Parliament committee queries accountability — $80M in drugs left to expire

MY POINT IS: Independent Senator and member of the Public Administration and Appropriations Committee (PAAC) of Parliament, Marlene Attz, makes a point during a sitting of the committee in the Red House on Monday. - Photo courtesy Office of the Parliament

CONCERNS have been raised over issues of due diligence and accountability as a committee of Parliament heard on Monday that a whopping $80 million worth in drugs earmarked for the national health system was allowed to remain in storage over a ten-year period at the Ministry of Health until they all became expired and useless.

The issue was discussed during a sitting of the Public Administration and Appropriations Committee (PAAC) whose members emphasised the need for stronger oversight to protect public health resources and give taxpayers value for their money.

Chief Chemist and Acting Director of the Chemistry Food and Drugs Division of the Ministry of Health, Hasmath Ali, stressed the importance of careful management, noting that ensuring public safety requires strict due diligence.

“Due diligence is required to ensure the safety of the population. In circumstances that relate to health, there is no argument from me on that,” Ali told the committee.

Committee member and Independent Senator Dr Marlene Attz raised concerns over how such a significant loss occurred, questioning whether systemic inefficiencies contributed to this accumulation of expired drugs. She suggested involving laypersons in oversight committees to provide additional perspectives and support.

“Even listening to the contributions regarding due diligence, I wonder how we got to a stage where we had $80 million worth of expired drugs," the senator said.

Atzz questions if "lethargy" permeated every sphere of TT's health system.

"We were so careful in some areas but ended up with $80 million worth of expired drugs that did not benefit anyone in this country. It represented a cost to all of us.”

Efforts by Newsday to reach former health minister Terrence Deyalsingh for a comment on Monday all proved futile. He was health minister during the ten-year tenure of the former PNM government.

Ali clarified that the expired drugs were under the responsibility of another entity tasked with procurement, storage, and distribution but acknowledged there was need to address the issue.

“The $80 million in expired drugs accumulated over ten years. The entity responsible, actually procures, stores and distributes on our behalf, so they would be (the ones) accountable,” he explained.

Highlighting efforts to modernise operations, Ali revealed plans to review and update the Food and Drugs Act, to make this legislation current and more effective.

He also said the division is considering moving the drug registration process online, so as to improve efficiency while maintaining safety standards.

Attz said that moving forward, the ministry must prioritise creating efficiencies that benefit citizens and safeguard public funds.

“$80 million is a cost to us. I know there are certain ministers present who would probably want a very detailed explanation as to how $80 million of the people’s money was lost in this manner,” she said.

'IT'S A MINISTRY ISSUE'

In a brief interview on Monday, North Central Regional Health Authority (NCRHA) CEO Davlin Thomas emphasised that while procedural aspects are important, the procurement of drugs is managed wholly by the ministry based on public demand – not by the regional health authorities (RHAs).

“The issue is not with the procurement process itself, but with how these drugs are managed upon arrival and how they are distributed,” Thomas opined.

On the topic of drug distribution, he explained that usage patterns are governed by public demand. That demand is sent to the ministry as the RHAs themselves do not make decisions on procurement.

He stressed RHAs neither procure drugs nor govern demand – instead, demand originates from the public, and procurement is handled entirely by the ministry.

Asked if the ministry liaises with RHAs to determine demand, Thomas said he could not comment on the internal processes of the ministry.

“I cannot confirm how the data is sent to the ministry. The ministry is notified of what drugs are being sought by patients, and they make their decisions.”

Thomas agreed that digitisation would vastly improve oversight.

"Now, the ministry has a Hospital Information System, or digitised inventory systems, at the Northwest and Central RHAs, particularly for pharmaceuticals," he confirmed.

That system, he said, was implemented in January 2024, allowing inventory to be tracked digitally, with the aim of pharmacy protocols now being digitised for precision.

"It can track if a patient registered in the Northwest Regional Health Authority requests the same drugs at North Central. The data should be more accurate, at least for North Central and Northwest, because the ministry can now analyse it in a more sophisticated way.”

Thomas said the aim of the integrated system is to improve distribution, which now follows established patterns. Recent digitisation efforts have enhanced both tracking and accuracy.

HOW THE SYSTEM IS

Another senior official at an RHA who opted to speak anonymously, shed light on what he described as persistent challenges in inventory management, which he said contributed to surplus stockpiles of pharmaceuticals, some of which are left to expire.

He said the difficulties lie in forecasting and managing medical supplies under current protocols.

“Proper forecasting is very difficult. Values are submitted by staff, but final approval rests with principal finance officers, equipment managers, and the minister. Decisions are often made in a very short period, which, in my opinion, isn’t enough time to make an educated choice.”

The source said actual consumption rates often differ from what is ordered.

“If a facility consumes 20 units a year, they might order 60 just to avoid shortages. This leads to excess stock that eventually must be returned, or is destroyed.” Or, he pointed out, as in the case of the issues raised at the PAAC meeting – $80m worth of drugs were left to expire.

Compounding the problem is the lack of clear emergency drug protocols compared to practices in countries like the US, he said. In other countries, drugs nearing expiration can sometimes be re-purposed or safely used, whereas local policy requires disposal once expiry has reached.

He explained the process of returns and destruction.

Items nearing expiration are returned to suppliers within a stipulated time-frame, while others that cannot be reused, undergo a “board of survey” evaluation to determine monetary value and disposal procedures.

“This isn’t just about pharmaceuticals. It also applies to non-pharmaceutical items, which can be refurbished if possible.”

Staff shortages and procedural delays further exacerbate the problem, he said.

“We try to manage inventory carefully, but the system is overwhelmed. There’s often a rush to return or write-off items before they expire, which can lead to errors.”

Despite these challenges, he said improvements are being made through training in inventory management and stricter monitoring of stock usage. “We’re seeing better outcomes over the years. Expiry rates are decreasing, and staff are more aware of proper procedures.”