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Release
NPP, October
17, 2012
“SAVING OUR HEALTH SERVICE, KEEPING OUR
PEOPLE HEALTHY”
Speech by Nana Addo Dankwa Akufo-Addo,
2012 Presidential Candidate of the New Patriotic Party, at the
Sunyani Nurses Training College, Sunyani, on 17th October,
2012.
Good evening. I have just been told that NDC propagandists are
at it again on FM stations in Accra. This time, the story is
that I collapsed on a platform whilst touring the Kumawu
constituency. I toured Kumawu some two weeks ago on 1st
October and it is strange that this matter should come up now
on the eve of my speech. It’s a total fabrication. I did not
collapse; I have never felt stronger; and I am very fit to
deliver a speech on health. I thank the authorities of this
college for this opportunity to talk about a subject of utmost
concern to all of us: good health, our individual health and
the health of the nation.
When you meet somebody, family, friend or stranger, the
greeting that is exchanged is an enquiry about each other’s
health. You ask after each other’s state of health and you
wish each other good health and you wish good health for their
family. It is for good reason that we do this. We dread being
sick and we know we have to be healthy to do life’s work and
achieve our aspirations.
The wealth of the nation depends on the health of its people.
We have to be healthy to transform Ghana, we have to be
healthy to try to make a brighter future for Ghana, we have to
be healthy to work for ourselves, never mind, try to work for
you.
And to talk about this subject, I don’t think we could have a
better place or audience than a Nurses Training College and an
audience mostly of student nurses. When it comes to
healthcare, you are at the front line and the policies that
government adopts affect you directly and you are in a
position to tell what works and what doesn’t.
In 50 days’ time, we will go to the polls to choose not just
between candidates for president and Members of Parliament,
but we will also decide between two profoundly different
visions for the future of our country’s education and
healthcare systems. This evening I intend to lay out the
differences and hope it would help make your choice easier and
you would choose the NPP vision for Ghana and for your future.
On December 7, the nation has a chance to make a decision on
two major issues: (1) whether Ghanaians should have universal
access to free quality education for every child under the age
of 18, and (2) which party can be trusted to deliver access to
affordable quality healthcare for every Ghanaian. The NPP
believes that free quality education up to secondary level and
affordable healthcare are essential for the healthy, educated
workforce we need to transform the economy, create wealth and
enhance the welfare and wellbeing of every Ghanaian.
Tonight’s talk is about the health of the nation but I want
first to say a few words about the NPP education policy that
seeks to provide free quality education to all our children
from kindergarten to senior high school. Regardless of all the
propaganda and distortions, the good people of this country
know that this is something we should do, we can do, and we
will do. The people of this region, I am told, know all too
well that while our new caretaker President, the NDC
presidential candidate, is going around the country struggling
to convince parents that Ghana is not ready and cannot afford
free secondary education, reports from the ground are that his
party activists, sensing that this position will damage their
electoral prospects, are going around rural communities with a
picture of the NDC presidential candidate to lie and say he is
the person promising free SHS. This is typical NDC duplicity.
It appears that their capacity for deceit and double dealing
is limitless.
The NDC adopted the same attitude when the NPP, under the
leadership of President Kufuor, introduced the National Health
Insurance Scheme. NDC MPs’ of the time, including their
current presidential candidate, then MP for Bole Bamboi,
walked out of Parliament and boycotted its proceedings dealing
with the NHIS law because of their opposition to its passage.
But, when the programme was successful, they claimed falsely
it was their idea and that they had a pilot scheme at Nkoranza,
near here. They don’t have the vision to deliver to the people
of Ghana, so they try to rewrite history.
The NPP will go a step further to save our health system and
keep our people healthy: we will offer all children free
access to the NHIS. This means that parents no longer have to
be a subscriber to the NHIS for a child to benefit. Millions
more children will be covered by free healthcare.
The NHIS shows that the NPP believes in fairness as a
principle of social action. We believe that access to social
services should be on the basis of need, and that government
has a duty to keep its people healthy. We are proud that we
are helping to create a society of fairness and opportunities
for everyone, including the most vulnerable. The NDC now
admits that the NHIS is preferable to the cash and carry
system they were operating, but if you look at their
performance managing the system, you have to doubt their
sincerity. We must save our health system, and keep our people
healthy.
