Parliament raises alarm over missing ambulances, idle equipment in referral hospitals
An investigation revealed that 15 of 18 ambulances allocated to Moroto Regional Referral Hospital could not be traced, while billions of shillings worth of medical equipment remained unused.
Among the missing equipment were a neonatal ventilator valued at sh165.38m and a defibrillator. (Photo by Maria Wamala)
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Parliament has raised concern over the mismanagement of public resources in regional referral hospitals.
An investigation revealed that 15 of 18 ambulances allocated to Moroto Regional Referral Hospital could not be traced, while billions of shillings worth of medical equipment remained unused.
The concerns are contained in a Public Accounts Committee (Central Government) report on the Auditor General’s findings for the financial year ended June 30, 2025, which Parliament adopted on Thursday.
The report, presented by Sarah Rwansasura, the Woman Representative for Jinja City and chairperson of the committee, exposes widespread financial irregularities, procurement violations, staff shortages, drug expiries and failure to put critical medical infrastructure into operation in eight regional referral hospitals.
The hospitals investigated are Arua, Fort Portal, Gulu, Hoima, Soroti, Moroto, Kayunga and Yumbe.
While guiding the House on the report’s consideration, Speaker Jacob Oboth questioned the need for debate where MPs had no substantive additions to make, urging legislators to contribute only when their interventions would add value to the findings and recommendations.
At Moroto Regional Referral Hospital, the committee found that although the Ministry of Health’s records indicated that 18 ambulances valued at sh5.062b had been allocated to the facility, only three could be physically accounted for during the inspection.
The committee also found that critical medical equipment worth billions of shillings was lying idle, including intensive care unit (ICU) equipment that had been poorly stored in general warehouses.
Among the missing equipment were a neonatal ventilator valued at sh165.38m and a defibrillator.
Multi-billion oxygen plants remain idle
The investigation also exposed the failure to operationalise oxygen generation plants worth approximately sh7.7b in Moroto, Yumbe and Soroti, despite the critical role of medical oxygen in treating patients with severe respiratory conditions.
At Moroto Regional Referral Hospital, two oxygen plants valued at sh3.727b had remained non-functional for three years because the plant house was incomplete.
The construction had been assigned to the UPDF Engineering Brigade under a six-month contract in 2022 but remained unfinished, leaving the equipment locked up.
At Yumbe Regional Referral Hospital, another oxygen plant valued at sh3.727b was abandoned after its 800-ampere circuit breaker broke down.
Soroti Regional Referral Hospital also had two of its three oxygen plants non-operational because the required central service contracts had not been provided.
The committee recommended that the Ministry of Health and the UPDF Engineering Brigade complete, commission and hand over the oxygen plants in the affected hospitals within 60 days of the report’s adoption.
The report further found that Gulu Regional Referral Hospital had six ventilators that could not be used because their gas delivery hoses were incompatible with the hospital's wall gas connectors.
At Soroti, three ventilators, each valued at sh357.2m, lacked basic batteries and monitors.
Meanwhile, Hoima Regional Referral Hospital’s CT scanner, valued at sh1.5b, was operating at only 12% capacity, serving about six patients daily against its capacity of 50.
The committee attributed the low utilisation partly to patients’ inability to afford the user fees.
The investigation also exposed serious payroll irregularities, including sh120m paid to two medical specialists at Arua Regional Referral Hospital despite evidence that they were absent from duty.
The hospital paid sh73m to a consultant orthopaedic surgeon, Dr Pariyo, and sh47m to a physician, Dr Akusa, over 12 months.
However, biometric attendance records and medical records indicated that the two specialists had not reported for duty during the period under investigation.
The committee recommended that the money be recovered from the responsible officers and accounting authorities.
In another worrying finding, six regional referral hospitals returned a combined sh2.598b in unspent wage funds despite severe staffing shortages affecting critical medical departments.
Fort Portal Regional Referral Hospital returned sh1.154b in unspent funds while operating with a reported 78% staffing gap.
At Arua Regional Referral Hospital, only three of the 51 approved critical care positions were filled.
The committee also found that some hospitals had entire departments, including emergency medicine and ear, nose and throat (ENT), operating without staff.
The report attributed the staffing gaps and unspent wage funds partly to delays in recruitment.
