PARLIAMENT OF MALAWI | Committee on Health

Ajouté : 2026-05-31

[00:03:54]Good morning honorable members and good morning our stakeholder. Welcome to today's engagement.

[00:04:01]Today is a continuation of the inquiry that we've been having since Monday this week and today we are interfacing with uh uh officials from the ministry of health um and nurses council. Before we go into the details of our discussions, may I ask honorable members to introduce themselves starting with uh a member from that far corner, please.

[00:04:36]Thank you so much, chair.

[00:04:38]My name is Mollis Harrison Chikafa representing the people of the Danyama constituency. Thank you chair.

[00:04:52]>> Thank you chair through you. Good morning um Dr. Feso representing the people of North conu.

[00:05:01]Thank you.

[00:05:04]uh through the chair I am Alexander representing the people of Central East and I'm a member of this committee.

[00:05:13]Thank you.

[00:05:18]>> Good morning um honorable chair. I'm De Goomba. I come from Gingi Southwest constituents. Thank you.

[00:05:27]>> Morning chair. My name is James Impunga.

[00:05:30]I represent the people of Za city south constituents.

[00:05:36]>> Good morning chair through you. My name is right Alex Mah representing people of and I'm a member of this committee.

[00:05:44]Thank you.

[00:05:46]>> Good morning chair. I'm Jeremiah Jumb representing the people of Broutheast constituency.

[00:05:58]Good morning chair and and uh everyone in the in the house. My name is Skea Longi Chimoto Piri uh representing the people of Kotakam Kula constituency.

[00:06:11]Thank you.

[00:06:14]>> Good morning chair. My name is Kirenda representing the people of Zimba's constituency. Thank you.

[00:06:23]>> Morning chair. Uh my name is McKenzie Inquazich Palamoto. I represent the people of Matab North constituency and I'm a member of this committee. Thank you through you honorable chairperson. Good morning. My name is Chance Mutali coming from Chipa South >> through you honorable chairperson. My name is Sun Kalumo parliament secretariat.

[00:06:50]>> Good morning chair and the whole committee. My name is Endless Nar Parliament Secretariat.

[00:06:55]>> Good morning honorable chair and committee. My name is Judith Mara Parliament Secretary.

[00:07:01]>> Thank you very much. Oh >> good morning chair. I'm Peter Jinga parliamentary secretary.

[00:07:06]>> Thank you very much and my name is Anthony Masamba person parliamentary committee on health. At this juncture I would like to ask the stakeholder to introduce themselves please.

[00:07:23]Good morning chair. Uh my name is Dan America. I'm secretary for health. We are accompanied by medical council of Malawi uh pharmacy medicines regulator authority and nurses council um uh with us. They will introduce themselves.

[00:07:40]Thank you.

[00:07:43]>> Good morning chair and members. I'm shared missya board chairperson for pharmacy security authority BM. Thank you.

[00:07:53]>> Good morning honorable chairperson. Uh my name is Charles Maya. I'm the director general for pharmacy and medicine electoral authority. Thank you.

[00:08:04]>> Good morning honorable chairperson.

[00:08:07]My name is David Zolo. I am the registister in chief executive officer for the medical council of Malawi.

[00:08:18]Uh good morning uh chairperson and honorable members. My name is John Nebara acting registister and midwife's council of malar.

[00:08:32]Good morning chairperson and all the members. I'm mondera director of reg regulatory enforcement medical council of Malawi.

[00:08:46]>> Honorable chair and all members. Good morning. I'm Emily Gama. I work with Minister of Health as a deputy director of nursing services.

[00:08:58]Good morning, chair and all the members.

[00:09:03]My name is Simon Chawinga, director of finance and and administration at Medical Council of Mali.

[00:09:13]>> Good morning, chair and honorable members. My name is Olivia Guadada, communications and planning officer for the medical council of Malawi. Thank you.

[00:09:23]>> Good morning chair and all honorable members. My name is Kesna Bandanda, the registration office at Medical Council of Malawi. Thank you.

[00:09:33]>> Good morning chair. I'm John Hango. I'm the acting director of professional practice and conduct nurses and council of Malaw.

[00:09:44]Uh good morning chair and all honorable members. I'm Joseph Josiah from PM.

[00:09:50]Thank you.

[00:09:53]>> Good morning chair and honorable members. I am Ellos Rodeni. I'm the vice chair of pharmacy medicines and regulator authority. Thank you.

[00:10:08]>> Good morning chair and honorable members. I am Chrissy Juru, compliance and enforcement manager Pare. Thank you.

[00:10:22]Is that all? Right. Thank you very much.

[00:10:26]Once again, welcome to Parliament and uh Parliamentary Committee on Health in particular. Like I said, this is a continuation of the interface that we have been having as a committee with various stakeholders including the ministry of health and others who have already appeared before this committee.

[00:10:46]We are conducting an inquiry specifically looking at the the corruption that is taking place in health facilities. We know uh that we have PM here. Um we already have a presentation and we have seen the presentation. There are two things um that we need to look at. SH yesterday spoke very clearly about these two things. So he spoke about the theft and the corruption. So theft is something different. Corruption is also something different. We are focusing particularly on corruptive practices taking place in health facilities. How are these practices compromising the uh delivery of quality health services uh to patients? How is it affecting the access or to health uh uh to medical care services uh by patients? These are critical areas that we are looking at.

[00:11:43]So when you are making your presentation please make sure that you are focusing particularly on these uh pressure points corrupt practices in health facilities how is it hampering the access to quality health care services. I give you this opportunity now to make your presentation. But before I do so, I ask the SH if you could have a word or two before I hand over to the presenters this morning.

[00:12:16]>> Oh, thank you very much uh honorable chairperson and the house.

[00:12:22]Um uh we we are pleased that we we are with our regulatory bodies.

[00:12:30]um to present on the on the issue at hand. Uh and by your guidance uh we will try to stick to the two areas of u main area of corruption uh and also talking to uh theft a little bit cuz that's what is out there portrayed by the public.

[00:12:55]Uh I'm not sure how much time each presentation is being given. Chair >> addressed to 10 minutes max.

[00:13:04]Thank you very much. So uh we'll start with uh pharmacy medicines regulator authority. Chair I think you can proceed if you are ready.

[00:14:56]Thank you very much uh chairperson and all honorable members here present SH and colleagues from legatory agencies.

[00:15:05]Uh we have been allocated 10 minutes so sort of skip a few slides just to catch up with time. So so I am presenting uh on behalf of the farmers and medicines regulatory authority. Like I've said, I'm the director general.

[00:15:23]And next slide, please.

[00:15:27]So this slide basically just gives an outline of my presentation and uh you will appreciate the same.

[00:15:34]Next slide, please. That's an overview uh of our mandate and establishment and the sort of uh the secretariat where we are based.

[00:15:45]And the next slide uh gives uh the mission and vision for the authority.

[00:15:50]Uh I would request for the next slide please. So on this line I think uh this is where we're trying to give a picture in terms of uh our areas of focus uh in terms of regulation. As an authority, we have the mandate of uh inspecting uh pharmaceutical establishments right from the manufacturing point, the distribution systems to the point where medicines are being dispensed to the uh clients. At the same time, we also have the mandate of making sure that the clients or the patients are receiving medicines that are of safe and of quality uh standards according to uh uh uh the standards that the PMR established.

[00:16:35]Next please.

[00:16:37]So in terms of how our uh regulatory agency is linked to the subject matter which is focusing on corruption um we are very much involved into uh uh operations that are targeting uh arrest of u theft of medicines especially from the public hospitals.

[00:17:00]And in terms of how we operate, uh we normally work in collaboration with the uh um uh the Malo police service, the drug theft investigation unit and ourselves as PMA. At times we also work with the uh MRA and port officials, but frequently we work very much with the uh police service and the drug theft in investigation unit.

[00:17:27]During our investigations, what has been noted is that we have two mechanisms through which medicines are uh diverted or are taken out of the hospitals. Uh smaller quantities disappear in form of page where uh members of staff would get smaller quantities out of uh uh the pharmacy or the wards where uh they are working. And the second mechanism is where medicines are diverted in large quantities maybe at the point where medicines are being taken from central medical stores to uh the hospitals and in between that's where medicines also get diverted. Sometimes they are taken out of the hospital by way of theft through some sort of collusion uh with the fellow members of staff and maybe some security officers.

[00:18:16]So during joint operations um we focus on illegal possession of products because ideally medicines are supposed to be handled by those that are registered with us and they are supposed to be kept in premises which we have also licensed.

[00:18:35]So in terms of how we conduct our uh operations, we target informal markets because this is where most of these illegal activities do happen.

[00:18:49]And the the mode of operation usually is uh plant schedules and sometimes whistle uh blowing because sometimes the general public would alert the PM of illegal activities through tip offs anonymous.

[00:19:05]Now when we have done our investigations um and we find that they are illegal practices the cases are subjected to two strings of approach. Either we take the criminal route where the police uh takes charge in terms of presenting uh the suspects to the courts and where professionals are involved uh uh we take the legary route where we subject them uh to a disciplinary uh process and where we have uh identified other casers who are not um within the domain of PMI uh would always refer them to either NES council or medical council for appropriate disciplinary action when undertaking disciplinary um action against uh those that are suspected to have uh conducted an offense.

[00:20:05]Uh traditionally we have three uh sort of punishments that are issued to the suspects if they are found guilty. So for any pharmacy malpractices regarding premises, we either um enforce permanent closures, we either suspend the premises from operating a business or we issue a warning. Similarly, when personnel are involved, we can either uh dregister and what it means they cannot practice uh uh for a defined period or permanently not practicing depending on severity of the case. We can also suspend the personnel or give them warning depending on the the nature of uh um uh the case. So just to give a highlight in terms of uh the cases that we have handled uh recently between 2021 and uh to date we had a case of pathogen where five pharmacy professionals working under char uh in the northern region of Malawi were colluding with central medical stores uh personnel uh to order uh excessive quantities of pathodine and then supply the same to uh the illegal uh supply chain.

