Source: Rot at public hospitals exposed – DailyNews Live
Bridget Mananavire 28 June 2017
HARARE – The Auditor-General has unravelled shocking levels of official
corruption at government hospitals where public funds are not being
properly accounted for at a time when patients are failing to access basic
drugs due to resource constraints.
In a report tabled in the National Assembly last week, the
Auditor-General, Mildred Chiri, revealed that the little revenue flowing
into public hospitals from Treasury and fees is not being adequately
accounted for, yet very little is being done to arrest the situation.
For instance, over 100 000 litres of fuel worth $124 000 could not be
accounted for in the period covered by the audit.
Karoi District Hospital failed to account for 71 842 litres of fuel worth
$86 210, while the provincial medical directors’ office in Mashonaland
West could not account for 4 900 litres valued at $5 948.
It was the same situation at the provincial medical directors’ office in
Masvingo where 872 litres worth $1 046 could not be account for and at
Masvingo Provincial Hospital, which could not explain how 3 912 litres
worth $5 454 was used.
At Mutare and Gweru provincial hospitals, authorities could not account
for 17 090 litres worth $21 609 and 3 370 litres valued at $4 522,
respectively.
This was caused by weaknesses in internal control systems in the
management of fuel, amid fears that the resource could have been diverted
for personal use.
“If fuel records are not properly maintained, there is room for fuel
stocks being converted to personal use given that fuel is an attractive
commodity,” reads part of the report.
“Management of health institutions should ensure that all fuel received
from suppliers is recorded in the fuel registers on receipt and issues
should also be recorded. Physical checks on fuel stocks should be carried
out regularly.”
In their responses, management said they would implement Chiri’s
recommendations.
This comes as the ministry of Health and Child Care is demanding back fuel
used during President Robert Mugabe’s 93rd birthday celebrations.
In a letter to the director of health services at Zanu PF headquarters,
one C Chizema, dated February 27, Health and Child Care permanent
secretary Gerald Gwinji made startling revelations that his ministry gave
the ruling party 320 litres worth of fuel coupons for Mugabe’s birthday
bash held in Matobo.
Only 100 litres have been reimbursed by the party.
Asked to clarify the donation, Gwinji told the Daily News that the
ministry gave Zanu PF an ambulance and fuel to use during the birthday
celebrations on the understanding that they would pay back the fuel.
Zanu PF has always faced criticism of abusing State institutions to fund
its programmes.
And yet most hospitals and clinics in rural areas do not have fuel for
their ambulances, resulting in patients being ferried in wheelbarrows or
scotch-carts.
The Auditor-General’s report also revealed that property, plant and
equipment at Mpilo Central Hospital in Bulawayo, was not insured, while
motor vehicles were not registered in the hospital’s name.
“Significant losses may be incurred by the hospital in the event of
insurable disasters occurring. Motor vehicles should be registered in the
name of the hospital,” Chiri said.
“Management should ensure that all or some of the hospital’s assets,
including motor vehicles, based on some systematic risk assessment process
are insured.”
She said Mpilo Hospital paid $1 800 to a certain company in October 2013
for the supply of computers, which are still to be delivered.
“In addition, another company was contracted to improve the radio therapy
unit at a cost of $206 000, of which $35 000 was paid out as a down
payment during 2013. However, the company had not provided any services to
the hospital by the time the audit was completed,” she noted.
In their response, Mpilo management said they would ensure the cars were
registered in the hospital’s name.
“Admittedly, most government assets are not insured as it has not been a
standard practice before. However, there is no harm in adopting the
recommended position, funds permitting. In addition to the above, efforts
are underway to ensure that all vehicles are registered in the hospital’s
name,” they said.
Chiri went on to note weaknesses in the management and bookkeeping systems
at the hospital, which she said would result in loss of revenue.
“I noted some significant weakness in the inventories management system. I
could not therefore obtain audit evidence to ascertain the accuracy of the
inventories’ unit costs used to compile the stock valuation report as at
December 31, 2013.
“Prior period financial statements were not audited. I was not able to
ascertain if opening balances for 2013 were not materially misstated
through alternative procedures.
“I could not verify several payments amounting to $391 061 and $57 356
made during the years 2013 and 2014 respectively. These payments were
classified as capital work in progress on the Radiotherapy Unit due to the
lack of supporting documents.
“I could not also verify several transactions relating to goods purchased
during the year 2014 amounting to $130 228, due to lack of supporting
documents.”
She also noted significant weaknesses in the hospital’s billing system
“and I could not satisfy myself as to the accuracy, valuation and
completeness of revenues and trade receivables”.
As such, revenues and trade receivables may be materially misstated in the
financial statements.
Other hospitals, including Mutare and Masvingo provincial hospitals, were
also accused of incurring accommodation expenditure without approval from
the Health Services Board (HSB).
Due to lack of clear policy direction, administrators at Mutare Provincial
Hospital incurred total expenditure of $45 975 (2014: $57 411) for rented
accommodation for medical doctors.
The expenditure was incurred without the authority from the HSB and
Treasury’s concurrence.
“This was in violation of Section 4 (10) of the Health Services Fund
Manual. I made the same observation that related to Masvingo Provincial
Hospital on page 291 of my report for the year ended December 31, 2015,”
reads part of the report.
“Further to the above, there was confirmed lack of consistency in the
ministry’s health institutions on payment of accommodation allowances for
doctors. Out of seven health institutions visited, six were not paying the
allowance.”
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