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More than 300 casual workers in hospitals in the Accra metropolis have complained about the delay in regularising their employment status with the Ghana Health Service (GHS). Although they have worked far beyond the stipulated six months under Ghana�s labour laws, the casual workers, popularly referred to as �unconfirmed staff�, claimed that every year they were promised that their status would change. When the Daily Graphic visited nine health facilities under the Accra Health Metro Directorate, namely, the Achimota Hospital, the Princess Marie Louise Children�s Hospital, the Maamobi Polyclinic, the Kaneshie Polyclinic, the Dansoman Hospital, the Civil Service Clinic, the Ussher Clinic, the Castle Clinic and the Makola Clinic, it found that a number of the workers at the various units, such as wards, pharmacies, laboratories, accounts, records and transport, were casuals. Although most of the workers who interacted with the Daily Graphic had worked between four and 12 years, their employment status had not been regularised. As a result, they are not on government payroll and have to be paid by the various hospitals with their internally generated funds (IGFs). For causal workers without a first degree, the hospitals pay monthly salaries ranging between GH�100 and GH�180, while first degree holders earn GH�200. However, their counterparts on government payroll receive between GH�350 and GH�500. The national daily minimum wage, based on 27 working days for public sector workers, was recently increased by 10 per cent from GH�4.84 to GH�5.32. Casual workers speak �Our situation is more than being subjected to slavery. It is not easy to work as a casual worker in a hospital at all,� one of the 53 casual workers at the Princess Marie Louise Children�s Hospital said. �The situation in Ghana, economic wise, is very difficult. There is agitation here and there on the labour front, but we the unconfirmed staff have not engaged in any strike for all these years. When you visit the hospital, we are always busy attending to patients, whether confirmed or unconfirmed. So one would find it very difficult to make such a distinction. But when it comes to motivation and wages, unconfirmed staff are isolated and treated otherwise,� another worker said. At the Achimota Hospital, a woman who said she had been on the casual list for four years noted that it was time the Ministry of Health heard �the cry of all casual workers because life is not smooth for us at all. The treatment we are receiving does not motivate us to work with joy�. Administrators at most of the hospitals who spoke to the paper on condition of anonymity explained that there were procedures for the regularisation and that each year names were collated and profiles forwarded to the Metro Health Directorate for onward forwarding to the regional and national levels. �We are working on it. Tell them to be patient,� one general administrator who admitted that there was shortage of staff said, adding, �But the government already has a heavy wage bill to take care of and so it will be difficult to put all the casual workers on the state payroll now.� Metro Director�s sympathy The Metro Health Director, Dr George Mensah, explained that the employment status of the casual workers could only be regularised upon approval by the Ministry of Finance. When asked about the meagre wages paid to the casual workers, he said, �It is an unfortunate situation. We sympathise with them, but not much can be done. We are basically trying as much as possible to review the wages every year and also ensure that their social security contributions are paid.� He said a committee which was set up to look into the conditions of service of the casual workers had made some recommendations which were expected to be implemented by the beginning of 2014. �We cannot say they should go home because their conditions of service are not good,� he said, and indicated that all hospitals in the metropolis had, since the beginning of the year, not received their National Health Insurance reimbursement which was used for the payment of the casuals, as well as maintenance and the cost of health supplies. He explained that the directorate had adopted a strategy of recommending to the ministry to replace the casual workers with workers on the government payroll when the latter resigned, died or retired. �The problem is that there are quite a number of casual workers and we do not get many workers retiring, resigning or dying, but whenever there is an avenue we do our best. This is not a new problem; it has been this way for years,� Dr Mensah said.