[00:21:28]So when we made our investigations, we establish that the drugs were not accounted for at the facilities where they were [clears throat] likely to be uh diverted.

[00:21:39]And then on the action that we did for those that were involved um because we are pharmacy professionals who were um very convey how serious the transaction was involved we dregistered them and what it means they are no longer practicing pharmacy uh in Malawi.

[00:21:59]We had a second case of theft or supply of expired insulin in 2022.

[00:22:10]So the PMR was not notified by Zuzu Central Hospital about nonresponsiveness of insulin to patients that were receiving uh insulin [clears throat] at the time. And this insulin was supposedly uh purchased from Galaxy Pharmaceutical wholesalers.

[00:22:30]Honorable chairperson and members, insulin is a drug that is used in the management of diabetic conditions and therefore you would appreciate how important and critical this product is.

[00:22:44]So upon our investigations, it was established that the insulin product was tampered with, particularly the label, and there was an alteration of the expiry date to indicate or to imply that the product was still viable for use to cheat the the users.

[00:23:06]And our further investigations also revealed that the insulin was sourced from Queen Elizabeth Central Hospital where they had quarantined this product in redness for disposal because it had expired.

[00:23:22]Honorable members and chairperson, you may wish to note that this product uh was received as a donation to Queens and at the time it was being received, it had a short shelf life.

[00:23:37]So the stolen insulin uh was supplied was I would say the in insulin was stolen by a farmer's technician working at Queens at the time and it was supplied to Galaxy Pharmaceuticals where it was being rele.

[00:24:03]So upon interrogation uh of the suspects, it was established that the procurement agent for this company, the Galaxy Pharmaceutical uh limited uh confirmed that they were buying the product from the vendor, in this case the pharmacy technician, Bert Queens.

[00:24:23]Honorable chair and members, you may wish to appreciate that Galaxy Pharmaceuticals had two uh facilities, one in Liilonge and the other one in Blante.

[00:24:34]The directors of the pharmaceuticals at the Galaxy Pharmaceuticals as well as the pharmacists for both facilities were uh indicated to us that procurement was done by officers u from the institution who are not professionals and obviously they are not too sure about the illegality of the activity that was happening.

[00:24:56]What action did we take as PM?

[00:25:00]So the pharmacists who were involved in this m practice at Galaxy Pharmaceuticals were given written warnings and the pharmacist I mean the farmer technician from Queens who was supplying this expired insulin was dregistered and barred from practicing pharmacy in Malaw for the premises in Nonge the pharmaceutical wholesal uh premises were permanently uh closed and barred from doing business in Malawi.

[00:25:32]Apart from the pharmacies and other key personnel in the Galaxy Pharmaceutical Supply Institution, uh the rest of the key personnel in the institution were arrested and you may wish to appreciate that the case is still in court because it was criminal in nature.

[00:25:50]We also had a case around 2012 where Zimba District Hospital reported a pattern of death of babies from mothers who had been administered chlorenico as a prophylaxis in preparation for cesarian section.

[00:26:10]This activity happened between 1st and 30th November 2012.

[00:26:17]And members, you may wish to appreciate that the product in question was manufactured by Health Biotech Limited in India and was imported into Malawi by Galaxy Pharmaceuticals.

[00:26:36]As you will recall chairperson and members that in my first slide or so I talked about our role in inspecting pharmaceutical premises including manufacturing company.

[00:26:48]This company biotech failed uh good manufacturing practice inspections conducted by PM in 2012.

[00:26:59]What that meant was that the company was not registered in Malawi and was not eligible to supply medicines in Malawi.

[00:27:08]Members through you chairperson.

[00:27:12]You may also wish to appreciate that in 2012 PM was operating as pharmacy medicines and poisons board because we transitioned to PM in 2019 following the passing of the new act. uh in the same year. So at the material time PMPB did not have procedures for issuing import pay per pay permit as we are doing now where we scrutinize the eligibility of uh the medicines the supplier as well as the manufacturer in terms of compliance the requirements according to PMI guidelines.

[00:27:53]So further investigations revealed that GA Galaxy Pharmaceuticals upon learning that there was there were issues at in Zimba District Hospital. They silently recalled all the remaining quantities of the product from the hospital and allegedly shipped them to the manufacturer without the knowledge and authorization from PMPB at the time.

[00:28:20]A few samples that were made available to PM for quality control testing submitted alongside the complaint from Zimba DHO could not establish any possible linkage of the reported adverse events and further testing could not be conducted because of the absence of quantities required for the same because the remaining quantities had been taken out of the hospital chairperson and members.

[00:28:54]Notwithstanding this, the authority initiated a disciplinary proceeding against Galaxy Pharmaceuticals on charges of importing and distributing unregistered products and conducting unauthorized product recall.

[00:29:11]The wholesale farmer's license for Galaxy was revoked and the proprietor for the Galaxy Pharmaceutical Company was also permanently banned from engaging in any pharmaceutical business in Malawi.

[00:29:27]Later on, the authority noticed that a son to the owner of the company that was banned, in this case, Galaxy Pharmaceuticals, established and registered a new wholesale in the name of GPSL Pharmaceuticals, which was resembling the previous company, but was mostly using abbreviations, was not detailed.

[00:29:53]And this happened in 2019.

[00:29:58]Chairperson and members, you may wish to note that at the time this company was being registered, the board granted approval for registration of GPSL on the understanding that it constituted a separate establishment under a different proprietorship linked to the cases of theft. Honorable chairperson and members, currently we have cases that are listed on this slide. I'm not too sure if I have to read them through or you would appreciate in the interest of time but maybe just to highlight the link between these more practices to the guidance that you honorable chair provided that how do these practices affect quality of services and access to medicines.

[00:30:52]Honorable chair, you would appreciate that government provides resources in public hospitals for procurement medicines for the people of Malawi to access free of charge. And where we have theft and diversion, obviously the public is denied access in the process. And where these medicines are also diverted, we are not too sure where they are kept.

[00:31:21]And in most cases, these medicines are also made available in an informal market and exposed to unfavorable conditions which may also affect their quality. And then we can't guarantee their safety as well where the public is accessing these medicines uh from an informal market where the medicines have not been stored according to the required uh storage conditions.

[00:31:44]So honorable chair and members, you appreciate that on this slide we have a number of cases that are still pending in the court where we have no control in terms of how quickly they can be uh processed in our investigations. Honorable chair and members, the paperbased inventory management system currently in use in public hospitals is a contributing factor to the theft and the diversion because um those in charge of the responsibility um have challenges to account for. And in some cases where theft cases have been identified, there is some sort of manipulation of records and then we fail to establish and conclude cases because of the same.

[00:32:40]Now I take you honorable chair and members to the challenges that PM is facing.

[00:32:46]Following the passing of the act in 2019, we needed to have regulations in place to enable us operationalize the provisions of the act. We submitted our draft regulations to the Ministry of Justice for processing and you may wish to appreciate that the regulations are still being processed where we do not have regulations.

[00:33:09]Honorable chair, we do have challenges to enforce some of the provisions in the act because the nitty-g gritties that are required for us as PMI to operate are not yet provided for.

[00:33:23]The second challenge honorable chair and members is that currently PM is operating uh in Langu and we do not have regional offices in the regions uh of the country north, south and probably uh eastern region.

[00:33:42]Issues of human resource capacity remains a challenge where we have limited inspectors and obviously financial challenges cannot go without mention. Honorable chair, with the global developments currently in place, the pharmaceutical market is becoming thin day by day. And you would appreciate honorable chair and members that as PM our survival is heavily dependent on revenue that we collect from uh licensing and registration of premises as well as products. And where the numbers are declining obviously it has got an impact on how much we are generating.

[00:34:26]And you may also wish to appreciate that on registration the decision to register a product or to retain a product on the register lies in the hands of the market authorization holder in this case is the manufacturer depending on how they look at the market for Malawi. Now PM has no control over which products they should bring in should they see that there's no business in Malawi and in effect it also affect us in terms of revenue collection.

[00:34:58]The other challenge honorable chair and members is where we have delays in clearing court cases that have been uh presented before the courts and obviously chair we also have limited control on how quickly these cases can be processed through the courts.

[00:35:18]What strategies have we put in place as PM to address some of these issues that I have highlighted on regulations? Honorable chair and members, uh we are working very closely with the Ministry of Justice through the Minister of Health, the Office of SH to make sure that the processing of regulations is fasttracked so that we are also effective in terms of our operations on the ground.

[00:35:46]On issues of personnel, honorable chair and members, you might wish to appreciate that PM undertook a functional review which has given provisions for uh establishment of the regional offices in order for us to take the services to the people. And as soon as we got this approval, processes uh of placing members of staff commenced with the guidance of uh uh the department of human resources and development and OBC as well.

[00:36:23]So with the functional review in place, we are sure that we shall be able to establish the regional offices but also recruit additional members of staff including inspectors. You have 3 minutes. Thank you honorable chair. This is not it.

[00:36:41]on strengthening revenue collection.

[00:36:44]Uh we have put in place strict adherence mechanism to the prescribed um currency as guided by um uh the recent gazette notice on fees where we collect our revenue in dollars as prescribed where it is prescribed that we collect in Malawi Patcha we're enforcing the same so that we are adequately financed and we have adequate resources for our operations.

[00:37:14]We are also proactive in terms of revenue collection from prospective clients uh locally and we are vigorously visiting and following up for payments.

[00:37:25]In line with the guidance from the government, we are implementing expenditure control measures to make sure that we save on limited resources that we have through the austerity measures that government introduced.

[00:37:41]And to address issues of efficiency, we have digitalized our regulatory processes and we are continuing with the same in all other aspects of the regulatory processes. inspection and registration. We are processing licenses digitally. Finally, honorable chair, to empower the public to report on any cases of suspected theft and diversion of medicines, come 1st July 2026, we are introducing um a tip off anonymous hotline where the public will have to alert us on any suspected cases of theft and diversion of medicines.

