Akash Sama­roo

Lead Ed­i­tor – Pol­i­tics

akash.sama­roo@cnc3.co.tt

The Pub­lic Ad­min­is­tra­tion and Ap­pro­pri­a­tions Com­mit­tee (PAAC) has raised se­ri­ous con­cerns over the Min­istry of Health’s in­volve­ment in de­ter­min­ing which phar­ma­ceu­ti­cal sup­pli­ers were paid by NIPDEC, ques­tion­ing why for­mer health min­is­ter Ter­rence Deyals­ingh was in­volved in a process that was sup­posed to be in­de­pen­dent­ly man­aged by the State pro­cure­ment agency.

The is­sue arose as the com­mit­tee ex­am­ined how hun­dreds of mil­lions of dol­lars owed to phar­ma­ceu­ti­cal sup­pli­ers were pri­ori­tised at a time when avail­able fund­ing was in­suf­fi­cient to set­tle all out­stand­ing bills.

Ev­i­dence be­fore the com­mit­tee in­di­cat­ed that NIPDEC was re­spon­si­ble for as­sess­ing out­stand­ing in­voic­es and de­cid­ing which sup­pli­ers should be paid and how much. For­mer NIPDEC chair­man Dr Maryam Ab­dool-Richards said her un­der­stand­ing was that pay­ments were gen­er­al­ly pri­ori­tised ac­cord­ing to the age of out­stand­ing re­ceiv­ables.

How­ev­er, Ab­dool-Richards ac­knowl­edged that the board had re­ceived com­plaints from small­er sup­pli­ers whose sig­nif­i­cant­ly aged in­voic­es re­mained un­paid, even while larg­er sup­pli­ers con­tin­ued to re­ceive pay­ments.

Health Min­istry Per­ma­nent Sec­re­tary Asif Ali ex­plained that, un­der the nor­mal process, NIPDEC sub­mit­ted in­voic­es to the Min­istry of Health, sup­port­ed by sup­pli­ers’ in­voic­es. The min­istry then ap­plied to the Min­istry of Fi­nance for re­leas­es un­der its bud­getary al­lo­ca­tion and trans­ferred the funds to NIPDEC for pay­ment.

Sep­a­rate loan fund­ing, how­ev­er, was ac­cessed di­rect­ly by NIPDEC and did not pass through the Min­istry of Health.

Ali said that by 2022 and 2023, out­stand­ing debts to large, medi­um and small phar­ma­ceu­ti­cal sup­pli­ers had be­come sub­stan­tial, while the min­istry’s bud­getary al­lo­ca­tion was in­suf­fi­cient to set­tle all out­stand­ing oblig­a­tions.

He said the sit­u­a­tion was fur­ther com­pli­cat­ed by glob­al in­sta­bil­i­ty in the phar­ma­ceu­ti­cal in­dus­try and con­cerns that sup­pli­ers and in­ter­na­tion­al prin­ci­pals could stop sup­ply­ing Trinidad and To­ba­go be­cause they were not be­ing paid.

Ac­cord­ing to Ali, pay­ing in­voic­es sole­ly ac­cord­ing to their age could have jeop­ar­dised sup­plies of crit­i­cal med­i­cines if com­pa­nies pro­vid­ing drugs with few or no al­ter­na­tives re­mained un­paid.

He said a strat­e­gy was there­fore de­vel­oped un­der which loan funds were used to pay larg­er and medi­um-sized sup­pli­ers, while the min­istry’s bud­getary al­lo­ca­tion, trans­ferred through NIPDEC, was used to fa­cil­i­tate pay­ments to small­er sup­pli­ers. He cit­ed on­col­o­gy and HIV med­ica­tions among the crit­i­cal sup­plies that had to be pro­tect­ed.

How­ev­er, it was the min­istry’s in­volve­ment in se­lect­ing sup­pli­ers and rec­om­mend­ing pay­ment amounts that trou­bled the com­mit­tee.

