Norton admits drug procurement change led to countrywide shortages

staff pressured to cancel bids, re-tender to accommodate favoured companies ― source

The explosive revelations about collusion in the drug procurement system are just the tip of the iceberg in an avalanche of corruption which thrives in the local health sector, former Public Health Minister, Dr George Norton disclosed.

dr-george-norton
Former Public Health Minister, Dr George Norton

“It is much, much more than we can ever imagine. I am going to say this, that report is probably the tip of the iceberg; you’ve got much more information to come,” Dr Norton revealed to Guyana Times during an exclusive interview at his new office within the Ministry of the Presidency.
Dr Norton, who was recently transferred from his post as Public Health Minister following an influx of negative publicity that erupted over the drug bond scandal, had requested an independent investigation be launched into the drug procurement process after he suspected mass malpractice within the process.
A Board of Inquiry (BoI), headed by retired Assistant Commissioner of Police, Winston Cosbert, was established and conducted a three-week probe into the system.
The report, which was leaked to the media ahead of Cabinet’s consideration, unearthed shocking instances of collusion between suppliers and Health Ministry staffers.
The report also recommended that a senior Health Ministry official be fired for his role in these malpractices.

Missing drugs
Dr Norton, during his 18 months at the Public Health Ministry, noticed instances where drugs which were ordered could not have been found, and only upon inquiry, did staffers inform him about the situation.
“When medical supplies left the central bond, there was no correspondence to say that this amount left and this amount was delivered. The other thing is when you were told you were expecting so much medication, only after you found that the medication is short, then you are told that all did not come,” the Minister explained, reflecting on one instance when he summoned staff to his office and demanded an explanation for the confusion within the system.
Dr Norton strongly believes that information was being deliberately withheld from him.

Credibility
Another issue plaguing the drug procurement process is the absence of verification procedures on the credibility of the suppliers of drugs to the Public Health Ministry.
This deficiency resulted in the situation whereby the Ministry was procuring drugs from a blacklisted Trinidadian pharmaceutical firm called Western Scientific.
“I tried to find some information about a particular company known as Western Scientific, and I defended this company because I needed their drug as urgent as possible because we were having a shortage, only to find out that this company was blacklisted by IDB [Inter-American Development Bank] because of so many corrupt practices,” Dr Norton recalled.
The BoI discovered that a female employee of the Ministry admitted during her testimony that she had in fact spoken to a bidder from the Trinidadian company, which was soliciting inside information.
The BoI also found that an accountant attached to the Ministry’s Materials Management Unit approached a senior staff at the Ministry with proof that the same female employee was giving insider information to a bidder, but he failed to act on it.
As such, the report noted that the senior official was “wilfully evasive and deceptive” during his testimony.

False certifications
Furthermore, the Minister explained that when the procurement process became open to competitive bidding, the influx of bidders made it challenging to do background checks on every bidder even though they met the criteria.
“You asking me to go to each one of these companies that are bidding in spite of the fact that they reach all the criteria there; I don’t know their background, I only worked 18 months there…It is really asking quite a lot for me to swear about the integrity of every company,” he stated.
Dr Norton added, “And I am not making excuses: I am telling persons what is actually on the ground. I am not begging for sympathy; I am saying it as it is.”
He noted too that some companies would submit the required documents, but only later it would be discovered that the paperwork was fraudulent.
“In order for you to supply certain things like reagent, you need a certificate of authorisation from manufacturing company. Information was provided that some of these letters of certification were false,” the Minister disclosed.
He noted that the Ministry needed to do in-depth research into each bidder to ensure they were above board, an undertaking which would require much work that could not have been sorted out in 18 months.

Change
The Minister conceded that the change in the drug procurement system also made the process quite challenging, resulting in countrywide shortages and opening avenues for malpractices to occur.
But he maintained that the change was needed since it was unfair to continue along the lines of sole sourcing.
“You are changing a system with the same persons involved, with short staff and persons who are simply not qualified, with the infrastructure not in place, you will run into difficulties…I want the nation to know that that CoI was asked for by me, because you were given information, to be told that you have everything under control – only to find yourself on the limb again,” he stated.
He explained too that with the new system (whereby the Regions submit the list of drugs they want to purchase and the monies budgeted for the Regions are sent to the Ministry for bulk purchases in order to benefit from economies of scale) created many shortcomings.

“It’s the change that caused the difficulties,” the Minister admitted.
Nonetheless, he was adamant that the change in the system was needed and with adequate and competent staff, the process could be strengthened to work for the public’s benefit.

Sole sourced
Meanwhile, a source closed to the Public Health Ministry has confirmed that the ministry is engaged in sole sourcing more than ever before. For example, soon after the 2015 elections, the Ministry sole sourced $300 million in drugs from the International Dispensary Association (IDA) and paid 100 per cent in advance. Then, aside from Western Scientific, there is a second Trinidadian favoured company that gets all the contracts for kidney dialysis for millions of US dollars by bypassing tender procedures. As the BoI also revealed, a favoured new company was caught actively faking important documentation on the road to securing yet another sole-sourced contract for nearly $100 million in critical HIV diagnostic products. Most, if not all, of these items, circumvent the Food and Drug Department’s registration guidelines and so there is no system of quality checks to protect the citizens of Guyana.

Retenders
Another source at the Georgetown Public Hospital Corporation (GPHC) has revealed to this publication that despite experiencing pressing and critical shortages of drugs and medicines, the Ministry and hospital were often pressured to cancel bids and re-tender them so as to facilitate favoured companies. Valuable time and financial resources are squandered in this manner, not to mention it is unfair to legitimate bidders.
In other instances, the closing dates for tenders are extended to accommodate the preferred bidder(s).

Prequalification system
As the Minister now tragically admits, it was the change in the drug procurement system, which led to countrywide shortages. Prior to May 2015, the then Government operated a prequalification system which shortlisted companies on the basis of: (a) quality control procedures; (b) financial capacity; (c) infrastructural (as in warehousing) capacity; and (d) human resource skills to supply essential drugs and medicines. The prequalification system was designed under World Health Organisation (WHO) guidelines and proved effective against the same problems to which the Minister now alludes above. At the minimum, there can be no doubt that the prequalification system ensured that critical medicines were consistently available in the requisite quality and quantity. (Devina Samaroo)