The former Chief Executive Officer of the University of Ghana Medical Centre (UGMC), Dr Darius Osei, has criticised the “pay-before-service” culture in Ghana’s emergency wards, labelling the practice of demanding money from trauma victims a death sentence.Speaking during a high-profile JoyNews dialogue on Thursday, 2nd April 2026, Dr Osei argued that the current system, where Good Samaritans and grieving relatives are forced to navigate a gauntlet of billing points while a patient’s life hangs in the balance, is a fundamental betrayal of medical ethics.Drawing from his tenure at UGMC, Dr Osei revealed a blueprint for reform that he successfully implemented at the premier facility. He advocated for a nationwide policy where no financial reimbursements or payments are collected from emergency patients within the first 24 hours of arrival.READ ALSO: Former UGMC boss recounts ‘up and down’ hospital nightmare resulting in niece’s death“There was a policy that no money should be collected from any patient within 24 hours. Patients must be attended to within 10 minutes,” Dr Osei stated. “It is so cumbersome going around with documentation, getting payments done and so forth. Nobody carries 20,000 or 10,000 in their pocket… and they go pay this, pay that, pay that. By the time they finish, the patient is dead.”The “one-stop-shop” emergency unit modelDr Osei emphasised that an emergency unit is only as fast as its nearest diagnostic tool. He recounted how he restructured UGMC to ensure that pharmacy, laboratory, and radiology services were all physically located within the emergency footprint to prevent the fatal “up and down” movement of staff and relatives.“That is the reason why it is called an emergency,” he noted, adding that true emergency care means having the medicines and scans available at the point of impact rather than across a sprawling hospital campus.Beyond the billing crisis, the former CEO pointed to a “technical vacuum” in Ghana’s districts. He observed that while the Ghana College of Physicians and Surgeons is producing high-quality specialists, they remain concentrated in Accra because regional and district hospitals lack basic diagnostic equipment like CT scans.“I believe that if for nothing at all, each district hospital should have a CT scan,” Dr Osei urged. “We don’t have standards. Let’s standardise our operations… these days, [imaging] has become part of our diagnostic tools because students have been trained with these tools and that is all they know.”A call for national standardisationDr Osei concluded by calling for a radical redefinition of the Ghanaian emergency protocol. He argued that without standardised equipment and a “Care First, Pay Later” legal framework, the nation will continue to lose citizens to “predictable and preventable” delays.As the debate over the “No-Bed” and “No-Money” policies intensifies, Dr Osei’s testimony provides a proven administrative model that prioritises the patient’s heartbeat over the hospital’s bottom line.