Avoid discrimination and employ private trained nurses and Midwifery graduate on merit

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Richard Odame National President, PUSAG

The Private Universities Students Association of Ghana has brief the press about the discrimination meted against Private trained nurses and the hardship this situation has put these students through.

A statement issued by the aforementioned Association indicate that, private trained nurses who have completed their training and had sat for NMC licensing exams which issue PIN numbers have been denied postings.

The president of PUSAG said, they are looking forward to having a stakeholder meeting with the Chief of Staff, Minister of Health and the Minister for employment and Labour Relations within 10 days from today.

Attached is the full statement.

PRESS STATEMENT FROM THE PRIVATE UNIVERSITIES STUDENTS’ASSOCIATION OF GHANA (PUSAG) AND GAHTI DATED SEPTEMBER 15, 2016

Distinguished Student Leaders herein present, our amiable friends from the media, invited Guests, ladies and gentlemen, all protocol duly observed, we wish we could greet you on a joyous note but we are inundated with challenges hence we have almost lost our sense of joy as PUSAG and GAHTI.

The challenges notwithstanding, we would do the needful as tradition demands and say good day to you all and a very big thank you for honoring our invitation despite the short notice.Before we go on to the germane issues, it is very fair to intimate that PUSAG has for the past few months enjoyed healthy collaboration with stakeholders especially the Education ministry. Although all our demands have not been met, progress has been made. If the progress we have made together with our stakeholders should have continued, we think this forum might not have been necessary.

This press conference has become necessary because it is of our humble view that officials from the Health ministry, Ministry of Finance and Economic Planning and the Employmentand Labor Relations Ministry are not been straight forward with us especially on matters concerning the postings of nurses who attended private training institutions.

BACKGROUND

In Ghana, there are about 10 public and 64 private universities offering degree programs. Out of the 64 private universities, about 18 of them offer degree programs in nursing. This number aside, there are 12 additional private nursing institutions that have been duly certified and recognized by the Nursing and Midwifery Council of Ghana. So in all, there 30 accredited private nursing institutions in Ghana.

As you are all aware, there are basically three programs nursing trainees may opt for. They are enrolled nursing programs (certificate nurses), Diploma nurses’ program and Degree program for nurses. On the average, it costs an individual GHS 7000, GHS 10000 and GHS 22000 to complete the certificate (2years), Diploma (3) and degree nursing programs respectively. For the purpose of precision, I must intimate that the above figures represent only fees paid to training institutions. It excludes other educational costs like boarding and lodging, feeding, transportation etc.

Per the recent data particularly in 2016, about 4500 nurses graduated from over 104 nursing training institutions including the degree awarding institutions we have in Ghana. This 4500 figure comprises Degree, Diploma and Certificate nurses. Out of 4500, 1300 (representing 28.9%) of them were degree nurses. If we are to take only these 1300 degree graduate nurses this year, about 800 (representing 61.5%) attended private institutions.

So per this record, the private schools supply the country with the greater numbers as far as degree nurses are concerned. Aside the degree nurses, the private schools also supply good numbers as far as
certificate and diploma nurses are concerned. In fact, about 58% (2500) out of the 4500 attended private institutions. These private individuals include all PUSAG members and private GAHTI students.

In the past, governments were hesitant dealing with the private nurses because of mistrust. This mistrust was cured with the introduction of licensing examination under the auspices of Nurses and Midwifery council that led to the award of PIN to qualified nurses.

BENEFITS - PRIVATE NURSING SCHOOLS

It is not for nothing that the facts and figures have been spelt out in the paragraph above. To situate the debate properly, it is very crucial that we engage you on some of the benefits the government, the state Ghana, the trained nurses and the general public derive from these private nursing
institutions.

To start with, the private nursing schools offload government’s burden in providing facilities and space for potential nurses. As it is always the case in every country, governments are constraint by the economic problem ofscarcity; limited resources against competing needs. Governments therefore are unable to absorb and discharge their responsibilities to the fullest hence the involvement of the private sector. As far as the nursing subsector is concerned, the public spaces are limited therefore it takes a lot including leveraging on your network before gaining access (admission) into them as students.

The private nursing schools have minimized the burden and frustrations that hitherto governments and potential trainees found themselves in.

