E2m drugs unaccounted for at P. Peak Hospital
PIGG’S PEAK – Over E2 million worth of medical drugs are allegedly unaccounted for at the Pigg’s Peak Government Hospital.
It was gathered that the medical drugs went missing as there were no stock cards, where they should have been recorded to have been distributed.
According to the Auditor General (AG) Timothy Matsebula’s Forensic Investigation Proposal and Audit of Acquisition, Distribution and Management of Pharmaceuticals Report, E2 283 688.91 worth of pharmaceuticals were unaccounted for at the hospital in the financial year 2021/22.
In total, the report shows that over E11 million medical drugs had not been accounted for in different health institutions of the kingdom. The Mbabane Government Hospital has the highest value of unaccounted-for medical drugs, which is over E9 million. Pigg’s Peak Government Hospital is second on the list.
Recommendations of the AG were that the Ministry of Health should investigate the unaccounted-for medicines, with the aim of recovering and reporting any unrecovered stock to the Losses Committee at the Ministry of Finance. It was also suggested that the Ministry of Health should have a system that monitors the medicines from ordering, receiving, stores until dispensary to patients. Matsebula also advised that the Ministry of Health should strengthen internal controls and implement monitoring controls to ensure that facilities adhered to regulations.
The last recommendation by the
AG was that the ministry should evaluate the use of the Stock Record Cards, and design controls which would help mitigate the risk of misuse of medicines in the facilities.
The report then states that in his response, the Controlling Officer (Principal Secretary (PS) Dr Simon Zwane) acknowledged that the ministry was aware of the poor documentation of stock in health facilities, because of the manual system being used at that level.
Monitoring
The report states that Zwane said the ministry planned to improve monitoring through structured supervisory visits. However, he said transport and fuel constraints remained a challenge for proper supervision by the regional pharmacist.
“The ongoing digitisation Electronic Logistics Management Information Systems (ELMIS) will improve visibility and enable timely interventions where challenges are observed. It has been noted that when health facilities are busy and have long patient queues the staff tend to be complacent and not record the medicines in the tally cards, as they move them from the storeroom to the dispensing site, which makes it difficult to tell the difference between real losses and carelessness.
“Also, the ministry needs to procure medicines prepacking machines to reduce the burden of the manual pre-packing of medicines from the staff,” the report quotes the PS.
Zwane is said to have highlighted further that the ministry had observed a need to improve the security systems at facility level and had engaged the Royal Eswatini Police Service (REPS) to conduct a comprehensive security assessment for all health facilities for informed decision making to improve the security of medicines at health facility level.
The report indicates that as per the auditor’s evaluation, the response from the controlling officer does not state how the issue of unaccounted-for medicines would be addressed and recovered. The PS was yesterday reached for further comment, especially relating to the unaccounted for or missing drugs at the Pigg’s Peak Government Hospital. He confirmed that the ministry would launch an investigation over the issue of unaccounted for drugs in public health institutions.
The AG further observed, in his report, that there was no way of tracing and accounting for the medicines issued by dispensary to patients and that it was not possible to ascertain, at this stage of the process, if the medicines reached the patients.
Critical
“This is seen as the most critical part of the process where the question can be answered if the acquired medicines were all issued to patients based on the prescription. The ministry had developed a Client Management Information System (CMIS), which does not interface with the ELMIS to at least give reports on accountability of medicines,” he stated.
In some of the clinics visited, the AG said the system was not yet operational, they still used the old stationery process of prescription and due to insufficient cash flows, they sometimes made copies of the stationery just to improvise, and these copies did not have duplicates to remain with the facility after prescribing to the patient. He said this made it difficult to trace medicines that were prescribed and issued to patients during the use of those photocopies.