ACCRA, GHANA — The Ghana Medical Association (GMA) has urged the government to create a Ghana emergency healthcare fund to pay hospitals for treating patients in life-threatening emergencies who cannot pay immediately, MyJoyOnline reported on 9 November.
GMA General Secretary Dr Richard Salomey spoke to JoyNews after the association’s 68th Annual General Conference. He said the government should consider “creating a sustainable funding arrangement to support emergency care.”
How a Ghana emergency healthcare fund could work
The GMA suggested that the fund could be financed from part of the National Health Insurance Scheme (NHIS) allocation and a percentage of private vehicle insurance premiums. The proposal is especially relevant for road crash victims and other emergencies, according to the report.
Salomey said “a reliable financing mechanism is also necessary to ensure that patients can access urgent medical attention.” The association said it is ready to contribute to discussions, but that the government must lead.
Details such as the financing structure, eligibility criteria, administration and accountability have yet to be worked out, and the GMA did not propose an amount for the fund.
The idea of a Ghana emergency healthcare fund is not new in the region. Health advocates in several African countries have argued that emergency care should be free at the point of use for the first hours, with costs recovered later from insurance, government or the patient where possible.
The no-bed syndrome
The proposal follows President John Mahama’s announcement on 6 November of plans to expand accident and emergency (A&E) centres at Korle Bu Teaching Hospital, Komfo Anokye Teaching Hospital, Tamale Teaching Hospital and 37 Military Hospital, with work expected to begin next year.
The government aims to raise emergency bed capacity to at least 10 per cent of each facility’s functional beds. Korle Bu has 1,500 functional beds but only 65 A&E beds, and meeting the target would mean “more than doubling the current emergency bed capacity from 65 to at least 150 beds,” Mahama said.
“When a patient arrives in critical condition, we cannot simply say, ‘No bed, no bed, go somewhere else,’” Mahama said. He said patients must at least be assessed and stabilised before a safe transfer.
The Ministry of Health will also pilot an Integrated Bed Management and Referral Coordination System linking major hospitals and the National Ambulance Service, to help find facilities with capacity and coordinate transfers, MyJoyOnline reported.
The Ghana Armed Forces Critical Care and Emergency Hospital is also opening to the public and will begin receiving patients immediately, according to the report.
Why payment is the sticking point
In many African countries, including Ghana and Nigeria, hospitals ask for payment or a deposit before treating patients. Accident victims, people found unconscious and patients brought in by strangers often arrive without money or relatives, and treatment can be delayed while staff wait for payment.
Hospitals argue that unpaid bills drain their budgets for medicines, consumables and staff, especially when NHIS reimbursements are delayed. A dedicated fund would aim to separate the decision to treat from the question of who pays, by guaranteeing reimbursement for the first hours of emergency care.
Road crashes are a major cause of emergency admissions in Ghana, and many victims are young adults. Quick treatment of bleeding, head injuries and fractures can prevent death and disability, but only if hospitals are confident they will be paid.
The GMA said a Ghana emergency healthcare fund would need government leadership, and that doctors are willing to help design rules on eligibility and accountability.
Nigeria is debating similar issues. Its lawmakers are considering bills to penalise hospitals that delay emergency treatment, and doctors there have argued that emergency care needs funding rather than only penalties.
Learning from other models
Some countries use road accident funds, financed by levies on fuel or vehicle insurance, to pay for treatment of crash victims. Others include emergency care in national health insurance packages with fast reimbursement rules. Ghana’s NHIS covers emergencies, but providers say payments are often late.
Health economists say any Ghana emergency healthcare fund would need clear rules on what is covered, rapid payment to providers and strong audit systems to prevent abuse. Linking the fund to the planned bed management system could help track where emergency patients are treated.
The GMA’s proposal adds to pressure on the government to address the no-bed syndrome not only with more beds but with the money, staff and coordination needed to treat every emergency patient promptly.
Why it matters: Patients die when hospitals wait for payment; guaranteed funding for emergency care could save lives on Ghana’s roads and wards.
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