Former Mulago hospital executive director, Dr Byarugaba Baterena, addresses the media at the hospital in Kampala on December 1, 2020.  PHOTO/FILE

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Indicted ex-Mulago top boss cries foul

What you need to know:

  • Dr Byarugaba Baterana, who has been locked out of his office since his interdiction in March—denies the allegations contained in a report authored by the parliamentary Public Accounts Committee.

The former Mulago hospital executive director has been indicted in multi-billion shillings accounting scandals, more than six months after leaving the national health referral facility.
The case against Dr Byarugaba Baterana is hinged on a failure to provide evidence to back up a number of expenditures.
In an exclusive interview with Saturday Monitor, Dr Baterana—who has been locked out of his office since his interdiction in March—denies the allegations contained in a report authored by the parliamentary Public Accounts Committee (PAC).

The House is scheduled to debate and take a vote on the “Report of the Public Accounts Committee–Central Government, on the Report of the Auditor General on the Health Sector For FY2020/2021” on Tuesday.
Dr Baterana attributes the findings by the House Committee to a failure by Parliament to access the evidence, which he says the current occupants of the offices he and others were removed from, should have provided to legislators.

PAC findings
Dr Baterana’s name and that of Ponsiano Nyeko, the former assistant commissioner (Accounts), feature prominently in the House report tabled on September 20 by PAC chairperson Medard Ssegona (Busiro East). Both individuals were part of the top management team arrested and charged by the State House Health Monitoring Unit with graft, fraud and impropriety.
PAC has recommended further investigation by the police’s Criminal Investigations Directorate (CID) and the prosecution of the duo.

Dr Baterana’s 12-year reign as Mulago boss came to an end following his March arrest in which the State House Health Monitoring Unit alleged that more than Shs28.8b, based on preliminary findings, was unaccounted for.
As executive director, Dr Baterana was also the accounting officer of the hospital. At the heart of the accusations against the duo is the missing Shs3.8b meant for the payment of interns and Senior House Officers (SHOs). According to the PAC report, Dr Baterana and Mr Nyeko failed to provide accountability for the funds.
From the duo, PAC demanded EFTs that could account for the said sum. The parliamentary committee instead received those that related to different financial years outside the scope of their inquiry.

Consequently, PAC concluded that Shs3,867,161,000 was not satisfactorily accounted for and the  use of the account “Mulago Infrastructure Development”, which was opened for a specific function—to receive money for payments of Interns and SHOs—was irregular and susceptible to abuse.
“The committee recommended that Dr Baterana and the head of accounts Nyeko be investigated by police and if found culpable should be prosecuted for the loss of funds meant for payment of Interns and SHOs,” the legislators directed, adding, “Further, Mulago National Referral Hospital should … open a specific account through which interns and [SHOs] are paid.”

When contacted, Mr Nyeko declined to comment on account of no longer occupying the office.
Dr Baterana says official records that can easily clear the issues raised by the House committee from the Auditor General’s report are available at Mulago. He further reasoned that the current office holders were part of management and should have availed the records to the legislators.

Umeme bill
Parliament wants a forensic audit into the payment of electricity bills by Mulago hospital after payments to the electricity distributor—Umeme—were flagged.
Financial statements flagged by the Auditor General and PAC show that Mulago hospital paid Shs3.1b instead of the Shs2.3b owed to Umeme.
Parliament noted that there was a mismatch in the figures Umeme had billed Mulago as at the end of the 4th quarter of FY 2020/2021 and the figure quoted as outstanding electricity arrears by the Mulago officials at the end of FY2019/2020.

“This Committee [PAC], therefore, found these explanations unconvincing because the entity [Mulago] could not avail the invoices from Umeme Ltd indicating the bills on which basis the money was paid. The committee also noted that misstatement of liabilities could result in loss/ misappropriation of funds and renders the credibility of the accounts doubtful,” the PAC report reads in part.
The PAC committee wants Dr Baterana to be held liable for the Shs823m paid to Umeme in excess of their bill. A forensic audit has been ordered to investigate the flow of these funds with the view and possibility of prosecuting any possible culprits. Forensic audits are often used to extract facts, which can be used in a court of law.

Shs294m query
Dr Baterana has also been fingered for diverting more than Shs294m from activities for which they were budgeted by Mulago and spending it on other activities without seeking and obtaining the necessary approvals in accordance with Section 22 of the Public Finance Management Act, 2015.

