By Lynford Simpson, Staff ReporterWITH NEARLY $300 million in user fees owed to hospitals across the island, Parliament's Public Accounts Committee has recommended a review of the system of assessing patients to determine those who are unable to pay.
Meantime, Auditor-General Adrian Strachan has painted a picture of sloppiness in the accounting practices of the Ministry of Health and its related agencies.
At the same time, the Ministry of Finance and Planning is not in favour of allowing a write-off of user fees owed anytime soon, Robert Martin, Deputy Financial Secretary told the PAC.
Grace Allen-Young, Permanent Secretary in the Ministry of Health, who appeared before the PAC Tuesday, told the Committee that the Government's stated position of not turning away patients because of their inability to pay, will be maintained. As such, the $290 million owed to the four regional health authorities is likely to increase.
Mrs Allen-Young explained that the Ministry had appointed assessment officers to determine patients' ability to pay. "But even on determination of persons' ability to pay, there are individuals who access the service ...and leave the hospital without paying," she said. "The dilemma for the Ministry is that no person must be denied care and we have to give care to all persons attending," she added.
The Permanent Secretary said the Ministry was restrained from taking any action against the delinquents, but had taken steps to sensitise the public as to the cost of health care. Monthly reminders are sent and direct calls made to persons with outstanding bills.
Noting that much of the outstanding amount was perhaps "uncollectable" PAC Chairman Audley Shaw stated that: "This might be one of those cases where we might just be spinning our wheels." He questioned whether the Ministry of Finance would give consideration to writing-off the amount.
This is not likely anytime soon. Robert Martin, Deputy Financial Secretary told the Committee that the Ministry did not approve write-offs of receivables unless the particular ministry or department had demonstrated that all efforts had been exhausted in collecting the outstanding amounts. He explained that the statutes of limitation for seven years would provide more time for the Ministry to collect. "What we are doing is giving them the extra time to put the effort in to collect this $290 million. The Ministry of Finance is not prepared to approve write-offs just like that."
The Auditor-General's review uncovered internal control weaknesses and accounting deficiencies.
The following were among his findings which were presented to the PAC:
Uncollected fees totalling $156.9 million at seven hospitals in the South East regional health authority as at March 31, 2001. Mr. Strachan warned that "failure to collect outstanding fees could adversely affect the operations of the hospital."
March 31, 2001 $150.8 million owed to suppliers of goods and services.
March 31, 2001 $157.4 million owed to suppliers of goods and services in the North East Regional Health Authority and $91.3 million in PAYE deductions from employees' emoluments had not been remitted for the period October 2000 to June 2001.
Staff occupying homes by the Government were not contributing to the cost of utility.
Mr. Strachan also pointed to inadequacies and irregularities involving $754,335; inadequate control of public money; unsubstantiated payments totalling $308,626; lack of formal contracts for security services totalling $3.515 million; interest charges of $71,628 on unauthorised bank overdrafts, a breach of the financial instructions; and the fraudulent conversion of six cheques totalling $132,947.
Up to the time of the Auditor-General's report, the required furniture and equipment inventory records were not maintained and therefore did not reflect fixed assets of $11 million.
Meanwhile, a sewage treatment plant installed at the Annotto Bay hospital in Portland, nine years ago, remains non-functional despite expenditure of $15.4 million over the years.
In May 2001, the Ministry engaged the services of a consulting firm to evaluate the plant. It recommended that extensive modification costing about $2.5 million would be necessary to make it functional.
In the meantime raw sewage continues to flow freely onto the hospital compound and a nearby school, putting residents at risk.
