Former Chief Executive Officer of the University of Ghana Medical Centre (UGMC), Darius Osei, has advocated for the adoption of a “care first, pay later” legal framework to reform emergency healthcare delivery in Ghana.
He criticised the prevailing “pay-before-service” practice in emergency wards, describing the demand for upfront payments from trauma victims as a “death sentence.”
Dr Osei argued that the current system forces Good Samaritans and relatives to navigate multiple payment points while a patient’s life hangs in the balance, a situation he said undermines medical ethics.
Drawing from his experience at UGMC, he outlined a model that prioritises immediate care, revealing that a policy was implemented at the facility to ensure that no payments were collected from emergency patients within the first 24 hours.
“There was a policy that no money should be collected from any patient within 24 hours. Patients must be attended to within 10 minutes. It is so cumbersome going around with documentation, getting payments done and so forth. Nobody carries 20,000 or 10,000 in their pocket… and they go pay this, pay that, pay that. By the time they finish, the patient is dead,” he stated in an interview with Joynews on Thursday, April 2.
Beyond payment delays, Dr Osei stressed the need to redesign emergency units to improve response times, noting that access to diagnostic tools is critical in saving lives.
He explained that during his tenure, UGMC was restructured to ensure that pharmacy, laboratory and radiology services were located within the emergency unit to eliminate delays caused by movement across different parts of the hospital.
“That is the reason why it is called an emergency,” he said, adding that lifesaving interventions must be readily available at the point of care.
He also highlighted a “technical vacuum” in many district hospitals, pointing out that despite the training of specialists by the Ghana College of Physicians and Surgeons, many remain in urban centres due to lack of essential diagnostic equipment in other regions.
“I believe that if for nothing at all, each district hospital should have a CT scan. We don’t have standards. Let’s standardise our operations… these days, [imaging] has become part of our diagnostic tools because students have been trained with these tools and that is all they know.”