Allegations of financial misapplication and scarcity of drugs, among others, have been rocking Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH), Amaku, Awka, Anambra State, for some time.

A source in the hospital alleged that the health institution has become a drainpipe for siphoning millions of naira through bloated salaries, hiked allowances and inflated imprest bills. The source claimed that salaries and wages have risen sharply from 2021, despite the fact that the number of staff on the payroll has not increased. The source alleged that, in March and October 2021, salary increased from the usual N81 million, N82m, N83m to N88m.

However, the chief medical director of COOUTH, Dr. Joe Akabuike, described the allegations as false, malicious and assassination of his character. He said the institution had witnessed uncommon transformation since he assumed office. He also said the reforms being introduced have triggered agitations.

Allegations

The source alleged that nothing explains the quick increase by N5m, and no promotion allowance reflected in workers’ salary for the month. More suspicious, according to the group, was the workers’ salary of December 2021, which ballooned to N171m.

An aggrieved insider, a worker in the hospital, questioned the sharp increase in wage bill, saying: “How come the salary increased from N81m, N82m, N84m to N171m (N87m increment). Does it mean the staff strength doubled in December? We were not even paid any Christmas bonus in December. We received the same salary we got in December 2020.”

Another source alleged that the chief medical director of the hospital, Ababuike, a former commissioner for health in the state, allocated to himself N5m security vote monthly, against the sum of N1.5m approved by the state government. While some nurses in the hospital earn less than N50,000, the sum of N5m is spent monthly as ‘security vote’ for the CMD, the source alleged.

The source said there was no framework for the security vote of the CMD of a government hospital, rather the huge sum is written off monthly without any retirement of the spending.

The source further alleged that the security funds were initially used to pay hired security men contracted from a private security outfit to watch over the hospital and mind the two gates to the facility. According to the source, previously, the money for security was N500,000, which was usually paid to the security company, which in turn paid the security personnel.

The source claimed that the money was later increased to N1.5 million by the state government, after the former CMD wrote to express concerns about insecurity in the hospital.

“Some persons suspected to be cultists were apprehended in the hospital in 2018, causing panic among staff. To guard against future incidents, the then CMD applied for an increment in security fund, to help police the hospital better, and this was approved,” the source said.

The letter conveying the approval from the secretary to the state governmnet, Prof. Solo Chukwulobelu, read: ‘Your letter on 27th November, 2018, referenced COOUTH CMD, Vol. 2, 125, refers; I am alarmed by the rising security threat to both the staff and patients at COOUTH.

“As you are aware, security is of paramount importance to Governor Willie Obiano’s administration. Therefore, in so far as: The income of the hospital is able to support the requested sum of one million, five hundred thousand naira, for security provision, and this request is without any recourse to the state government, the state government expects (you) to do the needful to ensure adequate security is maintained at COOUTH at all times. Your request is, therefore, accordingly approved with effect from 1st December, 2018.”

The source alleged that, in the past administration, the hospital implemented the N1.5 million security fund, until Akabuike came in March 2021 and hiked it to N5m.

“Although the sum of N5m is expended on security monthly, the number of security personnel posted to the hospital by the company has not increased and no security equipment was procured during the period.

“Patients in the hospital have often complained of the lack of recommended drugs in the pharmacy department of the hospital. Patients also complain that their food is more expensive than outside, even as the quality is poor. When you want to buy drugs, something that one should buy here at a cheaper rate, they always tell you they don’t have it, so you have to go outside, where you will buy it at a high cost, yet you will not be assured of the quality. Go to the pharmacy section in this hospital, it is always empty, no drugs there,” the source alleged.

The source further alleged that even though most drugs needed in the hospital were usually unavailable, the cost of procuring drugs has gone even higher: “If you look at the purchase of drugs in this hospital for last year, you will see that January, February, March and April followed a steady sum of drug supply. But from July 2021, it jumped to N17m in November 2021.”

He alleged a sordid procurement deal involving the leadership of the hospital, where drugs paid for were never supplied. He also claimed that “so many contracts on drug procurement and supply went under the table. They did not follow due process and approval by the board. The board should perform its oversight function and request for evidence of payment and supply of those drugs. Board should also request for evidence of bidding for drug supplies, which is the rule in government, and why there is no drug revolving fund in the hospital. Drug procurement and supply has become a conduit pipe for siphoning money.”

