NOTE OF EXIT MEETING

SUBJECT: Internal Audit of Catering services for Region 1: A.G. Jeetoo Regional
Hospital, Brown Sequard Mental Health Care Centre and S. Bharati Eye
Hospital

DATE : Friday, 22 September 2023

TIME : 10.00 hrs
VENUE : Conference Room, 9th Floor, Emmanuel Anquetil Building, Port Louis

Members Present:
Ministry of Health and Wellness (MOHW)
Mr D. Conhye Permanent Secretary (Chairperson)
Mr. A. Punio-Naiko Assistant Permanent Secretary
Mr V. K. Modi Deputy Director Nursing
Mrs M. Lim Manager Financial Operations
Mr P. Latchoomun Manager Financial Operations
Mrs P. Unnuth Manager, Internal Control
Mrs S. Baznauth Principal Internal Control Officer
Mr N. Namah Chief Hospital Administrator
Mr R. Gooly Deputy Chief Hospital Administrator
Mr Dunputh Manager Human Resource
P. Ramkhelawon Manager Human Resource
Mrs R. Ramchurn Senior Human Resource Officer
Mrs T. Lootooa Office Management Assistant
Ms N. Rajagopal Service to Mauritius Intern

Jeetoo Hospital
Dr A.Jugduth Regional Health Director
Dr R. Bundhun Medical Superintendent
Mrs Y. Ramkissoon Regional Health Service Administrator
Mrs B. R. Jeeawoody Regional Nursing Administrator
Mrs N.B. Jadhakhan Manager Financial Operations
B. R Goorah Manager Procurement Supply
Mr A. Rama Manager Human Resource
S. Utchanah Assistant Manager Human Resource
Mr R. Balkooram Assistant Catering Officer

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 Mrs Gowreesunkur Senior Nutritionist

Brown Sequard Mental Health Care Centre

Dr Mungroosing Medical Superintendent

V. Gokool Hospital Administrator
R. Gungabissoon Assistant Catering Officer

Region 5 Victoria Hospital

Mrs K. Mungur Principal Nutritionist

1.0 Welcome Address

The Chairperson welcomed members present and informed that the purpose of the
meeting was to discuss on the report submitted by the Internal Audit on the Catering
services at A.G. Jeetoo Regional Hospital, Brown Sequard Mental Health Care Centre
and S. Bharati Eye Hospital.

2.0 Discussions

2.1 Committee took note that there was lack of staff at the Management and Supervisory
level in the Catering Units. It was noted that the post of Catering Officer was advertised
by the Public Service Commission (PSC), however, interview had not yet been
conducted. In addition, it was highlighted that in the catering cadre, it would be
Assistant Catering Officers who would be eligible for interview for the post of Catering
Officer and 1 Catering Supervisor was recently recruited and posted at Jeetoo Hospital.
The Manager, Human Resource, Mr A. Rama, highlighted that lack of staff was
disrupting the smooth functioning of the hospital.

2.2 Committee was informed that, as regards Jeetoo Hospital, payment of foodstuffs was
not being effected through their respective Sub Vote items since 2022, that is, input in
the system was wrongly done, therefore, making it difficult to obtain financial
information on expenditure incurred. Mrs Jadhakhan, Manager Financial operations,
of Dr A. Jeetoo Hospital informed that, the matter had been resolved and proper inputs
were being done. The Internal audit proposed that a letter be written to the other
Regional Hospitals to request the latter to account the expenditures under the correct
vote classification. Mrs LIM, MFO agreed to issue the letter to all Regional Hospitals.

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2.3 Committee also took note that, after the demise of the late Assistant Manager
Procurement and Supplies (AMPS) of the General Stores, there had been no
replacement for one year. The E-IMS had not been updated since 2020. Some staff have
been put in place to clear the back log and updating of the E-IMS against payment for
the overtime performed.

2.4 Committee was informed that ledger entries were wrongly posted by the Catering Unit.
Upon query, the Catering Unit explained that there were only 2 Officers posted in the
kitchen. The wrong entries were due to the heavy load of work. The Internal Control
Unit (ICU) proposed that the entries in ledgers should be verified each ten days.

2.5 In addition, the GF5 booklet was normally used for indenting purposes for receipt of
goods at the Catering Unit from the General Stores. It was noted that Original Copies,
which were normally supposed to be removed by the General Store for ledger updates,
were still in the GF5 booklet. This implied that ledgers were not properly being updated
by the General Stores. The Manager Procurement and Supply was requested to look
into the matter.

2.6 Committee was informed that a Standard Normal Diet scale for patients was established
in 1996 and revised in 2018, whereas there was no updated Diet scale for hospital staff.
Mrs Mungur, Principal Nutritionist mentioned that a meeting has already been
organized about the diet scale and a proposed diet scale was drafted in file but has not
yet been approved by the Accounting Officer. The Chairperson requested that the Diet
Scale should be updated and sent for approval within 1-month time.