If you look at their performance at managing the scheme these
past four years, you have to conclude that either they do not
really believe in a national health insurance system, and
their advocacy of a one-time premium reinforces this
perception; or they lack the competence to administer it. We
must save the NHIS now from the incompetent hands of the NDC.
This election presents the people of Ghana with a clear choice
between a well-thought out and comprehensive plan for
education, health and the economy on the one hand, and on the
other, a President who is offering four more years of
visionless leadership from a government that pretends to be
working for you. Four more years of the reckless borrowing
this government have been doing will mean more of our money
having to go to debt payments and even more excuses for why
they won’t invest in our health and education.
The wealth of the nation depends on the health of its people.
To transform Ghana, we have to be healthy, and our government
has a duty to ensure that the most vulnerable have access to
quality healthcare.The NPP has a record of care and
achievement. The last NPP government introduced significant
initiatives to expand health service coverage. The next NPP
government, God willing, will introduce comprehensive measures
to tackle the fundamental problem of too many Ghanaians dying
because they can’t get proper care. I want to see ambulances
carrying the sick to the hospital for treatment and not turned
into hearses. We will continue the policy started under
President Kufuor to establish an efficient ambulance service
well-coordinated with emergency care in the hospitals and
nationwide to be sure when patients get to you, you can still
help them.
PRIMARY HEALTHCARE
As I have gone round this country, I have heard enough to know
that when it comes to health, what people want is more
investment in the primary and community health sector. We need
preventive care and regular access to doctors. An improved
primary healthcare system is a vital component of saving our
health system and keeping our people healthy. The NPP will
focus on primary healthcare infrastructure and personnel
because improving the health of all people will reduce visits
to hospitals,
The environment and the physical conditions we live in to a
large extent influence the state of public health. It is
therefore in these areas of sanitation, proper ventilation,
personal hygiene, good nutrition, provision of safe water and
immunization to which we will pay the greatest attention. An
Akufo-Addo government will concentrate efforts on the
provision of good water for the people as this will eliminate
at least 75% of the communicable and infectious diseases such
as cholera, typhoid, guinea worm, billharzias and most
diarrhoeas that plague our people. It is a great relief that
we seem to be on the verge of eradicating guinea worm
infestation from our country, (I hope nobody collects the 200
cedis on offer for the report of any new case) but we cannot
say the same about the regular outbreaks of cholera that have
been occurring in our cities. We must all see this as a
disgrace to our nation and work on personal hygiene to
eradicate such diseases from our society.
Our health education efforts will be increased to promote the
total wellness of the body. Our diets are changing for the
worse as our life styles become more sedentary and this is
leading to new diseases and conditions that were unknown to us
in the past.
As a people, we no longer exercise enough; we might know more
about sports and support a wider variety of football teams
than in the past, but sports participation and physical
activity among the population have decreased. Our abysmal
performance in recent Olympics games is a sad demonstration of
this fact.
We shall seek to remedy this situation with a start in
promoting school sports. The old saying of a sound mind in a
sound body is as true today as it ever was.
Of course, this is the time and place for me to congratulate
the great performance of the Black Maidens in the FIFA Under
17 competition, where they emerged as bronze medallists. They
have brought joy to our hearts and they have set a good
example to us all.
Better sanitation, personal hygiene, good nutrition, an active
lifestyle and exercise will all help to keep us healthy, but
being human, we shall fall ill and there will be accidents and
we will need doctors and hospitals and nurses, and laboratory
technicians and pharmacists and all the allied health workers
that make health facilities work.
Trying to fashion the financing for a sustainable and
effective healthcare system has proved challenging to
virtually all countries and societies throughout the ages, but
I think it is fair to say that there is universal agreement
that a nation must have a healthcare system that ensures that
the most vulnerable are assured of protection. The National
Health Insurance Scheme introduced by the NPP in 2003 sought
to do just that.
THE NHIS
The NHIS is one of the greatest legacies of the NPP and a
precious asset for the nation. It has been acclaimed as the
most pro-poor healthcare system on the entire African
continent.
