Health Minister’s directive aims at systemic reform, not just punishment — CDD Fellow

Public health expert and Democracy and Development Fellow at Centre for Democratic Development (CDD-Ghana), Kwame Sarpong Asiedu, has backed the Health Minister’s decision to fully implement recommendations from the investigation into the death of Charles Amissah, describing the move as necessary to address deep systemic and human failures within Ghana’s healthcare system.

Speaking on  Super Morning Show on Thursday, May 7, Mr Asiedu said the ministerial directive should not merely focus on punishment, but also help uncover the institutional and behavioural issues that contribute to preventable deaths in the country’s healthcare sector.

“For me, I see the ministerial directive not only as a means to punish, but a means to understand the attitudinal problems there that cause these things to happen,” he stated.

According to him, without addressing the attitudes and professional conduct of healthcare workers alongside broader institutional weaknesses, meaningful reforms would remain difficult to achieve.

Mr Asiedu explained that the committee report investigating the circumstances surrounding Charles Amissah’s death exposed multiple failures within the healthcare system, including system breakdowns, technical deficiencies, and human errors.

He stressed that emergency care begins from the first point of contact, noting that delays and lack of proper emergency response can significantly reduce a patient’s chances of survival.

“When you have an emergency, the journey starts from the first person who comes across you,” he explained.

The public health expert raised concerns that many ordinary citizens lack basic life-saving skills such as first aid and emergency support. However, he said the report revealed a more troubling reality — that even ambulance personnel reportedly lacked adequate emergency response training.

“The technicians who came with the ambulance couldn’t do that either. Neither could they offer advanced support,” he said.

Mr Asiedu recalled previous concerns he raised years earlier during discussions surrounding the government’s One Ambulance, One District initiative. He argued that ambulances alone cannot improve emergency healthcare outcomes unless they are supported with trained personnel, functioning equipment, and coordinated referral systems.

“I had this conversation when the One Ambulance, One District policy came, that the ambulance itself would be a vehicle of transport if, one, the equipment; two, the personnel; and number three, there’s no system in place like a dashboard directing the ambulance to say there’s a bed here or there,” he stated.

“We had this conversation six and a half years ago… the pigeons have come back to roost.”

According to him, the report indicated that Charles Amissah was already losing significant amounts of blood during delays experienced at the emergency response stage.

Mr Asiedu also criticised the handling of the patient at hospitals involved in the case, particularly reports that health workers at the first hospital allegedly refused to attend to the patient due to the unavailability of beds.

“When they got to the first hospital, they were told that there’s no bed. The health professional then refuses to see the patient. That’s another system failure,” he said.

He questioned whether proper emergency protocols and standard operating procedures existed at the facilities involved and whether the conduct of health professionals met accepted professional standards.

Referencing the medical principle known as the Bolam test, Mr Asiedu explained that healthcare professionals are expected to act in ways consistent with competent practitioners possessing similar skills and training.

“The first question you are asked is the actions you took, would they be in consonance with the actions of a competent health professional with the same skills as you have?” he explained.

He noted that if established emergency procedures existed but were ignored, then the competence and professionalism of the staff involved must be scrutinized. Conversely, if no procedures existed, then the institutions themselves must bear responsibility for the failure.

Mr Asiedu warned that the repeated failures across multiple hospitals involved in the case expose wider concerns about Ghana’s emergency healthcare system, especially because the incident occurred within the Greater Accra Region, where healthcare infrastructure is expected to be among the best in the country.

“This was Greater Accra Region, where the national capital resides,” he said.

“So if technicians have these defects, what are the skills gaps across the country?”

He noted that skilled healthcare professionals and specialised medical services are already concentrated in urban centres, making the findings even more alarming.

“You expect that in the national capital you would have the best people with the best skills,” he added.

Mr Asiedu welcomed assurances from the Health Minister that the committee’s recommendations would be fully implemented, describing the commitment as overdue but critical for national healthcare reform.

“When the minister says that the report will be implemented to the letter, I’m like, good grief. Go ahead, Godspeed and implement it,” he stated.

“And it shouldn’t just be across Greater Accra. This has to be a national drive because this is just scary.”

He also highlighted the committee’s conclusion that Charles Amissah died as a result of “medical neglect,” describing the finding as both serious and technically significant.

“It says the patient died from medical neglect. That is very technical,” he said.

“The entire medical space over 118 minutes neglected the patient. That was the cause of death.”

During the discussion, host Winston Amoah referenced Ghana’s 2011 Policy Guidelines for Hospital Accident and Emergency Services, which outlines standards for triage systems, resuscitation units, and 24-hour emergency care.

Mr Asiedu agreed that Ghana’s healthcare challenge is not the absence of policy documents, but rather poor enforcement and implementation of existing guidelines.

“It’s not like we’re reinventing the wheel. All the documents exist,” he said.

“The gaps were identified in the health facilities assessment report as well in 2023. It’s not like we don’t know these things.”

He concluded by stressing that sustainable healthcare reform in Ghana must address both institutional weaknesses and the attitudes of healthcare workers simultaneously.

“When a system fails, you need to identify all the points of failure and fix them, including the personnel question,” he stated.

“For me, people may have the conversation around the chicken and egg situation… do you fix the system before you fix the people’s attitude or the attitude before you fix the system? The answer is both have to happen.”