The recurring challenge of overcrowding and the shortage of hospital beds at Ghana’s referral and teaching hospitals has been linked to patients’ failure to adhere to the “Gatekeeper System.” This system requires patients to follow a structured treatment pathway, starting from Community-based Health Planning and Services, Community-based Health Planning and Services Compound, (CHPS)to district hospitals, regional hospitals, and finally referral to teaching hospitals when necessary.
Proper adherence to this process would significantly reduce overcrowding at teaching hospitals. However, while patients cannot be entirely blamed, there is a need for the public to comply with the Gatekeeper System to help curb congestion at referral facilities.
The Member of Parliament for Agotime-Ziope and a member of Parliament’s Health Committee, Charles Akwesi Agbeve, made these remarks on the Adekyee Mu Nsem morning show on Ahotor 92.3 FM, hosted by Citizen Kofi Owusu in Accra.
He further noted that Ghana’s ambulance system is defective, describing it as a major challenge affecting the effective delivery of quality healthcare. According to him, the limited number of ambulances and logistical constraints hinder operations across all levels of the healthcare system—from CHPS compounds to district, regional, and teaching hospitals.
Mr. Agbeve also concerns in the implementation of the Free Primary Healthcare policy, arguing that it lacks the necessary infrastructure and resources to ensure effective delivery. Recounting his concerns, he stated that many health facilities across the country have only about 5% of the required equipment.
He further blamed the previous government for neglecting the health sector over the past eight years, citing what he described as misplaced priorities, including the Agenda 111 hospital projects.
Highlighting disparities in healthcare access, he stated that the doctor-to-patient ratio stands at approximately 1:1,000 in Accra, compared to about 1:22,000 in the Oti Region. He called for urgent policy interventions to address these imbalances.
In a related development, the crisis at the Accident and Emergency Centre of Korle-Bu Teaching Hospital goes beyond a lack of beds. The Korle-Bu Doctors’ Association (KODA) has pointed to a weak national referral system as a key factor overwhelming the facility.
In a statement issued on March 23, 2026, KODA said persistent overcrowding at the emergency unit is largely due to lower-level hospitals being unable to manage cases effectively, forcing them to refer patients to Korle-Bu as the default option.
“The provision of 1,000 extra beds would not immediately translate into enough health personnel to care for these patients,” the association stated. “Any number of beds provided in Korle-Bu would be filled up in no time because referring hospitals lack the capacity to manage the conditions they send to higher centres.”
According to the association, the situation reflects deeper systemic challenges within Ghana’s healthcare delivery system, where referral pathways are not functioning as a coordinated network.
KODA is therefore calling on hospital management to engage the Ministry of Health and the Ghana Health Service to strengthen the referral system. This, it said, would ensure that patients are treated appropriately at different levels of care instead of overwhelming a single facility.
The warning comes amid renewed public concern about conditions at Korle-Bu’s emergency centre, particularly reports of overcrowding and patients being treated in unsuitable spaces.
Beyond systemic issues, the association also raised concerns about the legal risks faced by doctors working under such conditions. It has advised its members to document clinical environments thoroughly when attending to patients, especially in situations where care is delivered under substandard conditions, such as on the floor due to lack of space.
Doctors have also been urged to formally report all instances of overcrowding and resource shortages to their superiors, including Heads of Unit and the Director of Medical Affairs.
KODA further cautioned its members not to compromise professional and ethical standards despite the pressure. “The law courts would not accept such a sacrifice,” the association warned, noting that clinicians could still be held liable for adverse outcomes even under difficult working conditions.
The association added that while proposals to address challenges in Ghana’s healthcare system have already been made by the Ghana Medical Association and other stakeholders, what is now required is the political will to implement them.
According to KODA, resolving the crisis at Korle-Bu will require a comprehensive, system-wide approach that strengthens capacity across all levels of healthcare, rather than focusing solely on expanding infrastructure at a single facility.