“Pay this, pay that, and the patient dies” – Former UGMC boss demands end to cash-and-carry in emergency care

The former Chief Executive Officer of the University of Ghana Medical Centre (UGMC), Darius Osei, has strongly criticised the entrenched “pay-before-service” culture in Ghana’s emergency healthcare system, warning that the practice of demanding upfront payments from trauma victims effectively amounts to a death sentence.

Speaking during a high-profile dialogue hosted by JoyNews on Thursday, April 2, 2026, Dr Osei described the current system as a serious violation of medical ethics. He highlighted how Good Samaritans and distressed relatives are often forced to move between multiple billing points to make payments while critically ill patients wait for life-saving care.

According to Dr Osei, this bureaucratic process creates dangerous delays at a time when every second is crucial, fundamentally undermining the core principles of emergency medicine.

Drawing on his experience as CEO of UGMC, he outlined a reform model he implemented during his tenure, which prioritised immediate care over financial procedures. Central to this approach was a policy that prohibited the collection of any payments from emergency patients within the first 24 hours of arrival.

“There was a policy that no money should be collected from any patient within 24 hours. Patients must be attended to within 10 minutes,” Dr Osei explained. He added that the existing system—where relatives are required to process multiple payments for services—creates unnecessary delays that can lead to preventable deaths.

“It is so cumbersome going around with documentation, getting payments done and so forth. Nobody carries 20,000 or 10,000 in their pocket… and they go pay this, pay that, pay that. By the time they finish, the patient is dead,” he stressed.

The “One-Stop-Shop” Emergency Unit Model

Dr Osei further advocated for a structural overhaul of emergency units across Ghana, emphasising the importance of proximity and efficiency in critical care delivery. He explained that during his leadership at UGMC, he implemented a “one-stop-shop” emergency model where essential services—including pharmacy, laboratory, and radiology—were integrated within the emergency unit itself.

This design eliminated the need for patients’ relatives or hospital staff to move across different departments in search of diagnostic services or medications, a process he described as both inefficient and dangerous in emergency situations.

“That is the reason why it is called an emergency,” he noted, stressing that effective emergency care requires immediate access to diagnostics and treatment at the point of need, rather than across a dispersed hospital layout.

Addressing the “Technical Vacuum” in District Healthcare

Beyond emergency ward practices, Dr Osei highlighted a broader systemic issue within Ghana’s healthcare system—what he termed a “technical vacuum” in district-level facilities. He pointed out that while the Ghana College of Physicians and Surgeons continues to produce highly skilled specialists, many of these professionals remain concentrated in Accra due to the lack of essential diagnostic infrastructure in regional and district hospitals.

He specifically cited the absence of advanced imaging tools, such as CT scanners, as a major barrier to effective healthcare delivery outside major urban centres.

“I believe that if for nothing at all, each district hospital should have a CT scan,” Dr Osei urged. He further emphasised the need for national standards in healthcare delivery, noting that modern medical training increasingly depends on access to advanced diagnostic technologies.

“We don’t have standards. Let’s standardise our operations… these days, imaging has become part of our diagnostic tools because students have been trained with these tools and that is all they know,” he added.

Call for National Reform and Standardisation

Dr Osei concluded with a call for a comprehensive overhaul of Ghana’s emergency care framework. He advocated for the introduction of a legally backed “Care First, Pay Later” policy that would guarantee immediate treatment for all emergency patients, regardless of their financial status at the time of admission.

He warned that without clear national standards, adequate infrastructure, and patient-first policies, Ghana risks continuing to lose lives to delays that are both predictable and preventable.

As national discussions around “No-Bed” and “No-Money” healthcare policies intensify, Dr Osei’s intervention provides a practical, experience-based model that places patient survival above administrative and financial processes.