The Committee met with the Deputy Minister for Finance, Hon Kwaku Kwarteng and a technical team from the Ministry of Finance and the Ministry of Health to consider the Request.
Teaching Hospitals are required to be the centres of excellence and complex care in the hierarchy of healthcare in the country. Its core function is to provide healthcare, medical research and training of health workers at pre-service, post graduate, post-basic and in-service levels.
Teaching hospitals also offer referral and specialised care to primary and secondary curative care services at all levels within its catchment area.
Health service delivery constitutes the mainstream function of the teaching hospital, and it spans the delivery of primary and secondary curative care services through the general out-patient department and polyclinic structure and systems.
The mandate of teaching hospitals to offer major clinical training and research work adds another dimension to its nature of requirement in terms of space, which would justify such other adjunct facilities such as demonstration rooms, mini laborateries for side ward procedures, day rooms for patients, and teaching space around patient beds in order to secure ease of movement and for effective teaching, while not compromising on comfort.
It is due to these important roles teaching hospitals play that Government has been committed to support sufficiently all teaching hospitals in the country to offer referral and specialised care to primary and secondary health services at all levels.
The Tamale Teaching Hospital is one of the teaching hospitals in the country. It is also strategically placed and serves over half of the land mass of Ghana and four of the ten regions. The hospital also serves as the only referral center for tertiary health care in the northern sector and also is a major recipient of patients on the trans- ECOWAS trade route.
Unfortunately, the hospital is in a deplorable condition and unable to fulfil its core function. If the hospital is to play its vital role, given its location, then there would be the need for a major rehabilitation of the hospital.
It is in line with Government's policy that the Government sought and Parliament approved a number of Loan Agreements to finance the upgrade and major rehabilitation of the Tamale Teaching Hospital.
To this end, the project was broken down into two phases. In the first phase, the existing hospital was rehabilitated and reconstructed into a fully functioning 400- bed tertiary hospital with teaching facilities. It also included facilities for a psychiatric unit and an obstetric unit. phase one has been completed.
Phase two is expected to increase the capacity of the hospital with an additional 400 beds. In order to implement phase two, Parliament approved the Loan Agreement for €47, 977, 325 between the Republic of Ghana and ABN AMRO Bank NV of the Netherlands in 2012.
As part of the conditions precedent to the loan, the project is to be waived of import duty, import VAT, ECOWAS levy and other approved imposts including EXIM levy, Special Import Levy and inspection fees.
The project is currently underway. However, in order not to stall the project and avoid possible delays, there is the need to request Parliament for a tax waiver for the project. It is this request that is currently before the House for approval.
The request is for a tax waiver amounting to six million, sixty-eight thousand, nine hundred and thirty-three Euros (€6,068,933.00) for the importation of construction materials and equipment for the project.
Duration of the Project
The project is to be implemented over a period of two years.
Scope of the Project
The technical team informed the Committee that the scope of the project entails the following;
Construction of new 4-storey Accident and Emergency Building; Four-storey new building including faculty offices;
Four-storey building including 155 bed obstetrics and gynaecology;
Four-storey building including 200 bed children ward and play rooms;
New mortuary building for 50 bodies with pathologists offices;
Demolishing of current mortuary and existing power station building;
Project management/supervision cost;
Consultancy fees for supervision;
Staff housing of a mixture of 3- bedrooms and 2-bedrooms.
Benefits of the project
Responding to the benefits of the project, the technical team indicated that the project, when completed would ensure quality healthcare for the growing population in the northern sector of the country. It would also provide new clinical services, specialties that are required to serve the growing health needs of the population.
The northern sector also records unacceptable high infant mortality rates. There is, therefore the need to expand peadiatric services in the sector. These
services would be expanded by the Tamale Teaching Hospital when the project is completed to address the challenges.
Further, the intake into the University for Development Studies (UDS) School of Medicine and Health Sciences currently stands at 50 students per year. This intake requires a teaching hospital with a minimum of 650 bed capacity as required by the Medical and Dental Council, the professional accreditation body.
The project, when completed, would enable the UDS School of Medicine and Health Sciences meet the minimum standard required for the institution to train doctors.
The technical team also indicated that the location of the hospital is strategic to take advantage of being a hub for medical tourism in the sub-region, with road access to neighbouring countries of Burkina Faso, Togo, La Cote D'Ivoire, Mali, Niger and Nigeria
Status of the project
In response to the current status of the project, the Committee was informed that the project is 50 per cent complete. The technical team acknowledged that the project was, however, behind schedule; but explained that the delay was due to the tax exemption issues.
Temporal Permits for clearing goods
The Deputy Minister noted that in order to ensure the project is not overly delayed, as a result of delays in obtaining tax waivers from Parliament, the Ministry of Finance issued temporal permits to enable the clearance of some items of ongoing projects.
The Committee was informed that the Tamale Teaching Hospital project benefited from these temporal permits to mitigate the delays in obtaining tax waivers from Parliament. So far, total temporal permits of Gh¢9,832,340.31 was issued to temporarily waive import duty to enable the contractor clear some equipment for the project.
This temporal exemption has been included as part of the request currently before Parliament for approval.
Tax exemptions in Agreements
The Committee enquired what Government was doing to address issues relating to tax exemption.
The Deputy Minister indicated that Government has already entered into a number of loan agreements with tax exemption provisions. These agreements have to be complied with. Going forward, Government intends to now negotiate as much as possible, new agreements with minimal tax exemption clauses. The Ministry is also reviewing the tax exemption process.