Ensuring accountability in Guyana’s health sector

It was recently reported in the media that a multi-million-dollar fraud was uncovered at the Ministry of Public Health, in connection with the Health Expo which was held from May 30 – June 2 this year. Subject Minister Volda Lawrence herself came out very emphatically on the issue, and indicated a detailed overhaul of her ministry to stamp out what she referred to as “misappropriation of funds and blatant attempts to steal”.
The minister emphatically declared, “Fraud had been ongoing a long time at the Public Health Ministry…and some parts of the ministry’s train have been derailed”. Minister Lawrence then boldly declared: “The madness has to stop. I will not compromise the issue of accountability within the public health sector”.

Minister Volda Lawrence

The minister should be applauded for grappling with this reality, since the quality of the ministry’s service to the public and her own success as a minister revolve upon running an efficient and clean ministry, where there will be no theft or misuse of public funds.
Very often, in recent years, whenever issues of corruption arise, ministers tended to be on the defensive, rejecting all criticisms and advice, as most emanated from the opposition party; although, in reality, much of it would have come from citizens who had no affiliation with politics, and would merely have desired to see ministries perform well and achieve their targets. Minister Lawrence seems to be freeing herself from the syndrome of defensiveness, and is taking matters in hand.
The Old Civil Service was known for its incorruptibility, and for its officers to act with transparency and accountability. One of the main reasons for this was that there were the General Orders, and the financial regulations were well laid out and explained in booklets. Every public servant was expected to study these booklets which outlined the way administration works and how public funds are accessioned, received and used. The contents of these booklets are still part of the public service procedures, but they are obviously ignored, because, in most cases, they are not known to exist.
When Minister Lawrence cautioned her programme officers, “I am advising you to check what you sign, and ensure it meets the regulatory requirements and it is in keeping with your programmes”, it is quite obvious that those managers were not fully au fait with the financial regulations.
The fraud was uncovered in relation to the hosting of the health expo, but there are other areas of the ministry which need cleansing and strengthening, and these would include procurement, stores, and the public hospitals.
For example, Procurement: the rules affecting tendering and the quality of the goods and services received should be under constant surveillance. Once the rules are followed with full commitment, one would always be successful. If extraneous criteria are introduced into the processes, then this would open the doors to corruption and ultimate failure.
The Government has a tender procedure whereby orders must be tendered for, and those tendering must be reputable suppliers with proper cold storage facilities etc. This tendering procedure was established to protect Government and prevent public funds from being siphoned away. However, many believe that this tender procedure is very often being ignored by the officers of the GPHC and the regions.
Now that Minister Lawrence seems to have emerged from the ‘newness’ of ministerial office in relation to the stark realities of administration, she should be helped, once she is committed to acting objectively and strictly according to the rules and regulations. In this process, she may assemble a ‘think tank’ of capable persons irrespective of their political and other affiliations, and let them make recommendations as to how to achieve a health sector of which the nation could be proud. Such a ‘think tank’ would work for no more than three months, and may also consider other health sector matters of national importance, such as national drug security and the specialty hospital.
We had said before that the administrative structures of the health services are fairly good and workable, but they are not being worked by those employed to do so. We believe the time has come for an independent and thorough inquiry to be carried out with the aim of freeing the sector of corrupt and inefficient employees. Citizens must be able to have confidence in the manner in which the health sector is being managed, hence all efforts must be made to ensure public monies are not fritted away or siphoned off.

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