Finance raises red Flag over covid-19 irregular supplies

The finance ministry has called on the Auditor General to undertake a forensic audit on all expenditures by the health ministry in response to the Covid-19 pandemic.

Finance also asked the Public Procurement and disposal of Public Assets Authority (PPdA) to undertake an audit on all direct procurements undertaken by the health ministry in response to the pandemic.

This was after the finance ministry's budget monitoring and accountability unit discovered several irregularities by contractors that the health ministry hired to provide services.

A report released last week by the monitoring team noted that although the health ministry achieved most of the planned interventions, irregularities in relation to adequacy, availability and timely deliveries, high and varying unit costs, lack of accountability, duplication of efforts, laxity in wearing masks, planning and equitability are already affecting some of the gains registered by the sector.

The physical monitoring of the utilisation of the funds was conducted between August-September this year.

According to the report, by June 30 this year, the Government, development partners and the private sector had released to the health ministry sh264b and sh215b was still in the pipeline.

Overall, the budget for the multi-sectoral Covid-19 response (March 2020 to June 2021) was over sh2.2 trillion.

By June 30, this year, over sh766.7b was received and committed towards Covid-19 prevention and response interventions.

However, a review of the interventions has established that many contractors hired by the ministry did not deliver as expected.

Intensive Care Unit (ICU) equipment 

According to the report, with a sh42.3b supplementary funding, the health ministry contracted several companies to supply and install ICU equipment in regional referral hospitals.

However, the monitoring team discovered that although one of the companies, Elsmeed EA Limited, was contracted to supply 1,553 units of equipment to 17 hospitals at a cost of sh26b by August, it did not.

The delivery period was extended to December due to high demand of the same equipment internationally.

Another contract was signed between the ministry and Joint Medical Store (JMS) to procure 388 pieces of ICU equipment, including ventilators, worth sh10.5b. 

The 388 pieces included 28% ventilators, 25% patient monitors, 24% oxygen therapy apparatus, while the rest (22%) wereIiCU beds.

It was noted that although the equipment was expected to be delivered in six weeks, the deal was not achieved by June 30.

By the time of review, JMS had only delivered equipment to six hospitals — Naguru, Entebbe, Jinja, Mbale, Lacor and Lira. 

"Other hospitals had not received the equipment by September 2. deliveries and installations were expected to be completed by December.

It was noted that some hospitals, such as Gulu and Arua, did not have adequate space for the ICU equipment," the report noted.

Unaccounted for beds

The report states that the health ministry signed three contracts with JMS, worth sh1.3b, to supply 1,000 beds and mattresses, 2,000 blankets and 2,000 bed sheets.

The unit cost of each bed was sh890,000 and sh119,491 for a mattress.

However, it was established that although all beds were delivered at Mulago Hospital and Namboole case management centre in August, the verification team only verified the delivery of only 331 beds and mattresses.

"The list of the rest of the beds was not availed to the monitoring team. Although over 300 beds were moved from Namboole (quarantine centre then) to Mulago Hospital, the latter acknowledged receipt of only 290, instead of the 300 beds communicated by the ministry. Mulago Hospital also received 108 mattresses, which were not commensurate to the beds provided," the report states. 

Oxygen plants cost questioned

The investigators questioned the sh6.4b that was given to Silver Bucks Pharmacy Ltd to supply and install two oxygen plants at Mulago and Entebbe hospitals.

The auditors demanded to know the rationale when the same company, in 2017, supplied 13 plants to different referral hospital at the same cost.

Although 100% of the invoice value of number R1658/MAY20/01 was paid by June 30, deliveries and installations had not commenced by September.

Fake tents investigations also established that 20 sleeper tents procured at a cost of sh3.8b from Lumious Uganda Limited could not be used to accommodate patients as earlier anticipated due to their weak specifications and capacity.

Each of the 100 capacity tents was procured at a sum of sh163m. 

The auditors established that although the contract stipulated 20 tents, only 13 were signed and installed at Namboole by the time of monitoring in September.

"The users and stakeholders at Namboole questioned the suitability and quality of tents procured by the ministry," the report states.

Mobile health facilities

The report revealed that the ministry contracted Modula House Engineering and Construction Company Limited to establish fabricated health facilities at the border points of Elegu, Malaba, Mirama Hills, Mutukula, Katuna and Mpondwe at a cost of sh7.5b.

Each of the facility was estimated to cost sh533m.  The works involved recast reinforced concrete partitioned using concrete block walls, roofed with iron sheets, as well as installation of aluminium windows and doors, including internal wooden doors.

The facilities were expected to house a laboratory and also serve as a staff house.

The auditors, however, noted that although the contract signed was expected to start 14 days upon signing on June 16 and end by September16, it was discovered that by September 15, the contractor had fabricated 50% of the mobile facilities required, but could not install any for lack of land at the designated places.

"Confirmation of land availability was not done prior to contract signing, leading to resource overruns. Equipment and human resource to run these facilities was also not planned. An explicit plan for both items could not be traced by the time of monitoring," the report states.

Unclear payments

Although there was a guideline that travellers from abroad should cater for their accommodation costs, the health ministry reportedly paid sh170m to Kirigime Guest House for quarantine services rendered to 86 travellers.

"The cost per room at Kirigime Guest House was sh60,000, exclusive of meals of sh50,000 (breakfast and evening tea at sh10,000 each, lunch and dinner at sh40,000). The selection criteria regarding the beneficiaries of these services remained unclear," the report states.

Spray pumps missing

The report revealed that although the ministry contracted N2M Company Limited in June to supply spray pumps at a cost of sh530m, by August and September, none of the treatment centres visited had received the spray pumps, except Entebbe Hospital.

The pumps, which included 80 mist sprayers, 99 power sprayers and 19 transport jet pumps, were meant to aid disinfection of places, materials of Covid-19 confined places, treatment centres, homes and ambulances.

About masks

In May, the ministry signed a sh3.9b contract with various service providers to procure personal protective equipment (PPes).

Each medical mask cost sh4,946, which the auditors said was expensive. the report revealed that some contracts had no witnesses to contract signing.

The Government also allocated sh35b to the ministry to procure and distribute nonmedical masks to all people aged above six years.

On July 9, the ministry signed contracts worth sh32.5b with 16 suppliers to produce 11 million masks in various lots. but later, the quantity was revised to 21.4 million masks at a cost of sh57.3b. by August, the report says only 16.1 million masks, worth sh25.3b, had been delivered.

"The need for masks, increased by 190% over the initial plan, still left out other Ugandans. Procuring 21.4 million masks indicates that half of the population in Uganda is below seven years, which is not true. Issues related to inadequate planning still exist and have translated into unending requests for supplementary budgets for masks," the auditors noted.

Tthe auditors also questioned the allocation of sh6.6b to Kampala capital city Authority (KccA) to empower women groups to make face masks.

"While the initiative is good, relevant stakeholders should clarify questions related to the mandate of the health ministry to provide empowerment funds," the report states.

On-spot checks also established that there was low use and uptake of government masks by the population, especially in Kampala, wakiso and Mukono districts.

"Field findings indicated that several people preferred to use their own masks than the ones provided by the Government, citing issues related with quality," the report states.

Ministry's take

The health ministry permanent secretary, Dr Diana Atwine, declined to comment, saying she had not yet received the report.

However, she said the report's recommendation for audit is not a new thing.

"The Auditor General and PPDA always audit these activities at the end of every financial year. But it is important for us to look at the issues raised by the monitoring unit so that we are able to improve where there are gaps," Atwine said.