Key hospitals grind to a halt as they run out of cash

By Standard Team

Health services in public Hospitals across the country have been crippled by an acute cash crunch following delays by Government to release funds.

The most affected are the seven provincial hospitals and five district hospitals, which also act as referral institutions in the rural areas.

As a consequence, crucial supplies like food for in-patients, water and electricity have either been withdrawn or cut down as suppliers demanded full payment for services rendered since January.

So bad is the situation that some suppliers have threatened to withdraw their services until debts are settled.

The Standard has established that the Government — weighed down by famine and a heavy wage bill in the resettlement of internally displaced persons from the December 2007 post-poll violence — had not disbursed Sh300 million as cash float for the health facilities.

The allocation for the current quota (January - April) has not been remitted although this should have happened in the beginning of January. The last remittance was received in November.

Sources told The Standard the Ministry of Medical Services only sent the Authority to Incur Expenditure (AIE) forms that enables the health facilities to receive services and supplies on credit.

"The AIE came promptly stipulating the vote heads and how much to be spent, but Treasury is yet to release the funds," said a Medical Officer of Health who declined to be identified for fear of victimisation.

Provincial general hospitals as well as major district hospitals, which are categorised as Level 5 and have nursing schools, receive Sh8 million per quarter.

Level 4 includes all sub-district hospitals are entitled to Sh1.8 million every quarter.

Level 2 and 3 include dispensaries and health centres. They get a total of Sh350,000 to Sh400,000 per quarter depending on their size.

The money is utilised to offset recurrent expenditure such as water, electricity bills, gas for fridges to store vaccinations, fuel, and to substitute allowances for staff and foodstuff for in-patients.

The Government admitted there were problems with cash flow from the Exchequer but said this would not cripple operations.

Medical Services PS James ole Kiyiapi dismissed reports of the developing health crisis as "an imaginary problem."

"We disbursed the money to pay all suppliers to these facilities countrywide," Prof Kiyiapi insisted.

Visible hardship

But according to one source familiar with public procurement, AIE forms under normal circumstances are accompanied by money, which was not the case this year.

The Standard investigations found no evidence that the money had been disbursed but there was ample proof of hardships endured by medical personnel in different regions.

The cash crunch has left the Nyeri Provincial General Hospital on its knees due to debts.

The chairman of the local chapter of Kenya National Chambers of Commerce and Industry Herman Kairu confirmed that the traders and suppliers had already filed a formal complaint.

He said the traders had written to President Kibaki seeking his personal intervention. "We are waiting for word from the President, since the hospital seems to be unable to honour its obligations," said Kairu.

The traders, he added, had also written a protest letter to the PS in the Ministry of Medical Services.

"As this quarter comes to an end, the health facilities are foreseeing a situation whereby another AIE will be sent without the money hence piling up the bills," said another source.

However, Kiyiapi accused suppliers of trying to pressure for immediate payment contrary to Government operations.

"The Government cannot pay unless it has already received the supplies it has asked for," said Kiyiapi.

Unlike previous years, Kiyiapi said, the ministry was working to ensure the issue of pending bills does not arise. "The ministry drew up a Sh115 million cheque recently to clear all the pending water bills," he said.

But the hospitals suppliers will hear none of it. In Nyeri, one supplier said: "Some of us are contemplating stopping deliveries. We have been working on false promises from the hospital’s management."

He said the supplies would have been stopped long ago "were it not for the mercy of patients."

"Most suppliers would have terminated their services were it not for contractual agreements with the hospital," said the supplier.

Kitale District Hospital Medical Superintendent Dr Maurice Wakwabubi said they were yet to receive the third quarter allocation.

He sait the hospital owes suppliers millions of shillings but refused to disclose the figure.

"Some of our operations have been affected due to lack of money. We are relying on funds from the cost-sharing kitty," said Wakwabubi.

Debt ridden

The institutions have incurred heavy debts to sustain their daily operations due to delayed disbursements.

"We have been using the little money collected from patients to run the hospital," said a nurse who sought anonymity at the Eldoret District Hospital.

We also established that several hospitals in Nyanza have not received their allocations since beginning of the year.

In Kisii, the hospital’s medical superintendent, Dr Geoffrey Otomu said they received their quarterly allocation of Sh4 million in the first week of March, one and half months late.

"Money came a bit late but we managed to convince our suppliers not to discontinue supplying us," he said.

Reporting by Sam Otieno, Elizabeth Mwai, Osinde Obare, Francis Ngige, Robert Nyasato, Kepher Otieno and Ngumbao Kithi.

 

 

Read all about: Ministry of Medical Services Authority to Incur Expenditure National Chambers of Commerce and Industry AIE

 

 

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