The Ministry of Health faced tough questioning and criticism during Tuesday’s Appropriations Committee hearing at Nitijela. Chairman Senator David Paul, Finance Minister Brenson Wase, Resources and Development Minister Alfred Alfred, Jr., Senator Mike Kabua and other members of the panel asked numerous questions about lack of services being offered at Majuro and Ebeye hospitals and accountability problems at the ministry seeking answers from a panel of top health officials, led by Minister Kalani Kaneko and Interim Health Secretary Dr. Kennar Briand. This year’s health budget is pegged at over $33 million, about 16 percent of the national budget.
Minister Kaneko and Assistant Secretary Mailynn Konelios-Lang highlighted plans to use a significant level of funds in FY2017 to purchase new diagnostic equipment and hire specialist doctors. Paul, citing the hyperbaric chamber that was opened in 2010 and soon after broke down and was shut for years before reopening recently, said bluntly: “It’s a waste of money to bring equipment in, it works for a year and then breaks. Do we actually have trained people to operate and maintain (the equipment to be purchased)?”
Asked by Senator Dennis Momotaro about hiring doctors, Dr. Briand said it is difficult to get doctors to work in RMI because RMI’s funding package is not attractive compared to Palau starts doctors at $70,000, whereas RMI offers $40,000.
Ministry officials said they wanted to have an agreement with the Public Service Commission to allow Health to take sole responsibility of hiring doctors. They said, too, that consultants are to train hospital human resources staff to be at the same level as PSC.
When Paul asked if the hospital has a Quality Assurance Department, Briand said there used to be a Quality Assurance department but it is vacant.
“I recommend you start one immediately,” said Paul.
Paul said every year for the past 11 years, the ministry has violated the RMI procurement law with its medical supplies and medicine orders. “What’s the point in Nitijela passing laws if they’re not followed?” he said. Audits have shown the hospital repeatedly used “emergency” to avoid bidding and other requirements for orders.
Konelios-Lang described challenges of the government’s slow-moving purchasing process. “In the end, it’s always about patients,” she said. “We don’t want to jeopardize their health.” To ensure adequate supplies, the hospital is now trying three-month bulk orders of supplies, she said.
Kaneko talked about the need to go around time consuming requirements to purchase needed medical supplies when a health outbreak hits Majuro.
But Finance Minister Wase told health officials, “there is no excuse for emergency purchases when the budget is approved and funding is available on a quarterly basis.” Wase added that the audit findings (problems) of the ministry “were not related to outbreaks.”
Read more about this in the September 23, 2016 edition of the Marshall Islands Journal.