What Kofi Abotsi said on consulting GMA on drones for medical supplies (UPDATED)

The former dean of the Faculty of Law at the Ghana Institute of Management and Public Administration (GIMPA), Ernest Kofi Abotsi has discounted claims that government and the Ministry of Health should have consulted the Ghana Medical Association (GMA) before seeking to sign a service agreement with California based firm Zipline for the deployment of drones for medical deliveries.

Speaking on the news analysis programme - Newsfile - aired on Joy News TV and Joy FM on Saturday, Kofi Abotsi made a useful technical argument to back his claim.

His argument was that although "stakeholder consultations are important and I think when they fail at all levels, it is regrettable. I would have wished that government had consulted all the other entities including the Ghana Medical Association (GMA) because ultimately they are an important stakeholder and they have to be consulted."

However, he argued that although consultation is good to ensure inclusiveness in decision making and also ensure transparency, he did not believe that the prime institution that government was bound to consult at the initial stages of the deal was the GMA or the Association of Biomedical Scientists.

”Let’s be clear, all consultations are useful, consultations enrich the process, consultations are the heart of deliberative governance and therefore consultations are fundamentally useful because you can only enrich whatever decision you are about to take if you do consult.”

"In that respect, therefore, all failures of consultations are problematic. It’s also however important to pay attention to the fact that there is a distinction between, or there is a clear demarcation between responsibilities in the medical business just like many other professions, where you have the administrative structure and then you have the professional body."

"The doctors are the professionals, and then there are administrators. The question of availability or otherwise of the logistics of supplies of equipment or of products or all other necessities that are necessary to carry out the medicals business is the preserve of the administrative body of the Ghana Health Service, the Ministry of Health, the structure."

"So in terms of consultation, these are the primary stakeholders, it is important to then draw the distinction, that we may have primary stakeholders and secondary stakeholders."

"With the greatest respect to the Ghana Medical Association, I think they are the secondary stakeholders in this respect because their responsibilities primarily, is to deliver the healthcare," Mr Abotsi said.

Although debate on the drone for medical deliveries has heightened, it appears that when subject to critical in-depth analysis and without populist and political sensations the argument can easily be settled in favour of the policy.

On the Saturday December 15, 2018 NewsFile programme, which is a news analysis programme aired on TV on Joy News and on radio on Accra based Joy FM, but for the representative from the opposition NDC party all three other panellists spoke in favour of the deal.

Senior journalist and Editor-in-Chief of the Crusading Guide newspaper, Abdul Malik Kweku Baako had this to say “Where we are today is that Parliament has passed the deal after all the controversy. My honest view is that this project is in order. It makes sense to me especially knowing that our health sector is not at the right level''.

Even on his part, Dr. Dominic Ayine, the NDC Member of Parliament for Bolgatanga East in the Upper East Region said he disagrees with the GMA that the deal be suspended.

Parliament has already approved the deal and with this Zipline will provide services by way of delivery of medical supplies to centres upon request and they will, in turn, be paid after a service is delivered. The project is expected to complement the existing medical delivery systems in the health centre, focusing primarily on emergencies. This will ensure quick supplies in case of stock-outs and also eliminate wastage in the system.

The government of Ghana will not pay a pesewa from its budget for this project.

Below is a transcribed version of what Mr Kofi Abotsi said

”Let’s be clear, all consultations are useful, consultations enrich the process, consultations are the heart of deliberative governance and therefore consultations are fundamentally useful because you can only enrich whatever decision you are about to take if you do consult.”

In that respect therefore, all failures of consultations are problematic. It’s also however important to pay attention to the fact that there is a distinction between, or there is a clear demarcation between responsibilities in the medical business just like many other professions, where you have the administrative structure and then you have the professional body.

The doctors are the professionals, and then there are administrators. The question of availability or otherwise of the logistics of supplies of equipment or of products or all other necessities that are necessary to carry out the medicals business is the preserve of the administrative body of the Ghana Health Service, the Ministry of Health, the structure.

So in terms of consultation, these are the primary stakeholders, it is important to then draw the distinction, that we may have primary stakeholders and secondary stakeholders.

With the greatest respect to the Ghana Medical Association, I think they are the secondary stakeholders in this respect because their responsibilities primarily is to deliver the healthcare.

