Gordon Robinson | Ain’t it wondrous?

So Chris Tufton’s Review Committee appointed to do UHWI’s Board’s work has submitted its report.

The Committee was asked to:

• Review and identify gaps and/or weaknesses in UHWI’s Corporate Governance and Management structures; 
• Make recommendations on possible changes necessary to mitigate, manage or eliminate risks associated with Auditor General’s (AudGen’s) findings and strengthen governance and accountability;  
• Make recommendations on implementation of AudGen’s recommendations (Holy redundancy, Batman!)

Translation from Gobbledygook: The Committee’s terms of reference were to obfuscate. Deal only with structure. 

Up front the Committee stated its view was “UHWI could have played a more cost-effective role within Jamaica’s health system had it not suffered from chronic and egregious governance and management failures.”

Hey, that’s not “structure”. Remember don’t talk about malpractice. Governance, accountability STRUCTURES only please. Essentially, the question put to the Committee was “how did UHWI’s governance structure permit malpractice (oops, sorry, RISK of malpractice)” as if misuse of tax exempt status was nothing more than a natural consequence of weak governance infrastructure not weak governance.

Clearly, this exercise was restricted, from the get-go, to constructing the Shaggy Defence.

But we get a peek at the true culprit(s) in the Committee’s observation that “these failures are largely a result of UHWI operating as if it is an institutional orphan. It has resisted the governance framework emanating from its public sector lineage, while not absorbing governance practices from its university heritage. Its seeming orphan status has been facilitated by the actions and omissions of each of its parent entities, GOJ and University of the West Indies (UWI), These parent entities, having faithfully appointed Board representatives, have, thereafter, not engaged in active and robust oversight [my emphasis].”

In plain parliamentary patwa, di parents dash wey di baby an’ lef’ it fi do as it like. But why try to share Government’s responsibility with UWI? Let’s get one thing clear. UHWI has ONE parent namely GOJ. It was created by a Statute passed by Government’s Parliament. 

Is Govament pickney!

Health Minister sets UHWI’s budget annually. Although Jamaica should contribute 70-75% of UHWI’s budget in reality other Caribbean nations cough up less than 10%. In 2022, Jamaica allocated Seven Billion Dollars to UHWI for a four year period. Then in 2023, $530 million more was allocated for the UHWI Modernization Project. In 2024 $481 million more was allocated for ongoing UHWI transformation. In 2026 an additional $270 million was earmarked for UHWI project upgrades.

Do the math.

Why should UWI be overseeing anything except UWI? How much does UWI contribute to UHWI’s annual budget?

Because UHWI is a teaching hospital, seven members of the eighteen-member Board come from UWI of which three are ex officio members. That’s like appointing a racehorse trainer, jockey and groom to a Government owned Racing Promoter’s Board as was the case during CTL’s day. They were appointed as stakeholder representatives to protect their members’ interest.

As stakeholder whose employees contribute to UHWI’s education programs, UWI has membership on UHWI’s Board to protect their teachers’ interests. But they have zero financial interest in UHWI and certainly don’t have any authority to allocate taxpayers’ dollars for UHWI to spend.

UWI is no parent of UHWI. It’s a domestic helper assisting the child in daily routines for an absent parent.

Yet the Committee began by ascribing responsibility for oversight to an entity with zero authority or capability to do so.

The Committee doubled down on this culpability dilution:

“The key theme that transcends the Committee’s recommendations is that GOJ and UWI must now both contribute in human and financial resources to a process of active and effective oversight support….” 

Wha, wha WHAT??

What human resource has UWI denied UHWI? What financial obligation does UWI owe UHWI? Yes, it has stakeholder representation on UHWI board. Again trainers, jockeys and grooms contribute to the racing product so were represented on the Government-owned promoter’s Board. But they are NOT paying the promoter’s bills nor are they responsible for anything beyond professional contributions made outside the boardroom.

Similarly, UWI contributes teachers at UHWI but UWI has zero responsibility to provide financial or oversight support to UHWI. Under the Education Act, Principals are ex officio school board members and teacher representatives are elected from academic staff depending on the school’s classification. Should Principals/teachers’ contribution go beyond teaching and representation on Boards?