[00:38:26]Honorable chair, I thank you for granting PMR an opportunity to present before you. Thank you.

[00:38:35]>> Thank you very much. We quickly go to medical council of Malawi.

[00:38:39]You are starting at uh I think 10. You are starting at 10. You are finishing at 10 to 11. So you have 10 minutes.

[00:38:50]You are starting at 10. Uh no, you are starting at 20 to 11. So you are finishing at 10 to 11. Thank you very much.

[00:39:15]Thank you honorable chairperson and thank you honorable members for the opportunity uh for us to come uh as led by the secretary for health and sanitation. Uh the first slide presents the outline of what we prepared to present which was shared with uh parliament two days ago. Uh we'll focus on the key areas only in the interest of time. Um, honorable members, you know our mandate. We were here again some three months ago, so I will not go through the mandate. Suffice to say that the medical practitioners and dentist act of Malawi of 1987 gives the medical council the responsibility to regulate medical, dental and allied health practitioners.

[00:40:04]Through that act we have five responsibilities of regulating practitioners, healthy facilities, training, disciplinary and playing an advisory role. Coming straight to the conversation of the day, uh these are the common corrupt practices that are being handled at the medical council of Malawi. The first one is charging for services meant to be for free at the point of care. Uh we have received a couple of in really concerning reports.

[00:40:35]Uh I'll give an example of a patient who came to the medical council complaining that they were made to pay for services and they had to go back home to sell their only piece of land that they depended on which is pretty sad. So the essence of charging for services meant to be for free is pretty common. And there is also abuse of part-time private practice where the employer has allowed them to go and work for locom. Some practitioners tend to abuse that timing.

[00:41:07]Uh the third element that we have been dealing with is on stealing of medicines and supplies. Most of these cases are referred to us by the PM as the director general reported that if it is a practitioner who is regulated by the medical council, they will report them to the medical council and we do take on uh those cases uh and uh deal with them from a professional point of view. The fourth element is using public resources for personal benefit. What we have seen is that some practitioners would refer patients for care outside the facility if it is a public facility when those services are readily available at a public facility. So that where they go they have to make some money from the patients. But we have also seen that uh an an example of that would be usage of diagnostic and treatment services uh for benefit uh at a personal level. The scary one honorable members is issuing of fake uh medical or internship reports. That's another form of corruption that we have seen and related to this of late we have received cases where practitioners come and apply to the medical council of Malawi when their certificates are fake but we are able to identify them and as I'm speaking we have a number of cases in court where we got them arrested and we do our due diligence to uh to make uh those investigations and address them. uh these acts of misconducts according to the act are categorized as disgraceful or unprofessional conduct. Now we have a couple of observations from the medical council pertaining to these acts of corruption. The first one is that really these acts of uh corruption are practiced by a few number of practitioners about 1%. Uh at the medical council we have about 14,000 registered practitioners but those that practice these like for 2025 we're about 101. So it's a few practitioners but the level of uh what happens is what is pretty scary. So as much as we have to think about those that are doing it, we would want to commend those practitioners that are not doing it, which is pretty encouraging. Now when we review the information, we have the data on why these corrupt practices are prevalent. Honorable members, our conversation so far when we do a root cause analysis has been thinking about moral decay and lack of integrity. We have seen that there's prevalent unprofessionalism amongst some practitioners. Secondly, it's an element of inadequate human resource but also inefficient human resource monitoring system where some practitioners employed by their employer leave the facility go and do personal issues and if there is no good way of monitoring will never know if the practitioner is there. We were very happy to hear that Muzu central hospital have installed CCTVs and are really able to monitor some of their workers. We saw in the papers I think that's one of the really good things about you know monitoring of health systems that would be helpful. uh for example in terms of human resource when we look at the number of practitioners we have in Malawi about 3,000 practitioners registered active practicing in Malawi and compared to the population of 22 million we have in Malawi members you see that the ratio is about one medical doctor to about 8,000 Malawians that is very high the global average at the moment is 1 to 600 population so we are having a really uh big human resource gap in Malawi and when we go to those facilities there's also a high vacancy rate we have also seen that there is increasing demand for health care in the context of inadequate resources and the everinccreasing population honorable members you might agree that we are doing very well to build new healthy facilities but data in Malawi shows that every 50 seconds there's a new birth in Malawi a newborn.

[00:45:23]I mean yesterday we were reading for uh for Kasungu we are told that about 80 birth per day Kasungu alone. So the everinccreasing population balancing with the current human resource and the resources that are available for ethic care could be what is causing the burden and then resulting for some practitioners in these corrupt practices. But there is also honorable members issues of poor remuneration and increasing cost of living. And we have had scenarios where patients have also enticed some practitioners. But this is usually as a result of inefficient systems and inadequate resources which have pushed patients wanting to get the services quicker than they are allocated at the particular time. Now in terms of how these issues issues of alleged corruption, how they are being handled at the medical council, we receive a lot of complaints from the public about this. And our source of complaints are the patients and their representatives as we can see from the slide. That's stage number one. We also receive some of these complaints from institutions like the anti-corruption bureau ombbudsman employers themselves uh like the hospitals even the ministry of health is also referring these cases for processing at the medical council. Some of these cases we pick them up in the media as long as there is adequate information for us to be able to follow it. We will take that issue and follow through. Then an investigation is conducted on those issues. Once the investigation is conducted that's stage two the reports are vetted and stage number five uh there's a disciplinary hearing committee that is conducted where the complainant the practitioners are called together to present uh each side of the story and then determinations are made during the disciplinary hearing the ministry of health ministry of justice department of statuto cooperation are always part and parcel of that team and the public is represented and then once a final final decision is made. Feedback is given both to the complainant, the public, but we are also every quarter publishing these findings through the social media, through the newspapers as well as through the website and uh of the medical council of Malawi. All this is in order to educate the public to know they have got a way of complaining if they face them. And this has resulted in an increasing in the reports that we have been handling. Honorable members, as you can see on this slide, moving on from 2018 when the medical council received only 19 reports and we were able to process only 10 uh of those complaints. Going to 2025, we received 101 reports. Out of those 101, we were able to process 75 reports. Our hope is that we should be able to resolve all of them. But you can see there is a gap almost 26 that we are not able to do.

[00:48:18]Issues of human resources gaps, issues of uh issues of resources not being adequate have been some of things that we have been facing. Coming on to the concluded disciplinary cases, honorable members, we can see that the corruption is happening in all types of facilities.

[00:48:36]The first um uh pie chart we can see would appreciate that 32% of these cases are happening in public facilities. 29% are happening in CHAM facilities as well as uh Islamic Health Association of Malawi facilities and whilst 26% are happening in private hospitals and 13% are happening in private clinics. Moving on in terms of the profession we will see that the medical doctors are responsible for the 34 34% of those types of cases clinical officers about 38%. Then we also have got diagnostic staff because these acts of corruption also involve laboratory services, radiography services. That's why you see that about 10% are happening in those type of stuff. And lastly, in terms of specialty, I want to take you to the blue. There are two blues there. You will see that ethics and professionalism which are specific to these types of cases are the topmost 25%.

[00:49:37]So out of the 101 we handled 25 cases were cases related to uh the corruption and the unprofessionalism that we talked about in terms of where the practitioner has been found guilty. What happens honorable members? You will see that we had to pull out a couple of offenses related to this where they have illegally charged patients for services meant to be for free or where the practitioner has received kickbacks from patients. The minimum penalty is suspension for a maximum of four years but they are also required to pay for the cost of the investigation. The maximum penalty is dregistration.

[00:50:18]Deregistration when practitioners are deregistered they have a chance of being placed back on the register but once we erase is also one of the penalty they can never ever practice in Malawi or anywhere in the world because if they go anywhere they go they will ask them if the medical if they registered by the medical council and the medical council will be able to give evidence that they were deregistered uh when they are convicted criminally let's say the PM took that practitioner to court and they have been convicted, they can also be suspended from the register or be dregistered by the medical council as long as they are a medical dental or allied health practitioner. Now, when they have issued fake medical reports or even fake uh internship reports or submitted fake registration certificates to the medical council, they are suspended for a minimum of one year but the maximum penalty there is erasia. So that is how uh these cases are being handled at the medical council of Malawi. Um honorable chair allow me the last minute uh because of time I will stop here because I've handled a lot of the issues that are in the preceding slides. Suffice to say that we have done a lot of work to prevent these things.

[00:51:32]Now at the medical council we demand that every institution include issues of professionalism in their curriculum.

[00:51:39]Secondly we have been doing awareness.

[00:51:41]We visit every hospital annually. We also do visit the healthy training institutions to talk to students and lastly we also visit their associations.

[00:51:51]Another element that we have been doing is that we have gone digital. Now a registered practitioner at the medical council. I mean we just went digital on Monday. Honorable members, you can easily search whether someone is registered by the medical council, but also our practitioners can easily uh apply through the online system and that will help uh people who go to access the care to verify if their practitioner is really a registered practitioner. But we also do produce a list of registered practitioners for the whole public to be aware. In terms of the last request we have uh from this honorable house, honorable members, we have a healthy professions bill uh that is at the level of the ministry of justice. In there we have included more stiff penalties. We have included issues related to dress code and identification of practitioners. So we would be hoping that once it comes to this honorable house, you'll be the ones who are going to support that bill so that it can be passed. uh so we have tried to make more stringent penalties through there but also where resources are available we always appreciate the support that this honorable house has been giving to the medical council of Malawi uh honorable chairperson that's uh the last slide from the medical council >> thank you very much medical council you have done 13 minutes we go to nurs's council 10 It's Uh good morning uh chairperson and honorable members.

[00:54:00]Uh this is nurses and midwives council of Malawi uh to make a presentation on the issue at hand.

[00:54:09]uh but at the outset let me uh say that as nurses and midwives council we are excited to be part of this conversation because nurses and midwives uh is the face of any healthy facility.

