KUALA LUMPUR – Critics have warned that the move to channel certain funds for the Health Ministry via Putrajaya’s development expenditure (devex) in Budget 2021 would pave the way for more red tape, leading to possible corruption.
They said the move is unlike previous years when such allocations were made through the operating expenditure (opex).
They also cautioned that the categorising of consumables amounting to RM4.29 billion under "Program Khusus" (Special Programme) can also make disbursement prone to graft and abuse.
Former health minister Datuk Seri Dr Dzulkefly Ahmad said the Special Programme expenses must be scrutinised as they are "highly discretionary" in nature.
"Putting opex into devex is very confusing. Actually, it's not even necessary at all!" he said in a tweet.
"How service/supply in devex are managed has also raised questions. Will they be managed through tenders, direct negotiations or direct purchase?"
* Program Khusus mesti diteliti Betul2 SEBABnyq, ia bersifat 'Highly Discretionary', sekaligus Terdedah Rasuah dan Salahguna Kuasa.
— Dzulkefly Ahmad (@DrDzul) November 7, 2020
* Bagaimana utk mengurus 'Service/ Supply dalam DEVEX pun menjadi tandatanya? Apakah diurus dengan Tender, Direct Nego atau Direct Purchase?? (End)
Dr Dzulkefly later told The Vibes that while most opex spendings have established channels of procurement through tenders, devex spending is less transparent.
This is because devex categories are not visible, leaving room for “individual judgment”. They are thus discretionary and more vulnerable to political influence, corruption, and leakage.
He said they can also lead to newer methods of procurement like direct negotiations and direct procurement.
He urged the government to provide a clear breakdown according to medical disciplines or services.
On Saturday, Finance Minister Tengku Zafrul Abdul Aziz had refuted allegations that his ministry had reduced annual spending on the health sector, pointing out that the RM31.9 billion allocation for 2021 is higher than RM30.6 billion for this year.
However, Dr Dzulkefly pointed out that the deduction of RM1.9 billion in emoluments and payments for contractual staff means that the “actual” allocation is only around RM30 billion.
Stakeholders in the health sector are concerned that the devex channel will effectively prevent funds from being passed to hospital pharmacies and clinical departments, and disempower state hospitals.
They also fear that public hospitals and health departments will have to make requests for funds, putting added burden on their administrators.
Health advocate Dr Arvinder Singh HS said it was not the time to change how funds are allocated in the midst of the Covid-19 pandemic, as it would add barricades to disbursement.
"In fact, mechanisms must be put in place so that money can be obtained and spent based on urgency, especially where Covid-19 is concerned," he told The Vibes.
Dr Arvinder added that the existing system in place since 2018 should be retained as the ministry's officials are familiar with it.
Concerns about departmental access to funds
Azrul Mohd Khalib, chief executive of the Galen Centre for Health and Social Policy, said the Finance Ministry had yet to reveal how the various departments would obtain funding with the departure from the conventional budget framework.
"Not having departmental control over such funding, and instead having to refer to a different authority could be a bureaucratic challenge,” he said.
“It could add a layer of authoritarianism and delays which may not be suitable if the treatment is needed in a timely manner. We will just have to wait."
Bandar Kuching MP Kelvin Yii also questioned the need to reclassify expenses under the Special Programme rather than dividing them up for each department.
He warned that it would make obtaining funds for departments less transparent.
"How does each department get access to such allocation? Do they need to apply for it? Who makes the decision?" he asked in a press statement.
"What it actually does is add bureaucracy to (the) whole process, which may delay the funds even with (when) there is a matter of urgency," he said. – The Vibes, November 10, 2020
JUST IN: Bandar Kuching MP Kelvin Yii has raised eight questions in response to Finance Minister @tzafrul_aziz's rebuttal over claims public health items under Health Ministry had been slashed next year. Core issue, Yii said, is that health budget is insufficient. pic.twitter.com/508GJpy5nM
— emmanuelsamarathisa (@esshimself) November 8, 2020