Linking the above, the obvious limited public spaces meant that the state was unable to raise the needed nurses to man the health sector. Ghana in times past had degrading figures not only in the area of doctor to patient ratio but also nurse to patient ratio. There were some communities (especially rural Ghana and the upper regions) that had one or two nurses serving both as nurses and pseudo physicians.

The advent of private training nursing institutions have soared the number of nurses trained annually and has earned Ghana enviable praises both at the international (WHO) and sub-regional levels. For example, in 2012 and 2013, Ghana recorded an improvement both in the doctor to patient ratio and nurse to patient ratio. The W.H.O target was one nurse is to 1000 patients in a year as at 2012.

Despite our 20% improvement over the 2012 numbers, Ghana could not meet both the W.H.O target and its own national target (1 nurse is to 800 patients). We achieved a ratio of 1: 1200. Due to the skewness of development in almost all the sectors of the economy, Greater Accra and Ashanti region benefitted immensely but fortunately the region that benefitted more in terms of percentage improvement is upper east region (previously sidelined region).

This positive was recorded through the assistance of private nursing schools.
Furthermore, with the emergence of private nursing institutions, youth who could have hitherto been denied opportunity to pursue their dream in nursing now have a fair chance of realizing their dreams. If these individuals had been denied opportunities, they might have been added to the stock of commercial sex workers, burgers, petty thieves and armed robbers.

There might have been so many vices that could have destabilized our peace and democracy. It is fair to state that since the youth are the people we are discussing, many of these youth might have given births at an uncontrollable rate and this might have come with its concomitant effects.
Private nursing schools are key partners in ensuring quality health care delivery in our communities and the country at large.

It is an established fact when hospitals through the workings of the government do not increase nurse staffing to adequate levels, patient complications can occur and patient care can deteriorate to the point that hospitals fail economically and the nation loses its human resource through avoidable deaths.

Evidence abounds to illustrate the point that improved nurse to patient ratio leads to quality health care delivery. This is one of the many advantages private nursing schools help to achieve. Aside that, as these schools help to create jobs for individuals, the government is able to raise enough revenue from them to prosecute the national developmental agenda.

NORM

The situation in the past has been that, since the government specifically the Ministry of Health sees the private nurses as key agents in ensuring quality health delivery especially in vulnerable communities, the long standing practice is that, after the one year mandatory rotational program (for lack of better word let’s say National service program) for trained nurses, these individuals buy forms from the government and both the public and private nurses are posted to various stations to serve their country.

CURRENT SITUATION

For the past two years, trained nurses both public and private nurses bought forms in anticipation of them getting posted. In fact, over 2800 individuals from private nursing training institutions have bought forms yearly at (30 cedis) per head. Per our calculations, our compatriots have given an amount of about GHS 84000. Yes, whopping GHS 84000. We do not want to say the government has extorted monies from our poor friends.

The understanding was that there were few administrative issues to be cleared before these individuals get posted. It therefore came as an unpleasant surprise when the President in his “Media Encounter” at the flagstaff house on January 12, 2016 make allusion to the effect that the public nurses are unemployed because trained private nurses are virtually taking their jobs hence he (His excellency) has given a directive to the employer to revert this misnomer.

This obviously points to the direction that until all public bonded nurses are posted, no individual trained privately as a nurse will be posted by the system. After gleaning this from the President, we made efforts to air our objections to all stakeholders including the chief of staff whom in a letter stated among other things that it is unfair to differentially treat publicly trained nurses and private trained nurses since they are all Ghanaians.

We thought that the sane verdict from the Chief of Staff would have brought normalcy in the health sector as far as employment is concerned. Unfortunately, till date, no privately trained Nurse has been posted. Only public trained who are bonded (taking allowance) are been posted. We are of the full conviction that, contrary to what we were made to believe during our interactions with stakeholders, the proposed labour rationalization policy as captured in the External Credit Facility (ECF) between Ghana and the International Monetary Fund (IMF) is the cause for this. Ironically, now that the numbers show government is making fantastic gains in the construction of CHP compounds, building polyclinics, district hospitals, regional hospitals etc, this is the time private nurses are not getting jobs.