The source claimed that the CMD had, upon assumption of office, removed the former HOD Pharmacy within two months of his starting as CMD. It was also alleged that the former HOD Pharmacy was ousted and replaced with a loyalist, who was not a pharmacist but a family friend of the CMD, right from his days as commissioner.

In addition, it was alleged that disbursements on items that record zero expenditure in the past now run into millions of naira. Imprest and advances also rose from N307,000, at the time Akabuike assumed office, to N1.6m in November 2021. It was further alleged that office stationery moved from zero expenditure before Akabuike’s assumption to N160,000, and later N400,000, then jumped to N21m in September and N3.2m in October 2021.

Sources alleged that there was no evidence of such expenditure in the hospital.

“Even patients on sick beds are not spared. One of the patients, wife of a driver who was recently involved in an attack by gunmen, related her sad experience at the hospital. She lamented that medical bills keep rising, even as patients are subjected to mandatory feeding daily at the cost of N2,100. The food came from a popular eatery working in partnership with the hospital. Since COOUTH is a government hospital and believed to be relatively cheap, the bulk of their patients are mostly the poor. It wasn’t surprising when some patients started complaining about the daily N2,100 for feeding, which is weaved into the medical bill,” a source alleged.

It alleged that an indigene of the state, Nnadozie, had earlier raised the alarm over the development, with a petition to the state government, calling for intervention. The petitioner allegedly questioned what business the management of COOUTH had with an eatery to compel all patients to N2,100 daily for meals.

Nnadozie, in the petition to the governor of Anambra State, Prof. Chukwuma Soludo, allegedly said: “The management of Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Awka, contracted Ofiaku Kitchen to feed every admitted patient daily.

“This feeding is compulsory at a whopping price of N700 per meal. That is, every patient in the hospital pays a compulsory N2,100 daily, whether you accept the food or not. You have no choice than to pay for it, according to how many days you spent in the hospital. It’s being coded in such a way that, once a patient is admitted, they start giving him/her food without making the cost known to the person. Many always think that the food is free, until the day the person will be discharged and a bill presented.

“While I was in the hospital a few hours ago, a reliable source lamented that most patients lay curses on the hospital after paying the compulsory feeding bill. She (a nurse in the hospital) said that the feeding was formerly N300 per meal before they brought in Ofiaku Kitchen and sacked the former. I then met a patient who complained that she had spent about two months in the hospital, that she was surprised when one of the nurses told her that it would be in her best interest to ask the hospital to discharge her. The nurse then revealed to her that the hospital is billing her N2,100 daily for feeding alone. Then multiply by about 54 days she has spent in the hospital. This feeding bill is different from the main hospital bill.

“I am calling on the new governor of Anambra State, Professor Charles Chukwuma Soludo, through the commissioner for health, to investigate this ugly information and intervene on behalf of the suffering patients. Most of these patients are so poor that they hardly eat complete three square meals in their various homes, yet the hospital is using their sickness as an advantage to enrich the Ofiaku Kitchen and some selfish persons in the hospital’s management.”

The source further alleged that the recurring expenses of the hospital were made to feather the nest of the leadership, while threats by resident doctors in the hospital to embark on strike over poor working conditions continue unabated. It was alleged that the workers in the hospital were poorly remunerated, as against the bogus entitlements and privileges enjoyed by the leadership.

They claimed that “while the standard of the hospital continues to decline, many believe that the days ahead may be worse, as doctors in the hospital have already served a notice of strike to the CMD.”

The source said a letter to the CMD, by the COOUTH chapter of Medical and Dental Consultants Association of Nigeria (MDCAN), stated that the doctors were ready for a showdown with the hospital management.

The source alleged that “the letter signed by the chapter chairman and secretary, respectively and dated April 12, 2022, and titled: Notice of industrial action by MDCAN COOUTH chapter read in part: ‘Recall that the Anambra State government promised to pay all doctors working with the state good salaries. To be convinced this promise was fulfilled, the MDCAN, COOUTH chapter, signed an agreement with the hospital management board in January 2020 for an improved pay package.

“As part of the bargain, the hospital management commenced the payment of the new salary emolument at 70 per cent implementation and pleaded with the MDCAN, COOUTH Chapter, that a full (100 per cent CONMESS) will automatically be effective by January 2021. However, the payment of 100 per cent CONMESS did not commence as promised, and the members were appealed to to be patient in January 2022. As a responsible government that does not play with the health of her citizens, additional subventions were released to the hospital management to make sure health workers were adequately remunerated. To our greatest chagrin, when the February and March 2022 salaries were paid, what our esteemed members received was far below their expectation, and the shortfalls were not also paid.

