By Kebba AF Touray
The National Audit Office (NAO), in an Audit Report, revealed that there was a fraudulent suppression of revenue at Gambia’s main referral hospital (EFSH), totalling One Million Five Hundred and Eleven Thousand Four Hundred and Forty-Four Dalasi and Forty-Two Bututs (D1,511,444.42).
The NAO reported this suspected suppression in a report of its special audit on the facility for the period 1 January 2021 to 30 April 2024.
Suspected fraudulent Suppression of Revenue: According to the NAO, during the audit exercise, they extracted the total worth of the number of ticket books that were allocated to the Edward Francis Small teaching hospital by the drug revolving fund from the period 1st January, 2021 to 31st December, 2023.
NAO reported that, according to the ticket books allocated by DRF, the hospital was expected to collect revenues worth up to D41,925,000 during this period
In their finding, the NAO however stated that review of Revenue analysis forms and bank deposits relating to DRF revenues collected from the period 1st January, 2021 to 31st December, 2023, revealed that the actual revenues collected from DRF tickets was worth D40,413,555.58 “resulting to a suspected fraudulent suppression of revenues worth up to D1,511,444.42.”
Implication, as indicated by the audit office, is an indication of misappropriation of funds, as the amount of DRF revenues deposited into the bank is less than the total amount of revenues expected to be received as per DRF allocations.
The NAO recommended that “management should ensure that they investigate this matter and hold the Finance Director responsible at the time accountable for these suppressed revenues.”
Non-Traceable Supply to EFSTH from CMS:
In this respect, the audit office reported that review of the EFSTH stock records shows the Central Medical Store (CMS) supplied the medical items.
“However, we were unable to trace these items to either the pharmacy or the surgical stores based on receipts from the CMS. The implication is that the missing receipts might indicate that there is a problem in record-keeping or stock management, and this might lead to potential theft or misplacement of stock,” said NAO.
The NAO buttressed that these are essential medical items, “if they are missing, it could impact patient care or operational efficiency,” and thus recommended that management investigate the missing supplies and take corrective actions to address the potential risk of fraud.
Failure to Implement Robust Control Program for Waste within the Hospital: The site inspections, NAO continued, revealed a leakage of waste within the hospital environment, and this indicates that EFSTH does not have robust controls in place for waste management.
“This implies that the absence of a robust waste management control system can lead to several significant health and environmental risks, including risks to the patients and staff, ranging from infections and contaminations and the risk to the environment,” said the Audit Office.
The office also recommended that the management ensure that there is proper implementation of the waste management control system to mitigate the risk to both patients and the environment.
The Management of EFSTH, in their responses, said that the unused ticket amounts to D205,175.00, and it has been accounted for, noting “the missing tickets that have been accounted for are up to 490,000, and the unaccounted tickets will be recovered from the Director of Finance.”
Management, on non-traceable supplies, said that it has provided the tally receipt cards for the sub pharmacy, and “management will take corrective action to strengthen the process.”
On a robust control program for waste management, the management stated that there is ongoing general renovation that includes the covering of all the gutters in the hospital.
“The Ministry of Health has a waste management guideline that is being utilised for such guidance. There is also an infection control guideline in EFSTH. Waste management segregation is about to be commenced in EFSTH,” the management added.
