Dear Editor,

When a critical machine at a public hospital is out of service because one replacement part has not been procured, who should the public hold accountable? Too often, the immediate reaction is to blame the minister, the Government, or a lack of funding.

But what happens when the money is available, the need has been identified, the paperwork exists, and the procurement process simply does not move with the urgency required? This is a question that needs to be asked at the University Hospital of the West Indies (UHWI) and indeed across Jamaica’s public sector.

Procurement is not merely an administrative function.

In a hospital, procurement can be the difference between a functioning diagnostic machine and one sitting idle; between a patient receiving timely care and waiting weeks or months; and between taxpayers receiving value for money and watching public resources go to waste.

If a machine is down and requires a replacement part, why should it take an unreasonable length of time to purchase that part? If equipment has been approved for acquisition, why should files sit on desks while patients and medical teams suffer the consequences? And if procurement meetings are being scheduled for next week to make decisions that could have been advanced weeks ago, we need to ask a more uncomfortable question: Is the problem Jamaica’s procurement system or the competence, urgency, and accountability of some of the people administering it? There is a tendency to say, “Government procurement takes time,” as though that should end the discussion.

It should not.

Due process is essential, transparency is essential, proper documentation and accountability for public expenditure are essential, but none of those things should become an excuse for paralysis.

A procurement system can be compliant and still be inefficient.

When administrators fail to move paperwork, follow up with suppliers, obtain quotations, escalate urgent matters, convene decision-makers promptly, or anticipate the replacement needs of essential equipment, the consequences are not abstract.

Doctors cannot do their jobs efficiently, patients wait, services deteriorate, equipment remains unusable, and taxpayers ultimately pay more.

This problem also helps explain why bodies such as National Reconstruction and Resilience Authority (NARRA) have emerged.

There is clearly a recognition that Jamaica needs greater efficiency, competence, and accountability in the management of public resources and assets.

But creating another authority will not, by itself, solve the underlying problem.

We must confront the culture that allows files to sit, deadlines to drift, and urgent procurement matters to be treated like routine paperwork.

Public-sector procurement officers and administrators should have measurable timelines, there should be clear escalation procedures for critical medical equipment, there should be consequences when avoidable administrative delays disrupt essential services, and the public should be able to distinguish between a genuine funding problem and an internal management failure.

University Hospital of the West Indies (UHWI) is one of Jamaica’s most important health institutions.

Its doctors, nurses, and other health-care professionals cannot provide world-class care if the administrative machinery supporting them moves at a fraction of the speed required.

So when the next hospital machine goes down, before we automatically ask: Why hasn’t the Government bought a new one? perhaps we should also ask: Was the money available? When was the request submitted? Who received it? How long did it sit? What action was taken? And who was accountable for ensuring the procurement was completed? Those answers may tell Jamaicans far more about the problems in our health-care system than another political argument ever will.

Procurement delays in health care are not simply paperwork problems, they become patient- care problems.

And that is why accountability cannot wait.

James Edwin

New Kingston, St Andrew