News Desk Report
The management of the Korle-Bu Teaching Hospital (KATH) says, it has in the last 9 months being on a rescue mission to block the leakages in the system, leading to the loss of millions of Ghana Cedis from the state-run hospital; the largest health facility in the country, which has been saddled with massive corruption.
So far, there have been head counts, review of maintenance contract agreement, better revenue collection systems with the help of HFC Bank, restructuring of the procurement of medicines and consumables and appointment of new administrators to various department, all in an effort to stop the loss of revenue running into millions of Ghana Cedis.
A confidential report, prepared by the board led by businessman, Eddie Annan, revealed that a head count exercise that out of a Six hundred and Ninety (690) names of nurses, doctors and technicians, which were presented to the Government for payment in arrears amounting to GH¢11million, the number of Internally Generated Funds (IGF) reduced to 270 and reduced the total arrears to GH¢ 6.7million, after the Head Count.
“After the Head Count exercise, all names of former staff confirmed dead, retired and dismissed were immediately deleted”, adding “Korle Bu has paid GHC7.7 million to date (June 6, 2014) comprising the total of arrears and regular monthly salaries”.
On Contract review, “Korle Bu is under a maintenance contract agreement with Philips International and was paying Euro 350,000.00 every year. Machines were down – as high as 70% to 90%. Meanwhile, Korle Bu’s old MRI, CT Scan, Flouroscopic machines were working only 30%, on the average, yearly. Management took a decision not to renew that contract. This is because it was a total waste of resources”.
“Philips International is currently ready to offer new equipment, new maintenance agreement with suppliers’ credit for 5 years interest of 5% only using Korle Bu’s old machines as deposit. The new management has reviewed the contract with Moorfields Eye Centre which was going to cost the hospital huge sums of money”.
On Revenue Collection at Korle Bu, it said “Revenue collection at Korle Bu was substantially in the hands of individual staff. Billing was also largely at the discretion of the ward clerks and accountants”. But “New management brought in HFC Bank which introduced electronic means of billing and collection at all cash points. As a result, revenue collection jumped from GHC 350,000.00 on the average to GHC 2,000,000.00 per month”.
“To date, Korle Bu is collecting an average of GHC 4.4 million a month as a result of efficient collection and blockage of leakages”.
At the Korle Bu Stores Management, “a frightening percentage of procured consumables and medicines were being stolen by the handlers of these items. A situation where a requisition book from the ward requesting 5 boxes of an item is altered to read 15 boxes at the point of collection of the items, at the main stores. The extra 10 boxes are dropped somewhere between the main stores and the satellite stores at the departments”.
But “through perpetual vigilance and effective auditing of the main stores, satellite stores and the wards, the situation has improved. Also, through effective stock monitoring, declaring of artificial shortages have been drastically reduced”.
The Restructuring of the Main Revenue Centres of Korle Bu, the confidential report said, “Radiology, Laboratory and Pharmacy used to have chronic challenges of shortages of reagents and films, and patients were directed by our own doctors to go across the street for x-rays among others.
The new management, has reversed this trend hence “there is no shortage of films or consumables”, management has ring-fenced 30% of daily revenue generated into an escrow account, the 30% revenue is used only for replenishment of consumables and maintenance and “another 30% is being earmarked for equipment replacement and retooling of the department”.
For this reason, the “revenue has moved from negative to positive GH¢ 400,000.00 per month”.
“Radiology used to be officially managed in terms of revenue collection day time to 2pm in the afternoon. There was nobody officially designated to collect the revenue after 2pm in the afternoon till the following day. Today, the story is different. There are 6 personnel officially running on a shift system and generating bills. Currently, all revenue is collected by the HFC Bank, 24 hours around the clock.
That has contributed significantly to the total revenue collection of Korle Bu”.
In the Laboratory, “firstly, the new management inherited a department saddled with multiple challenges. There were issues of administration, governance and logistics”.
“There was a challenge as to whether or not the laboratory should be run as a business centre or research department and, for that matter, be headed by a Medical School personnel. Where the concentration was in one direction it led to the deprivation of the other”.
“The new management found a common ground to merge both the business element of the department and research and the teaching component of the department and, today, it is substantially resolved”.
“The second issue, which was the issue of logistics, has also been dramatically resolved. The department has a business plan and a procurement plan for a year, which enables management to make financial provision for their needs constantly”.
Additionally, “the doctors at the hospital are encouraged to use Korle Bu Laboratory in order to generate revenue for the hospital. That has again resulted in substantial improvement in the revenue generation of Korle Bu”.
The “Pharmacy has been the biggest challenge of the new management of Korle Bu. It was more or less an island of its own, defying almost all management directives. This year instead of submitting their procurement plan by December 2013, the plan was submitted to management as late as April 2014. As a result, Korle Bu’s operations were seriously affected by all repercussions of the foreign exchange fluctuation and the new foreign currency policy of Bank of Ghana”.
