Bright Simmons throws mud at Agenda 111, which builds district hospital at half the cost

The Covid-19 pandemic revealed that some 101 districts in the country had no proper district hospital and seven regions were in need of regional hospitals, as well.

President Akufo-Addo set out to fix that and with an environmentally-friendly design from world-renowned architects, Adjaye & Associates, managed to deliver a 100-seater district hospital at $17.9 million, which is about half the cost at which district hospitals were traditionally built, ranging from $35 million to $45 million.

However, Bright Simmons of Imani Africa, in a recent piece described Agenda 111 as an essentially a wasteful and expensive project.

“The government used COVID-19 as a pretext to embark on a massive hospital and clinic building spree even though no budgetary provisions had been made for such in the medium-term expenditure framework.

“The Health Ministry was not directly involved in strategy, so there are no plans on how to stock these “111” large hospitals/clinics, staff them, or provide for their maintenance. Nor is it clear from which department’s budget these costs will be serviced.

“Everything was done in the Chief of Staff’s office within the Presidency. Favoured contractors were handpicked and blessed with the juicy multi-billion dollar opportunity. Two in particular: famed Ghanaian architect, Adjaye, and luxury estate developer, Buena Vista,” Bright Simmons claimed in his piece.

“⁠No one really knows how much the whole spread will cost. In 2021, $100 million was released to get things started and pay “mobilisation”. Since then, reports say a further $300 million has been released to contractors.

“None of the hospitals have been fully completed and certified as built to the requisite clinical standards. It is up to the next government to foot the bill. The pending liability has usually been estimated at $1.45 billion, and contractors are waiting for large disbursements to keep the work ongoing. Promises to complete by September this year were of course completely arbitrary and driven by nothing more than the electoral campaign calendar.

“What is frightening is that the Ministry of Health has suddenly taken a look and now claims that about $7.5 billion is required. You heard that right. 250% more than the entire IMF package of $3bn, which required the painful DDEP to happen before Ghana could qualify. But even if it is the $2 billion some analysts assumed, it is still bigger than the energy sector arrears some fear might trigger a bigger round of dumsor. Yet, no one is talking about it,” Mr Simmons further wrote in his piece..

Asaase News checks have identified inaccuracies in the publication by the Imani Vice President.

In defending the project, a senior source at the Office of the Chief of State describes Mr Bright Simmons as demonstrating an inability “to distinguish between contractors and consultants and their roles and conjures his own figures on project costs to support his malicious claims.”

Asaase News‘ investigations shows that since 2021, Government has presented the scope of the project and costs to Parliament in the 2021 budget and subsequent budgets each year, supported by documentation. It appears, however, that Mr Simmons did not take time to do proper due diligence before the publication.

Mr Simons say the project was hijacked by the Presidency. But documents show that the Ministry of Health(MOH) and Ghana Health Service(GHS) were full and active participants of the project development committee of Agenda 111 from the beginning and every year since 2021, the Ministry of Health has led a team to present project information to the Health Committee of Parliament.

The Agenda 111 project is being implemented as a Special Initiative under the Office of the President and the Minister for Health is a member of the Project Implementation Committee chaired by the Chief of Staff.

MOH and GHS developed the Employers Requirements for the project, reviewed and approved all architectural, engineering designs, specifications and medical equipment to ensure that the hospitals meet the high clinical standards and specifications of the Ministry of Health.

One Hundred and Eleven sites (111) varying from 8acres -40acres in size across the country were identified, surveyed and geotechnical investigations were undertaken by the Consultants. The hospitals (District, Regional and Psychiatric hospitals) were designed by a team of 12 Ghanaian consulting firms and their construction is being supervised by a further 8 Ghanaian consulting firms comprising Architects, Structural Engineers, MEP Engineers, Quantity Surveyors and Biomedical Engineers

In all 20 Ghanaian consulting firms led by Project Coordination & Project Management Consulting Firm are involved in the pre-contract and post contract phase of this very complex project covering 111 sites.

The various design & supervision consultants as individuals and firms, have several years of experience in healthcare designs and have consulted widely for the MOH, GHS and other healthcare institutions in Ghana over the past decades.

The cost of the fully equipped standard 100- bed district hospital at $17.9M under Agenda 111 is the lowest cost at which any Government has delivered a standard MOH/GHS 100 bed district hospital in Ghana in recent memory.

These hospitals are being delivered to the highest clinical standards and specifications across the country to bridge the yawning gap in healthcare infrastructure in Ghana.

“How can Bright Simmons intimate that the same MOH which has not been part of the project, now posit that the project needs $7.5billion to complete? He goes on to say no one knows the project cost and yet concludes by indicating a value as a pending liability. Simple math will show that this is a figment of his own fertile imagination, and statements like this best serve his own interest,” a source at the Office of the Chief of Staff who is familiar with the Agenda 111 project told Asaase News.

“There has been no doubt that because Ghana entered into an IMF Program, securing funding for the project has been a major challenge and has severely affected completion of the hospitals. Nevertheless we would encourage the writer to appraise himself of the facts and not rush to expose his ignorance about matters he knows little or next to nothing about,” the source further stated.

Emphasising his point, Asaase News‘ source quizzed; “Did the writer (Bright Simmons) in his research not come across data that suggests, there was a huge infrastructure gap, that over 88 Districts and the newly created Regions did not have District and Regional hospitals?

“That the Middle and Northern belt of Ghana does not have a single Psychiatric Hospital? Is he aware that GHS raised these as a key issue in healthcare delivery? Does he know that this was a key input in the Agenda 111 Programme when the President announced the programme in his “Fellow Ghanaians Speech to the Nation” on 20 May 2020 at the height of COVID-19 ?

“Of course it goes without saying that Agenda 111 will address many more healthcare delivery challenges beyond Covid. Healthcare delivery knows no political colours. Ghanaians are the beneficiaries. The Agenda 111 hospitals project is an initiative that both the out-going NPP Government and in-coming NDC Government have publicly committed to completing in the shortest possible time to bridge the healthcare infrastructure gap.

Our checks show that 30 hospitals have achieved completion rates of more than 70% including 3 that have achieved completion/commissioning and are being prepared for operationalization. Another 26 have achieved completion of between 50% -69% and are expected to be completed/commissioned next year if funds are made available.

When fully completed it is expected that Agenda 111 hospitals will employ a minimum of over 33,000 nurses, doctors and allied healthcare professionals in the country. A huge health infrastructure gap impacting healthcare delivery will be improved as an estimated 4 million Ghanaians all over the country will be brought closer to accessible healthcare. We urge the public to disregard the outright lies, half truths, and mischief Bright Simmons seeks to portray in his article.

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