By Spy Uganda
Parliament’s Public Accounts Committee of Parliament has raised alarm over a mix of financial irregularities and deepening service delivery constraints at two major regional referral hospitals, exposing systemic weaknesses in Uganda’s public health system.
Appearing before the committee this week over queries in the Auditor General’s report for FY2024/25, officials from Masaka Regional Referral Hospital and Mbarara Regional Referral Hospital faced tough questions on unauthorised spending, underutilised funds, stalled projects and worsening congestion.
At Masaka, legislators queried an unexplained additional expenditure of UGX73 million beyond the approved budget, alongside a sharp rise in payables from UGX641 million to UGX848 million. The committee also faulted management for failing to fully utilise wage, pension and gratuity allocations, leaving UGX611 million unspent.
PAC Deputy Chairperson Gorreth Namugga criticised the lapse, noting that gratuity and pension are statutory obligations. “When this money hits your account, it is meant to serve workers. Failure to use it denies others employment opportunities,” she said.
Lawmakers further questioned the retention and use of Non-Tax Revenue (NTR), after the hospital collected UGX586 million but remitted only UGX355 million to the Consolidated Fund. Officials said part of the funds catered for privately deployed staff, a response the committee rejected as unlawful “spending at source.”
Under Uganda’s Public Finance Management Act, all public funds must be appropriated by Parliament and remitted accordingly, with unauthorised expenditure constituting an offence.
The committee also flagged critical service failures, including an idle oxygen plant supplied by the Uganda People’s Defence Forces that has remained non-functional for over two years due to delayed installation. Legislators warned that such lapses risk lives, particularly in emergency care.
Meanwhile, scrutiny of Mbarara hospital painted a picture of a facility overwhelmed by demand but starved of resources. Built nearly a century ago to host 270 beds, the hospital now operates with over 550 beds squeezed into the same space, serving a catchment population of about four million people.
Daily, the hospital handles around 600 outpatients and up to 570 admissions, yet it operates on a medicines and sundries budget of just UGX2.8 billion, far below the estimated UGX53 billion required.
Acting Executive Director Deus Twesigye told MPs that specialised services such as neurosurgery and cancer treatment continue to attract referrals from across western Uganda, worsening congestion.
“We are overwhelmed both in service delivery and medicines,” he said, renewing calls to elevate the facility to national referral status.
The committee also raised red flags over a stalled 32-unit staff housing project, which has gone four years without completion due to funding shortfalls. Of the hospital’s 326 staff, only 16 are housed on-site, raising concerns about emergency response and staff welfare.
Further audit findings revealed troubling conditions: patients admitted on floors and in tents, outdated beddings, shared changing rooms for male and female trainees, and unsafe storage practices where medical supplies are kept alongside food.
An earlier inspection by the Inspectorate of Government, led by Aisha Naluzze Batala, uncovered additional concerns including idle equipment, alleged illegal charges and diagnostic inefficiencies. An ultrasound machine has been unused since June 2025, while the X-ray unit reportedly operates with expired films, forcing patients to rely on phone images for diagnosis.
PAC warned that these systemic failures,ranging from weak financial discipline to underinvestment, undermine Uganda’s commitment to equitable healthcare under the National Health Policy and broader obligations under universal health coverage frameworks.