Suppliers who won tenders, decided not to supply, demanding 50%-100% increase in prices. They refused to supply even at an increase of 20% across board for all medicines. Management was compelled to purchase some of the urgent medication outside the procurement process.
Management decided to deal with the manufacturers directly for the supply of medicines. This, they were more than willing to supply.
The hospital was offered a special package which include; maintaining the old prices of 2013 with a further discount of between 25% – 40% irrespective of the volume; they are also going to give Korle Bu 6 months’ credit for all purchases; they are also fixing the exchange rate from the beginning of the contract and NOT subject to exchange rate fluctuations;they will supply all their items through their accredited agents and pay them fixed fees for clearing at the port and distribute to the premises of Korle Bu.
“The import and significance of this arrangement is that Korle Bu is going to make savings of 30% – 40%, an equivalent of about GHC 15 million, from medicines alone. If this is extended to all consumables and purchases at Korle Bu, Korle Bu is likely to make savings of about GHC 40 million”.
“This will go a long way to position Korle Bu in line with Government’s new policy of weaning Korle Bu off Government payroll”.
Other Notable Achievements are that some IGF staff, who were migrated onto the Government of Ghana (GoG) payroll were paid retrospectively, even though Korle Bu had already paid them through the IGF. After audit exposure, the beneficiaries were made to pay back all the monies collected illegally. This has created hatred for the new management.
“The Human Resource Directorate, has a staff strength of 22 of which 20 are in the ranks of managers, senior managers and above. Only two are junior officers. Of these two, one is a cleaner and the other a secretary. Management has directed the restructuring of all directorates, following the exit of the head of department on May 31, 2014”.
At the Accounts Directorate, there is a tall list of staff (majority of whom are accounts personnel) who have collected loans from the institution and have not paid a pesewa after 3 years of collection.
Management has directed the commencement of the payment of all loans collected by staff. In reaction to this, information about payment and expenditure document of management is now in the public domain as is being witnessed by all.
There is a clear intention, especially through the media, to sabotage the effort and continuity of this restructuring exercise.
The report said “the board took a decision that all Directors should be assessed on annual basis irrespective of the fact that they have a 4-year contract. Those who have finished serving their 4-year contract should not enjoy automatic renewal. They should face a Committee set by the Board, led by the Provost of the Medical School plus the Dean of the Medical School and the Dean of the Dental School”.
“Three (3) directors have gone through that exercise – The Director of Nursing and Director of General Services meritoriously passed. The Director of Human Resource unfortunately did not pass the acid test do the renewal of the 4-year contract. As a result, he is no more with the institution but has vowed to join ex-director in court with Korle Bu and has sent letters to all places indicating his intention to fight the new management”.
“The new management is also conducting an internal audit of all directorates i.e., Human Resource Department, Finance Department, Pharmacy Department etc. The Pharmacy Department has fought the Audit Unit every inch of the way including denying access to the software for the inventory. Management managed to prevail on them to grant access”.
“In a flash, the office of the Auditors was broken into on Sunday June 1, 2014, despite the presence of security. The matter is under investigation”.
“It is therefore not surprising that the current crises looming is being orchestrated by a group calling itself Senior Staff Association, whose President is a Pharmacist, championing the interest of the Director of Pharmacy and claiming that the new management is mismanaging the finances of Korle Bu”.
Meanwhile, “to date, the new management has been able to sustain the IGF payroll of over 900 staff, every IGF staff is now being paid Single Spine salary, a decision which could not be taken in the last 4 years as a result of financial challenges and all doctors, consultants, nurses and other workers on IGF at Korle Bu are being paid without obstruction”.
More so, the 485 workers, nurses and doctors who went on demonstration earlier in the year are being paid regularly every month while the arrears of the Nurses, Doctors and Technicians have been paid to the tune of GHC 7.7million, and Management has also placed all non-clinical IGF staff, who were on Ghana Civil Service Salary structure (GCSS), on Single Spine Structure (SSS). An amount of GHC 438,360.80 was used to pay their salaries”.
Furthermore, “the herculean challenges, the new management is undertaking some major infrastructural development from IGF without any burden to Government.
It announced management has set up a Clinical Audit and Governance Committee to audit the clinical operations of the hospital to improve patient care while the Internal Audit Unit has been strengthened by the hiring of qualified Auditors as “Korle Bu’s finances still remain seven digits to date. A data centre has been set up in the hospital”.
It revealed that “the new management inherited an amount of GHC 350,000.00. Now the hospital generates GHC 4.4million per month”.
With respect to ongoing Proposed Projects by Management in the last 9 months, it has directed the expansion of Reproductive Health Building, the completion of 15 SSNIT flats for staff, the building of a new Surgical Block, the renovation of the Chenard ward and Gynaecology OPD and the Procurement of 450 new hospital beds to ease congestion at the Emergency Department.
It is also to establish a Private Wing to increase revenue generation and patient care, expansion of Drug Manufacturing Unit, the Training of staff on software application as part of the E-Health Project, as part of staff welfare, management is working on a Mutual Health Insurance Scheme as top-up for NHIS.