Ministry of Health on spot for varying ICU equipment costs

Health CS Sicily Kariuki

A Dutch company hired to supply medical equipment to hospitals in a Sh63 billion programme has publicly disowned a price list tabled in Parliament by the Ministry of Health.

Philips Medical Systems Nederland BV was initially contracted by the Government to deliver Intensive Care Unit (ICU) equipment at a cost of Sh3.6 billion.

But after variations, the cost shot up to Sh4.5 billion. Philips Business Development Director Roelof Assies said the pricing for the items, according to the contract, was different from what Health CS Sicily Kariuki tabled in documents marked as Annex 14.

“The individual item is separately priced, and our numbers and quantity stated as well. We are not aware of the list tabled by the ministry,” Assies told the committee chaired by Isiolo Senator Fatuma Dullo.

The document marked as Annex 14 shows that among the items leased to 98 county health facilities and four national referral hospitals, as part of the theatre and Intensive Care Unit (ICU) equipment, are consumable and disposable kits that ordinarily should have been procured by the Ministry of Health instead of leasing.

The items include spotlights, drip stands, microwave ovens, dressing and general-purpose trolleys, instrument trolleys, washing basins, baby cots and electric kettles. Others are syringe pumps, infusion stands, operating theatre lamps, theatre tables, resuscitators, linen trolleys, patient stretchers and resuscitation trolleys.

Microwave oven

For instance, in Kakamega Level Five Hospital a microwave oven was leased at Sh1.2 million ($12, 805), three spotlights leased at Sh4.2 million ($42,164), which means each spotlight is leased at Sh1.4 million.

The market price for a theatre spotlight is Sh1,900, which in total should have been Sh5,700 for three pieces. For the patient trolley, which costs Sh26,680 per unit in the market, the taxpayer paid Sh1,447,630 per unit in the lease agreement, which is more than 54 times.

For the High Dependency Unit (HDU) beds, each county leased the equipment at Sh600,000 for four units, but under MES project they paid Sh5.3 million.

Anaesthetic machine

A trolley dressing that goes for Sh15,000 ($150) in the market was, under MES, leased at Sh1.29 million ($12,900).

An anesthetic machine that costs Sh2,650,991 ($265,099) in Kenyan market value was, under the lease scheme, acquired at Sh13.1 million ($131,380).

A patient trolley at current market value costs Sh26,680, but under MES, the ministry leased it to counties at Sh1.5 million. An instrument trolley that costs Sh22,080 was each leased at Sh534,500.

Assies, however, said the figure, as reflected in the document tabled, was different from what they signed with the Ministry of Health.

“Under Annex 14 presented to us by the ministry, even if you were going to the moon, a microwave oven that can be purchased locally cannot cost Sh1.2 million ($12, 805). You must have obscene mark-ups,” said Bungoma Senator Moses Wetang'ula.

Philips Medical Systems Nederland BV (Netherlands), which supplied six ICU equipment, distanced itself from the list tabled by the Ministry of Health, claiming the prices indicated were not theirs.

For instance, a stethoscope that was supplied under the MES cost Sh4,700 a unit, inclusive of landing fees. Documents tabled by the ministry however showed it cost Sh1.2 million.

“What is important is that this is MES contract, the total price is built up on equipment, financing, innovation works and training price. All these together make sum price,” Assies, who is also the firm's CEO, said.

Mr Wetang'ula further had pressed the company boss over what he termed exorbitant prices under which the equipment were procured.

“Are you telling us that you built the price of innovation, in, for example, a spotlight, which is illegal? Are you trying to demonstrate that you took advantage of the situation to make a kill from Kenyans,” Wetang'ula asked.

In a list of close to 30 items, Philips only supplied five that they manufacture, while the rest was purchased locally and supplied.

“It seems you were trading, you went and bought other items from the market, put a price on it and supplied to the government,” Wetang'ula insisted.

Delivered items

The company boss further told the committee they had delivered items under the contract except for Meru Level Five Hospital, which is still constructing the ICU wing.

Under the contract, the Dutch medical manufacturing company was to supply, commission, service and train medical staff on the operations of the ICU equipment and to deliver to 11 health facilities.

Assies told the committee that his company had so far installed 78 ICU beds, 39 High Dependency Unit (HDU) beds, trained 61 BioMed, and trained 57 ICU nurses and 243 ICU staff.

Already Philips has installed the ICU equipment in 13 hospitals in Thika, Machakos, Nakuru, Nyeri, Embu, Coast General, Msambweni, Garissa, Kakamega, Jaramogi Oginga Odinga Teaching and Referral Hospital, Moi Teaching and Referral Hospital, Kisii and Narok.