New scandal of how Afya House varied and awarded costly deals

Fresh details in what is turning out to be a medical leasing equipment scandal show how some companies, originally awarded tenders to supply medical equipment, ended up being awarded other unrelated tenders on the order of ministry officials.

Documents in our possession show that two companies, selected by the ministry to supply medical equipment, ended up being awarded tenders to construct buildings at the health facilities, plumbing works, electrical works, roofing, landscaping, painting of the buildings with no consultation with county bosses and at exorbitant prices.

Investigations by the Sunday Standard also indicate that the said contracts, that extended the terms of references to other companies that undertook similar extensions, have been kept away from public scrutiny to allegedly allow top ministry officials to buy time and adjust the contractual figures downwards.

For instance, one such document seen by Sunday Standardshows that the extensions included the leasing of air conditioners, diesel generator, a contract to furnish the radiologist’s office and reception area with furniture under a revised Management Equipment Services (MES) to the tune of Sh63 billion.

Counties had little room to wiggle out of the deals pushed down on them, as often the orders made were meant to be obeyed.

In one such occasion, a letter in our possession shows howNyamira Governor John Nyagarama was asked to sign one such deal.

The letter by Morang’a Morekwa on behalf of Health Principal Secretary Peter Tum, dated last month, directs the governor to accept a CT scan project to be implemented by two companies.

Asked to sign deal

“This is therefore to request you to identify with the assistance of the contractor, a suitable site within the Hospital to construct the CT Scan Centre. After the completion of the CT Scan Centre, please sign off the contractor by checking all the above,” states Morekwa in the letter.

It continues: “The National Government through the ministry is in the process of equipping 37 government hospitals with computerised tomography CT scans. Nyamira county referral hospital has been selected as one. The purpose of this letter is to introduce the two companies as the contractors to implement the project the contract scope involved.”

When Nyamira Senator Okong’o Omogeni confronted Health Cabinet Secretary Sicily Kariuki over the issue, she explained that it was part of the principal contract involving five international suppliers, but subcontracted to two companies.

The same letter was sent out to Kisii, Kakamega and Trans Nzoia counties, where county officials insist that they were never consulted on the need for the facilities.

At Kisii Level Five Hospital, despite having a new operational CT scan machine, it has received another similar one and an X-ray machine which they did not request from Ministry of Health.

In an interview with Sunday Standard, Kakamega Governor Wycliffe Oparanya, who is also the Council of Governors’ Finance Committee chair, registered the governors’ frustrations in their attempts to reject the project, saying they were even blackmailed that they were they cause of many deaths in their counties.

“We were blackmailed and the equipment imposed on us. There were no consultations done when the ministry realised every county had different needs. Health is a devolved function yet we were kept in the dark on this matter,” said Mr Oparanya.

He recounted how equipment was delivered to Kakamega General Hospital on a Sunday night.

“Which government office works on Sunday night? Nobody was available to receive them. It was the same case with the CT scan delivered last month without my knowledge. I only heard the Deputy President William Ruto make the announcement during Mashujaa Day celebrations at Bukhungu Stadium,” he said.

Oparanya said they do not know the value of the equipment, reason for leasing and who sought them.

Amidst the uncertainty, an additional 21 hospitals are now part of the Medical Equipment Scheme. Governors say they do not know where these facilities are and who made the requisition for the additional equipment.

“This is illegal. We are being deducted at source and it’s against the Public Finance Management (PFM) Act. Each county has been billed over Sh400 million for the last four years. It was an agreement at the Intergovernmental Budget and Economic Council but has far-reaching effects,” he noted. A governor from Mt Kenya said his county has never received any equipment yet the government has been deducting money since 2015.

Following these revelations, governors are now calling for an audit into how the Sh485 million that each county has so far been billed by the government was spent, despite the fact that some counties are yet to receive the equipment, while others received CT Scans and X-Ray machines which they have never used.

Devolved function

The 2010 Constitution clearly sets health as a devolved function and the one-million-dollar question is the involvement of Afya House that has abrogated itself the responsibility of the county governments.

Nyandarua Governor Francis Kimemia called for a forensic audit saying the matter should not be trivialised but true value for money be established.

Senators are already calling for a halt in the disbursement of funds towards the scheme until the investigation is concluded.

Majority Leader Kipchumba Murkomen (Elgeyo/Marakwet), who was directed by Deputy Speaker Kithure Kindiki (Tharaka/Nithi) to coordinate the probe alongside three chairmen of departmental committees -- Michael Mbito (Health), James Kinyua (devolution) and Samson Cherargei (Justice and Legal Affairs) -- said they will scrutinise ministry documents beginning tomorrow.

“Our decision will be based on the interest of the country. We will balance responsibility as we oversight the necessity on government’s duty to provide proper healthcare to citizens,” said Mr Murkomen.

The fate of the medical equipment scheme lies with the Senate, which will on Wednesday receive a preliminary report prepared by an ad-hoc committee formed to investigate the matter.

Mbito said that they will be looking for information on the project with the view of informing the nation about it.

Mr Cherargei said he will be looking at the contractual obligations between the suppliers, government and the counties over the matter.

Minority Whip Senator Mutula Kilonzo Jnr (Makueni) warned that if the ministry will not be forthcoming with the documents, they will not pass any other monetary allocation.

“We will also summon the contractors to explain the reasons for the variations which have exceeded the 25 per cent threshold under the PFM Act. The Treasury will have to explain the basis of turning a blind eye to the obvious and apparent violation of law,” Mutula said.

Council of Governors lawyer Peter Wanyama said that the issue ought to have been arrested in 2015.

“The Ministry of Health has not been transparent with the project. Governors were not furnished with the parent contracts to establish the true costs, leading to the current variations. The governors were only supplied with draft contracts and ordered to sign an MoU,” he said, adding that the contract costs remain a mystery.

“That is why we moved to court but the case was dismissed on a technicality not on merit. We were told it’s an intergovernmental relations dispute and not a case,” Wanyama said.

Afya HouseMinistry of HealthCorruption