Massive Corruption & Mismanagement in the Health Sector

By Abdul Rahman Bah

The 2023 Auditor General’s Report has exposed widespread financial irregularities and systemic failures within the Ministry of Health and Sanitation (MoHS), revealing critical deficiencies in financial management, procurement, contract oversight, and healthcare service delivery. One major finding highlights the Ministry’s failure to account for significant funds allocated to the Malaria Control Programme. While NLe17,087,713 was transferred into the programme’s bank account, expenditure returns for NLe933,901 remain unaccounted for, raising concerns over potential fund mismanagement. The report also uncovers unsupported payments, including NLe2,738,955 in undocumented bank withdrawals lacking essential records such as receipts, back-to-office reports, and signed beneficiary lists. This lack of accountability makes it impossible to confirm whether funds were properly utilized, increasing the risk of financial losses. Another critical issue is the Ministry’s non-compliance with the Ministry of Finance’s recommendations regarding a stalled construction project in Mathaska Village, Port Loko District. The project, valued at US$3,984,014.96, was taken over from the National COVID-19 Emergency Response Centre. However, an April 2024 inspection—35 months after contract approval—found it incomplete. Despite recommendations to reassess the project, cancel an addendum, and establish a Contract Management Committee, no corrective actions were taken. Delays in completion pose risks of cost overruns due to inflation. Unauthorized procurement activities were also noted, with the Ministry exceeding its budget for diet and cleaning services by NLe12,771,234. Despite a budget of NLe48,716,000, actual expenditure reached NLe61,487,233.84 without required approval from the Ministry of Finance, signaling financial mismanagement. The report further highlights inefficiencies in medical supply procurement and management, leading to the distribution of expired or substandard medicines. At Connaught Hospital, large quantities of expired drugs were found in storage, with no records of requests for timely disposal. Similar issues were identified at Lakka Government Hospital, where expired and potent drugs were improperly stored together, increasing risks to patients. Infrastructure problems also plague healthcare facilities. Bo Government Hospital reported unpaid contracts for cleaning services and patient diets, threatening service disruptions. Additionally, the hospital’s deteriorating water reservoir led to inadequate water supply, posing sanitation risks. Medical equipment shortages were another major concern, with hospitals such as Bo Government Hospital lacking essential tools like blood pressure monitors, thermometers, oxygen machines, incubators, and patient monitors. Outdated and faulty equipment further compromised healthcare service delivery. Financial mismanagement was also uncovered in the National Emergency Medical Services (NEMS), where NLe273,276 in withholding taxes and NLe1,760,232 in PAYE taxes were unpaid to the National Revenue Authority (NRA). Similar issues were identified at Connaught and Jui Government Hospitals, where substantial public funds were unaccounted for. The National Medical Supplies Agency (NMSA) was found to have failed in the timely distribution of essential drugs to district health facilities, causing shortages that negatively impacted patient care. Poor warehouse management was also noted, including the unauthorized distribution of Free Healthcare drugs to private medical facilities and the lack of basic security measures such as CCTV cameras. In some district medical stores, medical supplies were stored in substandard conditions without proper ventilation, leading to stock deterioration. The report concludes that systemic failures in financial accountability, procurement, contract management, and healthcare delivery within the Ministry of Health and Sanitation demand urgent intervention. Strengthening regulatory oversight, enforcing stricter procurement guidelines, and ensuring financial transparency are critical to improving healthcare service delivery and safeguarding public funds.