Filenews 21 March 2022
An incinerator of Nicosia General Hospital, for the incineration of clinical waste, which cost taxpayers €1,700,000, was sold "new" to a private individual for an amount of €81,991.
The above is one of the most important findings recorded in a Special Report of the Audit Office, entitled "Audit of the Ministry of Health".
In particular, the most important findings of the audit are the following:
- Weaknesses were observed regarding the procedures for the granting of state aid to various bodies, such as the payment of sponsorship to bodies that received support from other Ministries, the payment of sponsorship, even though the Agencies had unused deposits and the granting of sponsorship exceptionally, without adequate evaluation.
- Regarding the payment of a state grant to the Bank of Cyprus Oncology Centre (CBC) (€15,000,000 in 2020), we found that no action plan was prepared for the compliance of the CBC with the required good governance procedures, in accordance with the relevant circular of the Treasury, while the bank balances of the Centre were not taken into account before the payment of the grant.
- Regarding the purchase of services by the Cyprus Institute of Neurology and Genetics (ING), we noticed that there is no control over the prices charged for services, while we indicated once again the need to update the relevant agreement between YY and ING.
- We observed that, in one case of purchase of radiotherapy services, the HR paid the relevant compensation to a legal person other than the contractor of the contract.
- We found weaknesses in the pre-payment check carried out on the invoices of Germany's National Health Service for the provision of health care for subsidised patients. In addition, a case of sending a patient to Germany was identified, which, it transpired, was not a beneficiary, while the required approval of the expenditure by the Ministers of Health and Finance (Article 15 of the Financial Assistance Scheme for health services not offered in the public sector) was obtained with a long delay.
- We noticed again that the HS has not defined a procedure to obtain evidence for the stents charged by private hospitals for operations performed on subsidized patients.
- While the trial of a case was pending, for the purpose of establishing the possibility of disciplinary misconduct by an Officer of the Medical and Public Health Services, he was promoted to a higher position.
- Since August 2020, the HSO has been recovering from the HIO the cost of purchasing medicines related to the 2nd phase of the GHS, but without recovering the administrative cost. It also financed the purchase of specific HIO drugs for the period until 31.8.2020, in violation of the relevant legislation.
- The subsidy of patients, for treatment in the private sector, is made from the Budget of the Ministry, in violation of the General Health System Law. We suggested that the sending of patients to the private sector should be regulated through Regulations and that the costs should be recovered from the HIO.
- Weaknesses were identified in the Accounting Department of the Ministry, regarding the reconciliation of Funds at the end of each month, the keeping of all the necessary supporting data in the Envelopes, the offsetting of credit and debit balances, the timely payment of invoices, etc.
- In 2004, an incinerator was purchased for Nicosia General Hospital for the incineration of clinical waste, for a total cost of €1,700,000, which could not be operated for the purpose for which it was purchased, resulting in it being sold in 2019 to a private individual, through a public auction, for an amount of €81,991.
- The termination of the license agreements for the use of the canteens in the Public Hospitals resulted - until the day of the audit - debts of the Contractors to the state amounting to approximately € 8.2 million. Indicative are the cases of the canteens of Nicosia General Hospital and NAM III, which, although they were terminated in 2015 and 2017, respectively and are handled by the Legal Service of the Republic, their total debts amount to approximately €6.75 million, without having been able to recover either the amounts due or the premises.
- In 2015, it was decided to install a new Integrated Health Information System in public hospitals and in the same year specifications and open tender documents were prepared by experts secured by the World Health Organization. Almost seven years later and after various amendments were made to the tender documents, the estimated cost and the timetable for its implementation, the project has not yet even been awarded, despite the fact that the CySEC considers it as a project of the utmost importance, which will help in the qualitative upgrading of its services and the rational management of its resources.
- From the investigation of a complaint lodged with our Office, concerning a tender by the GOP for the procurement of materials through the negotiation process, on the basis of urgency, we found that the GOP requested a bid from only one economic operator, while this procedure allows other economic operators to be invited to submit a bid.
- The Ministry of Health, on the basis of a "Project Fitch" study, considered that the use of the office automation system (eOASIS) was the most advantageous for the archiving of patients' electronic files, with an estimated cost of €954,300, compared to the selection of a new system, through an open tender, of an estimated cost of €1,015,600. Our Service expressed its reservations as to whether the reasons for the use and suitability of the eOASIS system were adequately documented and whether the choice of an open tender for new software would be a more advantageous option and, finally, due to the fact that it was not technically possible to use eOASIS for the above purpose, it was secured, through an open tender by the Department of It Services, new software worth €48,400+VAT.
- The Ministry of Health launched a tender for the purchase of medical services by the private sector, for the conduct of an Interventional Retrograde Of Cholangiopancreatography (ERCP), which it cancelled after the submission and evaluation of the tenders, after it was found that these services could be offered by the Nicosia General Hospital.
Internal control system
"In order to address the weaknesses identified, a reliable internal control system should be put in place to ensure that the relevant regulations and procedures are complied with, as well as that our Agency's recommendations are followed and implemented, in the context of the principles of good administration," EY said in its general recommendations.
