The Institute of Economic Affairs wants the government to halt its plan on renewing the Managed Equipment Services (MES) project, citing various accountability gaps in the first phase.
The economic think-tank is instead a calling for a new audit to ascertain the project's usefulness.
The first phase commenced in the financial year 2015/16 and ran for seven years to last year, with plans already underway to renew the contract.
“Budget policy statement released in February this year shows the government has allocated another Sh5.9 billion to extend the MES project,” said John Mutua, IEA projects coordinator at a media briefing in Nairobi.
The public policy lobby further said it has been unable to find any justification for the extension because the original contracts are still not public, and there is no public assessment of the impact of the project.
“Without a comprehensive audit or evaluation of the project to inform appropriate reconfiguration, the question of value for money of the project remains unanswered,” Mutua said.
The Ministry of Health awarded leasing agreements to six international firms, which supplied and have been servicing specialised medical equipment at a project cost of Sh63 billion.
The six General Electric from the United States, Philips from the Netherlands, Bellco SGL from Italy, Esteem from India, Mindray Biomedical of China and Symex Europe GMBH from Germany.
Mutua claimed that although the health sector reports paint a rosy picture of the MES project performance; findings from both the auditor general and senate ad hoc committee on the MES reports reveal glaring gaps.
“The question on the justification for its extension remains, exacerbated by the fact that recurring audit issues, transparency questions and functionality gaps, among others, have not been addressed,” he said.
"For instance, queries on the gap between the Sh38 billion allocated as the original budget and the Sh45.9 billion on contract signing are yet to be answered."
He added that an explanation on why the actual spending by the end of 2018/19 review period being Sh25.9 billion, above the target of Sh22.9 billion is still at large.
The renal, laboratory, ICU radiology and theatre equipment were leased to at least two level 4 hospitals in each of the 47 counties.
The Association of Medical Engineers of Kenya is in favour of the extension of the project.
“These equipment are technologically advanced and at the same time expensive so if you abandon this project at this particular point where are you going to take these machines because they are new machines some have not worked some have been working,” Peter Ayieko of AMEK said.
University of Nairobi health systems expert Ephantus Njagi however, dismissed the lobby's analysis by IEA as shallow, saying it fails to grasp public health benefits that should be included while calculating return on investment.
“There is a lack of understanding of what MES is and this calls into question the validity of the findings,” said Njagi, one of the consultants that MoH consulted before launching the scheme in 2015.
“There is a different way to measure impact in healthcare. You should look at if hospitals are providing services which they couldn’t before, how many deaths have been averted, how many healthy years you have added.”
In January last year, MES Contracts Review Team led by George Opondo Ooko proposed an extension of the contract for a further three years while at the same time initiating a post-MES planning process to ensure the continuation of services.
Ooko said decommissioning the equipment or transferring them to respective hospitals could prove counterproductive.
“These options may lead to rampant equipment breakdown and prolonged downtime negating gains already made. The extension is limited to three years and is mainly for maintenance and servicing of MES equipment as defined in the Service Requirements and equipment schedules in the contract,” he said.
In its report, the task force said at least 3,848,162 patients have benefited from X-ray exposures, 1,797,597 from ultrasound scans while a further 628,821 patients have benefited from theatre operations from the machines.
The task force proposed the provision of additional dialysis equipment to 15 hospitals with high volume patients to enable them cope with the increased numbers as well as theatre equipment to optimise theatre services in the MES supported hospitals.
Early last year, governors also supported the three-year extension.
However, in December, the new lot of governors said they do not support the extension without another audit.
"That there is need to review the conditions set by CoG before renewal of contracts and address Article 187 requirements on intergovernmental agreements," CoG said in a statement last December.
