His position to cancel trainees’ allowances in the future can cause him another defeat…
Migrating trainees to Student Loan is not a better option for the allowance.
The former president during one of his interactive digital conversations dubbed ‘Let’s talk with JM’ on Sunday [June 7, 2020], disclosed that his government would continue with the payment of the allowances, while gradually migrating trainees unto the Students Loan Scheme*.
The Position of the former President…
“You know that it was a very critical issue in the run-up to the 2016 elections. What I had said was that we were not going to cancel the allowances. We were going to migrate the health trainees and educational trainees to the student loan scheme. Now what I have said going up to the 2020 elections is that we are going to let the status quo remain. It means that we are going to continue paying trainee allowances, but we are going to improve the student loan and adapt it so that it serves the same purpose as the allowances.”
“So for now, if I become the President on January 7, 2021, we are going to maintain the status quo. It means that they will continue to receive the allowances and when we have improved the Student Loan Scheme and made it is attractive enough for all students to go for it, then we will migrate everybody to it. So that’s my position on it as of now,” he said
The former president still does not believe in paying teacher and nurse trainees allowances. He rather believes in paying them on a student loan, for which the trainees will pay back such loans with interest.
Attached to this write up is a document showing the loan repayment?
I believe this student loan migration is not what the teacher and nurse/midwife trainees will opt for. It is not a better option for the current training allowances that they won’t payback.
Taking into consideration the allowances given to the nurse/midwife trainees, they contribute 30% to health care products during their internal and external clinical. They deserve allowances that they will not pay back than a loan that they have to pay back with interest.
Flashbacks on allowances brouhaha…
▪ Trainees’ allowances cancellation in 2014 reportedly caused undue hardship for thousands of trainee nurses nationwide, leading to President Akufo-Addo taking up the issue in 2016 with a pledge to restore it when given the nod at the polls to lead the country. (Daily Guide, 2017)
▪ The cancellation in 2014 was done without any system in place to manage the situation. No allowances, no access to a student loan. The government did not consider this before canceling the health trainees’ allowances.
▪ In 2016, a Technical Committee set up by the former President to review the issue of nursing students’ allowances has recommended the payment of an abated allowance with a possibility to migrate them onto the student’s Loan Scheme (MoH, 2016)
▪ President Mahama on Thursday tweeted saying: “On the matter of trainee teacher allowances, better to lose on principle than win using falsehood. We’ll not reverse the decision. #UCC Forum.” (September 2016)
Is allowance the cause of admission quota?
Trainee allowances cannot be a reason for admission quota. Admission quota is implemented effectively in every serious organized institution across the globe. Such quota ensures students do not overwhelm the class capacity and the resource capacity of an institution. With or without trainee allowances, admission quota will still be implemented.
The reduction in quota is to enhance the health system with the available limited infrastructure at the various Nursing and Midwifery Training Colleges. Over the years, the nursing training system has declined; so many “mushrooming” of nursing institutions and trainees during clinical at times outnumber the capacity of some clinical coordinators and the available resources for their training during clinical. Hence the decision to reduce the intake to ensure effectiveness in the health system.
Honestly, my position is that any health training Institution that does not have an affiliated hospital for effective training of the trainees in clinical experience should be taken a second look in terms of accreditation. The government and other stakeholders should also ensure no nursing and midwifery training Institution is accredited without affiliation to a hospital for clinical practice.
If the nurse to population ratio in Ghana is 0.8/1000 and doctors to population ratio is 0.2/1000 in 2018, why is the country not focusing on increasing quota admission at the Medical Schools?
Furthermore, our health system needs an effective reform whereby the number of health trainees to be admitted and trained is already budgeted for financially by projections. Recruitment should be mapping training. Without effective quota and proper projections, human resource management cannot be properly done.
Does allowance payment have a significant effect on financial clearance/employment?
If yes, why were we having Coalition of Unemployed Nurses and Midwives in batches when allowances were canceled from 2014 to 2016?
Payment of training allowance; GH¢400 monthly cannot pay 1/3rd salary of a staff nurse.
The former president submitted that the Government of Ghana budget for payment of trainees allowances in 2017; GH¢252,000,000 could have employed 14,000 nurses. This means the estimated GH¢1,500 as the salary of nurses. This cannot be entirely true, as salary differs per cadre of nurses you recruit. To add, the market premium which under his office got frozen was not considered for his analysis. Furthermore, the said amount cannot recruit 18,000 nurses and continuously pay them for more than one year.
The country should be focusing on how to achieve a Universal Health Coverage in terms of the distribution of the health workforce to increase accessibility and availability.
Significant incentives and other policies like rural incentive allowances, accommodation, and effective implementation of early study leave approval and early promotion for Health workforce serving in rural and hard-to-reach areas should be the focus to attract and retain health workers in such areas. This will ensure equitable distribution of our health workforce across the health facilities, districts, and regions.
Conclusion…
The cancellation of trainees’ allowances was not a good policy. Migrating health trainees to a Student loan in the future for them to repay with interest as posited by the former president should be taken a second look by his Technical Committee on health if any.
The justification for cancellation of health trainee’s allowances by the former president is not justifiable.
No government should cancel health trainees’ allowances in the future.
Other important health policies can help improve the six building blocks: from health services to health financing. The political parties should have a better understanding of these building blocks and let their campaign manifesto reflect policies that will help strengthen the health system significantly.
Source: Douglas Adu-Fokuo, RN. MPH. IMPH (Public Health Expert), douglasadu.int@gmail.com
