Gordon Robinson | A hospital sicker than its patients

Public concern abounds about a recent Auditor General (AudGen) report on University Hospital of the West Indies’ (UHWI) procurement practices.

Much off and leg spin deliveries were bowled in media including those using distraction to confuse us regarding AudGen’s subject and purpose. I listened with amusement on radio to a rambling cover version of “It Wasn’t Me” by Chris Tufton where he relied on UHWI’s regional character; it’s partnership with University of the West Indies (UWI) making UHWI a teaching hospital; its proximity to privately owned Tony Thwaites Wing; and, the best part, “I only appoint eight members of the Board” to obfuscate the fact that AudGen was enquiring into expenditure of Jamaican taxpayers’ money on contracts governed by Jamaica’s procurement rules.

So what did AudGen say was her purpose?

“The audit….evaluated how UHWI managed its procurement activities to achieve value for money. It was crucial for UHWI to implement effective procurement procedures that maximised value, minimised waste, and improved efficiency thereby ensuring public health procurement resources were used to greatest effect.”

One more picture, hold it!

AudGen was enquiring into how UHWI spent taxpayers’ money ( “public health procurement resources”) in “procurement activities”.

What did those enquiries reveal?

“….deficiencies in UHWI’s governance, procurement, and contract management processes…. If not addressed, these could increase risk of corruption and undermine UHWI’s ability to deliver quality healthcare.”

Watchya now! AudGen didn’t enquire into expenditure by institutions separate from UHWI like UWI or The Wing. AudGen expressly enquired how UHWI spent Jamaican taxpayers’ money. She found procurement practices non-compliant with every Government Procurement rule or guideline. Under the Constitution and Financial Administration and Audit Act, AudGen is required to audit the accounts, financial transactions, operations and financial statements of, inter alia, central government ministries, departments and statutory bodies.

UHWI is a statutory body established by The University Hospital Act and overwhelmingly funded by Jamaican taxpayers. It’s a public hospital subject to AudGen’s monitoring.

So no amount of wriggling, obfuscation and deflection can change the governance reality that the buck for UHWI’s ineptitude (or worse) stops briefly at UHWI’s Board before landing with a resounding kerplop on Tufton’s desk. Examples of AudGen’s findings:

(1) Major “gaps” in UHWI procurement management (key documents missing) was compounded by the absence of “basic needs assessment and procurement planning”

What the actual furshlugginer?

For fiscal years 2018/19-2024/25 no formal strategic procurement plan was submitted. But, since no needs assessment was done before procurement, it was unlikely procurement plans existed.

What’s the big deal about “needs assessment”? AudGen’s report:

“[Needs Assessment] typically begins with establishing clear strategic and operational objectives, defining procurement goals, requirements, and specific targets. It then involves developing comprehensive procurement plans with (sic? which?) detail strategies, timelines, and budgets to guide procurement activities effectively. Strategic planning is essential for guiding the operational plan, which determines procurement requirements and ultimately leads to the development of a comprehensive procurement plan.”

For 2018-2025, none of this was shown to AudGen “despite having paid two consultants a total of US$186,600 to conduct strategic and operational reviews in 2022 and 2024.”

Instead UHWI sent AudGen a five year budget which included an overall corporate plan without showing how UHWI’s procurements fell within that plan. It also presented two annual plans not approved by UHWI’s Board.

Did UHWI Board(s) not ask for these legislatively mandated procurement plans? Didn’t they wonder how come so much equipment and tools were procured without them seeing one procurement plan based on a needs assessment? Didn’t they report this glaring failure to Minister? Didn’t Minister ask for at least annual reports from UHWI’s Board? Who approved the employment of these “Consultants” to “review” non-existent strategy? Did the Board know? Did Minister know?

What did the Consultants’ report advise?

I recall (apologies for personalizing this), decades ago, as Executive Chairman of a high profile Statutory Board, I personally sent the Minister a monthly report of the organization’s activities. I considered it an essential part of the job especially as I’d insisted he NOT try to help me do the work.

What was UHWI Board doing? Taking tea?

For the past six years, UHWI submitted zero annual reports detailing how $65 billion in subventions were used. This isn’t petty cash. It’s taxpayers’ money for which UHWI MUST account.

