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Updated: Management explains as hospital worker racks up €35,000 in overtime

A nurse and patients in the hyperbaric unit.

A nurse and patients in the hyperbaric unit.

Updated 4.16 p.m.

The management of Mater Dei Hospital said this afternoon that despite a shortage of resources, it had cut down on overtime and other shortcomings, including overpayments, highlighted by the Auditor-General in a report tabled in Parliament yesterday.

The Audit office had reported that a  hospital consultant received €80,000 in allowances, three nurses were paid a mysterious diving allowance and a payroll officer got €35,000 in overtime... all from taxpayers’ money.

In a statement, Mater Dei Hospital said that the issues considered by the auditor were, in most cases, the same ones already under scrutiny by the current management. It said it had cooperated fully with the NAO in order to tackle as many critical issues as necessary.

It was clear, it said, that the  shortage of human resources was a main issue which, in turn gave rise to overtime. 

"Today at MDH there are three officers and seven clerks catering for the salaries of over 4000 employees. Computerisation of this activity is under way but the complexities due to the wide variety of different salary and allowance arrangements in the different professions are making this implementation long and complex.  This is the reason why a high rate of overtime was undertaken in the salaries section," Mater Dei said.

"Manual checking and computation of the variety of allowances of such a huge number of employees and rosters takes time. MDH management has repeatedly attempted to institute a mechanism where all MDH employees punch in and out of work using an electronic attendance validation system but such requests were repeatedly turned down by the unions," it said. With such a system, control and expediency would be easier, resulting in many fewer mistakes.

The management added that in 2011 and 2012 a significant effort to control  overtime was made and this resulted in a significant decrease in overtime compared to previous years. Overtime was carried out only where services need to be delivered to guarantee patient safety.

"All discrepancies discovered in the audit have been corrected and any overpayment or underpayment sorted out. There is also a new system that ensures that such overpayments or underpayments do not occur," the management said.

"Unfortunately an ongoing union directive in the dentistry department advising dentists not to sign the attendance sheets (with times in and out) is not helping to sort the matter. 

"It also pertinent to note that the nursing diving allowance is related to the nurses giving treatment in the hyperbaric unit. This unit, which is one of the most modern in Europe, is not only used to assist divers but also to deliver specialised treatment to, amongst other, diabetic patients. The set up, is said, required both patient and nurses to spend time in the hyperbaric chamber exposed to atmospheric pressure as in diving, and hence, the diving allowance.

AUDITOR'S REMARKS

In his scathing review, the auditor said that a review of Mater Dei Hospital’s wage bill showed the amount budgeted for allowances and overtime was overshot by more than €700,000 in 2011.

The report noted that the consultant who received an €80,000 allowance was overpaid almost €16,000.

Overpayment seemed to be a repeated occurrence among consultants, who then had to pay back the extra money in monthly instalments.

Three nurses received “a diving allowance” that is not mentioned in any of the public service reform agreements signed to date.

The NAO said it was unclear whether the diving allowance was officially approved – the only information available on the subject was email correspondence between the Office of the Prime Minister and Mater Dei Hospital, in which the rate per diving hour is stipulated.

The report also noted the high level of overtime worked by hospital staff, which was not always authorised.

In some cases hospital workers doubled their salary with overtime payments, with the highest overtime earners being employees in the payroll office.

The NAO found that four employees in the payroll office – three of them clerks – earned an average of €28,700 each for overtime in 2011.

The officer in charge of authorising and certifying overtime at Mater Dei Hospital “happened to receive” the highest amount for overtime. She clocked up more than €35,000 in extra payments, according to the NAO.

The NAO questioned the correctness and reliability of dentists’ attendance sheets since there were inadequate controls.

Radiographers were also put in the spotlight because of what appeared to be a tacit agreement for them to work a 35-hour week, with any hours above the limit paid at overtime rates.

The NAO could not find a copy of the international guidelines that were quoted by the hospital administration to justify the radiographers’ working hours.

It seemed to be international practice for radiographers to work fewer hours, thus reducing their exposure to radiation. But in a pointed remark, the NAO said it could not understand why radiographers could not have a basic 40-hour work week, of which only 35 hours could be worked in radiation-exposed areas.

The Gozo general hospital was in a similar situation, with the NAO saying that wage-related payments were “not always backed up with proper records to substantiate the expenditure”.

The situation was particularly bad in the case of consultants, where no records were kept to indicate the number of sessions performed.

“Internal controls in various areas relating to salaries were weak or entirely lacking,” the NAO said, noting there were inadequate budgetary controls on overtime.

But the report covered other areas of public administration, highlighting various shortcomings, including the failure by most entities to reach the Government’s budgetary target of reducing arrears in 2011 by 10 per cent.

An analysis of direct order approvals, granted by the Finance Ministry in 2011, highlighted a number of concerns, including the incidence of “retroactive approvals”.

The full report can be viewed on the NAO website: www.nao.gov.mt.

Good Causes Fund

• The fund, administered by the Finance Ministry, had insufficient documentation to show how funds granted to beneficiaries were used for 2006 to 2010.

• Other shortcomings included funds distributed before the completion of projects and receipt of funds not always backed up by a signed declaration from the respective beneficiaries.

Wasteserv

• An audit of capital and recurrent expenditure incurred by the Government waste management agency revealed long delays and substantial cost variations on capital projects.

• Lack of transparency and non-compliance with procurement regulations were also noted, especially regarding sub-contracted labour.

Education

• Internal Education Ministry controls were not sufficient to ensure efficient administration of public funds.

• Control weaknesses were identified, including inadequate verifications resulting in incorrect payments and lack of proper stock records.

Sapport

• The social welfare agency had shortcomings in various areas, including the management of fixed assets, payroll and inadequate control of fuel consumption by general-use cars.

• Procurement regulations were not always followed.

Local councils

• For the second year, no audit opinion was expressed on the Mosta council financial statements because of various “material shortcomings encountered”.

• 23 local councils and two regional committees registered a deficit.

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