MTRH on the spot for including Sh4.5 million expired medicine in stock records

The Moi Teaching and Referral Hospital (MTRH) is under scrutiny over audit queries for the financial year 2019/2020, which revealed that expired medicine worth Sh4.5 million had been included in the inventories.

The audit also raised concerns over irregular payment of interns, unauthorised extension of credit services, unsupported medical records and accountable documents, as well as anomalies in budgetary control and performance, among other issues.

The hospital management, led by Chief Executive Officer Dr Philip Kirwa, appeared before a parliamentary committee yesterday and faced tough questions over the queries involving millions of shillings.

Members of the National Assembly Public Investments Committee on Social Services, Administration and Agriculture (PIC-SSAA), led by Emmanuel Wangwe, criticised the management for what was described as an “oversight” in the unsigned stocktake report that contained the expired drugs.

“The main issue is that none of the officers signed. It was a unique situation. If even one or two officers had signed, there would at least have been some indication that the stocktake was legitimate. But none of the officers who took part signed the report,” said Wangwe.

However, MTRH maintained that the issue stemmed from a formatting error in the expiry dates, which incorrectly indicated that the drugs were expired when they were not.

But the committee Vice Chairperson, Caleb Amisi (Saboti MP), expressed concern about the seriousness of such a situation, insisting that anyone responsible for the error should be held accountable.

He criticised the explanation as inadequate, stating: “It is unfortunate for the management to call this an oversight—it doesn’t make sense. You’re running the risk of having given patients expired drugs, or at least under-declared their expiry dates. Listening to your explanation was shocking. This is a health institution, where every signature could mean the difference between life and death.”

He continued, “When did an audit query become an oversight? You make it sound like a simple error, when in fact an audit sets out how things are supposed to be done. Saying it was an oversight doesn’t add up.”

Nominated MP Jackson Kosgei added: “Regarding the alleged expired drugs, shouldn’t the leadership of the institution have declared that the drugs were not actually expired? Why wasn’t that included in the report? The way this has been presented seems too casual. If that explanation is not backed by laboratory tests or other concrete evidence, it leaves too many unanswered questions.”

According to the audit report, a review of the stocktake report provided in support of the inventory figures revealed that expired drugs valued at Sh4.5 million were included in the inventories.

Additionally, the stocktake report was not signed by the officers who participated in the exercise. The report also noted that the accuracy of the inventory balance of Sh356,222,655 as at 30 June 2020 could not be confirmed.

Although management admitted to what they described as a “serious oversight,” the CEO insisted that a thorough review of the records had established that the drugs listed as expired in the stock report were not actually expired as of the date of the stocktake.

“Stock values are therefore correct and not overstated. The stocktake report for one of the stores (Nyayo Pharmacy), which was not signed, was an oversight by the officers involved. Management has noted this omission and has put in place measures to ensure that all stocktake reports are fully signed in the future,” the CEO explained.

He added that the management has resolved the issue through stock reconciliations and regular stocktakes in the pharmacy stores and has carried out adequate sensitisation of officers on the need to sign stocktake reports.

He further stated that during the year under review, the Covid-19 pandemic had affected operations and some staff may not have been present to provide the necessary documentation, even though they were available.

Another issue raised was the irregular salary advances given to interns, which the committee described as contrary to human resource policy and unsupported by law, as the interns are on the Ministry of Health payroll and only seconded to hospitals.

According to the audit report, the net debtors of Sh1.3 billion as at 30 June 2020 included a salary advance balance of Sh4.2 million, of which Sh930,000 had been advanced to interns in the 2019/2020 financial year and the preceding year.

The auditors also noted that interns who had received salary advances had been contracted for less than 12 months, which contravenes the human resource policy.

Furthermore, of the total amount advanced, Sh890,000 had remained outstanding for more than 12 months, and management did not provide evidence of efforts to recover the funds as required by the policy.

“Therefore, the hospital might not recover the Sh930,000 advanced to interns. Consequently, the completeness, regularity, and recoverability of the salary advance of Sh4.2 million included in the net debtors of Sh1.3 billion could not be confirmed,” the audit report stated.

However, Dr Kirwa clarified the situation, saying the hospital receives medical doctor interns posted by the Ministry of Health and that the decision to advance salaries—approved by the board—was intended to support the interns, most of whom had just left university.

“It was essentially to support them so they could provide services. Due to delays in processing the payroll by the Ministry, the hospital offered recoverable salary advances to help them meet their living expenses,” Kirwa explained.

He added that while a few interns failed to follow the proper clearance procedures, the hospital has been pursuing them through their current employers, including the Ministry of Health and county governments, to recover the advances.

The committee directed the hospital management and the auditor to correct inconsistencies in the information presented during the session and to report back at a later date, to ensure clarity and accuracy in the final report to be tabled in the House.