NAO re­port high­lights ‘man­age­ment by cri­sis’ at Sir Paul Boffa Hos­pi­tal and on­col­ogy cen­tre

Malta Independent - - FRONT PAGE - He­lena Grech

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.

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