[00:54:25]So when issues of uh uh theft corruption and the like are happening it really disturbs us as a regulatory board of the profession. So uh chairperson uh that's what uh we have prepared to share. Uh of course we we are already familiar with the mandate of the nurses and midwives council of Malawi. Uh we are going to also have a look quick look at the regulatory functions.

[00:54:57]Uh the mechanism for resolution of cases that midwives council receive.

[00:55:04]uh the nature of the cases especially we just extracted from the April 2024 to May 2026 the type of cases that we have received then just to share with this uh committee the types of uh the allegations and indeed we'll proceed to see the interventions to address the misconducts negligence and professional uh misconducts that we see with our practitioners. Last but not least uh are the challenges that we face as we transact our regulatory uh mandate. Uh chair and honorable members uh that's what explains the legal I mean the legal basis for the existence of nurses and midwives council. uh we are guided by the act number 16 of 1995 and we are there to regulate the nursing midwiffrey education training practice and conduct of those uh registered under it. So as nurses council in training institutions we are talking about developing the syllabus that will guide curriculum implementation so that in the end we have a product that is able to deliver what the uh Malawi society deserves.

[00:56:28]uh not only in the training institutions, we also look at the issues of nursing in the hospitals in the healthy facilities to see how the nurses are practicing and we also actually very mindful of conduct. Provision of service is another aspect but also conduct is something that we expect from our uh professionals.

[00:56:55]uh chair and uh honorable members the regulatory functions we are talking about development and review of syllabi and regulatory tools registration and licensing of healthy facilities as well as uh nursing and midwy workforce. Ours is a profession for them to practice they have to be licensed. So that's what we basically uh do uh investigation of cases very important for this meeting because that's where we are revolving around and also monitoring and evaluation as nurses and midwives council we are required to go around in the various health facilities in the country to see how the nursing and midwife services are being uh provided.

[00:57:48]uh chairperson and members and honorable members. This is just a synopsis of the mechanism that is there in the nurses and midwives council setup in terms of how we address issues or complaints that have been uh lodged with us. First thing is investigations. When we receive the cases, the complaints, there is a team that goes around to investigate and the reports are submitted or presented to the investigation committee of the council. Uh after that one, the investigation committee escalate issues that have come out of that uh committee to the disciplinary uh committee of the council. uh at this point penalties and everything of that sort are met and indeed we also make referrals because the nature of our job we work with our other players in the healthy facility. So if the case is to do with medical council we make referral to medical council. If the case is to do with PM we also do the same. We also make referral to security agents like the police if their case is of that uh nature. For instance, maybe if it's a rape case.

[00:59:08]Uh this is just a uh a to depict uh num the cases that we've been able to uh to handle in the period January 2024 uh up to May uh 2026 uh chair and members we have nature of cases districts where those cases took place. We kind of tried to identify uh the he facilities but just to get that it happened in which district in Malawi and the status where we are in terms of uh uh resolving uh that case.

[00:59:49]So some concluded some under investigations as it is depicted in this uh presentation. Uh chair let me also just mention that the nature of the complex that we do receive as nurses council is threefold. It's about my practice. Uh this is doing something contrary to what you know as a nurse or a midwife. Uh secondly is negligence.

[01:00:16]You know I'm supposed to do this to a patient but you do otherwise. That's negligence. And then professional misconduct. If you report for example uh for juj wild drug that's uh professional misconduct. So these cases that we are sharing here are all to do with those uh main areas in terms of the nature of the cases. Uh chair the recorded cases in 2024 to 2025 we had 16.

[01:00:48]Uh in 2025 to 2026 we had 14. uh this year is still ongoing and we have so far uh registered three cases.

[01:01:01]Uh we felt as necessary midwives council we should share sources of complaints.

[01:01:06]Most of the cases that we do receive are coming from maternity and when we talk about maternity is all antal care, labor and delivery, postnatal care and neuronet. uh we also receive cases from the general ws as well as cases that have happened outside uh the hospital arena.

[01:01:28]Uh types of penalties is the next that what to share. uh chair when the cases have been uh lodged with the council the outcome could be a warning dependent on the severity of that case uh or just admonishing that particular practitioner or caution in that case we are writing something to the practitioner or to the healthy facility involved suspension is also the one of the remedies dregistration uh and that associated with the period of time that the disciplinary committee determines that a particular practitioner has to be removed for a uh for a specific period.

[01:02:13]Cancellation is also one of the uh penalties. Erasia completely taken out of our register is also uh one of the penalties. And last but not least uh we make referral dependent on the nature of the case. uh chair and members uh the things that we are doing interventions.

[01:02:35]So we started the review uh of the nurses and midwives act. You can see this one is an act number 16 of 1995 so many years ago and we revised it. we finished last year but it's at the stage of at means of justice waiting to be tabled uh in this August house and uh I think that's where we also need your support chair and honorable members to have this because it has included issues that are bothering us currently uh revision of the code of ethics and conduct as nurses and midwives we are guided by a code uh of conduct. We have reviewed that one to include issues that are current uh development and review of nursing and periphery care standards. Uh that is also to make sure that we are up to date in terms of what is expected of us as service provider. Uh development or review of uh miffer competences. We are moving towards a situation where our nurses are performance is measured on competency. Not just me acquisition of knowledge but want them to be uh competent and demonstrate that when they are providing uh patient care. We are disseminating all these documents because there are so many players uh that are involved in the provision of nursing and midwiffrey prayer chair. We also have radio programs so that society is aware that we are there if issues of nursing and midwifree happen they should report uh to us. uh introduction of the to line we have that number to improve accessibility of nursing and midwiff regulatory uh services. Uh chair and honorable members there's what we call continuing professional development.

[01:04:49]Uh we understand our profession is dynamic things keep on changing to make sure that nurses and midwives keep a breast of current events. There's this intervention and we also have a satellite office. Now >> you have 2 minutes >> to increase our uh visibility challenges. Chair, I talked about the bill uh that is there at Ministry of Justice and would love to have it supported and passed into an act so that we address so many issues that we mentioned uh delays by facility or goodsman uh office to report cases. We work with facility on boots and offices. So we have some delays to receive cases from them. Missing of patient records is also one of the challenges. When we are going to investigate, we don't find some records. Uh public awareness of the existence of the council isn't that 100% and that's why we have those uh radio uh programs. Uh disfranchised society is one thing. chair uh not so many are able to report cases even if they haven't received global care in the facilities uh professional remedy and composition some think is there to give composition so the the expectation is like uh dwindles when is the addresses to do with professional issues uh resource constrance is one of the issues that also affect us to quickly investigate the cases that are reported to us. Uh chair, that's what we had as nurses and midwash council to share. Thank you chair and honorable members. Thank you.

[01:06:44]>> Thank you very much uh for that uh beautiful presentations very insightful presentation. So we've been having this uh interface with various uh stakeholders starting from Monday but we deliberately wanted to have you here today on the final day because you are regulators.

[01:07:06]Most of the cases being reported here are involving your staff staff members.

[01:07:15]That's why this committee decided that you appear on the final day after hearing from other stakeholders. Time for plenary uh honorable members questions in Zumba city south.

[01:07:31]Then we go to Kodakula. From Kodakula we go to the people the wise people of Chiao Central East. From CH Central East, we go to the people of Jipa South.

[01:07:47]Then we finish off with the people of uh Zimba.

[01:07:51]Thank you very much. In that order, uh chairperson, thank you so much and through you I should thank SH and this team for the very elaborate presentations.

[01:08:06]chair. Um I have two questions but first let me u mention that I think we are living in a time whereby the moral decay as presented by Dr. Zoe I think it's a concern.

[01:08:28]uh I think no sector has been spared and it's sad that even the medical practitioners they they also accept that the moral decay has also gone into the professions it's very sad as a medical doctor a nurse working while being supervised under CCTV I think it's very unfortunate it's supposed to be a calling it used to be a calling this profession you know so it's a very very unfortunate but I think I to commend as SH and your team for the fantastic job that we are doing. Chair, I wanted the medical council and PM also to uh clarify certain areas.

[01:09:11]The issue of Galaxy company me I was smelling some criminality in that. So I was very disappointed that the company was it closed but the owner was not even apprehended.

[01:09:25]But I I was smelling some criminality. I think those actions of selling us was that insulin that was expired. I think this is criminal. So I thought maybe SH would also want to speak to that. Does it mean that our acts whether it's a PM act or pharmacy act or the indeed the public health act are inadequate to catch these criminals and make sure that they don't repeat because if you let let them squat free they can do it again.

[01:09:53]And this is what the presenter also mentioned because I think the penalty was not adequate. So I thought maybe SH would want to speak to that.

[01:10:05]Secondly, chair um PM did mention about short shelf life of donations and I think one of the products I think it was insulin it had a short shelf life. I think the director general mentioned that but I don't know if you have taken an action to say do we continue to receive donations which have got short shelf life. I didn't hear any action on that one. Finally chair I said two questions but allow me to ask a third one.

[01:10:35]Medical council it was a brilliant presentation but you said you have got issues resolving cases uh for 19 2025 you remaining with 26 cases if I got you correctly. I wanted you maybe to zero in what type of uh cases are remaining are these very serious ones and in the meantime because you have not resolved them what is happening are you using the same transfer issue asking the DHO to transfer someone because you are not you have not resolved because the transfer let's face it it's not a it's not a solution when only moving a problem from to etc. So I also wanted to hear from the medical council what is happening in the meantime with these 26 unresolved cases. Thank you chair.

[01:11:19]>> Thank you very much the people of Zumba city south. I think I need to make uh uh some um guidance here. I know SH may um want to tackle your first question regarding the galaxy but these issues are in court. When we are coming up with this inquiry, we are mindful of the fact that we have this issue which is under investigation and it is in court. um well the SH might choose to address these issues um carefully considering that the case uh well and that's what the cl is uh telling me here I think sh um uh for the avoidance of uh other legal issues we may paint this question and I consider the other three questions or two questions that the people of Zumba city south have asked we go to Um, >> uh, thank you so much here um for granting the people the people of God uh to ask um, uh, two qu two quick questions, two brief questions.