(2) Government’s electronic Procurement portal (GOJEP) wasn’t used consistently to publish and report procurement activities.

AudGen: “As of June 10, 2025, UHWI conducted only 71 procurement activities on the platform. While 800 procurement activities, valuing over $1.6 billion, were reported to the Integrity Commission for 2024, only 20 were recorded on GOJEP….”

So how were 780 procurements managed? How were the public given the opportunity to tender? How can $1.6 billion in government contracts be awarded using such nebulous procurement practices but nobody knows?

AudGen found:

“The procurement guidelines specified the methodologies to be employed for acquiring goods, services, and works, depending on their respective value thresholds. These methodologies included International Competitive Bidding, National Competitive Bidding, Restricted Bidding, Direct Contracting Procurement, and Emergency Procurement.

“We requested a copy of UHWI’s contract register for 2019-2024. In July 2025, UHWI provided a listing of only 157 contracts, each exceeding $3 million, awarded between 2019 and 2024. The procurement methodology for the selection of the contractors was not included [my emphasis] . UHWI was unable to provide a comprehensive register of relevant contract details such as start and finish dates, contractor names, contract values and duration...”

So, an arbitrary procurement strategy was standard operating procedure at UHWI. How is this possible? Why was oversight so religiously lacking? Surely it can’t get any worse?

But I’ve told you never to challenge worse. Heeeeere’s worse:

(3) UHWI improperly used its tax exemption privilege, allowing four private companies to avoid more than $23 million in import duties.

Wha, Wha, WHAT?

AudGen found:

“….six instances in which UHWI utilized its tax exemption status to facilitate importation of goods belonging to four private companies, resulting in significant financial losses to government. Specifically, UHWI used its tax exemption status to facilitate importation of laundry equipment, with CIF valued at approximately $28 million for Private Company 1, yielding an estimated tax benefit of $6.6 million.”

Wusser:

“Similarly, the misuse occurred with importation of office furniture and medical equipment CIF value $40.6 million; cups and dishes CIF value $1.41 million, resulting in revenue losses totalling $10.7 million [benefitting] Private Companies 2 and 3. These actions suggested an abuse of UHWI’s tax-exempt position to facilitate private entities in evading taxes…..”

Finally, wusserer:

“UHWI procured 40 waste bins from Private Company 4 CIF value $6.6 million. The transaction received customs duty waiver of approximately $3 million; however, UHWI paid the private supplier $11 million plus additional costs for the said waste bins. There is no evidence UHWI used the competitive procurement process.”

Need I say anything more? Unless AudGen is reporting from the Loony Bin (one of the 40 bought from Company 4?), SOMEBODY should go to prison.

How did Health Ministry respond to these egregious breaches of public trust being exposed?

Ministry’s statement January 14: “The Minster has taken immediate steps to address the governance and accountability gaps highlighted by the Audit Report….”

Steps? What steps? “the appointment of an Institutional Review Committee”

Well kiss my red, wrinkled rungus kungus mi nungus! After trotting out names of eminent Jamaicans with impeccable credentials to so impress us we might ignore the real issue, Tufton declared his Committee’s remit:

“1. Reviewing and identifying gaps and/or weaknesses in:

• UHWI’s Corporate Governance and Management structures

• Financial, Public Procurement and Administrative Management systems

• Corporate Risk Management Systems

2. Providing recommendations on possible changes or adjustments that might be necessary to mitigate, manage or eliminate the risks associated with the findings of the audit and strengthen governance and accountability.

3. Providing recommendations on mechanisms to implement the Auditor General’s recommendations”

This egregious exercise in artful dodging is a colossal waste of these individuals’ time!

Item 1 is already done by AudGen. Items 2 and 3 already exist in public procurement rules, regulations and procedures. The problem is they’ve been routinely flouted. We don’t need another political musical chairs game obfuscating issues and delaying accountability.

UHWI is sicker than its patients! If we weren’t living in Wonderland, every alphabet soup police squad would be treating UHWI like SSL; appointed Board members would immediately resign for dereliction of oversight duty; and the “Committee” would be appointed in their place.

Peace and Love.

Gordon Robinson is an attorney-at-law. Send feedback to columns@gleanerjm.com