Today, the Office of the Controller and Auditor-General provided its report “Minister of Health: Management of personal protective equipment in response to Covid-19” to Parliament.
The inquiry found that the Ministry of Health and DHBs had planned for a national emergency but the lack of review of plans to ensure they were kept current and other gaps resulted in the Minister not being well positioned to ensure that the right PPE was available in the right quantities to get to the right people when it was needed.
The Auditor-General’s report details the Ministry’s PPE stock management for emergency and essential services and procurement practices. It found that procurement practices were accelerated on the grounds that usual procedures would have prevented them “from delivering adequate and appropriate PPE to the people who needed it”. Those short-cuts included reviewing the suppliers manufacturing documentation and product testing results without inspecting the actual product.
“We identified some risks in the accelerated testing and product acceptance processes for new suppliers and new PPE. Due diligence processes for PPE sourced from new suppliers and for new PPE products did not include the usual level of quality assurance. We are not in a position to assess the level of risk that this posed, but this risk was knowingly assumed given the pressing need to source and procure PPE in an extremely competitive global market.”
The NZPFU is of the view that the failure to be prepared and have to adequate stocks should never again be an excuse for weakening procurement processes. It is imperative that the most appropriate PPE is provided and international standards that cover of the manufacture, testing and use of the garment must be met.
During the early stages and height of Covid-19 the PPE for medical response was one of the key indicators of the lack of FENZ’s preparedness for a pandemic. Hundreds of hours was spent discussing the availability and distribution of PPE that met the required standards to protect firefighters and fit for purpose for the nature of response. It was a massive frustration for the union that we were continually battling the issue of standards and fit for purpose. FENZ has not been transparent about its procurement processes and despite repeated requests we have not been provided with the documentation showing what PPE FENZ requested, what standard (if any) of PPE was requested or who they requested it from and when it was requested.
The Auditor-General’s recommendations are:
- the Ministry of Health regularly review district health boards’ health emergency plans to ensure that they are complete, up to date, and consistent with each other and with the Ministry’s overarching Emergency Plan. The plans need to be kept current and tested regularly;
- the health emergency planning framework contain specific guidance about responsibilities for procuring and distributing personal protective equipment;
- the Ministry of Health and district health boards, with appropriate health and disability sector representatives, review how clinical guidelines for personal protective equipment will be prepared or amended and consistently communicated during emergencies. The Ministry needs to ensure that demand forecasting, supply, and procurement are updated to take account of changes to guidance that have an effect on demand;
- the Ministry of Health consider whether the roles, responsibilities, coverage, requirements, and planning assumptions for maintaining the national reserve of personal protective equipment are clear and remain appropriate;
- the Ministry of Health work with other government agencies to determine how workers and providers not currently covered by the national reserve of personal protective equipment access it in the future and clarify roles and responsibilities for this change;
- the Ministry of Health regularly reassess assumptions for the categories and amount of personal protective equipment to be held in the national reserve;
- the Ministry of Health implement a centralised system for regular public reporting on the national reserve and implement periodic stocktakes to confirm the accuracy of the data and the condition of the stock;
- the Ministry of Health reintroduce a requirement for district health boards to manage national reserve stock in such a way as to reduce the risk of stock becoming obsolete;
- the Ministry of Health, in collaboration with district health boards, prepare more detailed operational plans and processes that describe how the national reserve system should operate (including distribution mechanisms) and test these as part of future national health emergency exercises; and
- the Ministry of Health and the district health boards strengthen the procurement strategy by including an analysis of risks to the supply chain and have a plan to address those risks.
The report can be read here.