An Emergency Medicine Specialist, Dr Joseph Bonney, has warned that Ghana’s “no bed syndrome” is widely misunderstood, saying that the problem goes far beyond the availability of hospital beds.

Speaking on Newfile on JoyNews on Saturday, March 28, Dr Bonney said the issue has been wrongly treated as a location-specific challenge instead of a broader system failure.

“People have simplified this as a tiny event at one location and have not looked at the holistic picture of a bed management system,” he said.

He explained that the term “no bed syndrome” was deliberately coined to reflect a combination of challenges within the healthcare system, not just a lack of physical beds.

“The reason we use the word syndrome is that it is a group of signs and symptoms that all come together to characterise one event,” he said.

“So, it is not a single bed is not available. It is not that a doctor is not available. It is a combination of the two.”

Dr Bonney said this definition dates back to research conducted in 2017 and has since been discussed widely, including at the Ghana College of Physicians and Surgeons and other professional platforms.

Despite these efforts, he expressed concern that public perception remains narrow. He recalled reactions to a past discussion held in Kumasi, where some questioned why the issue was being addressed outside Accra.

Dr Bonney also addressed disturbing scenes often associated with the crisis, including overcrowding at major hospitals such as Korle-Bu Teaching Hospital and Komfo Anokye Teaching Hospital.

He said conditions in emergency departments can be so congested that it becomes difficult to distinguish between patients and their relatives.

“People were lying down, relatives… some of the people lying on the floor, we cannot even justify whether they were patients or relatives. Sometimes you even have to struggle to decide on who is sick.”

On allegations of bribery in accessing beds, Dr Bonney was cautious, noting that he could not verify such claims.

“I would have no proof of his claim that it did happen or it didn’t happen,” he said, but added that understanding how beds become available is key to addressing the issue.

He explained that emergency departments operate on a flow system, where patients are admitted, treated, and discharged. However, increasing demand continues to put pressure on limited resources.

“The question that comes up in our very busy emergency department is, ' Where are you finding a bed?” he said.

According to him, major referral hospitals are “victims of their own success” as patients increasingly bypass smaller facilities in favour of well-known centres.

“When you are sick, the ultimate aim is for you and your relatives to start thinking that when I get to Korle-Bu, there is ultimately a solution,” he explained.

“Even if the solution is just two doors away from you… The public has the notion that we should move towards the Teaching Hospital.”

He pointed to several underlying causes, including rising cases of trauma, non-communicable diseases and infections, as well as limited access to primary healthcare services.

Dr Bonney said some lower-level facilities lack personnel, equipment or round-the-clock services, forcing patients to travel long distances in search of care.

“If I have an accident and I’m going to that facility at 10:00 p.m., is somebody available to take care of me?” he asked.

He also criticised the lack of coordination between facilities, noting that patients are often referred without prior communication.

“People get up and say, ‘I went to this hospital, they said I should go to the next hospital… we don’t know you’re coming, we don’t know what’s wrong with you,’” he said.

Dr Bonney stressed that simply increasing the number of beds is not a solution, as each bed requires adequate staffing and infrastructure.

“When you choose to increase it, you should never talk about just increasing a physical bed. You would need nurses, doctors, oxygen ports, space,” he explained.

He warned that overcrowding can worsen patient outcomes and expose both patients and healthcare workers to additional risks.

“The minute you overcrowd your emergency… they’re going to pick up hospital-acquired infections,” he said.

He added that such conditions also create a difficult working environment for medical staff.

“You can’t be walking into the hospital, and the first thing you see is people on the floor… the risk of infection to yourself also heightens,” he said.