The Ghana Medical Association (GMA) says it will soon be forced to reject laboratory results without authorization by qualified laboratory physicians.

The GMA says it will carry out the threat if the current impasse between the Ghana Association of Medical Laboratory Scientists (GAMLS) at the Komfo Anokye Teaching Hospital (KATH) in Kumasi and the two laboratory physicians posted there, is not resolved by the Ministry of Health.

President of the Ghana Medical Association, Dr. Frank Ankobea, addressed the press at the end of the 3rd National Executive Council meeting on Sunday, May 30, 2021.

Attached below is a communique issued by the GMA at the end of the council meeting

“When push comes to shove, the GMA and its members may be forced to reject laboratory results without authorization by qualified laboratory Physicians at a point in time”, he warned.

The group also called for an immediate end to all forms of threats, harassment and assault directed at Laboratory Physician residents and specialists by the members of the medical laboratory scientists.

“All other forms of threats (including but not limited to murder and bodily harm), harassment and assault directed at these Laboratory Physician residents and Specialists should cease forthwith”, Dr. Frank Ankobea added.

COMMUNIQUE ISSUED AT THE END OF THE 3RD NATIONAL EXECUTIVE COUNCIL (NEC) MEETING OF THE GHANA MEDICAL ASSOCIATION (GMA) HELD AT EASTERN PREMIER HOTEL KOFORIDUA, EASTERN REGION, FROM MAY 28-30, 2021

The National Executive Council (NEC) of GMA having met and deliberated extensively on developments concerning the demands by Ghana Association of Medical Laboratory Scientists (GAMLS) of Komfo Anokye Teaching Hospital (KATH) chapter to have two Haematologists (Laboratory Physicians) removed from the laboratory and the practice of laboratory medicine generally in the country, hereby states as follows;

Historical background

Professionals with diverse background in medicine, surgery, nursing, laboratory and diagnostics, pharmacy and public health are required for holistic health delivery.
With the increasing knowledge in medicine, the practice of medicine has diversified over the years to include many sub-specialties to provide comprehensive care to patients.
Laboratory physicians are medical doctors who have undergone specialist training in laboratory medicine/pathology pathologists/laboratory physicians. There are four kinds (disciplines) of pathologists and these are the anatomic pathologist (whom most refer toas pathologists), the haematologist, the chemical pathologist and the medical microbiologist. and are also known as
Clinical laboratory practice is at the soul of the practice of Pathology generally or Laboratory Medicine as it is now called. This practice, in the nineteenth century, was carried out solely by Physician Specialists who later employed others' to help. This naturally places the ultimate responsibility and liability for quality testing on him and him alone. In Great Britain, the Physician Specialist practicing in the laboratory eventually came to be known as a Pathologist.

Training of laboratory physicians is not at all a new phenomenon. Training of laboratory physicians and practice of laboratory medicine has been in existence in Ghana for several decades. Initially this training took place outside Ghana especially in the UK (Royal College of Pathologists), just like most other medical specialties. The West African College of Physicians (WACP) took over this role in 1973 and finally the Ghana College of Physicians and Surgeons when it was set up in 2003 by an act of parliament (Act 635 now replaced by Act 833).

It is an agency of the Ministry of Health (MOH) mandated to train medical specialists in all medical disciplines including laboratory medicine. Lately, the Ghana College of Physicians and Surgeons as well as the WACP train pathologists who enrol into a 4-year membership program and a further 3 years to fellowship level (7 years postgraduate training in all). Thus training of laboratory physicians is not at all a new phenomenon.

Over the past couple of years some cadre of Laboratory Physicians have been prevented from performing their functions within the laboratory in the KorleBu Teaching Hospital (KBTH) especially and now Komfo Anokye and Cape Coast Teaching Hospital.
Also, Residents (postgraduate medical doctors in training in Laboratory Medicine) and some Specialist Laboratory Physicians have been denied access to the laboratory as well as in some cases, access to patient laboratory information for them to make inputs. This hostility was also extended to other categories of doctors doing residency programmes in other specialties such as internal medicine and family medicine who are mandated to have rotations in the laboratory as part of their training. In essence the laboratory has become a no-go area for postgraduate medical doctors in training, a development which has dire consequences for the training of our specialist doctors.

Misinformation by Ghana Association of Medical Laboratory Scientists (GAMLS)

The claim by the local chapter of GAMLS at Komfo Anokye Teaching Hospital that the two haematologists were posted to the laboratory to Head the unit is entirely false.
The view that only medical laboratory scientists regulated by the Allied Health Professions Council should work in hospital laboratories to the exclusion of all other cadres of laboratory professionals (especially laboratory physicians) in Ghana is erroneous and ill intentioned.
They have deliberately misinterpreted the provisions of Part I of the Health Professions Regulatory Bodies ACT, 2013 (ACT 857), albeit wrongly, to stop scientists with backgrounds or expertise such as Clinical Haematology, Clinical Biochemistry, Clinical Immunology, Human Biology, Molecular Genetics, Clinical Microbiology, Pathologists, or laboratory physicians who are not under the regulatory mandate of the AHPC, from working in the various laboratories in clear breach of the provisions of ACT 857.
The assertion by GAMLS that laboratory physicians cannot work in the various hospital laboratories because they are not under the regulatory jurisdiction of the Allied Health Professions Council is erroneous and baseless with same not grounded in Law. .
The laboratory space and set up is also not regulated by the same Council. The body mandated by Law to do so is the Health Facility Regulatory Authority (HeFRA).