Soroti Regional Referral Hospital was also found to have paid sh527m outside the statutory Human Capital Management and Integrated Personnel and Payroll System platforms.
The committee called for a special audit by the Auditor General to establish the circumstances surrounding the payments.
Sh373m lost in expired medicines, laboratory supplies
The committee further established that regional referral hospitals lost approximately sh373.16m through expired pharmaceuticals and laboratory reagents, partly because of uncoordinated supplies delivered by the National Medical Stores (NMS).
Arua Regional Referral Hospital recorded expired supplies worth sh148.7m, including antiretroviral drugs and F100 therapeutic feeds.
Fort Portal lost sh110.6m in laboratory reagents, while Soroti and Hoima recorded losses of sh79.5m and sh34.3m, respectively.
The committee attributed the wastage partly to the delivery of laboratory reagents without corresponding calibrators and controls required to use them.
The findings were particularly concerning at Soroti Regional Referral Hospital, which experienced a 400-day stockout of Darunavir, a second-line HIV medicine, despite other medical supplies expiring.
The committee recommended that NMS stop delivering unrequested laboratory reagents to hospitals and issue credit notes for expired or unusable supplies delivered without the necessary diagnostic controls.
Sh3.6b diverted to blood bank
The report also questioned the use of public funds by Soroti Regional Referral Hospital, which spent sh3.672b on civil works and equipment for the Soroti Regional Blood Bank, a facility under Uganda Blood Transfusion Services.
The hospital reportedly relied on verbal instructions from the Ministry of Health to justify the expenditure.
However, the committee rejected this explanation, describing the spending as an unauthorised diversion of public resources contrary to Article 164(1) of the Constitution.
Hoima and Soroti regional referral hospitals were also found to have handled sh1.785b in external funds without the necessary parliamentary appropriation and disclosure in their financial statements.
Hoima received sh689.85m directly from development partners, including the United States Centres for Disease Control and Prevention (CDC), Infectious Diseases Institute (IDI), World Vision, Global Fund and Gauff.
Soroti handled sh1.096b from the Ministry of Health, CDC and the AIDS Healthcare Foundation, including sh384m in internship allowances that had not been appropriated.
The committee also found that Moroto Regional Referral Hospital collected sh61.127m in non-tax revenue against an approved budget of sh6.149m and illegally spent sh54.778m at source instead of remitting the money to the Consolidated Fund.
Procurement irregularities, poor management
The report further exposed procurement irregularities, including deliberate splitting of contracts to avoid competitive procurement requirements.
At Moroto Regional Referral Hospital, the committee established that 17 micro-procurements worth sh174.271m were awarded to a single company, SITETECH (U) Ltd.
Each transaction was kept below the sh10m procurement threshold, and the hospital did not obtain the required three competitive quotations.
At Gulu Regional Referral Hospital, a sh98.82m contract was awarded to Lale Group using an expired tax clearance certificate that had been issued for a different project.
The committee also raised concerns about the poor management of medical supplies and infrastructure.
At Hoima Regional Referral Hospital, equipment worth sh882.4m remained idle, while the hospital lacked a functional incinerator and mortuary, resulting in the open-air burning of hazardous medical waste.
Kayunga Regional Referral Hospital was found to be operating with less than 20% of its authorised staffing structure, with entire hospital wings remaining unopened.
The hospital had also received only 3,415 of the 7,266 blood units ordered, representing less than half of its requirements.
At Yumbe Regional Referral Hospital, the entire High Dependency Unit remained idle, while the hospital had also overpaid two consultants by sh37m and underpaid a retiree's gratuity by sh15m.
Parliament directs on recovery of public funds
Following the adoption of the report, the committee recommended enforcement measures against accounting officers and other officials found responsible for the financial irregularities.
It called on the Minister of Finance and the Permanent Secretary/Secretary to the Treasury to institute formal inquiries under Section 78 of the Public Finance Management Act to establish responsibility and recover salaries paid to absent medical personnel.
The committee also recommended a comprehensive physical reconciliation of medical equipment and ambulances supplied to hospitals since the 2019/2020 financial year.
The Ministry of Finance, Planning and Economic Development was further urged to enforce the three-year domestic arrears clearance framework, targeting clearance by the 2027/2028 financial year.