“It is disheartening to say the least that the CMD turned around and labelled the document generated by the hospital management board an illegal document. The CMD also claimed that whoever signed such an agreement did so in error.”

Arising from its April meeting, the group allegedly made three resolutions: “That the hospital management should fully implement the 100 per cent CONMESS as agreed with the hospital management board effective from January 2022. That the MDCAN congress insist that the areas of the shortfall be paid. That the congress is hereby giving a 21-days notice to the hospital management to comply with the above demand, failing to do so; we will proceed on total and indefinite strike action.”

“When an official of the chapter was contacted, he confirmed that the body was still very ready to go on strike after the expiration of the period given to the hospital management. He, however, said that the commissioner for health, Dr. Afam Obidike, had waded into the matter, but a common ground had not yet been reached, and the doctors were not relenting on the commencement of the strike once the time elapses,” the source said.

The source added: “In March, Akabuike called journalists together to celebrate his first year in office, while also reeling out several achievements recorded by him. During the press conference, Akabuike conducted pressmen around the hospital premises for proper sight-seeing of the new developments, saying the hospital is now among the top best hospitals in the country with adequate facilities.

“He said: ‘Ordinarily, we are doing this to project this hospital to Ndi Anambra and Nigeria at large. This is the only tertiary institution of the state. We started as a general hospital, special hospital and now teaching hospital. I want to say that this hospital is one of the best hospitals in the country’.”

The CMD, however, responded to the allegations thus:

Over-blotted salaries hike allowances and inflated imprest bills

“The above are not true. The CMD does not determine the salary of workers. All imprests are retired and confirmed by the audit department before another approval is made for new request. In the case of the sum of N171 million quoted as salary in the month of December, this is just a case of salary overlap of two months being paid in the subsequent months.

Security issues

“The security vote approved by the government for the CMD has remained unchanged.

“I inherited a security outfit named OKPOSON, which was engaged by the hospital management in 2018 to guard both the teaching hospital and the School of Nursing, Nkpor, who mount every corner of the hospital and School of Nursing and Midwifery.

Pharmacy

“There was a need to engage a pharmacist at director level to supervise the intern pharmacist, which is the requirement of the Pharmacist Council of Nigeria (PCN), since the then HOD did not have the necessary qualifications. This made me to request for a pharmacist at that cadre from the State Ministry of Health who has the qualifications/specialization needed to fill the gap, sanitize the Pharmacy and to bring in all the necessary reforms. All the processes to start Drug Revolving Fund scheme (DRF) have been made and the scheme has started.

“There is now a better-organised system in the pharmacy, better stocked and funded to offset the inherited drug bills.

Health station

“A company named Health Station was contracted to introduce complete electronics solution to the management of the hospital, including collection of revenue, in 2015. The present management did not find their services satisfactory since, after seven years of operation, they have not implemented up to 40 per cent of their assignment, hence, their disengagement as approved by the board. It is worrisome that the management who disengaged the Health Station are now being accused of collecting money.”

MDCAN’s impending strike

“The present management secured 100 per cent CONMESS for all doctors who were previously been paid 70 per cent of the CONMESS since 2019. The payment is calculated based on National Salary and Wages Commission as approved by the government.”

Feeding of patients

“It is the standard practice in all tertiary institutions, teaching hospitals, to feed in-patients (except when patients cannot feed orally). That has been the practice operational in Amaku from inception. The advantages of this are obvious, which include: Feeding is timed for effective administration of drugs; maintenance of hygiene; ensure quality and quantity of food given and hygiene of hospital environment.

“On taking over in 2021, there were several complaints of the poor quality and quantity of food given to patients. The then vendor who was contracted to feed the patients at N400 per meal declined and dropped the contract. Another group was engaged and the high cost of foodstuff made them to also decline. We were forced to get the vendor (Ofiaku Canteen) who subsidized his meal from N1,500 he sells in his shop to N700 to the patients (inclusive of tax and services). We have not gotten any report from neither the patient nor the HOD Nutrition on this issue. However, the management is seriously looking into the matter with a view of getting a better solution.”(Daily Sun)

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