Government spent at least Shs 10 billion last year on medical treatment for its officials abroad, the latest report from the Office of the Auditor General reveals.
According to the audit report into the expenditure of the ministry of Health for the financial year 2015/2016, $2.8 million was spent on 140 patients. The figure excludes flight, upkeep and attendants’ costs.
With other costs factored in, notes the report, the figure must be significantly higher.
“Since the analysis was limited to patients approved by the medical board, many other individuals could be incurring much higher expenditure resulting into foreign exchange authorised on treatment abroad and the demise of patients who are unable to afford the high costs,” the report notes.
Shs 10bn is roughly half the sum needed to buy a new radiotherapy machine to replace the old one, which broke down last year, leaving cancer patients at Mulago hospital stranded.
Some of the favoured foreign destinations for medical treatment by Ugandans are India, Kenya, South Africa, Turkey, UK and the United States.
Ministry of health officials told the Auditor General that some patients had to be referred abroad because “the national referral hospital and other specialised institutions are being rehabilitated to improve capacity for local treatment.”
Of those treated abroad, 46 had a neurologic condition, 30 suffered from kidney failure, 22 had different types of cancer, while 13 had different heart conditions.
“I advised management to come up with a comprehensive health sector strategic plan to develop capacity for treatment of the identified ailments locally so as to be able to serve a bigger population and minimise foreign exchange authorised,” the auditor general notes.
Besides treatment abroad, the Auditor General’s report also questioned other dealings by the ministry of Health. For instance, it noted that a private company was paid Shs 800 million in storage costs basing on photocopies of supporting documents.
The report warns that payments against photocopies may result in multiple expenditures. The report also points out that in 2014, the ministry of Health signed a contract with a construction company for the rehabilitation and upgrading of the lower Mulago hospital complex at a contract price of $29m, inclusive of a Value Added Tax (VAT) component of $4.5m.
However, the report notes that VAT amounting to $2.5m had not been paid to the contractor, despite the fact that it had been budgeted for by the ministry of Finance, Planning and Economic Development.
“Delayed settlement of the tax liability may result into additional costs such as penalties and fines that are likely to be passed on to the government,” the report notes.
At the China-Uganda Friendship hospital in Naguru, the Auditor General discovered that the filing system in place made it difficult to trace supporting documents and relating them to their corresponding payments.
The report also notes that at the same hospital, notebooks were used to acknowledge receipt of cash instead of receipt books.
“This can lead to loss of funds to the hospital. It is also not possible to ascertain whether procedures in procurements and payments are followed by the hospital management,” the report says.
At the Jinja regional referral hospital, the Auditor General’s report pointed out that the hospital had expired drugs in its stores, some of which could end up on the open market.
The report notes: “I advised the accounting officer to engage the relevant authorities and ensure that the expired medicines are disposed of to avoid misuse.”