The management of the Edward Francis Small Teaching Hospital (EFSTH) has been given 45 days to recover public funds and take corrective measures following the discovery of a series of financial and administrative irregularities in audit reports covering the period 2021 to April 2024.
The directive follows FPAC’s review of the Auditor General’s management letter and related financial reports, which revealed weaknesses in financial management, procurement practices, recruitment procedures, and internal control systems at the country’s main referral hospital.
Among its key recommendations, the committee ordered the immediate suspension of call allowance payments to staff members who are not authorized under existing policies. FPAC also directed hospital management to recover all irregular payments within 45 days of the tabling of its report before the National Assembly.
The committee further called for disciplinary action and reforms to EFSTH’s recruitment processes after auditors identified shortcomings in the verification of academic qualifications and professional background checks for some senior staff appointments.
FPAC also expressed concern over allegations of financial misconduct and urged the Inspector General of Police to investigate suspected diversion of public funds involving supplier payments and transfers reportedly linked to personal accounts of senior hospital officials.
In addition, the committee recommended the recovery of funds associated with undocumented cash advances and payments that lacked supporting evidence of work performed.
The report also raised concerns about suspected ghost workers on the hospital’s payroll. Audit findings revealed that alleged salaries were paid to people who could not be physically traced. FPAC directed management to recover the amount involved and provide supporting documents within the time frame.
Other areas of major shortcomings were procurement and asset management systems including lack of inventory records, non-functional medical equipment acquired through public procurement processes and lack of a complete fixed asset register.
The committee recommended that, to improve accountability, EFSTH should strengthen its internal controls, staff attendance monitoring systems and record-keeping procedures.
FPAC also raised concerns over tax compliance issues, claiming that over D17 million in withholding taxes had not been deducted from payments to suppliers and recommended that the Gambia Revenue Authority (GRA) investigate the matter and collect any outstanding tax liabilities.
Lawmakers also urged urgent improvements in hygiene, sanitation and infrastructure at the hospital, in addition to financial management problems. The committee also recommended reviewing the institution’s tariff structure, which has not been revised since 2014 despite rising operational costs and increased demand for healthcare services.
FPAC emphasized that the full implementation of its recommendations is essential to strengthening accountability, improving oversight, and safeguarding public resources at the country’s premier healthcare institution.
Failure to heed the directives of the committee, it warned, could leave the hospital exposed to ongoing financial risks, damage governance systems and ultimately degrade the quality of healthcare services provided to the public.
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