Excerpts from the Prof. Ernest Aryeetey's Commnittee

We presents excerpts of "Summary of Main Findings and Conclusions' of the Report of the Committee set up by the Hon. Minister of Health in 2016 for a review of arrangements towards a National Health Laboratory Policy dated February 06, 2017.

"Who should be allowed to practice their profession in hospital laboratories?

It became obvious from the Committee's interactions with all the different stakeholders that the hospital laboratory space is one that has historically contained many different scientists, all with a very valuable role to play.

The role that the Laboratory Physician plays both in research and as a service provider is not in doubt. These roles are found in all hospital laboratories throughout the world, where they come in the form of Pathologist. Pathology is now known as Laboratory Medicine in the UK and covers Anatomic Pathology, Chemical Pathology, Haematology and Medical Microbiology.

It is inconceivable that any major laboratory can keep out Pathologist or Laboratory Medicine Specialists. Their role in research and in the teaching of different types of health professionals is well established and documented. It is therefore the view of the Committee that there is no strong reason for keeping out any group of relevant professionals from the hospital laboratories."

Who can head the Hospital Laboratories?

The appointment of the Head for the Hospital laboratory should ideally be the responsibility of the Hospital Management. In making the appointment the relevant scientific and technical preparation should count, just as the ability to provide leadership to a multi-disciplinary team covering all the different aspects of the laboratories work, including research and service delivery in the case of the teaching hospitals."

"Who should regulate the personnel working in and facilities at Hospital Laboratories?

It wouldbe reasonable to continue the arangement of regulatory agencies registering and regulating the conduct of professional practice for all the cadres that work at the hospital laboratory. This means there is no reason why the Ghana Medical and Dental Council cannotcontinue to regulate the professional practice of Laboratory Physicians. In similar vein, the Allied Health Professions Council can continue to regulate the activities of Medical Laboratory Technologist/Scientists and the Biomedical Scientist applying the provisions of Act 857 in the spirit and letter of the Act to capture the scope of expertise available." The management of of personnel should also be left in the hands the Hospital Management.

"The view of Teaching Hospitals It is also instructive to note the view of the teaching hospitals per their at the committee's representation Boards sittings. "The CEO of Korle-Bu Teaching Hospital represented the of Teaching Hospitals and noted as follows: At the teaching hospitals both the technologies and laboratory physicians and it are needed should be left with the employer to determine who does what in the The Head of the laboratory. laboratory should be somebody who understands and can interpret the science, but is primarily a management position. The Headship of the laboratory management is a decision and should not be interfered with by any institution".

The GMA therefore resolves as follows: That

All work Laboratory within Physicians (doctors) who have been forced out of their places of the various hospital laboratories (especially Anokye and in Korle-Bu, Komnfo Cape Coast Teaching Hospital) be restored with immediate effect to enable them practice their lawfully chosen profession or specialization and sub-specialties.
All resident medical doctors in and training with the Ghana College of Physicians Surgeons and West African Colleges of Physicians and those pursuing Surgeons especially programs in Laboratory Medicine should be or granted unfettered full access to all relevant laboratory spaces within the various in Korle-Bu, teaching sites residents Cape Coast and Komfo Anokye Teaching Hospitals where these are currently not allowed to pursue their training by the medical laboratory scientists group and its members.
All other forms of threats (including but not limited to murder and harassment and bodily harm), assault directed at these Laboratory Physician residents and Specialists should cease forthwith. The GMA takes a otherwise very serious view of these criminal activities at the work place that are directed members towards our by the medical laboratory scientists. The Ministry of Health, and the various ensure the swift hospital Management should also prosecution of the perpetrators of these crimes
When push comes to shove, the GMA and its members may be forced to laboratory results without reject point in time. authorisation by qualified laboratory Physicians at a
The GMA calls for a broader National Laboratory Policy.
The future of the medical its members to be profession is ata cross-road. The GMA calls on all of resolute in our quest to ensure that sanity is restored to the practice of the noble medical profession especially laboratory medicine, in line with best practices.
The GMA reserves the right to respond appropriately if these negative and criminal tendencies by members of the medical laboratory scientists group and other allied health professionals continue at the work place unchecked.

The GMA hereby serves notice that the afore listed resolutions if not fully addressed by the Ministry of Health and its agencies (especially management of the various hospitals) will result in the GMA taking drastic measures that will definitely disturb the current seemingly industrial harmony and health care delivery throughout the country. This is a commitment that the GMA and its members will never waiver on. Long Live GMA