An insurance scheme only works when clients and the service
providers are confident in the stability of the system. The
NDC government has created so much instability in the system,
no one has confidence in it. As is their usual practice, they
think they can use propaganda to cover their failure in the
health sector as well. Unfortunately for the NDC, the human
body cannot be lied to.
The government would have us believe that there is a
significant increase in usage of the NHIS, which they offer as
proof of their commitment to widening access to healthcare.
But, their own annual reports show up this claim to be false.
There is a decline in membership in the NHIS and a
corresponding increase in visits to the hospital by NHIS
cardholders. The NHIA’s own annual reports indicate that
active membership dropped from 9,914,256 at the end of
December, 2008, to 8,204,116 by the end of 2011 and according
to the NDC Manifesto, there have been 25 million visits to
hospitals by NHIS cardholders in the past year. This means
that we have a decline in membership and a corresponding rapid
increase in visits to hospital by NHIS cardholders. There is
something quite unnatural about this and the only explanation
there can be is that we are getting sicker than before.
Compare this to the constant growth in membership of the
scheme under the NPP, with NHIS membership increasing from 6.6
million in 2007 to 9.9 million in 2008, for example.
The most worrying indicator of loss of confidence is the
decline in renewal rates of membership in the scheme. I
suspect that many people were holding out on their renewal as
they waited for the NDC promise of a one-time premium payment
to materialise. If the consequences of this farcical NDC
promise were not so tragic, it would be a source of great joy.
Four years down the road they have not been able to implement
their one-time premium policy. We can only assume that it was
made to deceive Ghanaians just to get their votes.
As if it wasn’t bad enough that they dangled the one-time
premium payment promise, they introduced a form of payment
that has brought a lot of confusion and instability to the
scheme.
NHIS CAPITATION
The chaos that followed the decision by this NDC government to
introduce the capitation method of payment in the Ashanti
Region has been well documented and is fresh in all our minds.
This most populous region was a poor choice for a pilot
program, and it shows in the results. Subscriber confidence
has been reduced. There is reduction in active membership in
all schemes and in some schemes, as much as 80% in the first 3
months of implementation. Premiums collected from subscribers
were reduced by as much as 35.5% for the period January –July
2012 as compared to the same period for 2011.
The private health providers, who form the bulk of the health
service delivery in the region, withdrew from the scheme. Some
re-joined in April when some of their concerns were addressed,
making it clear that there had not been enough stakeholder
consultation and education throughout the process. This
brought unnecessary hardship and confusion to the subscribers
and providers. It impacted the health of the people of the
region. Most health institutions in the Ashanti Region have
been forced to introduce what is called a Co-Payment -- or to
call it by its real name, Cash & Carry -- through the back
door.
Capitation, as the pilot project in the Ashanti Region has
shown clearly to all Ghanaians, has failed. But we discover
the NDC is not quite finished- they are promising more chaos
and more suffering for subscribers to the scheme instead of
quietly withdrawing capitation. The NDC Manifesto calls for
the expansion of capitation! Yes, you heard right. At page 23
of their 2012 Manifesto, they are threatening to bring it back
in a big way. It reads “In the next four years, the NDC
government will… roll out capitation nationwide.” Yes, that is
what the NDC is promising. Fellow citizens, the NDC intends to
spread the ills of capitation to every corner of the country
if re-elected into office. Call it a timely warning because we
cannot claim we have not been warned. The ruling party is
sending out a clear message to the Ghanaian voter: ‘The NDC
Can Be Dangerous to Your Health’. Vote for NDC and pray you
don’t fall sick for another 4 years. Ladies and gentlemen,
this is too high a risk to take, if you ask me. The NHIS is
not safe in NDC hands.
The NDC either does not believe in national health insurance,
or they are incapable of operating the scheme successfully.
Both of them are unacceptable. Today, the scheme is to all
intents and purposes bankrupt. In 2008, under the NPP, the
NHIS was a net lender to Ghanaian banks. Now it is a net
borrower; and as at December 31, 2011, the scheme owed the
banks GHC105 million.
