An anonymous health worker’s open letter warns that intramural services—which let patients pay for faster access to specialists outside normal schedules—risk prioritizing those who can pay and undermining public confidence in state hospitals.
An anonymous open letter highlights perceptions that paying for intramural services can speed access to specialists and procedures in some public hospitals.
The letter calls for transparency and safeguards where public resources serve both regular and fee-paying patients to prevent conflicts of interest.
The concern includes reports that beds, theatres or other resources appear unavailable to regular patients while being accessible through pay arrangements.
# What the open letter says
A health worker using anonymity wrote an "Open Letter On How Health Workers Profit From The Patients Through Intramural Services" and sent it to The Herald. The letter questions the rapid growth of intramural practice in some public hospitals in Ghana, singling out Korle-Bu Teaching Hospital in the discussion.
# Specific accountability issues raised
The letter frames several concrete questions for regulators and hospital managers:
Those are framed not as accusations of deliberate wrongdoing but as institutional questions that merit open examination to protect fairness and preserve public trust.
# Perception and trust
The writer emphasizes perception as its own problem. Even without proof of intentional delay, widespread belief that money buys speed can erode confidence in public healthcare. The letter insists clinical need, not ability to pay, must determine priority.
# Calls for transparency and oversight
The open letter asks the Ministry of Health and Parliament to scrutinize intramural practices and to require clear safeguards where public resources serve both patient groups. The suggested oversight themes are transparency of scheduling and resource allocation, clear conflict-of-interest rules, and published procedures explaining how intramural work is organized relative to regular services.
# Where the controversy stands in public reporting
Related reporting indicates Korle Bu has publicly defended its intramural scheme, saying it is legal, approved and audited, and that it serves to extend specialist access outside normal hours and raise revenue. Other related stories show the controversy widened to scrutiny of the hospital's finance office after questions about accounting for revenue tied to the arrangement.
# Practical questions for patients and policymakers
For patients: ask the hospital about how intramural appointments are scheduled and whether regular waitlists are separate and protected. For policymakers and hospital managers: publish allocation rules, audit schedules, and mechanisms to report suspected unfairness so ordinary patients can be assured services aren't diverted.
# Bottom line
The open letter frames intramural services as a legitimate tool whose implementation can create an appearance or reality of unequal access. The writer asks for formal oversight and transparent safeguards to ensure clinical need—not payment—determines who is treated first.
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…As ‘Pay-to-Jump-the-Queue’ system comes under fire Serious questions are being raised over the operation of intramural services at the Korle Bu Teaching Hospital, following allegations that some patients may be gaining faster access to specialist care by paying additional fees, while others without the financial means
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