patient’s interests above profits; and most of all, they have the right to believe that the health care industry is there to cure and not to kill”
Batidam however acknowledged mechanisms being put in place by government and other stakeholders to address the problem of corruption, which cuts across all edges in society through strengthening the internal audit system across all ministries and departments that he said are necessary safeguards.
He also acknowledged efforts being made by the Public Procurement Board to help address the problem of corruption in public procurement, stressing that these efforts appear to be yielding modest results.
The procurement law, he said has alerted public servants to realize that flouting it is punishable by a term of imprisonment.
In this regard, Batidam stressed the need for more transparency in the healthcare system, urging government to grant easy access to information on key aspects of health related projects, budgets and policies.
To forestall corrupt practices in the health sector, he said Ghanaians must adopt and enforce codes of conducts for health workers and private sector companies, and provide on-going anti-corruption training.
He also called for the strict enforcement of laws and rules of conflict of interest to ban companies that indulge in corrupt practices from future bidding.
On an even more serious note, recommended the transfer of directors of procurement in MDA’s every two years, not necessarily out of the region but to a different MDA, to minimize the incidence of internal collusion.
To facilitate the prosecution of health workers who engage in corrupt practices, he noted that there must be a robust whistleblower protection for both government employees and private sector employees.
With this, he noted, every body could have confidence in the country’s health delivery system and a value for one’s money.