They have had four years to operate the one-time premium
policy, and have been unable to implement it. The Capitation
system of payment has been shown to be a disaster and will
collapse the scheme. Ladies and Gentlemen, when the NPP is
voted into office on December 7, God willing, we will inject
new life into the scheme and rebuild the confidence of the
service providers and the clients. We believe in it and we
will make it work. We must save our health system to keep our
people healthy.
HEALTH WORKERS
But, in order for the NHIS to deliver, we must have well
trained nurses, midwives, health technicians, pharmacists,
doctors and other allied health workers in sufficient numbers
serving with job satisfaction. We shall increase the capacity
of the institutions that train health workers; we have done it
before. Under President J A Kufour, all the existing health
training institutions were expanded and new ones established
across the country. Some private health training institutions
were also established. Intake for Diploma Nurses, for example,
was increased from 968 in 2000 to 7,068 in 2008. Community
Health Nursing intake increased from 500 to 2,214 in 2008. To
improve skills in the nursing profession, the health care
assistant training program was established and a number of
Health Assistant Training Institutions were also put up across
the country. Intake into such institutions increased from 477
in 2006 to 2,541 in 2008. This did not happen by accident. We
will expand health facilities and train more of our health
workers to attend to the sick. There are lots and lots of
young people who want to become nurses, we need lots and lots
of nurses, we will make it possible for them to train as
nurses. Our priority will be to train our doctors locally. We
will expand existing medical schools and establish a National
Institute for Biomedical Sciences, where medical students will
have their basic sciences and this will make it possible to
increase the intake of the medical schools.
At a time when Ghanaian students on government scholarships
across the world are crying for their fees and allowances to
be paid, and at a time when students at our nursing training
colleges are crying against the sudden 100% hikes in fees, the
NDC government, under an opaque scheme, operated by then Vice
President Mahama, found GH¢160 million to send people to Cuba
to be trained as doctors. The Cubans still insist it was a
scholarship scheme. If so, then it is most expensive. The cost
of this translates into GH¢106,000 per year for each of the
250 Ghanaians sent to Cuba. On the other hand, the cost of
training a Ghanaian doctor in Ghana is a fraction of that, at
just GH¢30,000 annually, according to the Ghana Medical
Association. Can you imagine what the UDS Medical School, for
example, would have done with just a third of this GH¢160
million investment over the next five years? We shall invest
in our own medical schools to train more doctors locally.
COMMUNITY HEALTH NURSE
In line with our primary healthcare policy, the NPP will
ensure that every village or deprived community has access to
a Community Nurse to provide the primary healthcare that often
makes the difference between life and death. These Community
Nurses, with a small and basic surgery, will be responsible
for basic public health education and primary healthcare.
MOBILE THEATRES
There are simply not enough specialists and facilities to
serve patients, especially in rural and remote communities. To
solve this problem, we need to think outside the box. The next
NPP government will, therefore, revolutionise the concept of
taking healthcare closer to patients’ homes with the use of
mobile theatres and mobile clinics. The use of mobile units
will mean we can, through a shift system, send the best of our
medical personnel and the state-of-the-art facilities to
patients in a way that mitigates the need for capital
spending, whilst allowing the best of medical care, including
surgical operations, to be deployed across the nation in a way
that is responsive to local needs. With mobile theatres, the
next NPP government will seek to deliver thousands of cataract
operations and other such treatments nationwide.
REFERRAL HOSPITALS
It is time that we took the bold step of establishing a number
of world-class referral hospitals and medical centres of
excellence in our country. Prof Frimpong Boateng, with the
successful Cardio-Thoracic Centre in Korle Bu, has taught us
that these can become income-generation ventures, as well. The
next NPP government will introduce policies to promote Ghana
as a centre of medical tourism in Africa. We will assist those
already doing so in the private sector to do more. This would
not only help to provide a satisfactory working atmosphere for
our specialist doctors, it would attract many doctors to come
and work in Ghana, and would help turn our country into an
attractive health tourism destination.
