There is growing anger among members of the Civil and Local Government Staff Association, Ghana (CLOGSAG) over Management’s decision to enrol its members in a private health insurance scheme without their approval.

The association is accusing the management of the Local Government Service of imposing a private medical insurance policy by Nationwide Medical Insurance on its members in spite of stiff resistance to the move.

The workers’ outrage follows a letter by the Head of Service at the Head of the Local Government Service, Dr Nana Ato Arthur, compelling the workers to purchase the scheme’s basic premium.

“Due to the slow pace of the registration process, the Office of the Head of the Local Government Service (OHLGS) is by this letter informing all staff who are yet to be registered on the scheme to enrol with the least premium on the medical insurance package.”

The letter added: “In view of this, all unregistered staff will be deducted by the minimum charges from next month, July 2023, onwards.”

Private insurance not comprehensively discussed

The association, in a letter dated July 6, 2023, indicated that it has not comprehensively discussed the scheme’s benefits with its members. Moreover, it pointed out that its initial concerns about the scheme had not been addressed. As such, it has not approved the mass enrolment of its members in the scheme.

“As a result, CLOGSAG is requesting the Controller and Accountant General’s Department (CAGD) not to effect any deductions towards the Medical/Health Insurance Scheme for the staff of the Local Government Service,” the letter signed by the Deputy Executive Secretary of CLOGSAG, Kojo Krakani, said.

The President of CLOGSAG, Ben Otto, told The Fourth Estate that until the association comprehensively understood the new scheme, it would continue to advise its members not to sign up for it.

“We have stated in the letter that we should get a proper understanding of how the whole thing is going to be. So that we can also sensitise our members, but that compulsion they are talking about should cease forthright,” he said.

He said CLOGSAG did not want its members “compelled” to sign up for health insurance when they were not prepared for it.

The association, he stated, would only encourage its members to subscribe to the new scheme if it covered sicknesses not included in the National Health Insurance Scheme (NHIS).

“We need to know because already there is a National Health Insurance Scheme in the country, which in my opinion is not really doing well. But it’s a government policy. The Local Government Service is also a government institution.

“So, it means that indirectly you are trying to do something that will affect the NHIS. But if you are able to let us have an appreciation of the kind of sicknesses it will cover and if the NHIS is not covering it, then we will encourage our members to sign on to it. But anything short of that we have actually told them to hold on,” he said.

Mr Ben Otto also told The Fourth Estate that some staff had already subscribed to the scheme.

Two staff of the Service who spoke to The Fourth Estate on condition of anonymity were concerned about the scheme’s relevance.

One wondered why the scheme must be “compulsory” when most staff had already subscribed to the National Health Insurance Scheme and other private health insurance services.

“What’s the point in having about three health insurance schemes when I can utilise only one at a time?”, the source asked.

Another source quizzed whether the CAGD could deduct health insurance premiums from his salary if he has not signed up for the scheme.

Head of the Local Government Service justifies private insurance

However, in an interview with The Fourth Estate, the Head of the Local Government Service, Dr. Nana Ato Arthur, said the decision to opt for private health insurance was to assist staff in paying their medical bills.

He said apart from the constant inability of the staff to pay their medical bills, two incidents in the past two years informed this decision.

“It started from some of the municipalities, Oforikrom Municipality. A staff fell ill. We went to Tech Hospital. Only Gh¢170, this staff didn’t have it. So, the staff of the municipality had to contribute to get this person to be discharged. Another staff fell ill in Koforidua. The bill was outrageous, Gh¢136,000. There was no way she and her family could afford.”

After the Local Government Service’s management chose to adopt private health insurance for its staff, it engaged all the needed stakeholders including CLOGSAG, Dr Arthur said.

According to him, the management decided to make the basic package compulsory because it realised the workers were not registering as quickly as expected. He said his March 2023 letter informing the staff about the compulsory enrolment was due to the delay in staff registration. The intended start of the policy was February 2023, he said. He indicated that for the insurance to be viable, it was crucial for the about 40,000 staff of the Service to join at least the basic package.

“We were realizing that if we should just wait until staff voluntarily gets on board, it will take us about five years. We wouldn’t get the number. More so, the computation of every insurance policy has something to do with numbers. The numbers will indicate to you what they will be chargin. After consulting the association of coordinating directors at the districts, then we said that the basic must become compulsory.”

He told The Fourth Estate that the basic package costs Gh¢30 per month. A staff who opts for this package is entitled to Gh¢5,000 as an in-patient and Gh¢1,000 as an out-patient annually. The staff would also be refunded Gh¢400 to cater for transport expenses.

Asked whether this policy does not undermine the viability of the NHIS, he said it was complementary and would not affect the NHIS.

“Some people are saying that such a laudable policy should be maintained. Nobody is saying that we should scrap the national health insurance scheme. It is complementary,” he said.

Dr. Arthur said the policy was not peculiar to the Local Government Service. Several other public institutions had adopted private health insurance policies for their staff, he said.

He mentioned the Ghana Revenue Authority (GRA) and the Environmental Protection Agency (EPA) as some of such public institutions.

It is not the first time members of the association are protesting financial demands on them.

CLOGSAG members in court over Tier 3 contribution

In May this year, some members of CLOGSAG filed a writ at the High Court seeking an interlocutory injunction to restrain its executive committee and the Controller and Accountant-General from further deducting Tier 3 Fund contributions from their salaries.

The members say the National Pensions Act 2008 (Act 766) makes the Tier 3 pension contribution optional, so it must not be compulsory for members of CLOGSAG.

CHRAJ Investigates Local Government Service

In March 2022, The Fourth Estate reported that 240 workers of the Local Government Service were unhappy about a directive to pay Gh¢6,000 each for a promotion-interview training. They were angry because the amount they were asked to pay was almost twice the monthly salaries of the officers being considered for promotion.

The directive to make these payments came directly from the Office of the Head of the Local Government Service (OHLGS).

Although the chief director of the Local Government Service, James Oppong Mensah, confirmed the directive as true, he was not happy about the staff speaking to the media.

“They should have regard for the Service. Why should they go to a journalist?” he asked.

After The Fourth Estate published this story, the Commission for Human Rights and Administrative Justice (CHRAJ) opened investigations into the matter.