No doctor chose to work in the northern regions

Is this shocking? No. Is this news? I think it’s not. This is what was reported by myjoyonline.com: “Northern Regional Health Service has bemoaned the unwillingness of doctors to accept posting to the region aftethat no doctor chose to serve in any of the health centres under the Ghana Health Service (GHS).

"They were given the opportunity to choose where they would like to go to and it happened that no doctor chose the Northern Region," he said at a consultative meeting with the Health Minister, Kweku Agyeman Manu.
The doctor to patient ratio in the north stands at one doctor to 51,000 patients”.

This is dead news as far as I’m concerned. This is a recurring problem from time immemorial and we all know about it. In fact, as part of the solution, that is one of the strongest points for siting a medical school in the north.

Amidst fanfare, we were told that their training was going to be so-community-based so that they would all, upon graduation, remain in the northern sector to help bridge the doctor/patient ratio.

Why is it so difficult to get doctors, particularly the University of Development Studies (UDS)-trained doctors, to remain in the north? Aren’t there people being paid to do this simple job of ensuring that one of the aims of setting up this medical school in the north is achieved?

Typical of us as a nation, we are excellent at enacting laws and setting down rules and regulations but legendarily poor at their implementation.

If indeed there is a clause binding UDS-trained doctors to serve in the north for some years as part of the original aim of setting up the medical school, then someone is not doing his job in ensuring that they fulfill this laudable requirement. But again, the monumental failure of this policyand lack of patriotism in us.

Many, if not most, of the latest breed of doctors are our own children, including the officials who should ensure the implementation of this policy and because we want our children in the major cities down south, we conveniently ignore our own rules. And of course, nothing ever happens to serve as a deterrent.

Let’s face it, doctors have always been posted to the north and other rural areas. Sometimes they turn up to ‘show their faces’ and disappear down south to do locum while still being paid by the GHS.

The best way to solve this problem is what the Director General of the GHS has suggested and this is something I’ve been advocating over the years, including once in the Daily Graphic.

Why are newly qualified doctors who have completed their two years compulsory housemanship still sitting at home or going round begging for locum in private hospitals when there are numerous hospitals over the entire country crying for doctors?

The problem is the current centralised employment of doctors and nurses. Despite the delays in posting, the current system makes it almost an automatic employment for all doctors. And that is why doctors can refuse their postings and still get their salaries.

The best solution is to decentralise employment and postings to the regional health directorates which willadvertise vacancies in the various district hospitals and polyclinics under them.

In this way, the contact is between the regional health directorate and the individual doctor and, therefore, if the doctors don’t show up, they don’t get paid.

To make this more attractive, doctors’ salaries should not be the same across board. Doctors who accept to work in the districts should be paid considerably more than their counterparts who choose to stay in the bigger urban areas.

Other incentives such as free accommodation and support for postgraduate training after three to five years of continuous service should be offered to such doctors. Any doctor who choose to stay in Accra or Kumasi, etc. should be deliberately denied these incentives.

We must deliberately create a huge gap in compensation between doctors who serve in the rural areas and those who choose the cities.

And another thing, we should stop this automatic employment thing as soon as the power/right of employment is given to the regions.

The new Director General of the GHS is on the right path and must stand his ground to ensure this works for all of us.

I hope it works. Indeed, I pray it works to ensure equitable distribution of medical personnel throughout the country. Excellent policy.