Allegations that paid intramural services speed access to care at Korle Bu Teaching Hospital

# What happened Serious questions have been raised about intramural services at Korle Bu Teaching Hospital after reports that some patients obtain faster specialist care by paying additional fees. Intramural services are provided by hospital doctors and specialists for extra payment outside the regular public-service pathway.

# Why this matters Korle Bu is Ghana's main public referral hospital and serves large numbers of patients, many with limited ability to pay. If payment for intramural services results in faster access to consultations, procedures, or operations, the hospital could effectively be operating two tiers of care within the same public institution. That situation threatens equitable access and professional ethics because clinical urgency should determine who receives timely care.

# What patients are reporting Patients and clinic attendees say they face significant intramural charges in specialties such as Surgery, Anaesthesia, Plastic Surgery, Orthopaedics, and Neurosurgery. The Herald sighted an invoice showing intramural fees exceeding GH¢30,000. Some patients say their conditions worsened as they waited for publicly scheduled care while others who paid reportedly moved ahead.

# Hospital governance questions The controversy shifts attention to hospital management and oversight. Key governance issues raised include:

• Whether intramural services use hospital equipment and facilities in ways that bypass public-service scheduling.
• What safeguards exist to prevent conflicts of interest when staff offer paid services within the public hospital.
• Whether independent mechanisms exist to investigate complaints about preferential treatment.

# Stakes for patients and the public system

# What needs to happen next The Herald's coverage triggered broader scrutiny. The article calls for a measured, credible process to establish facts rather than immediate conclusions. That process should include:

• Gathering and verifying patients' accounts and documentary evidence such as invoices and schedules.
• Allowing health professionals and departments implicated to respond.
• Reviewing how intramural services are registered, charged, and scheduled relative to public queues.

# Bottom line Intramural services can be a legitimate way for hospitals to retain specialists and offer additional options to patients. The problem arises if those services create a de facto pay-to-jump-the-queue system inside a public referral hospital. Establishing what is actually happening at Korle Bu requires transparent investigation, clear governance rules, and mechanisms that ensure clinical need—not financial capacity—drives access to timely care.