[01:12:37]>> Directed to who?

[01:12:39]>> Uh, to PMI PR >> PMI.

[01:12:43]>> Okay. I like the MRI thing but the addition of P yeah to PMR you mentioned of delays in finalizing the uh regulations at the Ministry of Justice.

[01:12:59]Uh the question is uh do you have any specific legal uh reforms that would you like you would like the parliament to uh prioritize so that they empower you to act decisively if I think that's clear.

[01:13:23]Uh the second one is uh would you like uh parliament to legislate mandatory disclosure uh of disciplinary actions um across all regulators or hospitals just to make uh the patients uh patients and communities aware of breaches and uh uh sanctions.

[01:13:55]Is it making sense?

[01:13:58]Thank you so much. So those are two brief and very quick questions. Thank you the people of Kodakura.

[01:14:06]The first one is about the regressions.

[01:14:10]Uh we know uh the regressions are there and other processes are happening. Uh but in the meantime, what else can uh parliament do regarding the legislative reforms that PMA would would want this committee to advance in the national assembly considering that the other processes are already taking place with regard to the regressions and uh the second one uh is also coming from the people of Anodangula where he's uh asking of seeking clarification whether the regressions may also want the mandatory disclosure of disciplinary actions taking place.

[01:14:55]Right, we go to uh Zimba.

[01:15:05]Uh thank you chair for giving the people of Zimba to ask some questions.

[01:15:12]Uh but also let me also thank the SH and all the presenters for their wonderful presentations.

[01:15:21]H sh I've got two questions.

[01:15:24]The first one goes to NMCM and the second one to PMA.

[01:15:33]uh to NMCM uh CSOS emphasize the importance of community oversight.

[01:15:43]How can NMCM advocate uh I mean integrate civil society and patient advocacy groups into the regulatory framework so that we should ensure equity to protect vulnerable patients and from misconduct.

[01:16:10]Uh the second one goes to PM.

[01:16:19]What realtime pharmaceutical tracking systems or mechanisms currently exist to prevent strange drugs from re-entering the public supply chain?

[01:16:32]and the labels.

[01:16:34]Thank you.

[01:16:41]Oh, thank you very much the people of Zimba.

[01:16:45]Just to reinforce the the point regarding the issue of uh uh the first question coming from the people of Zumba uh city south. So standing order 192 one a matter before court of law subject to the right of the assembly to legislate on any matter matters awaiting or under adjudic judication in any court of record shall not be referred to any motion debate or question from the time the case has been uh set um uh set down for trail or other words before the court if there's a real danger of prejudice to the trial of the case.

[01:17:36]That's why uh uh sh you can not tackle that question because we aware that issue is and is in court. Thank you very much. We go to the people of South.

[01:17:52]Uh thank you so much honorable chairperson for yielding the floor to the people of Chipa South.

[01:18:01]The people of Chipa South intend to ask two questions to PM.

[01:18:11]The questions are a direct reaction to the presentation by the director general.

[01:18:19]In his pres in his presentation, the DG uh mentioned that they intend to go regional following the functional review and it is the understanding of the people of South that if regulators are visible uh some of these corrupt issues can be minimized. So the people of Chiba South want to establish from the director general when exactly PM will go regional.

[01:18:56]The the the the second question emanates from the anti-corruption bureau. Yesterday we heard from the anti-corruption bureau that 35% of the medicines public medicines are stolen and the figure is quite alarming.

[01:19:25]It it is the wish of this committee first of all to confirm with you as a regulator that is it true that 35% of our medicines are stolen.

[01:19:39]Moving forward, we'd also want to hear from you as a regulator. What measures do you intend to put in place? Because most of the people that we hearing medicines are people who you you regulate. These are pharmacy professionals. If it's true that 35% of medicines go in the drain, what are you doing as a regulator to cover the same?

[01:20:03]Thank you so much, chair.

[01:20:05]>> Thank you very much for those questions coming from the people of Chiba South.

[01:20:09]just to also comment on the final question. So the 35% um uh drug theft is taking place between at the point where the drugs are taken out of the central medical stores going to uh where going to various destination and the drugs are diverted to privateies along the way. So I think this question can also be addressed by the SH because these are the public drugs coming out of central medical stores getting diverted to private pharmacies and institutions as they are going to their designated destinations. So SH take note and of course uh PR you can also come on the people of WH central east.

[01:21:01]Thank you chair for recognizing the people of NH Central East. Uh my first question is to the nurses council especially on the point of training. I'm not clear the way uh the nurses council is administering their qualifications.

[01:21:22]For example, first of all, there's this g of nurses understand the midwives.

[01:21:29]There's one year training these people.

[01:21:33]I wonder uh if they indeed regrated by nurses at Midwest Council of Malawi. I'm asking these questions because uh these nurses, they're not even allowed to work in private hospitals. They only allowed to work only in government peripheral areas, remote health centers. Secondly, on the training of nurses 3 years, what I know at first nurses were trained, they were getting certificates in nursing after completion of nursing and doing midwife. They were given those certificates that they have completed training as a nest midwife.

[01:22:16]Currently because maybe of political inter political interventions these people that now offered diplomas.

[01:22:26]So it's confusing in terms of employers that why should somebody be given a sort of a diploma yet they're supposed to be given certificates and if they are going for upgrading I understand probably these in order midwives for a degree program they needed to undergo for most three to four years yet somebody who is a state regist nurse after obtaining a diploma at college of nursing you can go only for 2 years to obtain a degree. So I'm wondering if their diplomas are they equivalent or not? Please clear us on this point. Thank you.

[01:23:09]>> Thank you very much. The second question is to the um yesterday we had u anticorruption bureau here and anti corruption bureau was claiming that about 35% of drugs are diverted from said to medical stores on the way to the district hospitals um if even if you try to find out you find out that most of the drugs about even out of that uh 35% % about 20% they cross the borders outside this country.

[01:23:44]For example, if you go to Dleslam, there's a city called Kyako, you find drugs being sold by vendors in markets labeled property government. So I'm wondering if PMA is serious on this especially if you are security agents for example if people are that traveling from they have embezzled the drugs from Long Blanta to the border Konga there are so many uh road blocks on the way.

[01:24:14]So what are I doing as PM to see to it that our drugs should not even cross the borders. Thank you.

[01:24:22]Thank you very much the people of uh central east, the wise people ofu central east for those uh beautiful questions, comments and observations.

[01:24:34]The continuous development programs of nurses amid wife. Please take note.

[01:24:41]We go to kab uh we go to zimbasa. The final one.

[01:24:52]>> Thank you, chair.

[01:24:54]Before I ask my questions, I would like to uh to give a point of order.

[01:25:04]Is it an order that um Zumba >> city >> city south to say I don't think is a good way. Thank you.

[01:25:20]>> Uh that is thank you for that point of order and uh we rule uh Zomba city south out of [clears throat] Thank you very much.

[01:25:37]Thank you. I should continue with my questions.

[01:25:41]Uh my questions goes to ministry of health. Uh if low salaries and staff shortages drives corruption. What is the ministry doing to fix uh these roots causes? And secondly, if private practice abdu persist despite regressions, who is fairing in enforcement and oversight? Thank you, chair.

[01:26:10]>> Thank you very much. two questions from uh and the people of Zimbasura going to the ministry of health low immunations and other conditions associated with uh healthcare patients educated on the medical standards and the second one is on same to MCM part-time private practice uh has been lots of people have mentioned about it and uh uh as being one of the factors or one of the issues that's causing absence of doctors from the hospitals that's the services are suffering because of the private practice. Uh why has MCM not banned or strictly regretted it?

[01:27:03]Are we protecting doctors over the patient's lives?

[01:27:10]Um in addition to that if or or should we consider uh banning or strictly regretting it uh what would you what what legal reforms what specific legal reforms would you want parliament to pass so that they can give you powers to stop the abuse in the hospitals.

[01:27:34]Uh the last one is on the community oversight that has been pushed by PWM.

[01:27:40]Uh the PAM and CSOS were in the forefront pushing for this oversight. Why hasn't MCM integrated civil society into your regulatory framework uh so that you do a con an inclusive consolidated scrutiny? Thank you.

[01:28:05]>> Thank you very much the people of Danut.

[01:28:07]As a matter of fact uh SB was here yesterday. They asked as asked this committee that wish to advance legislative process in the national assembly to the effect that there should be a ban of a private private practice by the medical doctors because according to SCB the corruption the corrupt practices in health facilities are also being influenced by the private practice by the medical doctors. MCM kindly take note. Pare it's your time to start tackling the questions then we move to MCM then uh NES council.

[01:29:00]>> Thank you very much honorable chair and honorable members who have asked questions to PM.

[01:29:06]uh with with your guidance chair I will only go straight to one question from the honorable member from Zumba city south where uh the honorable member is asking about whether I think in relation to the short shelf life of the donated insulin.

[01:29:28]Uh chair and members, you may wish to know that PMR has donation guidelines that should be followed whenever a donation is to come into Malawi and for a donation to come into Malawi, we request for documents that provides all the required information uh regarding um the provisions established by PMA. One of which is labeling where on the label you would find information about shelf life. When is the product expiring? When we scrutinize that we grant approval. When we are not in agreement, we do not accept. And the ministry of health also has got guidelines uh that also stipulate that any donation coming into Malawi should have at minimum 18 months shelf life.