CHALLENGES

From the above, the obvious belief is that until public nurses are posted, private nurses should forget getting posted. This we believe is unfortunate and will go a long way in worsening the unemployment situation in the country. For the past two years, life has been excruciatingly difficult for us as private nurses, private student leaders and our parents.

We will want to share just few of our challenges with you just because of the constraint of time To start with, consider a parent with very meagre resource borrowing about GHS 22000 (just for a tuition) to take his or her daughter through a degree program in nursing with the belief that once the child completes school, the child can meaningfully contribute to the households income stock only to be told that the future they saw (before taking this investment decision) has been shuttered. How will such a person feel?

This is the exact situation in which many parents find themselves. Some borrowed and used their family properties as collateral just to foot the tuition fees of their wards with the anticipation that after nursing, the child can also live a meaningful life that will have a cascading effect on the household. Today, these parents have lost their properties and they have their dreams dashed and they cannot tell when they can finally smile because government who is supposed to ensure at the very least equal playing field, it being the agent of divisive employer.

Secondly, private trained nurses who should by now live meaningful lives have now become albatrosses on the neck of their families. They don’t bring anything home because they lack jobs and they draw from the little in the households’ pot. The only place (private clinics) we could have found
solace (although conditions of service are tough and partially unrewarding) is not willing and ready to employ because of the challenges (high cost of running business and untimely release of NHIS claims) they are fraught with.

Now we do not know the life to live as human beings. Embarrassment defines our lives. Even our younger siblings we could have served as role models to, are unwilling to take their academics seriously because they believe that even if they go to school, the probability for them succeeding in
this country of ours is slim. The sad but obvious truth is that, it is increasingly becoming the case that, people who never attended school and engage in other activities have a brighter future than those who spend years pursing degrees, certificates and knowledge. It is not surprising that a lot of children (youth) are taking to the quickest route to wealth and shunning education.

RECOMMENDATIONS

We have few solutions to proffer on this challenge. We believe the policy the President articulated in Flagstaff House which has therefore emboldened the Health ministry to post public nurses first before private nurses must be looked at is unfair to say the least. We appreciate the factthat the government has a contractual arrangement with the bonded nurses and must be served. Let us interrogate this “public bond” excuse from the government.

This policy was introduced to incentivize people to opt for nursing programs and also to revert brain drain relating to the nursing sub sector. This subsidy is financed by the public including our parents and ourselves. So we believe a complete disregard to our interests as bona fide citizens of the land is to say the least unfortunate.

We know for a fact that if there were monies and hadn’t been our engagements with the IMF, all qualified nurses would have been absorbed. In trying to partially understand the difficulty of the government, we therefore implore government through Ministry of Health (employer) to apply a quota system in the posting process. It can either be 65 or 70% for public nurses and the rest for private trained nurses. This will ensure some semblance of equity and justice in the system.

Aside the quota system, we believe attention must be focused on making private clinics and hospitals vibrant to absorb some of the nurses who will not be engaged because of the quota system. As an incentive package, the government can give concessions or rebates to these private entities (clinics and hospitals) that will be willing to employ those nurses who will not be engaged by the government.

CONCLUSION - PLAN OF ACTION

The recommendations notwithstanding, we plan to submit all the receipts from the forms we bought in anticipation of getting posted back to the key stakeholders. We are by this medium serving notice to call for a crunch stakeholder’s forum to brainstorm and fashion the clearest way forward. The main
stakeholders we want in this meeting should include the Chief of Staff, The Finance Minister, Health Minister, The Employment Minister, Officials from the Nurses and Midwifery Council, PUSAG Officials etc. We entreat The Chief of Staff to convene this meeting within 10 days else we would take all legitimate measures to uphold our rights and resist unfair, inhumane, unethical, injustice and despicable treatments meted out to our friends, brothers and colleagues.

Thank you very much.

May God bless PUSAG,
May God bless GAHTI
May God bless Ghana

-----Signed---
Richard Odame
National President, PUSAG
+233 24 394 4302

Francis Kwabena Asante
Media Relations, PUSAG
+233 24 267 7779

Obed Bediako Asare
President, GAHTI Greater Accra
+233 24 624 7253

John Nketiah
Spokesperson, COUPN
+233 27 199 3768

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