It is someone’s job to make supplies available, it is someone’s job to ensure that certain basic necessities are ready and there.

That doesn’t imply or that is not to say they are not important, but I’m just saying that in the scheme of things, if government had consulted the people who are responsible for the administrative machinery of health care in Ghana, these are primary and there are others who have secondary responsibility in this respect.

So stakeholder consultations are important and I think when they fail at all levels, it is regrettable. I would have wished that government had consulted all the other entities including the Ghana Medical Association because ultimately they are an important stakeholder and they have to be consulted but I think that primarily speaking, the people who ought to be primarily consulted who have, if you like the technical input to make in this respect, or the administrative body, because it is their responsibility to ensure that supplies and basic prerequisites for carrying out the health care delivery is made available.

But I would like to take on the question of whether it’s from the Vice President’s office or and I don’t mind, with the greatest respect to my colleagues and people I think we spent a lot of time talking about this which is frankly not an issue, if you ask me.

The Vice President is a deputy to the President.

The President under Article 58 is the commander-in-chief and the holder of executive power. The ministries don’t exist, they exist at the behest of the president, that’s why the president can demolish and create as he wishes.

In that respect therefore, any ministry can technically be collapsed today the president becomes the minister and the Vice President can act on behalf of the president… therefore if the Vice President is leading any project be it a presidentially important project or whatever project, the Vice President have the full power and authority so to do.

So I don’t really think this is an issue and I’m wondering why its an issue, why we are debating whether a ministry should be doing it, once the Vice President is acting supposedly on behalf of the president, without the president expressly contravening the Vice President’s decision,…

I will like with your permission to also proceed on a certain assumption that when my political friends do what they do best, I try to go pure principle and I’m just saying part of the reason we have having this conversation is because, regrettably and I repeat this again, Parliament over the years has not been doing what it is supposed to do.

That is why we constantly have to re-evaluate, re-analyze, de-construct and critique what Parliament does, because if Parliament does what it is supposed to do, we don’t worry about the executive. The constitutional framers understands that the executive always has an incentive to “misbehave”, it’s an assumption because when people are given power, invariably they tend to abuse it and so what the structures of the constitution is intended to achieve is to ensure that whilst the executive has the power, Parliament will ensure that that power is moderated.

Over the years unfortunately, we’ve had a partisan Parliament and it has continued till today so I’m just going to say this for example, I think Parliament may do well to have certain basic minimum protocols, that we can check and once we check these protocols, we assume that any approved contract is okay. For example, does Parliament do technical briefings, and I know that the committee sometimes invite all kinds of people to appear before them but how thorough are these technical briefings.

Does Parliament for example has a template on minimum benchmarks, that have to be met for any contractual approval, i.e. for a certain contract to come before Parliament, or the committee, the proposer, the sector ministry which is interested, whoever is behind the contract, have you checked the following lines to ensure that we have bypassed all these things, do we for example have a necessity test, my friend Dominic Ayine and Nana Akomea who were arguing about necessities, what are the benchmarks.

Unfortunately both the NDC and NPP, electoral cycle after electoral cycle, we do this and the reason is that we don’t have the broad template to ensure that in terms of the enrichment of the governance process we follow these things because the specifics we can argue about them.

For example in this particular case, to do devil’s advocate for Nana [Akomea], Nana is not the devil, in terms of this one can justify it on the fact that blood is a peculiar product, it has a lifespan, it must be subjected to certain preservation in terms of transit, we have difficulty of access, in terms of our country, the roads etc, the inclusivity in health care, people in rural areas must equally have access to basic minimum things within the healthcare sector.

There must be a certain justification for it, but if you have to do the analysis at a certain level, the question is generally speaking, do we have a necessity test developed as a protocol and as a template that we subject everything to, not just this particular one.

I think it will be important for example if we look at that and the fact that we have just learnt that value for money analysis is often conducted after the fait accompli, Parliament has spoken and once Parliament has spoken, even if we don’t like it, we are bound and at that point what is the value for money, are we only subjecting ourselves to the pains of things we can’t change.

I think that broadly speaking, as a country, Parliament closes ranks because there some things that we shouldn’t see parties, there are some things which are broad national policies which are important and we need to see bi-partisanship.