Unhealthy projects - Cancer initiative among several in limbo ... health minister moves to rescue $billions
The failure of state agencies to complete several projects for which money had already been allocated could have seen the public health sector wobbling if Jamaica had been hit by Hurricane Matthew last week.
As the nation braced for Matthew, Health Minister Dr Christopher Tufton had expressed confidence that the health services were ready to respond to any eventualities arising from the passage of the hurricane.
But that came days after the National Health Fund (NHF) had raised the red flag after splashing out almost $2 billion on projects to improve the country's public health sector over the past five years, with not much to show for the expenditure.
More than half of the projects being implemented by the Government through the NHF to help save lives and improve service delivery in the health sector were either dormant or behind schedule, although most of the money had already been disbursed towards their completion.
The stalled projects include one to deal with cancer care, which was approved in December 2013 for $55 million with an expected completion date of May 2014. To date, only $18 million has been disbursed over the two years, with little activity so far in spite of the damage cancer continues to cost Jamaica.
According to a report seen by The Sunday Gleaner, the NHF has financed 63 projects valued at approximately $2.7 billion, but up to June of this year only 23 were completed and there was only $893 million left to be spent.
The projects, which date back to as early as 2011, were all approved and funded by the NHF through its Institutional Benefits Fund and are being implemented by either the Ministry of Health or the regional health authorities.
"Of the 23 projects completed, 96 per cent or 22 achieved practical completion within budget," the report noted.
"For the 34 projects that were behind schedule, there is the concern that additional funding may be required due to the lengthy delay in implementation. Additionally, as has been the practice observed, the scope of the project may be reduced to facilitate completion within the initial budget," said the report which was compiled by the NHF and submitted to Tufton.
Tufton has confirmed receipt of the report and told The Sunday Gleaner that he has taken steps to move the projects along.
According to the health minister, he is concerned about the implications of the delays, given the objectives of the projects.
"Without a doubt, delays cost time and money and certainly affect patient care," said Tufton.
He pointed out that some of the stalled projects are geared towards improving sewage treatment and sanitation in hospitals, training health care workers, upgrading or expanding hospitals, refurbishing heath centres and combating non-communicable diseases.
The health minister said a committee has been established to do an assessment and provide oversight responsibilities for the projects that are now in progress.
The committee, which met for the first time recently, is chaired by engineer Peter Jarvis and includes NHF Chairman Christopher Zacca.
It will be in place for the next 12 months, but is expected to submit a report to Tufton within the next three months.
CLEANING UP THE SYSTEM
"They will have to determine through their own assessment whether these overruns of time and cost are a function of inefficiency or deviant behaviour.
"Depending on the findings, it may lead to other things, but right now my goal is to clean up the system to make it more efficient so that taxpayers get value for money and there is an enhanced service delivery, because we are more efficient in how we allocate resources," said Tufton.
"We already have limited resources, and part of the mission of this administration is that we can't just keep squealing that we want more money, we have to also ensure that we efficiently use the resources that we have," added Tufton.
According to the report, there were 14 projects being carried out by the minister with a total approved value of more than $1 billion.
But up to June, less than one-third, or $311 million, remained to be disbursed and most of the projects were behind schedule by an average of 12 months.
All the health ministry's projects which had been deemed partially complete were done within budget.
In the meantime, the South East Regional Health Authority (SERHA) and the Western Regional Health Authority (WRHA) each had 15 projects being monitored by NHF up to June.
The report said SERHA had been approved $849 million for its projects and had spent less than half of the money so far, with 47 per cent of its projects behind schedule by 14 months, but there was no major concern about those not completed.
In the WRHA, seven of its 15 projects were behind schedule by approximately eight months, with most of the $591 million it was assigned already disbursed leaving it with only $84 million to complete those not yet done.
The Southern Regional Health Authority had six NHF projects, with three being behind schedule by approximately five months, while the North East Regional Health Authority had eight projects, with 63 per cent behind schedule.
"It is imperative that the issues currently affecting the implementation of the projects be addressed expeditiously ... ," the report warned the health minister.
ALERT! Outstanding NHF projects could hurt Ja
- HSF350 Cancer Care Project - This was approved for $55.20 million in December 2013 with an expected completion date of May 2014.
- HPP181 Health promotion and prevention of non-communicable diseases - Project was approved for $20.00 million in February 2014 with an expected completion date of May 2014. To date, only $14.22 million has been disbursed. The project is still ongoing.
- HSF 183 Training of Health Care Workers - Approved in July 2015 for $2.74 million with an expected completion date of June 2016. To date, no funds have been disbursed and project is considered dormant.
- HSF268 Expansion of Operating Theatre Phases 1-2 additional suites at St Ann's Bay Hospital - Project was approved for $140.00 million in May 2013 with an expected completion date of April 2014. To date, only $117.34 million has been disbursed.
- HSF140Provision of Funding for the Expansion and Upgrade of Falmouth Hospital - Project was approved for $329.18 million in February 2007. However, the project became dormant for a number of years before being restarted in October 2014, with a view to completing the outstanding works by June 2015.