Health delivery at the Volta Regional Hospital is said to be fast waning as a result of what has been described as the lack of commitment on the part of doctors and other staff of the hospital. Out of the about 18 doctors who should be actively working at the hospital every day, information gathered by the Daily Graphic point to the fact that only six of them are actually working, a situation that has made it extremely difficult for referred patients to see specialists. Information gathered by the Daily Graphic from patients and some hospital staff indicates that majority of the doctors only work for between one and two hours a day and thereafter leave the nurses to write prescriptions for patients. The Medical Superintendent of the hospital, Dr Geoffrey Nyamuame, when contacted only admitted, "We have some problems on hand which we are doing our best to solve.” By a memorandum of understanding (MoU) signed between the doctors and the Ghana Health Service (GHS), each doctor is supposed to do a total of 56 hours a week, which breaks down to eight hours a day, but most of them fall short of this target. One of the active doctors working at the hospital who pleaded anonymity confirmed all the information and expressed regret at the lack of commitment on the part of his colleagues. A 65-year-old woman who complained to the Daily Graphic recounted that she had, gone to hospital with an orthopaedic problem and had been told to go to a private hospital which she believed had links with some members of staff of the regional hospital. Two of the hardest hit departments of the hospital are the Orthopaedic and the Ear, Nose and Throat (ENT) Departments. Patients of those departments are compelled to return home after spending several hours at the hospital without seeing the doctors they are referred to. Another piece of information gathered by this reporter is that some doctors of the hospital, contrary to their professional code and demands of the job, refuse to respond to emergencies after 8.30 p.m. The hospital, in effect, is now being actively nm by only six doctors, including the medical superintendent, and a few others who are said to be overwhelmed by the volume of work. Other complaints received from clients of the hospital are that patients wait at the OPD for several hours before staff arrival, sometimes well after 10 a.m., and when they arrive they attend to those they know before others, without following the 'first-come, first-served' procedure. A member of staff of the hospital who confided in this reporter opined that there was a general breakdown of discipline and order at the hospital, leading to the situation where doctors did whatever they wanted without due recourse to laid down procedures and the ethics of the profession. The source hinted at power conflicts within the structures of the medical practitioners as one of the factors that might have led to that phenomenon. These factors have led to a drastic reduction in the number of patients who visit the hospital, and with the introduction of the health insurance scheme in some private hospitals, people have the option to go to some of these places where they say they are given better and timely treatment. An official source told the Daily Graphic that doctors at the hospital were not supposed to run shift, saying they were to work for eight hours, after which they were supposed to smnd by for emergencies. According to the source, the hospital had 20 doctors, 18 of whom were on salary, with the other two being volunteers. The problem, according to the source, had been created by the senior medical officers, most of whom run specialist departments. Efforts by the hospital administration to sanitize the system, according to the source, had been unsuccessful, adding that attempts to introduce a performance management system to check the practice was unsuccessful, as it was described as a move to victimize some people. Clients of the hospital, which also serves as the only referral point for major medical cases in the entire region, have, "therefore, appealed to the management of the hospital and the Ghana Health Service to move quickly and" address the problems at the hospital in order to forestall an imminent collapse. In their frustration, more patients have turned to the Ho Municipal Hospital which, some time ago, was on the verge of total collapse. From as low as 40 to 60 patients that the Ho Municipal Hospital recorded at its OPD in the days when it was near collapse, the hospital is now recording daily attendance in excess of 1,000. This has been made possible" through a five-year strategic plan which was drawn by the medical superintendent of the hospital and which, for now, is paying off in no small measure. The Ho Municipal Hospital, as part of moves to enhance its image and better its service provision, was the first and only hospital in the region to lend itself to peer review, a feat which no other hospital has been able to replicate up till now.