PHARMACEUTICAL INDUSTRY
Ghana has a successful local pharmaceutical industry, which
deserves special attention from government. My government
would help them to serve our people well and become more
competitive in the international market. We will borrow from
the experiences of India and elsewhere to become the masters
of this lucrative industry. Under the NDC, what we have seen
in recent years are measures that are counterproductive to the
growth of the local industry, with Facility Audit Fees, for
example, going up from $7,000 in 2008 to $15,000. At the same
time, the Food & Drugs Board has seen its share of the
national budget decreasing in real terms. We will change this
as part of our policy to focus more on preventive and primary
health care.
HEALTH OMBUDSMAN
In our efforts to enhance the quality of care, the NPP will
create an ombudsman with the power to investigate and support
complaints from patients in both public and private hospitals.
PERSONS WITH DISABILITY
As part of our efforts to build a society of opportunities for
all, we shall actively promote the provision of facilities for
persons with disabilities and invest more public funds to
ensure their proper integration to enable them achieve their
potential in life. I will ensure that the provisions in the
Persons With Disability Act, 2006, Act 715 are implemented. I
must here declare a personal interest; this is one of the laws
that I feel a personal attachment to, having started work on
it as Attorney General. Ghana cannot afford to ignore the
contributions of the many talented people in the society
simply because they are disabled. The likes of Prof
Bashirudeen Koray of the Ministry of Justice, a blind lawyer,
whose appointment I had the honour of approving as Attorney
General, bear testimony to what persons with disability can do
in a society where all have an equal opportunity of exploiting
existing opportunities and contributing to the creation of
new, exciting ones.
MENTAL HEALTH
One of the greatest challenges we have in the health sector is
in the area of mental health. There is an alarming shortage of
psychiatrists and mental health practitioners in general.
There are said to be only five specialist psychiatrists in the
public health system and this means that every mental health
problem rapidly deteriorates into a full scale crisis. We
shall offer incentives to make it attractive for young doctors
to specialize in psychiatry and we shall tackle the long
standing problem of the disgraceful state of the Psychiatric
Hospital in the middle of Accra.
CARING FOR THE ELDERLY
Ladies and gentlemen, we all continue to tell ourselves that
we have a society in which the elderly are respected and taken
care of. The truth, the reality, ladies and gentlemen, is very
far from this. In villages and cities around the country, we
are leaving our elders in pitiful conditions. There are many
elderly people who have been left by themselves, who have no
one to care for them.
We will introduce policies that will compel District
Assemblies to take a more responsible role in catering for the
needs of the elderly in our communities. Beyond that, my
government will offer incentives to the private sector to
provide the elderly with proper care homes. I know this will
require a major cultural jump but I believe it is time we
brought this silent and hidden problem out into the open and
find solutions. Those who have served their families and Ghana
deserve some dignity at the end of their lives.
Some of the other measures the next NPP government will
introduce to improve healthcare delivery in Ghana will
include:-
• Making dental care accessible to the poor and vulnerable
• Cutting down on red tape at both the NHIA and our hospitals
to invest the millions saved in frontline health service
delivery
• Refocusing capital investment on primary and community
services
• Increasing health spending in real terms every year
• Making sure the Public Procurement Act works in the supply
of pharmaceuticals and other health facilities
• Introducing eHealth policy to make access to healthcare and
health tips easily accessible to consumers via the internet
and mobile phones
We need to move away from management by crisis. The health
sector needs a management culture that is proactive and not
reactive. The Ghana Health Service will be helped to acquire a
more efficient Medical Information Management Systems designed
to better track performance across the delivery chain, and
provide the data needed to make excellent health care
decisions and save lives and keep Ghanaians healthy.
We will sit down with the private providers of health services
to work out how to attract greater investments and offer
lucrative incentives with the objective of creating a
competitive, consumer-driven healthcare service delivery
system.
Ladies and Gentlemen, we have it in our power to transform our
country and its economy. We will do it with the support of
people like you. Every day nurses and health workers around
this country perform little miracles. They bring care and
comfort to the sick and the distressed, they do it under
trying conditions. Under an NPP government, you will have
support from the top and together we will build a healthy and
prosperous Ghana. We shall not go back to a failed government
that is failing you, failing your health, failing your jobs,
failing your education, failing your future. Let us move
forward with the NPP.
God bless you
God bless Ghana.
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