What the granny gungus natty is being played at here?

Then the Committee went on a confused walk through a maze of global medical partnerships between public and private hospitals (e.g. Boston Medical Centre) and reviewed a 2023 report on UHWI governance that relied on a 1994 report both previously resting peacefully in File 13.

The 2023 report recommended: “UHWI should no longer be a Jamaican public body constrained by public sector rules….”

See. That’s it. Right there! How to get away with fiscal irregularity without really trying!! 

“….UHWI Ltd should be incorporated….as a not-for-profit limited liability corporation owned by UWI and each of the Contributing Governments.”  

DWL. So egregious procurement breaches are swept under the carpet and cured by unburdening UHWI from procurement rules? What the framfrig was this other than a desperate scramble to remove GOJ’s responsibility for UHWI’s funding and shovel it onto entities without a ghost of a chance of managing that burden?

The 1994 report tried a similar three-card-trick: “The authority of UWI over UHWI would be obtained by creating a company, University Hospital Company, owned by UWI which would lease the assets of UHWI.” 

Lease? How? With whose money? What would GOJ contribute? The square root of flip all? Have we gone stark staring ravers?

This must be the Guy Lombardo Show!

Eventually the Committee got around to mentioning AudGen’s report: “The Committee’s conclusion is that these breaches have as their foundation an overall culture of poor governance and oversight.”

Ya think? 

Now who should’ve been overseeing a Jamaican public hospital? UHWI’s Board? Government’s Health Ministry? Or would you prefer a nearby University? If last named, which? UWI or U-TECH that also has a medical school? Should Mona School of Business have oversight responsibility for Trade Board? Should MICO teacher training College have oversight responsibility for Schools registered under the Education Act?

C’mon man!

At page 13 of 34, the Committee finally accepted GOJ had underfunded UHWI for decades. But, as the Committee recognized “The lack of funding has been exacerbated by poor financial governance in relation to inefficient procurement, poor inventory management and an insufficient focus on protecting revenue sources.” 

So who controlled that? UWI? Or UHWI Board? Lookie here: it matters not how many outside representatives sit on a Board. It’s the Board that’s collectively responsible for the institution’s failures. 

And the buck stops at the Chairman’s desk.

Yet there seems to be an uncanny urge to look elsewhere. PAC called up a former Chairman; a former CEO; former whatever. This Committee wants to dump UWI into the blame cauldron. When will the moving finger point to the responsible entities namely current UHWI Board and Health Ministry?

The Committee peeked into every dark cul-de-sac seeking company for these blameworthy entities including anachronistic legislation; financial and strategic planning challenges; UWI’s “failure” to advise UHWI on good governance; blah, blah, blah.

For Pity’s sake those are challenges facing every public sector Board. If the Board needs GOJ help with challenges inform GOJ. The Board or GOJ or both MUST accept responsibility. There may be reasons but no excuses.

The Committee eventually admitted UHWI’s governance/oversight challenges are a “national problem” (page 27) then a “major national problem” (page 28). Who should address national problems but the nation’s Government?

The Committee considered but wouldn’t recommend a “separate oversight structure” like EPOC but did recommend against “relying exclusively on “normal Board monitoring”. Why not? Is the Board incapable? 

As the Chinese food chef said “Wok the heck?”

The Committee recommended: “UHWI’s parent entities should dedicate resources to create full-time support for the [UHWI] Board, by drawing on third party expertise ….”  because of the “degree and longevity of these governance challenges.”

In other words, neither UHWI Board nor unpaid third party oversight was good enough but “parent entities” must pay third party overseers to do the Board’s work.

Ain’t it wondrous? Years of poor Board/Ministry oversight costing tax payers gazillions in wasted dollars results in more taxpayer expense to get help. 

Ay, ay, ay!

Peace and Love.

P.S: On April 14, I wrote that Mark Malabver “ran on a PNP ticket in St. Thomas West (2020),” He was PNP Caretaker for the constituency and told the Observer in 2019 that he was "set to run" but was eventually replaced by Marsha Francis. So I should have written that he was “set to run” and not that he ran.

Gordon Robinson is an attorney-at-law. Send feedback to columns@gleanerjm.com