Public hospitals stand accused of gross financial mismanagement, chronic understaffing, and the misallocation of precious resources. A recent investigation by Parliament’s Public Accounts Committee (PAC) – Central Government has cast a harsh light on the sorry state of 16 major health facilities and specialized health departments during the 2021/2022 financial year.
The findings paint a grim picture of hospitals overstepping their budgets, concealing funds under the guise of statutory items, and neglecting crucial financial obligations such as pension and gratuity payments. These facilities, burdened by insufficient staffing, have also failed to establish basic IT systems for monitoring the usage of essential medical supplies.
In one particularly shocking revelation, Lira, Kawempe, and Jinja hospitals diverted millions from statutory expenditure lines designated for salaries, pensions, and gratuities. Mulago hospital, meanwhile, irregularly shifted a staggering Shs1.17 billion without proper authorization.
Such financial misconduct not only violates the Public Finance and Management Act of 2015 but also jeopardizes the delivery of healthcare services, completely undermining the purpose of budgeting.
In response to these allegations, accounting officers claimed that resource diversions were a desperate response to inadequate budget allocations and unforeseen emergencies. These emergencies supposedly ranged from equipment breakdowns to power outages and infectious outbreaks. Some AOs even argued that they dipped into gratuity funds to cover pension shortfalls, all while offering flimsy justifications for their actions.
However, these explanations failed to sway lawmakers. The Committee recommended stern reprimands for the AOs responsible for these diversions, emphasizing the importance of following proper financial procedures.
Furthermore, the Committee urged AOs to make use of the PFM Act of 2015, which provides guidelines for transferring funds within a budget as needed.
The PAC’s scathing report, which is based on the Auditor General’s findings, brings into sharp focus the financial mismanagement plaguing these hospitals and their detrimental impact on healthcare delivery.
In presenting the report, Mr. Medard Lubega Sseggona, the Committee’s chairperson, noted that meetings with AOs and hospital staff revealed a troubling pattern of underpayment for pension and gratuity, causing staff morale to plummet and hindering service delivery.
With Shs2.7 billion in domestic arrears accumulated across four of the hospitals, the legislators squarely placed the blame on AOs, alleging that they committed government funds beyond approved budgets. Even in their responses, AOs primarily attributed the arrears to inadequate funding and insufficient releases.
To remedy this dire situation, lawmakers called on AOs to strictly adhere to the commitment control system, budget for the settlement of domestic arrears, and formulate a plan for debt settlement. They emphasized the urgency of the matter to avoid potential litigation and associated costs.
Despite receiving the necessary funding, many institutions failed to fully implement their planned activities, citing Covid-19 disruptions. However, the Committee highlighted that healthcare workers, categorized as ‘essential workers,’ were expected to continue their duties, though reduced staffing levels hampered progress, particularly among non-medical staff.