DOH flagged over P43-B unused funds in 2018

MANILA, Philippines — The Commission on Audit (COA) has called out the Department of Health (DOH) over its failure to utilize P42.615 billion of its appropriated budget for 2018, including funds intended for its nine major health programs.

Based on its annual audit report, DOH received a total budget allocation of P109.491 billion last year and obligated 94.34 percent or P103.295 billion of it for various programs, projects and activities.

However, only 61.08 percent or P66.876 billion was actually disbursed, leaving a balance of P42.615 billion.

“Despite the satisfactory high rate (of) obligations, it cannot be denied that the low disbursement over allotment rate reflected that the utilization of funds was not fully maximized and programs and projects were not fully accomplished nor delivered to the intended beneficiaries/recipients,” the COA report read.

The audit body pointed out that the high obligation rate of the appropriated fund cannot be used to measure the accomplishment of an office as “obligations are only valid commitments based on the awarded contracts/purchase orders, where goods are not yet delivered and projects are not yet started.”

It noted that of the DOH’s total budget allocation, 51.67 percent or P54.809 billion was allotted for its nine major health programs, of which 91.70 percent was already obligated but only 36.49 percent was actually disbursed.

The audit body specifically noted that no amount was disbursed by the DOH for its Tuberculosis (TB) Control Program in 2018 even if 61.05 percent of the fund was already obligated. 

“It can be presumed that none of the planned activities under this program was carried out,” the COA said.

Another program with remarkably low fund utilization was the Family Health Program with only 0.75 percent disbursement, notwithstanding its 61.76 percent obligation over allotment rate. 

The other health programs identified in the audit report as having low disbursement over allotment rate were the mitigation of non-communicable diseases (5.14 percent), rabies control (6.65 percent), prevention and control of infectious disease (11.02 percent), national immunization (15.63 percent), health facilities enhancement program (32.66 percent), elimination of infectious diseases (40.98 percent).

Only one program – the Human Resource for Health Deployment – posted an above average disbursement rate at 88.84 percent.

Although the specific amount of fund obligated and disbursed for each program was not indicated in the audit report, COA noted that the DOH has been remiss in utilizing its funds for major health programs for two consecutive years, as it cited that only 40.19 percent was disbursed of the P60.725 billion allocated budget for health programs in 2017. – With Mayen Jaymalin, Delon Porcalla

The audit body recommended that the DOH direct its offices, hospitals, centers and other rehabilitation facilities to “formulate an attainable work plan to ensure program implementation within one year in consonance with the new cash-based budgeting approach of the Department of Budget and Management.” 

It also said the DOH can improve its fund utilization rate by implementing the projects, programs and activities throughout the year instead of bulk awarding the contracts and purchase orders at the last quarter of the year.

Even given these, Health Undersecretary Eric Domingo gave assurance that no money will be wasted and that medicines nearing expiration are already being distributed for use in the different regional offices nationwide.

This came after Secretary Francisco Duque III also observed an increasing supply of drugs in the DOH warehouse and ordered the creation of a new office to handle the procurement and management of the supply of medicine.

The COA noted that P18.449 billion worth of medicine purchased from 2015 up to 2018 have, as of end of last year, yet to be distributed to government hospitals, health centers and other treatment facilities.

Domingo said Duque designated an undersecretary to ensure that stocks of medicines are being properly mobilized.

“We took steps to distribute, reallocate the drugs and create an office to make sure the supply chain is being managed well,” Domingo pointed out.          

COA also previously reprimanded the DOH for over-procurement and poor distribution of medicine, resulting in the waste of millions of pesos in government funds due to expiration of stocks.

It reported that, as of Dec. 31, 2018, at least P18.449 billion worth of medicine purchased from 2015 to 2018 have yet to be distributed to government hospitals, health centers and other government treatment facilities. 

“A review is being done so we will not be purchasing if there are still stocks of medicines and so that drugs not needed in one region can be re-allocated to the other one that needs them,” Domingo explained.          

He said the DOH started the distribution of near expiration drugs – including filariasis kits, CD4 cartridge kits, Tuberculin PPD and Japanese Encephalitis vaccines – early this year to avoid wastage while assuring that the agency would not distribute expired medicines to its regional offices.

Janette Garin, former DOH secretary and now a representative for the first district of Iloilo, said the “constant movement of people and the super duper extraordinary delay in releasing documents and signatories” have brought back the problem on distribution.

COA also scolded the DOH, particularly in 2015 during Garin’s watch, for its over procurement and poor distribution of medicines resulting in the waste of funds due to the expiration of stocks.

Garin said that the recurring problem reflects “poor operation and the loss of systems that were previously installed to correct it.”

Among the reasons she cited as contributing to the problem were the removal of performing career people from their posts and transferring them to offices that are not their expertise, lack of accountability, lack of timelines as well as poor planning and acceptance of deliveries.