2.7 It was noted that the ‘Request for meal’ forms used were not standard across all
Regional Hospitals and there was no provision for signature/name of the Officer in
Charge. The ICU highlighted that the forms were also not appropriately filled, bearing
no stamp nor signature of the Officer in Charge. The Committee decided that a standard
form be designed for all wards and hospitals upon suggestion of Mr Balkooram. It was
agreed that Mr Namah would seek approval on file from Management. Once approval
has been obtained, he would circulate same to all hospitals.

2.8 The Internal Audit also highlighted that patients were not consulted prior to requesting
for meals to the Catering Unit, resulting in huge food wastages. They also proposed that
in order to avoid food wastage, the Daily Diet Sheet be filled in and patients asked
whether they would consume food and ensure that non-consumers were not being
served during meal time.

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2.8.1 Dr Jugduth, RHD of DR A. Jeetoo Hospital informed the Committee that this matter
was a sensitive issue and refusing to serve patients meal might give rise to public and
media issues.

2.9 Committee took note that food served in ward were cold as the time gap between
serving the food and collecting the food from the Catering Unit had a delay of 15+
minutes. It was also noted that the food was served in a normal trolley rather than food
trolleys, which were equipped with “bain marer”. Plastic Containers were also being
used to serve food instead of stainless steel containers increasing the risk of
contamination.

2.9.1 Mr Namah informed the Committee that with the provision of pack meals, the problem
of cold food and contaminations would be solved. Even the problem of food wastage
would be reduced.

2.10 According to surveys carried out, hygienic condition of wards was deplorable. Smell of
cigarettes, dirty bed sheets/curtains/pillows, bugs and pests on beds and even plates
were noted. The Committee requested Mrs B. R. Jeeawoody, the Regional Nursing
Administrator (RNA) to look into the matter and take necessary actions promptly.

2.11 With regards to Orthopedic Ward, it was also highlighted that the medical beds
represented a health hazard due to its non-protected edges of pipes. The Regional
Health Services Advisors would be requesting the Occupational Health and Safety Unit
to look into the matter.

2.12 The ICU highlighted the fact that the Catering Unit at the Brown Sequard Mental Health
Care Centre (BSH) was under the responsibility of a Catering Officer, Mrs M.J.A since
2019 and an Assistant Catering Officer, Mr R. G since 1996. Such long stay of staff
could cause familiarity to different stakeholders. The ICU requested the Ministry to
make arrangements for reshuffling and rotation of staff.

2.13 During the surprise checks carried out by the Internal Control Unit, it was noted that
rotten vegetables were being kept in the cold room of the BSH. Some vegetables were
also found to be of poor quality and not fresh. Mr Namah was requested to look into
the matter and to follow through.

2.14 The Committee was also informed that stale leftover food cooked 6 days prior were
also found in the cold room of BSH, hence, it was understood that fresh food was not
being served to patients. It was also noted that no records of leftover were kept, hence
no entry were made if these leftovers were being used or not. It also implied that ledger
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 records were not tallying with the actual stock of food. The Chairperson requested the
ICU to conduct surprise checks and to follow through. The Committee also suggested
that cameras be installed in the cold rooms and corridor of the hospital.

3.0 Way Forward

3.1 Mrs LIM, MFO was requested to issue a letter to all Regional Hospitals to request to
account the expenditure under the correct vote classification.

3.2 The Manager Procurement and Supply at Jeetoo Hospital would look into the original
copies that were still in the GF5 booklet and adjust accordingly.

3.3 Mrs Mungur, Principal Nutritionist would update the Diet scale and send for approval
within 1-month time.

3.4 It was agreed that Mr Namah would seek approval on file from Management for a
standard form for all wards and hospital, once approval would be obtained, he would
circulate same to all hospitals.

3.5 Mrs B. R. Jeeawoody, the Regional Nursing Administrator (RNA) would take prompt
actions with regard to unhygienic condition of wards.

3.6 The Regional Health Services Administrators would request the Occupational Health
and Safety Unit to look into the medical beds that represent a health hazard due to its
non-protected edges of pipes.

3.7 Mr Namah was would follow up on the issue of rotten and poor quality vegetables kept
in the cold room of the BSH.

3.8 ICU would conduct surprise checks and follow up on wastage of food and quality of
food served to patients and make sure that leftovers were being accounted on ledgers.
The Committee also suggested that cameras be installed in the cold rooms and corridor
of the hospital.

4.0 End of Meeting

4.1 The meeting ended at 11.15 hrs with a note of thanks from the Chairperson.

29 September 2023 Ministry of Health and Wellness

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