NAO report highlights ‘management by crisis’ at Sir Paul Boffa Hospital and oncology centre
A report penned by the National Audit Office on the public accounts for 2015 has outlined “a lack of internal control synonymous to management by crisis” with regard to Sir Paul Boffa Hospital as well as the Sir Anthony Mamo Oncology Centre.
The full document comprises 21 reports on the operations of various ministries, departments and other government entities, including an analysis of the Financial Report 2015.
An audit was carried out on the expenditure on contractual and professional services at both institutions. The report’s executive summary highlighted that the lack of control being referred to includes “expenditure falling outside the scope of the contracts in force, necessary authority for procurement obtained retrospectively, if at all, and habitual contract extensions hindering fair competition.”
The report also took issue with the fact that procurement procedure was not followed. “Concern” was expressed regarding procurement being finalised through negotiated procedure without prior publication of an EU contract notice.
The services procured were of substantial value, the report said.
In relation to the lack of publication of an EU contract notice for the procurement of services, the report noted that the frequency with which services were being procured through negotiated procedures “raised questions as to whether the respective Public Procurement Provisions were being breached or abused.
“The weaknesses in internal control ultimately impinge on the overall control environment within the respective functions of the hospital,” the NAO reported.
Turning to cleaning services at all healthcare institutions within the Health Ministry, there was a sudden termination of the contracted cleaning company leading to the need for approval from the Direct Orders Office within the Finance Ministry. Following approval, cleaning services were rendered on a temporary basis. The audit found that while timesheets from the temporary cleaning service were accompanied with invoices for January 2015, “these were not signed by the respective cleaners and housekeeper. Moreover, the timesheets were not endorsed by anyone from Sir Paul Boffa Hospital. This indicated lack of control over the record-keeping of hours worked and ultimately the respective payment.”
Sir Paul Boffa Hospital provided specialised in and outpatient services for dermatology, oncology and palliative care. From 7 September onwards, the report reads, only dermatology services continued being provided from this hospital as the other services were transferred to the newly inaugurated Sir Anthony Mamo Oncology Centre. The report adds that from December 2015, new admissions of patients requiring long-term care were made at Sir Paul Boffa Hospital as a temporary measure to ease the burden from Mater Dei Hospital.
“For financial year 2015, the revised budget earmarked for Contractual and Professional Services stood at €3,550,000 and €100,000 respectively, with actual expenditure eventually totalling €3,529,462 and €98,860.”
The main objective of the audit was to see if the system of internal controls in relation to the procurement of contractual and professional services provided for ensuring that funds were spent for their intended purposes, “within the approved limits, and in line with the provisions of standing Public Procurement Regulations.”
Issues of a lack of control and document verification were also found in the Free Childcare Scheme within the Family and Social Solidarity Ministry.