[01:30:28]Now we are also guided by the same to say if anything okay maybe before I talk about that the whole reason why this period is prescribed is basically to allow for the transit time the distribution in country and then the use of the same when we have the product on the ground. So we have guidelines in summary honorable chair and then we issue import pay per payment for donations and this is one of the things that I'm also doing. I'm happy to report that even the ministry when they are receiving donations they will apply to PMI to say we are receiving donation eggs would you grant us permission to and we have documents to that effect. Of course maybe we may not have brought them here but we do. So the challenge with donations of this nature, honorable chair, is that uh sometimes people are not in the know. We have uh facilities like Queens for example, you've got specialists and experts who have connections with some other um uh colleagues maybe outside the country and then they would donate direct to them and this is probably where we have this because they're not in the know about uh the existence of the guidelines. Maybe going forward chair it will be an issue of increasing sensitization about the existence of the guidelines but also the protocols that have to be followed.

[01:31:54]Um the second question uh came from uh the honorable member from is ita sorry for pronouncing it wrongly. So it was linked to our challenge on delays in finalizing regulations and the question was whether PM would need any legal reforms that parliament or this honorable committee would probably help to intervene. That's one thing. Um and then the question second question probably is also linked to the same because it's linked to legal reforms in a way. So let me handle it simultaneously. The answer is yes.

[01:32:37]and where exactly uh I will take you to the point where uh the act provides most of the fines that have been outlined in the in the act they're talking about the court administering the fines. Now when you have inspectors on the ground doing their work on day-to-day basis, they come across an issue that requires an immediate or an administrative fine was sort of not allowed because of how the act was crafted to say upon conviction and sentencing by you see. So in that effect we are sort of limited to enforce unless there's a separation between those fines to be administered by a court uh after taking through the court process and then we have separate administrative fines that the inspectors can impose there and then. So this is probably where we need the intervention of this uh honorable committee and you asked about uh should parliament uh okay so it's linked to the same mandatory disclosure or something I didn't get that one right if you may come again on that one.

[01:33:54]Can you use mic?

[01:34:00]>> Yeah. Okay. So, what I was trying to say is uh would you like parliament to uh give you power to uh disclose the preliminary actions that are taking place?

[01:34:14]>> Yes.

[01:34:17]Is it clear now?

[01:34:18]>> Thank you.

[01:34:22]>> Yes. Honorable uh member for yeah thank you very much for this uh clarity.

[01:34:29]If that is doable, honorable, this is going to be appreciated. Uh because uh we do have some gaps in the in the act where sometimes if a decision is made to publish the disciplinary actions that the regulator has done. Uh there's always fear to say are we not going to be sued because we are an entity that can be sued by nature of its existence.

[01:34:53]So if we have clear provisions in the act to say where the authority has taken its regulatory disciplinary measures uh the authority is cleared to proceed and publish we can also be happy to have that kind of intervention through this committee. Thank you very much.

[01:35:14]Question number three came from Zimba Penzi.

[01:35:19]I think this was related to the presence of a real-time tracking system in relation to uh was a preventive measure to prevent re-entry of drugs into the public circulation. Right.

[01:35:34]I think this would be probably be tackled by SH but maybe I can preempt to say uh the ministry uh is working towards digitalizing the supply chain uh to have a system that gives little time and visibility in terms of movement of commodities from the central medical stores uh down to the last mile and then how the same should be accounted for uh using the national identification system I think will highlight that one as he's concluding his remarks Question number four uh came from uh Chipa South. Uh this was in relation to the establishment of regional offices as mentioned in the um uh presentation by PMR.

[01:36:20]The question was when are we having these offices in the regions?

[01:36:26]Um let me indicate to honorable chair that as PM as soon as we got approval of the establishment after the functional review we are set to start implementation.

[01:36:41]The first step that we had to undertake with the uh support from the government was to do uh placement of staff members because we as you are aware honorable chair and members PM formerally existed as pharmacy and medicine pharmacy medicine and poisons board. So we had staff members who were recruited under that establishment and then when we transitioned to PM as an authority we undertook the functional view so that we have got proper uh uh bodies in position to execute the new mandate. So placement has been done. Of course we have got a few challenges to that effect but one of the uh provision that is in the new establishment is the creation of the office. So what has prevented us so far is the uh probably uh uh you are aware that there is recruitment freeze currently being enforced by the government. So as soon as this is lifted we will commence recruitment processes and then uh we'll have the offices uh established.

[01:37:52]Um the other question was it also from Chipa South? It's linked to the SCB 35% drugs stolen from public health facilities.

[01:38:03]Um maybe not necessarily to agree with the percentage because we have not seen the report and what sort of assessment tools or methodology was used to establish these figures.

[01:38:18]Uh but wholesomely we can agree that privilege of medicines is really an issue that is haunting us and the limitations that we have in to some extent is how the same is handled through the court processes because it takes time uh to clear them and obviously our hands are tied like the honorable chair has also uh alluded to Um there was also an issue to say the majority of these medicines are lost in between central medical stores and the health facility and the question was what action is being taken.

[01:39:03]I just wanted to mention uh through your chair that vehicles that are transporting medicines from central medical stores to the health facilities are tracked. There is a tracking system that is in place and any illegal diversion using a central medical stores vehicle would be captured through the system. But the diversion that is being me mentioned here is where hospitals have run short of medicines in the middle of the routine supply cycle of the central medical stores where now they use their vehicles to go and collect medicines from the central medical stores and then their vehicles they are not tracked and this is where the opportunity to divert comes in but not the central medical stores vehicles because they're tracked.

[01:39:58]Um the other question I think this was also linked to the crossber issue medicines labored for Malawi government found in Kalako in Tanzania across here.

[01:40:10]uh we may need to establish but we'll task our inspectors and probably maybe with the guidance of SH maybe we may have to go and see some extent across the other side to say how do they get these medicines from Malawi across the borders and we are also going to see how we can collaborate with our counterparts from uh the Malawi revenue authority and all those that are managing the border post.

[01:40:44]So through the office of the SH we ask for uh a coordination and collaborative mechanism to see how best these medicines of course I know maybe they use uncharted routes I don't think they go through the normal border post but this is something that we may have to establish >> and the other question I think is for the ministry I think for PM these were the questions that I took note thank you >> thank you very much we go to medical council of Malawi Thank you.

[01:41:19]>> Thank you honorable chair and honorable members uh for the questions that were shared from the medical council of Malawi. The first question we received was on the 26 remaining cases from 2025.

[01:41:34]Uh honorable uh member uh all cases that are reported to the medical council are always concluded. It's just that by by January when we were finishing the financial year on the 31st of uh March 2026, we had 26 cases that were remaining from the previous year. But as I'm speaking, I can confirm they are all serious cases and all of them are at different stages of being processed.

[01:42:04]About 10 of them have already been investigated. We already took them through the disciplinary committee and on 25th and 26th of June they are going to be presented to the board which is the main council for decision making.

[01:42:18]The other remaining about um uh about uh 16 they are being planned for presentation to the disciplinary committee the first week of September together with some cases that have been reported newly in this financial year.

[01:42:32]So we can assure you that every case is taken until conclusion but what we wish for is that within 6 months we hope to be concluding all those cases. Uh that's what we are intending to do would be able to do that with more resources including human resource. Uh honorable uh members the second question was on mandatory disclosure of disciplinary case outcomes. Uh we are happy to report that the medical practitioners and dentist act section 53 already mandates the medical council to publicize the findings of all disciplinary cases. And this is the reason why at the medical council after the board has concluded the case would always put up a press release in the newspapers and then would also make them widely known because we have seen it has improved even reporting of similar cases but also made other practitioners to learn and avoid doing similar issues. Uh the other question that came uh to the medical council of Malawi uh was on including the public in regulation. Uh we are happy to report that already the act provides that the medical council of Malawi council itself should have representative of the public and as the government is appointing members that is taken into consideration but also when we are handling the cases at the disciplinary committee patients and the public are always represented. We can give an example of the Malawi Health the Equity Network which is an organization that represents patients. they are always available in the disciplinary cases because we want the voices of the public and the voices of the patients to be taken into consideration. So that one is already handled. Um the last question honorable chair was on anti-corruption bureau and private practice and I think that's um a big elephant in the room uh that has been conversated at you know all levels and it's really critical for this committee to be aware uh honorable chairperson uh at the medical council we have different types of private practice we have full-time private practice where a practitioner doesn't work for for example for the government but they own the healthy facilities themselves and that is what they do full-time very much less issues there of course we know that other unscrupulous practitioners can go steal drugs from another facility and sell there but every time we visit the fulltime private practice we are always checking the evidence of where they bought the drugs and PM do the same we also do the same as medical council. If we find that there is a drug without a receipt and that receipt has to be from a pharmacy that is regulated by the PMA, if we find that drug, we close that facility and we hold the facility accountable for theft and the practitioner themselves are held accountable by the medical council and the license is sometimes actually withdrawn whenever we find those cases.

[01:45:43]So I want to assure this committee that there's a lot of work that is being done about that already. The second type of private practice, honorable members, is part-time private practice. And part-time private practice is where that practitioner is employed by another employer, but during their free time, they go to work elsewhere and they have to meet the minimum number of hours required by the employer. They also have to meet the minimum number of hours required by law according to the labor laws. So if they have worked for example 48 hours they have completed and they have extra time they use that time to go at another private private clinic. Uh that's what we call part-time private practice. Now I want to say here that it was introduced by government obviously through this parliament and I'll quote the I I I'll give a bit of details on that but the reason why you approved it was that a long time ago when medical doctors were going outside of Malawi for training and they looked at the remuneration package you had in Malawi.

[01:46:53]None of them wanted to come back. So in order to encourage them to come back and when they come back to Malawi so that they can be retained in the system whether private or charm or public this was started. It was an essence of retention of staff. Honorable members I can give an example when we look at our register at the medical council we only have got three cardiologists in Malawi only three. And what happens is for long there's only one cardiologist who is based at KCH. So when you have one practitioner and usually most of them they look at the money that they get paid at the end of the day. If they were only to be depending on the salary they cannot even manage to send their their children to a good school. So during the part time they allowed to go to work elsewhere. It has been a retention strategy in Zambia is the same. Actually the whole region is the same. Even in Europe, even in so before it happened here, there was a team that had to do a benchmarking to see how it could be done in Malawi. So it has been a tool to retain staff. Honorable members, every year we are having 300 practitioners who are leaving Malawi. If public if part-time private practice is completely stopped this number is going to go skyrocket and the chances are there will be very poor services available to Malawians because most of the experts might leave so that's one essence that has to be looked in into that has happened research has shown countries who completely ban completely banning private practice people have left to go for greener pastures elsewhere the good thing about private practice is improved access to services. Sometimes there are so many other big hospitals which have the resources but they don't have human resource. So if the ministry allows their practitioners to go there, sometimes they will allow them to offer the services using resources for example at that private facility but just using the hands that is coming from either another CHM facility or from the public service and it has also improved patient choice. Now that is not to say that private practice doesn't have problems.

