THE HEALTH | MARCH-APRIL , 2023

BY KHIRTINI K KUMARAN

The Report , released on Feb 16 , 2023 , revealed shortcomings in financial management , defective ventilators , expired vaccines , storage for medical equipment , excess personal protective equipment ( PPE ), lack of staff , surplus of medical equipment , insufficient oxygen supply , issues surrounding the MySejahtera application and even short-comings in providing ambulance services .

But particularly disturbing was the supply of defective ventilators by a vendor to the government . A total of 136 ventilator units was initially supplied by Pharmaniaga Logistics to the Ministry of Health ( MoH ) facilities with a procurement cost of RM24.07 million .

Of the total 136 ventilator units supplied , only 28 ( 20.5 per cent ) ventilator units could be used . Alarmingly , the remaining 108 ventilator units were unsuitable and unsafe for patients .

Of the unusable 108 ventilators , only 15 were returned to the manufacturer for replacement . Meanwhile , 93 of the ventilators did not meet the technical specification test and the performance and quantitative test , resulting in an estimated loss of RM13.07 million .

What ’ s worse , there were no records of the contract for the purchase of ventilators between Pharmaniaga Logistics and the MoH . Because the procurement was based on the company ’ s commitment to corporate social responsibility ( CSR ), the government was unable to claim the losses caused by the defective ventilators .

Due to a lack of supporting documentation , the audit could not confirm Pharmaniaga Logistics ’ precise roles and responsibilities in its interactions with the ventilator manufacturers .

In a statement , the Centre to Combat Corruption and Cronyism ( C4 Center ) said : “ The lack of transparency presents a high conflict of interest risk whereby politicians would be able to offer tenders to companies that they have a financial stake in .

“ Pharmaniaga Logistics ’ parent company , Pharmaniaga Bhd ,

Auditor-General ' s 2021 Report ( Series 2 ) highlights

Covid-19 Management

• Financial performance is at a level of 46.5 per cent to 100 per cent and is in line with the implementation of activities .

• The acquisition of 93 units of ventilators cannot be used

• A total of 1.10 million doses of excess vaccine had expired

• Inadequate health workers in ETD and ICU during pandemic ranged from 19.9 per cent to 95.3 per cent

• Medical equipment has no place to store post-Covid-19

• A significant surplus of PPE equipment with a low usage percentage

MySejahtera Application Management

• 1.12 million MySejahtera application break-ins

• A Super Admin account downloaded three million Mysejahtera application information using various IPs

• Uncontrolled possession of MySJ ID risks the uncontrolled use of vaccination certificates .

• Administration account management of the application is not carried out in accordance with the current regulations in force which are at risk of being misused

Management of Ambulance Services

• Failed to achieve KPI of arriving at the location in less than 15 minutes

• Ambulance distribution does not follow the trend of emergency cases received .

• The supply of ambulances under the emergency provision is 10 months later than the date of supply

• Shortage of healthcare personnel for ambulance services was itself chosen to procure the Sinovac vaccines through direct negotiation . Without a contract , the government is also unable to hold any entity liable or to account for the failure to procure and deliver potentially life-saving medical equipment at the height of a global pandemic .”

Malaysia entered the Covid-19 endemic phase on Apr 1 , 2022 following the effectiveness of public health prevention and control measures , including the Covid-19 vaccination programme in managing the transmission of Covid-19 infections in the country .

However , Covid-19 management achieved the goals of the Disaster Management Plan and National Covid-19 Immunisation Programme ( PICK ), according to the Report . It included an assessment of the performance and management of the outbreak activities from 2020 to April 2022 .

Ex-Transparency International Malaysia President Tan Sri Ramon Navaratnam suggested that the A-G come up with quarterly reports so the

Tan Sri Ramon Navaratnam rakyat can monitor the progress of the various ministries .

“ The private sector , for example , comes up with quarterly reports of their accounts . It is a good way for shareholders to monitor and keep abreast of what ’ s happening before it ’ s too late .

“ The new government must also take seriously the findings of the A-G ’ s Report , unlike past governments . Ministers should be made accountable to the people and not be busy politicking .

“ Set KPIs and deadlines to address and rectify the errors and suggestions made by the A-G ; otherwise , action must be taken ,” said Navaratnam , who was also former Deputy Secretary-General of the Finance Ministry .

THE PANDEMIC FINANCIAL MANAGEMENT

The ceiling allocation for implementing the Covid-19 outbreak management programme consists of RM10.691 billion for the Ministry of Health ( MoH ) and RM910 million for the Ministry of Science , Technology and Innovation ( MOSTI ).

Let us look at the significant deficiencies in the government ’ s financial and procurement management relating to the pandemic .

• National Covid-19 Immunisation Programme ( PICK ).

Under the PICK programme , for 2020 until April 2022 , the MoH had an approved allocation of RM5.742 billion of which it used RM4.502 billion .

Meanwhile , MOSTI had been allocated RM910 million for 2020 until October 2021 , but its total expenditure came to RM581.95