Chair­man Jagdeo Singh point­ed to email cor­re­spon­dence in which Ali rec­om­mend­ed ad­just­ments to NIPDEC’s pay­ment al­lo­ca­tions, in­clud­ing in­creas­ing pay­ments to some sup­pli­ers while leav­ing two small­er sup­pli­ers out of a par­tic­u­lar tranche.

The com­mit­tee al­so ref­er­enced a Feb­ru­ary-March 2024 email thread con­cern­ing a $311 mil­lion loan fa­cil­i­ty. Ac­cord­ing to Singh, the cor­re­spon­dence showed Ali rec­om­mend­ing pay­ments from a $25 mil­lion al­lo­ca­tion, in­clud­ing $9 mil­lion to Smith-Robert­son, $3 mil­lion to Su­pe­ri­or, $4 mil­lion to Vem­co, $2 mil­lion to Massy, $3 mil­lion to Bry­den, $2 mil­lion to Al­stons and $2 mil­lion to NWT.

Ali said he could not re­call the pre­cise fig­ures but ac­knowl­edged they sound­ed cor­rect. He char­ac­terised the min­istry’s in­put as a “strong sug­ges­tion” based on its as­sess­ment of the phar­ma­ceu­ti­cal sup­ply chain and the med­i­cines the coun­try need­ed.

The com­mit­tee chal­lenged that arrange­ment, not­ing that NIPDEC was a sep­a­rate com­pa­ny whose di­rec­tors had fidu­cia­ry re­spon­si­bil­i­ties and which did not fall un­der the Min­istry of Health’s re­port­ing line.

Ali ac­cept­ed that the min­istry had no au­thor­i­ty to in­struct NIPDEC and ac­knowl­edged that the com­pa­ny op­er­at­ed in­de­pen­dent­ly.

Ques­tions then turned to Deyals­ingh’s in­volve­ment.

Ali said he briefed Deyals­ingh be­fore send­ing at least one of the emails con­cern­ing pro­posed pay­ment ad­just­ments but in­sist­ed he did not seek the min­is­ter’s ap­proval be­cause the min­is­ter had no role in ap­prov­ing pay­ments.

“The min­is­ter doesn’t get in­volved in the pay­ment part of it,” Ali said, ex­plain­ing that his dis­cus­sion with Deyals­ingh was ver­bal.

That ex­pla­na­tion drew fur­ther scruti­ny from the com­mit­tee.

Singh ques­tioned why Ali need­ed to brief Deyals­ingh at all if the min­is­ter had no role in the pay­ment process and NIPDEC alone was re­spon­si­ble for de­ter­min­ing pay­ments.

Ali said the min­is­ter was kept in­formed be­cause the Trinidad and To­ba­go Cham­ber of In­dus­try and Com­merce had writ­ten re­peat­ed­ly about pay­ment prob­lems af­fect­ing phar­ma­ceu­ti­cal com­pa­nies.

How­ev­er, Singh re­mained un­con­vinced, say­ing he had “a very re­al dif­fi­cul­ty” ac­cept­ing the ex­pla­na­tion that Ali mere­ly in­formed the min­is­ter about rec­om­men­da­tions be­ing made to NIPDEC.

Oth­er com­mit­tee mem­bers al­so ques­tioned why the brief­ing was nec­es­sary, de­scrib­ing it as seem­ing­ly “su­per­flu­ous” if the pay­ment strat­e­gy was pure­ly an ad­min­is­tra­tive mat­ter.

Ali main­tained that his dis­cus­sion with Deyals­ingh was sim­ply to pro­vide feed­back aris­ing from cor­re­spon­dence re­ceived from the cham­ber.

At the end of yes­ter­day’s sit­ting, be­fore ad­journ­ing to a date to be fixed, Singh re­marked: “Some­thing is rot­ten in the state of Den­mark.”