The government has been urged to ring fence the COVID-19 Health Recovery Levy Act, 2021 (Act 1068) which became effective on May 1, 2021 to ensure that the money actually goes into supporting Covid health related activities.

The Coordinator, Policy and Advocacy at the Alliance for Reproductive Health Rights (ARHR), Mr Leonard Shang-Quartey, made the suggestion at a press briefing in Accra on June 29, 2021 on  the health sector portion of the national budget and implications for primary health care.

“We are suggesting that we should make sure the money goes solely to support the provision of goods and services, and infrastructure that we need in our battle against Covid. So, anything that does not fall under these should not qualify or be accepted,” he said.

Mr Shang-Quartey noted that allocation from the Annual Budget Fund Amount (ABFA) to health was low compared to allocations from the ABFA to similar priorities such as education.

He stated that about GH¢2,768,030,000 was utilised for four ABFA priority areas in 2020 as reported in the 2021 budget and distributed as follows: education and health service delivery (25 per cent), roads, rail, and other critical infrastructure (70 per cent), agriculture (three per cent) and industrial development (one per cent).

He, therefore, said there was the need for equity in the ABFA allocation to health and education because the merger of the two sectors made it difficult to unravel how much specifically went to each sector.

“We also understand there is pressure on that money from the Free Senior High School (FSHS) programme because it is similar to what we are fighting for in the name of Universal Health Care (UHC). We are saying that if it is not possible to raise the ABFA amount or pick from the non-defined critical infrastructure to support the real critical infrastructure such as health, then we should consider ring-fencing and making it very clear that the newly introduced Covid-19 Levy should be used solely for health infrastructure, and goods and services,” he explained.

He said the ARHR their main objective was to be able to improve on community health service provisions and facilities that had the right services.

That, he said, would give people more confidence in those facilities such that they would not try to by-pass into higher tertiary facility because they lacked confidence in what was being provided.

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Health delivery

He noted that government’s funding for wages and salaries item of the budget continued to increase steadily and increased by about 22 per cent in 2020.

Also, compared to wages and salaries, government’s allocations to goods and services were 0.6 per cent, 0.9 per cent and 0.6 per cent respectively for 2019, 2020 and 2021.

“It appears the ABFA is being relied on in place of government’s funding despite its complementary purpose. Internally generated funds appear to be playing a very important role in the provision of goods and services to the health sector with consequences for out-of-pocket spending,” he said.

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Recommendations

The ARHR recommended that the government must significantly improve its funding for capital expenditure and goods and services for the health sector, as it had the responsibility to provide adequate and equitable funding for all three budget items.

“The government should ensure that all people living in Ghana will benefit from the ever-increasing wage bill of the health sector by ensuring equitable distribution of health workers in districts and sub-district health facilities,” he said.

The alliance again urged the Ministry of Health to ensure that the laudable efforts of health facilities to generate internal income for significant financing of goods and services do not encourage increased out-of-pocket spending at health facilities as that will entrench existing financial barriers to access.

“Civil society organisations must develop the interest and capacity to track and monitor the deliverables reported in the budget to ensure resources allocated to health reach people in their communities,” it recommended.

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Covid Levy

The 2021 budget proposed a one per cent Covid-19 Health Recovery Levy against the backdrop of spending emanating from the Covid-19 Pandemic.

The levy is a stand-alone levy applied to the gross value of taxable supplies of goods and services provided under the Standard Rate and VAT Flat Rate Schemes.