Country Director of Aurum Institute Ghana, Nana Kofi Quakyi, has said Ghana’s “no bed syndrome” reflects deep weaknesses in the health system, warning that the issue is often wrongly reduced to the availability of beds in emergency units.Speaking on Newfile on JoyNews on Saturday, March 28, Mr Quakyi said the term “no bed” oversimplifies a much broader crisis.“We have to be mindful that when we say no bed, we are reducing… a whole cascade of systemic failures into a finishing issue about what kind of bed or what kind of treatment platform is available in the emergency room,” he said.He explained that several underlying problems, including weak infrastructure, lack of equipment, and staff shortages at lower-level facilities, are forcing patients to bypass them and head straight to major hospitals.“Why are those facilities actually being bypassed?” he asked, pointing to gaps in critical services. “Only 14 of them have 24-hour radiological services,” he said, referring to district and regional hospitals.Mr Quakyi added that even basic emergency care capacity is lacking in many facilities.“When it comes to airway… only 4% of facilities… had all the equipment they needed to actually do those interventions,” he said, citing findings from a health facility assessment.According to him, this has created a situation where pressure is pushed onto teaching hospitals, which then become overwhelmed.“They are just the least… handicapped in a system that is handicapped all the way through,” he said, describing major hospitals as “visible failure points” of a struggling system.He said that better data and coordination are needed, particularly in tracking hospital capacity in real time.“It’s not enough to know the number of beds we have. We have to have the real-time picture of how they are being utilised,” he said.Mr Quakyi also called for stronger collaboration with private healthcare providers, saying that they represent untapped capacity.“We have to be able to rope in the private sector,” he said, adding that private and mission facilities often have better equipment availability and uptime compared to public institutions.He pointed to the National Health Service in the United Kingdom as an example of alternative approaches, suggesting that Ghana could adopt managed equipment service models instead of outright procurement.“Rather than saying let’s spend the money outright… let’s engage a company that provides the equipment… and runs the equipment as a service,” he explained, noting that such arrangements could ensure maintenance and continuous supply of consumables.On financing, Mr Quakyi said legal mandates alone would not solve the crisis without clear funding mechanisms.“We do need a financing mechanism that guarantees the payments for emergency care,” he said.He raised concerns about accountability in situations where hospitals lack even basic medicines.“You have… hospitals that don’t have aspirin or don’t have adrenaline… If they see a patient who needs that… should those clinicians then be the ones who are liable?” he questioned.Mr Quakyi also highlighted the need for stronger health information systems, including electronic medical records that can show bed availability and patient flow across facilities in real time.“If we have 20 beds and 20 are used, it’s not useful to know they’re 20 beds. It’s more important to know that they are non-available,” he said.He cited Rwanda as an example where health information exchange systems allow both public and private providers to share data and coordinate care.The Aurum Institute Ghana Director further warned that staff shortages remain a major concern, particularly in critical and emergency care.“We are haemorrhaging… exactly the types we need in emergency care… to other countries,” he said.He dismissed suggestions that healthcare workers are to blame for the crisis, saying that the conditions under which they operate must be considered.“This is not a problem about doctors and hospitals making arbitrary decisions. What are we asking healthcare workers really to do under those circumstances?”Mr Quakyi said that addressing the no-bed syndrome will require difficult policy choices and sustained investment.“Ultimately, it’s a question of the political choices we make,” he said, adding that the government should prioritise funding, staffing, equipment, and system-wide reforms to ease pressure on Ghana’s healthcare system.