Inefficient NDSO guzzles health budget: Minister
… shortages of drugs persist in govt hospitals despite huge cash outlay to the NDSO
HEALTH Minister Nkaku Kabi says the National Drug Service Organisation (NDSO) is failing to discharge its mandate of ensuring adequate medical supplies including drugs at government health institutions despite receiving millions of maloti from the state for this purpose.
The Mafeteng-based NDSO received M450 million a year from the health ministry’s coffers for the 2018/19 budget. Only Queen ’Mamohato Memorial Hospital (M550 million) receives more money from the health ministry’s budget.
However, Mr Kabi says the NDSO is not justifying the huge allocation. He recently told the MNN Centre for Investigative Journalism that there is an alternative Indian-based company where the government can purchase the same medical supplies at a lower cost of between M80 and M100 million per year.
He said he had raised this issue in cabinet but his fellow ministers have not taken it seriously.
“I have tried to raise this issue in the cabinet but it doesn’t seem to be a pressing issue to the Minister of Finance (Moeketsi Majoro) and other ministers even though the health ministry is feeling the pinch of a lot of money being diverted towards a segment despite having an alternative that could save us more money,” Mr Kabi said.
The NDSO is a statutory body which was established in March 2007 as a trading account for the Ministry of Health. It is mandated to procure, store and distribute pharmaceuticals to over 200 health facilities nationwide.
The purpose of the trading account, according to Gazette No.19 of 2 March 2007 which established the NDSO, was to promote the health of Basotho “by developing, implementing and maintaining equitable and reliable systems for the procurement, storage and distribution of medicine and medical consumables of acceptable quality standard for all the health institutions in Lesotho at the lowest possible costs”.
The gazette directs the health centres to order their medicines from the trading account “in order to maintain sole source commitment”.
It further states that the hospitals “shall obtain authorisation from the trading account before purchasing medicines and medical consumables elsewhere where such products are not obtainable from the trading account”.
The NDSO, the gazette shows, shall be used to facilitate the redistribution of medicines within the government health institutions to address the problem of overstocking and wastage.
Mr Kabi wants the gazette amended to end the monopoly currently enjoyed by the NDSO.
He said while the nation was pointing an accusing finger at the Queen Mamohato Memorial Hospital for gobbling the biggest chunk of the Health ministry’s budget, the NDSO was also a problem.
“The ministry spends about M500 million on NDSO to procure drugs for health centres in Lesotho, but there is another source which is willing to take between M80 and M100 million for the same service… The NDSO has been given a monopoly, unreasonably.
“We recently went to India and found a cheaper organisation offering us the same quality and quantity of drugs with lesser price but we are unable to use that company because Lesotho laws which established the NDSO are binding,” Mr Kabi said.
Despite the high costs the government paid to the NDSO, the minister said the state entity was inefficient.
“We still have a huge challenge of hospitals running out of drugs while others operate without the necessary drugs due to the inefficiency of NDSO,” he said.
The minister said there could be politicians benefitting from the maintenance of the costly NDSO arrangement. He however, said he was unsure whether these could be from the current government or the previous one. He also refused to be drawn into mentioning names.
“The NDSO budget causes so much trouble to the ministry… I think there are people in high positions who are benefiting from the arrangement. That organisation is very costly to the Ministry of Health,” Kabi said.
Dr Majoro is yet to respond to questions that the Centre emailed him last month. But in a telephone interview, he simply said:
“I don’t recall Ntate Kabi complaining about NDSO to me or the cabinet, and to my knowledge, the organisation is still operating successfully…. Unfortunately, I don’t have on my table the NDSO as an issue but I will look into it.”
Dr Majoro referred the Centre to the finance ministry’s Senior Budget Officer Kori Lenyatsa, who said the NDSO was not to blame for the shortage of drugs at government health institutions.
“Even if the NDSO didn’t exist, the procurement of government drugs would still be very costly to the ministry’s budget,” Mr Lenyatsa said.
Speaking of drugs shortage at the health facilities, Mr Lenyatsa said there were several factors that included government red tape. He said the NDSO was not to blame.
He added that other possible cases would be late payments by the government which in turn prevent the NDSO from paying for procured drugs on time.
Mr Lenyatsa noted that the projected drugs revenue for 2018/19 is expected to increase from M420 615 681 million to M495 616 158 million.
The NDSO General Manager, Matebele Sefali, told the Centre that the organisation’s operations were responsive to the health ministry.
Mr Sefali blamed the government for the shortage of drugs in hospitals, saying there was an unnecessary red tape in the procurement processes that hampered the timely distribution of the drugs.
He said due to the long processes and red tape involved in the government system, it took ages before the purchase orders could be finalised and issued to the NDSO to deliver.
“What often happens is that we procure the drugs and store them even before we get payment from the government. The government can then reimburse us.
“But the processes take too long. It begins with filling and submitting a requisition to the Ministry of Health which needs to go through procurement procedures of the government and this usually takes a very long time. They eventually get an approving purchase order which they submit to the NDSO. Only then can we deliver the needed drugs.
“More than 90 percent of the times when there is an outcry over drugs shortages at government hospitals, it is due to unreleased purchase orders by the government itself.
“It is unfair to always have the NDSO blamed for the shortage of drugs when there are clear problems which we don’t have control over,” Mr Sefali said.
*Lerato Matheka is an investigative fellow with MNN Centre for Investigative Journalist