[01:49:06]It has huge problems and before going to those problems the medical practitioners and dentist act section 38 that's where now it says that in order to retain the staff the government through parliament said practitioners might be allowed part-time to go and work in private. The medical council just doesn't give the license without any restrictions.

[01:49:30]Honorable members, firstly there has to be a letter of application by the practitioner. Secondly, the employer has to allow them. In fact, I want this honorable house to be aware there are other employers who don't allow private practice at all. If the employer doesn't allow private practice, the medical council doesn't give a license to their employee because in the regulations this was a control. For example, we know CHAM facilities, they allow some CHAM facilities allow some of their employees to practice in private whilst some CHAM facilities do not allow. As long as the employer has not allowed them, then the medical council doesn't license. That's one element and a control that is there. And if it is someone who wants to participate in full-time, we require a letter of resignation or a letter that they were fired from their employer and then only then they are allowed in full-time uh private practice and then they are also assessed for eligibility. There are other practitioners who are not allowed for private practice if they if their behaviors are not correct and we have documented evidence but also their experience is inadequate. For medical doctors, they have to work for a minimum of two years. For clinical officers, they would have to work for a minimum of six years. So that's how we regulate.

[01:50:50]And lastly, there are practitioners who are allowed to own clinics. Okay, even though they are employed elsewhere. Now coming to the how this can be managed, we think that there has to be a balanced approach. um the way the regulations are and the way the act is already is providing so many safeguards so that people don't just start private practice on their own but their employer is key um practitioners working time at their primary employment it has to be tracked I think that's the element first element second element there are disciplinary processes already for those who violate private practice already at the medical council When we receive a letter from an employer that this one is not adhering to the regulations, we invoke that license. So it is taken away and they are no longer allowed to practice in private. Also as I said the employer can decide even the public system can decide to say we don't want our practitioners to be doing in private because ultimately that letter of authority has to come from the employer in this case either the director general but it always has to pass through the ministry of health. So if the public decides then the medical council will follow through.

[01:52:08]There will still be private practice but not for those ones that are working in the government. So it doesn't need a law. We already have safeguards that can allow that to happen because as every employer has got a right on managing uh their employees accordingly. And the other element is on ethical and professional conduct among those who are involved in private practice. But also there are some issues of increasing remuneration. If remuneration is increased, some of them would automatically stop. And I want to let this house aware that some we have received over I think 200 practitioners who have seized doing private practice on their own making a decision on their own. So those are the safeguards but a balanced approach really is required because others do private practice very well and they are some of the most harding workers wherever they are employed whether it is in the government or it is in char. So whenever we take this off we'd be punishing all the very same way. So there has to be a balance of holding those accountable accordingly but those that are also doing well to be held accountable.

[01:53:14]All right. Thank you.

[01:53:16]I think in short what the do is saying is u uh is asking the committee not to undertake the legislative processes that uh SB asked this committee to undertake just to review the act that you have mentioned here we go to N's council >> [clears throat] >> uh thank you very chairperson and honorable members. Uh I think I'll first take the question from Yes. Uh >> central east. It's in central east.

[01:54:00]>> And central east. Uh thank you very much for your questions. Uh let me first of all mention that uh uh when it comes to nursing and medical regulation and registration uh we have level one and level two um of our professionals. Level one are those that are on professional uh status. These are uh nurses with a bachelor's degree going up. Uh level two we have technician and these are with college diploma going below. So uh CM uh community midwiffery assistant because there was a mention in the question about training for one and a half years or one year uh it means that's about CMUs. So uh chair uh CMUs uh came in Mar as a replacement of traditional birth attendance.

[01:55:01]Uh that was around 2012 2013 when maternal death was just very high. We were at 675 per 100,000 life beds and in death we were at 47 1,000 life beds. So government made a decision how can we make the services accessible that's why we introduced the CMS and and and as much as we needed to do domesticate our interventions we also have to be relevant to international standards so somebody has to be trained not less than a year to be called a midwife all right so that's why this uh community midwiferary assistants were introduced were were actually trended at I mean within that period of time and one of the reasons to have these CMs deployed in the rural areas or the peripherals the way you put it uh the government of Malawi was also looking at what we call the three delay model. What are the delays? What factors uh prevent pregnant mothers uh from seeking healthy care? So there were issues of delay in decision making and delay in the distance uh I mean the dis distance issues long distances as well as delay to be given the care. Now most of our mothers are in the peripheral areas where we have all these problems. Now that is the one of the reasons why the CMAs have to be deployed to the peripherals or to the distant areas of our country. So I just wanted to mention that why the CMAs are often in the in the rural areas. Now uh the other question was about confusion between the registeredness and uh NMTY maybe when it comes to salary scale they're at on the same uh uh level. You are right honorable. Uh as as as as nurses council, the decision that was taken was to phase out the registered nurse. This one with a diploma because we also have this NMT nursing maybe for a technician with a diploma and this is a a college diploma.

[01:57:27]I mean uh diplomas that are obtained in most of the CH colleges in Malawi and Malawi College of Health Sciences.

[01:57:37]So uh the decision we took because of that confusion in terms of starting point for salary and what our view we said no let's have this card phase out and that was also in line to st to straighten the kink in terms of career progression because when we are determining the qualifications remember as a regulatory body we are also doing this in leazison or in collaboration with universities. So universities also have their criteria to admit uh somebody into the system. So we wanted actually to make sure that uh uh we just f this out. Then we have the NMTS that will be obtaining the diploma from the CH colleges. Then we have BSC that are in the university colleges and that sort the the the intervention that was put to address the uh the problem. Uh that's about the uh I think the questions that came from CH sorry South >> Ch uh then I'll progress to uh Zimba is it very yes uh the question was about why is it that we are not including or what is that we can do to include civil society uh groups in our regulatory framework.

[01:59:01]work uh on that one. Uh our act this is and midwife's act number 16 of 1995 provides there's a provision in the composition of the council to have a representative from from uh from the from society. So we indeed have uh representative from the society in the decision uh making processes of the council. And not only that, I talked about some of the interventions that we do like uh dissemination of our regulatory services. We make sure we invite uh civil society groups uh for them to come in and play their role in terms of sensitizing the masses uh for any nursing or medical regulatory services. So that's what we u uh basically do even in the reporting of cases we empower in terms of information sharing the civil society groups that in the act there's a provision that should you see um violation of nursing and mutual service provision report to the council so they can directly report to us as a civil society and we work uh within and the like in this uh regard I think the same question was also kind of reflected by DA uh DA chair yeah so it's the same thing that our act provides for inclusion in the composition of the council a member from uh from society and we also involve them in the uh issues that I've also alluded to so chair that's the question that to NFC thank you chair >> thank you very much We go to the people of North.

[02:00:58]>> Uh thank you very much chair. Uh you also recognize the SH and all the presenters uh in this room. Thank you very much for granting the people of Chipa North Consuency to ask two questions.

[02:01:14]Uh the two questions goes to the nurses council and midwife uh in Malawi.

[02:01:22]Um we had a consortium of journalists some few days ago and also the cso who submitted in their submission they highlighted the exploitation of women especially in maternity awards uh through uh cohesive demands that are made and looking at that how does the council ensure that there's accountability when d midwife the condition care on the official payment and official payment during the labor and delivery. So how is the council ensuring this that there's accountability on this kind of behavior?

[02:02:08]The second question is about we also had man yesterday and in their presentation they reported that there's weak conference resolutions mechanism especially in the hospitals and um you also highlighted that there are some delays with theman in your presentation. So how does the NS council um coordinate with the hospitals integrity committee that is available in the hospitals and also with the man to ensure there's disciplinary outcomes that are there um consistent and also transparent and also to reduce the delays that we mentioned. Thank you so much.

[02:02:59]>> Thank you very much. Uh two questions to N's council.

[02:03:06]Uh thank you very much honorable uh south >> north the opposite sorry uh indeed uh as nurses and midwives council we have heard uh cases of uh uh nurses or health care providers demanding uh some sort of payment uh for patient to be taken care We have heard that you you know the way we operate is very legal in nature because we have had instance where when those that are defending themselves in other words they responding to a case uh they demand that there must there must be somebody who has complained to the nurs's council Um so in that regard as we speak as necessary midwives council we have just had we haven't received uh a complaint uh officially receiving that complaint that okay I had this then how can we redress so that's the situation but we we are saying we can't just sit and watch as a regulatory body what is that we can do to navigate so that because it's really disheartening to see visibly poor client coming in the facility a provider like myself demanding if it wanted southern to be on the list to theater it's inhumane so we are we are working on that one but we are also sensing the society that there must be a formal complaint for us to to follow the legal procedures when it comes to addressing complaints so that's what we are basically doing on the coordin ination uh with the onsudsman offices at healthy facilities indeed we have challenges I happened to attend a meeting of stakeholders on the same I remember minister was there and the agreement was that because the composition of those who man the ombbudsman office at a healthy facility they of low card what I mean is that sometimes they fail to report a case that is to do with a medical doctor, a colleague for that matter at that facility. Maybe they are not very courageous enough to report that case for maybe a DNO or a senior person at that facility. The discussion was possibly maybe we should attach this one to quality director of the ministry so that this reporting issues are straightened. Uh there's nothing like I fear to to reporter but my senior or something like that. So that's what we are doing to make sure that clients access our services regardless. Uh chair that's what I can actually put forward as a response to to their [clears throat] question. Thank you chair.

