Korle Bu defends intramural practice as legal, audited service after pay-to-jump-queue claims

# What Korle Bu says happened

On September 16, 2026, Korle Bu Teaching Hospital issued a clarification signed by its Head of Public Relations, Mustapha Salifu, responding to media reports that described its intramural practice as a "pay-to-jump-the-queue" system. The hospital rejected that characterization, calling parts of the reporting inaccurate and saying management should have been contacted before publication.

# What intramural practice is, according to the hospital

Korle Bu describes intramural practice as a structured arrangement that allows patients to access specialist services within the public facility outside normal working hours. Clinicians provide these services early in the morning, during approved breaks, after normal hours (usually after 5 p.m.), and at weekends. The hospital says the arrangement is used by patients whose schedules make it hard to use regular service pathways.

The hospital notes intramural practice exists in other teaching hospitals in Ghana and internationally. It frames the service as a way to keep highly trained clinicians working inside public hospitals rather than leaving for private practice or locum work elsewhere.

# Fees, payments and revenue use

Korle Bu states there is an approved schedule of fees for intramural services. All payments are made to the hospital first and then distributed according to an approved sharing formula: the hospital receives a share and clinicians, administrators, accountants and other staff involved receive their approved payments after claims are submitted and processed.

The hospital says approved public tariffs sometimes fall 50–60% below real market costs for some services. Intramural revenue is said to help close those funding gaps and to support treatment for indigent patients. The Chief Executive can grant waivers to patients who have been properly assessed and confirmed to be indigent.

Korle Bu also claims that, where compared with some quasi-governmental and private facilities, intramural fees are generally more affordable.

# Governance, transparency and safeguards

Korle Bu emphasizes that the intramural framework required board approval before introduction and is subject to regular audits, including review by the Ghana Audit Service as part of annual audits. The hospital says this layered approval and audit structure provides legality, transparency and accountability.

# Context and related reporting

The clarification comes amid a series of Herald stories raising concerns about intramural services, including pieces alleging that money could buy faster access to care, and reporting that the hospital's director of finance faced scrutiny over accounting for scheme cash. Korle Bu responded that some of those reports contained inaccuracies and misrepresentations.

# What remains on the table

Korle Bu's statement lays out the hospital's position: intramural practice is lawful, audited and intended to expand access and fund gaps in public provision. It acknowledges risks and says approved procedures and audits are in place to catch unauthorized activity. The statement does not provide detailed audit findings or case-level examples of waivers or revenue distribution.

# Practical takeaways for patients

• Intramural appointments are offered outside regular hours and use an approved fee schedule.
• Payments are processed through the hospital and distributed under an approved formula only after claims are vetted.