Administrators of the University Hospital of the West Indies (UHWI) could have avoided more than half of its revenue losses if proper procurement and financial rules had been followed.

That is one of the major findings of an Institutional Review Committee, led by veteran attorney-at-law Howard Mitchell, appointed by Minister of Health and Wellness Dr Christopher Tufton to examine operational weaknesses highlighted in a recent auditor general report on the hospital.

Mitchell’s team has painted a troubling picture of how years of weak financial controls, poor inventory management, inefficient procurement systems, and governance failures not only crippled the hospital financially, but also directly affected patient care and daily operations at Jamaica’s premier medical teaching hospital.

Speaking during a press conference on Tuesday, where the committee’s findings were revealed, Mitchell said many of the UHWI’s financial problems were not the result of underfunding, but stemmed from repeated failures to follow basic governance and operational procedures.

“I’m speaking personally… but from my experience and my involvement with government functions and functionaries, if they followed the procurement rules, if they followed the financial reporting rules, if they followed standard practises, good standard practises of inventory management, certainly more than 50 per cent of the revenue loss would have been covered,” said Mitchell.

“That’s my estimation, because part of the reason why they don’t get their budget the way they want to get it is because they don’t have the reporting. So how are you going to keep giving somebody money if you don’t know what to do with the money?” added Mitchell.

He underscored that the breakdown in systems and accountability at UHWI had practical consequences for ordinary Jamaicans relying on the hospital for care.

“A good part of the reason why the hospital cannot function effectively is because sometimes they don’t have the medications, the bandages, because of poor inventory control, and the procurement of goods and services has been murky, to say the least,” said Mitchell.

He explained that weak inventory systems and poor oversight could create situations in which critical medical supplies are unavailable when needed, despite money being spent.

“If you do not have processes that deal with inventory control, with the control of your drugs, your medication, your plasters, your bandages and it is a free for all and you have no system of recording who gets what, you will end up with a situation where one day you go to the storeroom and there is no bandage, there are no pills. You will end up with parties external to the hospital having medical inventory better than the hospital which belongs to the hospital,” he said.

Mitchell’s committee also linked procurement failures to reduced patient care as it pointed out that overspending and weak compliance drained money away from health-care delivery.

“Similarly, with things that have to do with procurement, we have encountered situations in the hospital where, because procurement rules weren’t followed and a simple thing like three bids or offers being taken, you ended up paying three times the value of equipment. That impacts on your patient care and your patient delivery, because if you are going to spend money on this microphone that is more than a microphone is worth, you are not going to be able to spend it on the human life that you are empowered to take care of,” he added.

The committee also pointed to the hospital’s massive tax burden as another major threat to its long-term stability, noting that UHWI continues to grapple with approximately $40 billion in taxes, penalties, and interest while accumulating an estimated $300 million in additional liabilities each month.

Mitchell argued that the situation was unsustainable and warned that even if penalties and interest were reduced or waived, the hospital would still face billions of dollars in obligations.

He further warned that years of weak governance, poor financial controls, and operational failures had pushed UHWI into a critical state, with urgent intervention now needed to prevent further decline.

“As a consequence, the University Hospital is in critical state. It, itself, is in the ICU,” Mitchell said as he underscored the severity of the hospital’s financial and operational crisis.

But the health minister sought to place some of the hospital’s financial crisis in context as he argued that the institution’s role as Jamaica’s leading referral and teaching hospital often forced it to absorb costs that could not easily be recovered.

“The gaps between revenues and expenditure or cost is an ongoing gap, and I do agree that part of that lies within the inefficiencies of management, which is why we’re trying to correct some of those issues, but part of it lies also in the mandate of the institution, in terms of collections, in terms of serving clients that are either not able to afford,” Tufton said.

Tufton admitted that the Government sometimes contributed to the hospital’s growing receivables problem by sending patients for treatment without guaranteed payment arrangements.

“Every week I send people to the University Hospital and, to be totally frank, I am probably part of the cause of some of the delinquency, because the people that I send there for lifesaving treatment, if the ministry don’t pay, there’s no way that they’re going to pay. But lives are at stake, and I cannot, with good intentions and with conviction, tell people that they can’t go to the premier institution if they have an issue that requires a consultant that is not existing elsewhere,” added Tufton.

An aeriel view of University Hospital of the West Indies which is at the centre of a damaging auditor generals report on operations.