Editorial | UHWI procurement: recovery or funeral?

Over the last 30 years, scandals and controversies relating to governance and accountability have become normalised in Jamaica. Over that period the rate of economic growth has averaged less than one per cent per annum. The two phenomena are not unrelated. So, in many respects, is the quality of healthcare received by Jamaicans.

Jamaicans tend to think of healthcare in human terms: doctors, nurses, waiting rooms, hospital beds, and the dreaded phrase “no supplies”. But a big story behind shortages in the healthcare sector is the issue of procurement. If the process fails, treatment fails, no matter how skilled, or dedicated, the medical staff.

That is why the Auditor General’s recent performance audit on procurement at the University Hospital of the West Indies (UHWI) should not be read as just another public-sector controversy.

It should be treated as a serious national warning – the fiscal body is suffering internal bleeding, and the blood loss is being measured not only in dollars but in delays, dysfunction, and degraded trust.

The audit points to deficiencies in planning, weak documentation, poor transparency in e-procurement, and troubling practices such as procurement being conducted after goods and services were already delivered. There are also findings related to the misuse of UHWI’s tax exemption status, leading to losses to the public purse.

None of this is a minor bureaucratic sin. It is systemic governance failure in one of the most sensitive sectors of the state, which puts lives at risk.

CHAIN REACTIONS

Systemic failures are not fixed with outrage alone. And procurement failures oughtn’t to be seen as single acts of wrongdoing, but as chain reactions involving bad actors, weaknesses in technology, ineffective governance, and above all, a diminution of trust.

Procurement breakdowns always begin when decision-making power expands beyond accountability. If contracts can proceed without complete files and proper approvals, the organisation stops being a rules-based institution and becomes a personality-based one, dependent on who is in the room and what they feel like doing. That is a recipe for waste and elite capture.

The board of the UHWI has a major role to play in rescuing the ugly situation. The first solution is not fancy. It is about discipline.

No procurement should pass without a complete and verifiable paper trail. Every contract must have a full file – requisition, bidding documents, evaluation report, approvals, contract and delivery evidence. Where nab of these is missing payments should be frozen until the problem is rectified and responsibility assigned. Procurement needs chain-of-custody certification, similar to what is required of the police in the handling of evidence.

Next is technology. Jamaica already has an answer here – the The Government of. Jamaica Electronic Procurement System (GOJEP). But the audit suggests a serious gap between UHWI’s procurement activity and the publishing of those activities on GOJEP. That gap is not harmless; it is an opacity machine. Transparency is not a public relations exercise. It is a vital control mechanism.

The Board and the Ministry of Health and Wellness must ensure that GOJEP becomes the procurement system, not the procurement option.

A simple rule can change behaviour overnight: if the procurement is not on GOJEP (where required), then it is invalid. That single discipline would reduce discretion, widen competition, and make it far harder to hide irregularities behind institutional smoke.

A hospital may be a clinical institution, but it is also a public body that depends heavily on taxpayer funding. When annual reports and audited financial statements are not produced for multiple years, oversight collapses because no one can see what is going on in a structured way. It is like trying to treat a patient without lab results.

ENFORCERS

The Ministries of Finance, and Health and Wellness must therefore shift from being only funding bodies to also being enforcers. Subventions should be linked to compliance with governance reporting and procurement standards. This is part of good stewardship.

The state and taxpayers cannot keep paying for a system whose accountability organs are missing.

An important economic truth is that value-for-money comes from competition, planning, and disciplined contract management. Where planning is weak, urgency becomes a permanent excuse, and direct contracting becomes normalised. When this happens, prices rise and supplier capture expands. This is how markets work when the buyer is disorganised.

The management of UHWI must be required to produce an annual procurement plan with timelines and procurement methods, approved by the board and reviewed quarterly. Direct contracting should become the exception again, with every exceptional award justified in writing and audited. If benchmarking is added for common equipment and works, procurement becomes a disciplined market, not a private arrangement.

On a broader level, it must be appreciated that procurement compliance and management doesn’t happen in an absence of capability. As The Gleaner has posited in the past, the public sector needs more and better professional procurement officers, especially in the health sector.

That means training, certification, and systems that can survive changes in leadership. Jamaica must build procurement institutions with competence and high standards.

When citizens see procurement irregularities in health, they suspect more than inefficiency. They lose trust. Often, this is more expensive than any hospital contract.

In the end, UHWI’s audit should be treated as a turning point. The procurement breakdown wastes time and resources, which may be the difference between a patient’s recovery or funeral.