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Health ministry budget fiasco

by Lesotho Times
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MASERU — During the 2007/08 financial year the Ministry of Health had to return nearly 20 percent of its budget allocation to the treasury department because the funds had not been utilised, a report by the Auditor-General Lucy Liphafa has revealed.

The report issued last week said M93.8 million of the M525 326 574 allocated to the ministry in the 2007/8 financial year remained unutilised until it had to be returned to the treasury.

Ironically, this happened when Lesotho’s health sector continued to face severe problems due to lack of resources.

Medication at major hospitals was and is still in short supply while doctors and nurses continued to shun Lesotho due to poor working conditions and uncompetitive salaries.

Villagers were and still continue to walk long distances to access health services.

Ambulances and other basic medical equipment was in short supply at the country’s major hospitals and clinics.

At Queen Elizabeth II Hospital, Lesotho’s only referral hospital, some patients were sleeping on the floor because there were no enough beds.

New mothers in the paediatric ward had to sleep on the floor due to lack of beds. 

The geyser at the hospital remained unrepaired. 

Basic equipment like a CT Scan, a machine used to diagnose people with head injuries, remained broken.

Patients had to be referred to Bloemfontein because the hospital had not bought one.

The machine was only delivered in 2009.

Doctors and nurses worked painfully long hours because the ministry could not employ more.

But despite these problems the ministry could still afford not to utilise M93.8 million, money that could have been used to recruit more personnel, buy more beds and repair dilapidated hospitals and clinics around the country.

More drugs and equipment could have been bought.

While the Ministry of Health is not the first one to return money to the treasury due to underutilisation, the daunting challenges facing Lesotho’s health sector make the ministry’s frugality quite startling. 

Ministries and government are encouraged to save money but not at the expense of service delivery.

Lesotho’s blood bank has been at critical levels for years because there is just not enough effort to recruit more donors.

Although with the help of rich countries and aid agencies Lesotho tops the list of countries that are doing well to provide medication to people with HIV and Aids, many people still don’t have access to life-saving drugs.

The number of orphans continues to increase as more parents succumb to Aids.

Lesotho now has more than 200 000 orphans, according to aid agencies.

The auditor general’s report said M9.1 million of the M125 million allocated to the ministry for administrative purposes in the 2007/08 was not utilised.

Funds allocated to districts’ health needs were about M145 million but only M115.5 million was spent.

There are only three districts that used all the funds released to them or spent more.

Queen Elizabeth II Hospital was given M115 million but managed to use only about M105 million, leaving a staggering M10.4 million to be returned to the treasury.

This happened at a time when the health care quality at the hospital was deteriorating due to lack of personnel, drugs and basic equipment.

The Lesotho Flying Doctors Service, a crucial project that flies doctors to remote areas where there are no clinics, only used M3 million of the allocated M8.6 million.

The Social Welfare Department, whose role is helping people too poor to pay their medical bills, did not use M3.3 million of the allocated M7.9 million.

The department takes care of the disabled, aged, orphaned and other vulnerable people.

The department also provides wheelchairs to the disabled, white canes to the blind and other essentials to help people with disabilities.

Seabata Lengosane, the spokesperson for the Lesotho National Association of Physically Disabled Persons, said he was shocked that the social welfare department had returned funds to the government at a time when many people with disabilities were struggling to get basic equipment.

“I fail to understand why the department did not approach our association and plan together with us on how we could utilise the funds,” Lengosane said.

“We have many people who do not have crutches, wheelchairs and calipers but the department had the guts to return M3 million,” he said.

A wheelchair costs more than M3 000, Lengosane said.

The audit report said departments for mental health, HIV prevention and treatment, infectious diseases, labs and research also failed to utilise allocated funds.

So did the Blood Transfusion Services and National Health Training Centre.

The labs and researches department was allocated M18.7 million but spent only M7.5 million.

Out of the M39.8 million released to the department dealing with HIV, M10.5 million was returned to the government purse unused.

The president of the Lesotho Network of People Living with HIV and Aids (Lenephwa), Mohau Mabote, said the return of such a huge amount of money to the government’s purse reflected lack of vision on the part of the health ministry.

“It could have been channelled to food production for vulnerable children whose parents have died of Aids-related illnesses or those whose parents are still alive but are so ill that they can’t work,” Mabote said.

 “There should be food production projects for such people,” he said.

Mabote said in Maseru district alone, there are about 30 000 vulnerable children whose HIV-infected parents are unable to pay school fees.

Health Minister Mphu Ramatlapeng said she was not in a position to talk about the specific figures mentioned in the report because she was not in her office and did not have relevant papers with her.

She however said sometimes failure to spend all allocated funds is often caused by delays in signing certain agreements in certain projects.

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