Former Health Minister Gilbert McLean responded to criticisms concerning the state of the finances and accounting records of Health Services Authority by saying they have been in state of disarray for more than a decade.
Current Health Minister Anthony Eden has stated to the press that the absence of financial records at the HSA was unbelievable and that he had asked the Attorney General to look into the matter.
Mr. McLean agreed that the finances were a mess and said Mr Eden should have been fully aware of the situation, since the problem existed going back to when Mr. Eden served as Health Minister for seven years between 1994 and 2000.
‘Anthony has been the longest serving health minister and he’s talking about the mess left by the last government?
‘The problem has always been the administration and finances,’ he said. ‘Government has always poured money into health services.
‘There were never any proper accounting processes.’
Mr. McLean confirmed he had read a memo dated 31 October, 2002 from former Auditor General Nigel Esdaile that accompanied the report on the review of the HSA general computer controls and accounts receive controls.
‘I have been auditing and reporting on health services, particularly revenues, for almost a decade,’ Mr. Esdaile wrote. ‘During this period, I estimate the government’s revenue loss from the provision of health care to be in the region of $70 to $100 million.
‘In my opinion, revenue mismanagement and lost opportunities have undermined the very viability of our health services.’
Mr. Esdaile pointed out several problem points.
‘System weaknesses are only part of a larger overall problem; unbilled services, services provided and nominal or no cost, poor revenue management, inadequate revenue collection, ineffective debt collection, etc.
‘Had this been a business, we would have filed for bankruptcy long ago.’
Mr. Esdaile went on to state there was no simple answer to why the country had lost so much money on health care.
‘During this period, what struck me most was the almost complete absence of any collective will to improve the situation, combined with an ineffective accountability regime.’
Mr. McLean said he tried his best to get the HSA financial records current when he took over as Health Minister, and even engaged KPMG to do an audit of the HSA.
‘After doing initial investigations, (KPMG) said they could do the audit, but to try to go back into the disaster of records in order to do it in a way they could sign off on it, they said it would cost more than we could afford.’
Mr. McLean said the HSA then pieced together the financial records as best as they could.
‘But there was always lingering questions from members of the board about whether we were starting at the true beginning,’ he said.
Mr. McLean pointed out that he was the first minister to let the public know about the dismal state of the health services’ finances, telling the Chamber of Commerce that it was $50 million in debt.
He also told the public that most of the HSA’s accounts receivables had to be written off as bad debts.
During his tenure, Mr. McLean said he had two professional economists look at the financial systems that had been put in place.
‘They said they found it functioned in a sound manner and gave favourable comments on it,’ he said.
Deputy Financial Secretary and HSA board member Peter Gough confirmed on Friday that the HSA did in fact leave financial records.
‘Yes, they had financial records,’ he said. ‘But they didn’t have a comprehensive system that could generate proper financial statements.’
Mr. Gough noted that the HSA had implemented some good new systems like Cerner that were still not operating in the seamless way they should.
‘These sorts of problems don’t get solved over night,’ he said.
What was important, Mr. Gough said, was that the HSA had developed a plan to move forward.
‘We’re setting up the building blocks,’ he said. ‘I’m confident that we’ll get a good system in place.
Mr. Gough said the goal is to get the HSA to be self-sustaining by 2008.
‘What we need now more than anything is some support.’
Mr. McLean said all of the criticisms being made by the current government about the HSA finances are missing the most important point.
‘I believe our hospital delivers health care as good as anywhere in the world,’ he said. ‘We have the best physical plant in the Caribbean, I’m sure of that.’
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