Dr Baterana, the committee reports, admitted to reallocating only Shs59.7m from other budget items like advertisement and public relations. He attributed this to the disruptions in operations caused by the Covid-19 pandemic, forcing them to incur unappropriated costs of transporting medical workers and accommodating those on shifts. Recognising the “peculiar circumstances” under which Mulago was operating, the committee still faults Dr Baterana and his team for reallocating funds without following statutory procedure in contravention of the law and established accounting principles “It is a distortion to plans and budgets and it leads to unauthorised spending, thereby exposing funds to misuse, more so when Covid-19 could not prevent the accounting officer from seeking authority which was simply exchange of letters and mails,” the report reads in part. It adds: “The committee recommends that Parliament finds that, subject to accountability, the virement of Shs59,725,897 excusable in light of the unique circumstances under which entities were operating at the time but that the then accounting officer be strongly cautioned against virement without following the established legal procedure.”

Culpability
PAC also recommends that  “the accounting officer be held liable for the sum of Shs234,910,636, which remains unaccounted for and that the same be refunded to the Treasury and at criminal investigations be commenced by the police against the accounting officer with a possibility of prosecution.”

As the accounting officer, Dr Baterana is also accused of causing financial loss to the government of more than Shs474.4m through the refurbishment of the MRI machine despite it being non-functional ever since its acquisition and installation in 2018. He denies the charge.
Dr Baterana explains that the funds were spent on filling Helium gas that had leaked due to prolonged periods of non-use and power outages during that period. He adds that any omission to carry out the said maintenance would lead to further collateral damage and possible loss of the entire machine.

“The Committee agrees with the accounting officer on the necessity of maintaining the machine to avoid the possibility of a total loss. Further, the explanation given by the accounting officer as to the nonuse of the machine is credible and plausible,” the report states, adding, “The committee, however, was availed with no evidence in form of accountability for the sum of Shs414,479,100 despite a request by the Committee. The Committee recommends that going forward, the Ministry of Health should always ensure adequate planning before undertaking any procurement of medical equipment and supplies to avoid locking up huge sums in redundant capital equipment.”

Dr Baterana responds
On payment of Interns and SHOs
“When interns are posted to Mulago, the executive director, through their deputy and the heads of department where these people are doing internship, identify the numbers and compile a list, which is sent to the Ministry of Health. The ministry releases funds specifically for those doing internship at Mulago and the money goes to the individuals. 

The accounting officer has nothing to alter on who is to be paid. All he does is to pay. If you do not pay, these interns usually go on strike. In the year in question (2020/2021), there was no strike at Mulago … the question PAC is asking is not what the Auditor General asked. The Auditor General asked why we hadn’t recognised the money in the financial statement. We said we did. Then he said ‘you put [it] in the wrong place’. When we reached PAC, they asked us to present evidence that we paid, we agreed with PAC that the people running Mulago now are going to bring that schedule of payment from the Ministry of Health and also print out the lists of the recipients, the interns and SHOs, but unfortunately’ they didn’t bring them.”

On Umeme deal
“Mulago normally receives about Shs1.9b for Umeme every financial year. Unfortunately, that money is not enough. In a quarter, we receive about Shs447m and yet in a month, we need about Shs300m. Every year there is an accumulation of arrears. What we did was simply to pre-pay Umeme. All the money we received was paid to Umeme and Umeme recognised that we actually paid the money. These people are saying we shouldn’t have paid it all … if we didn’t pay that money, it would have gone back and yet in the next financial year, there is going to be another debt. The invoices are available. Ask Umeme how much we paid …we have got an office administrator in-charge and we have got all those documents. We already showed them to the Auditor General. That is why the Auditor General is not saying there is money lost. These utility bills are ring-fenced and even if you go to the financial year, which ended in June that I was not part of, you are likely to find that the hospital has something to pay to Umeme.”

On the Shs294m
“The problem of that money is what we call a mischarge, which basically implies that if you were given money to buy beans and you [instead] use that money for peas; even if you have bought it, you have mischarged. I agree with PAC and they agree with me that in 2021, we were working under difficult circumstances. There was a lockdown. Part of the money, we bought fuel, we bought food for some of the patients who were within. They asked us for documents to back it up and we said there is a heap of documents in Mulago and we agreed the people on the ground bring those documents. There are accountants in Mulago who are not on suspension. I really don’t know why the people in Mulago can’t bring those documents.”
 

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