[02:06:11]>> Thank you very much. Reaching this far we hand over to the SH to respond to some of the questions raised and of course your final remarks.

[02:06:22]Thank you very much uh chair and the committee.

[02:06:28]uh [clears throat] there were a couple of questions uh that were directed to the ministry. I mean just to mention chair the one regulator that is not here the health service commission uh we look at conditions of service.

[02:06:47]So none of the entities that are here talks about conditions of service of staff. The health service commission is one that is mandated to hire and fire and look at conditions of service.

[02:07:04]The issues that have been raised will be presented to the hair service commission chair on the remuneration. In fact, the process has already started. There's already a draft review of conditions of service for healthcare workers.

[02:07:18]uh only that most of the members of the previous committee their time has expired this May and there's a new uh uh commission that is being uh formulated.

[02:07:31]Uh secondly um the various entities are talking to uh various cutters within the sector but also infrastructure or or uh firms. So um the medical council has mandate on clinics and other healthcare providing uh facilities, PMarmacies and licensing the same.

[02:08:11]Uh it is noted chair that in terms of premises some of the owners of the premises are not themselves professionals but they may recruit a professional.

[02:08:26]Sometimes that gives a little bit of problems um uh how you criminalize uh uh uh the entity. So that's also one area that would have to be looked at when you're looking at uh institutions.

[02:08:45]There were few questions chair uh on on the SCB. I I'll start with SCB. uh they mentioned uh 35% of medicines u uh diverted or stolen uh we surely would need to get to be closer to ACB to understand uh the that magnitude yesterday we did uh acknowledge that there's theft but is it 35% % is it 30%.

[02:09:27]Chair we know where large volume medicine movement is that knowledge maybe SCB has but my office has we know where large movement of medicines takes place.

[02:09:43]The challenge sometimes we have is if you know there are well-wish Malawians chair that give information accurate information sometimes the challenge is how do you move immediately they will tell you that today there've been people from this most of neighboring countries are in country they are meeting at place so so and they're transacting But my office doesn't have cash cuz you need to move immediately. Uh and then you have to have a system that really can stamp on that. Let me just mention chair that the time the previous time I was in office uh in 2019 the president the president assigned an officer uh even from MDF directly to deal with this issue. So we know and we saw the changes we we could track them. The only ch challenge MDF had was they don't have prosecutory powers.

[02:10:53]Prosecuto powers are not with malai defense force but the information is there. Uh the national intelligence service shares this information. So it is there. I think it is issue of uh what is the best way we can nip.

[02:11:10]I mentioned chair yesterday uh the case that has just concluded now it's no longer a court case so we can discuss it of a foreigner who probably the biggest buyer of medicines within long people may not know what has gone down to get to that level uh but I mean my auditor was mentioning where our challenges are fortunately the director of public prosecution is taking that case up so We we are we can't leave this unattended. We managed to do uh why can't we do this one? I think it requires real commitment and it can be done.

[02:11:55]Um so the 35% uh would chat with the SEB uh but we also need to get a system that responds on time responds on time uh and and and uh gets these issues concluded as much as possible. Chair, what we are requesting on the legal side is custodial sentence, not monetary.

[02:12:26]Custodial sentence is what we are requesting um uh for for for us to to nip this.

[02:12:36]Um I think the uh we've tried chair to meet the SCB and OM on boardsman and uh in fact we created a forum for the director SV and the ombbudsman uh I created it it was on the same issues I will contact them uh because the issues around patient uh patient interface with the system which the office of the ombbudsman is by the way the office of the ombbudsman or the man in health started in 2018 2019 and who started it the directorate of quality services. So when uh the council is talking about reporting system it started with quality directorate of course uh and then we invited onsman. Yesterday we talked about the independence of that office and whether indeed it should be a fellow healthcare worker or indeed ombbudsman should have its own designated personnel. I think this is an issue that was on the table um to be to be looked at.

[02:13:44]Um those issues around um are there the tracking system of of medicines?

[02:14:00]chair the the biggest buyer of medicines in Malawi is central medical stores the single biggest buyer of of medicines so if you're looking at large volume medicines moving in hospitals it is central medical stores let me just mention here that yesterday there was a posting on social media around some drugs that are in uh in in South Africa at Baybridge those are not hospital medicines we don't give mandra If you if you read that article, you don't keep mandrex uh mandrex in hospitals. We don't keep that. So that is not anything to do with uh hospital uh medicines.

[02:14:43]Uh but chair we there are some recommendations. First thing is in terms of the digital movement of medicines or tracking of medicines.

[02:14:56]So from central medical stores to our district hospitals, we're using the open LMI lo uh logistics management information system to the district hospital.

[02:15:09]Our challenge has been supply to the health center. We've not reached that.

[02:15:14]So that's where the gap is. So if there any any misses could be there uh at that time at at that point tracking to health centers. Previously we used uh health advisory committees that when the a lot is arriving at a health center then the health advisory committee has to assertain medicines are there and then I think once they are there is how do you control movement of medicines uh uh at the health center and health facility there's a three lock system it should work uh but it has got its own limitations The area that we still a gap also is one other area that is still a gap is now the medicines have arrived at the pharmacy.

[02:16:07]How do you know that the uh the medicines have really gone to patient A patient B in the world.

[02:16:15]Uh so we already have within the system uh what we call EIN electronic health information network.

[02:16:24]uh and many people were trained.

[02:16:27]Many people were trained.

[02:16:30]What we would want our regulator especially PRA to emphasize on is that our pharmacist also have to embrace this digital. Our people need to embrace digital space uh digital uh digital systems. In some cases we've seen some resistance chair not all cases but in some cases we've seen some resistance. I think it can help us track the medicines at facility level.

[02:17:03]At ministry uh chair we now uh creating a logistics management unit cuz that faces interfaces with what is happening at central medical stores. uh and that has is now quite advanced uh the discussion on that and it will see the light of the day in the next few weeks.

[02:17:31]Um central medical stores the tracking system of the truck that is carrying medicines is there.

[02:17:42]Next thing that we are looking at is embossing some tablets and medicines.

[02:17:47]Embossing means that if you have a tablet of panadu, it should be there should be ingrained there that engraved that there's cms because then if you see that tablet in any other place other than a government facility, then it's a stolen medicine.

[02:18:09]All right? So some of our suppliers have already given us samples of what they what that would do to procurement is another question because now if a supplier is not able to emboss should we take them.

[02:18:25]So that's another side that we need we need to to be looking at. But we could say that all pre-qualified suppliers to central medical stores for medicines and this should be a mustd do for uh to emboss uh emboss where we can. Not all medicines can be embossed but the majority of what we need can be embossed and and indeed some of them have already have already uh uh given us samples of embossed uh medicines.

[02:18:54]Um I would say that uh for in terms of uh final uh cases that are done by all regulators or the three regulators they shouldn't stop at keeping the records to themselves.

[02:19:17]All of them should be shared with her service commission.

[02:19:21]He's the employer.

[02:19:25]So whether you've given one year, you've given a warning, you given whatever, health service commission needs to have a cop because they also have their own hearing.

[02:19:38]So I I that is a must. So if if I go to those places and they we don't see that then there's also underperformance of that institution. So it's a must when they're sending to uh to to SH all of them should go to SH cop to health service commission uh because then then we can look at the the hiring and and firing side uh uh chair for those that are the professionals uh I thought uh and then uh chair uh we asking parliament to allow all these institutions including health service commission to disclose the disciplinary findings. I think that's if it's not appearing in the law, we can we can really review. But if it's not appearing or if parliament I'm not sure how you you would do it but we need to start disclosing the uh final determinations on the disciplinary cases uh either for the suppliers uh facilities hospitals and and the individuals themselves. I think we need to uh uh to look at that.

[02:20:56]We there are some cases that are still pending chair and I think they probably are not yet for public consumption at this point. Thank you very much.

[02:21:10]>> All right. Thank you very much SH for the introduction that we have had.

[02:21:18]Uh honorable members, ladies and gentlemen, we've been meeting in this place since Monday and SH has appeared before this committee three days. He has led the teams from the ministry. This is the time he is appearing before this committee.

[02:21:39]This is something as a committee and of course as a chair we need to commend and applaud the SH for the commitment and dedication that he has demonstrated towards his work as SH but also by ensuring that we need to provide as a country quality health services to patients but also to achieve the universal health coverage. We have discussed a number of issues here. We started with public health act. He was here been discussing the health financing. He was here and today he is here. It shows how dedicated and committed the SH is.

[02:22:31]I also ask you the regulators the recommendations given by the SH should be adhered to. Take heat of the recommendations and we are here as a community to work with you.

[02:22:48]I should also highlight here the the cord your working relationship that is there between the ministry of health senior management team and in particular the cordial working relationship that we have with with SH every time we invite the members of uh uh ministry of health senior management team he's there he's a busy person but uh he leaves everything aside side and choose to be with us.

[02:23:22]This is why as a committee when you ask us to advance any agenda, the entire committee runs with that agenda because you know we know that you respect us and we also need to reciprocate the same respect that you give us. will not let you down because we save the same people that the minister of health is saving. There are number of issues that we need to do as a committee and we have lined up a number of activities ahead of us. Very shortly also be inviting you. We are in discussing in discussion with the SH and other senior management team members of the forthcoming investigation which will be robust we think because it is touching on a very critical subject altogether.

[02:24:21]We are looking forward to meeting you again in a very near future for that discussion again. Honorable members, I also want to thank you on be on behalf of the secretariat for the dedication that you have also demonstrated starting on Monday.

[02:24:43]No one has shown the symptoms and signs of withdrawal.

[02:24:49]Thank you very much and may God bless you all. But before we dispense SH and your team members, we have refreshments at the back as we always do. Please join us as we partake the refreshments. May God bless you all. Thank you very much.