On Tuesday, Jamaica’s Parliamentary Public Accounts Committee (PAC) deepened its probe into longstanding mismanagement allegations at the University Hospital of the West Indies (UHWI), uncovering fresh troubling evidence of systemic improper governance that has raised serious alarms among lawmakers. The review was launched following the release of a damning special audit report from the auditor general into the public hospital’s daily operations and financial management. What PAC members heard during Tuesday’s hearing left many top committee officials stunned: senior UHWI executives confirmed that the major public health institution carries a staggering $40 billion in unpaid tax obligations to the state, and has not developed any formal structured repayment plan to resolve the massive liability. Compounding this revelation, the hospital continues to operate under a temporary tax compliance certificate, a temporary status that is meant only for entities working to resolve outstanding compliance issues, rather than holding billions in unpaid taxes. The hearing also exposed another contradiction in the hospital leadership’s previous accounts: UHWI executives had previously claimed that severe flooding at the facility destroyed key physical files linked to multiple millions of dollars in awarded contracts, but they walked back that explanation during questioning before the PAC. Lawmakers also pressed executives on reports that an outside private entity was allowed to use UHWI’s official tax-exempt import status to bring goods into the country, resulting in more than $10 million in unpaid customs duties that the public is now forced to absorb. UHWI representatives gave inconsistent, halting responses when asked to explain how the private company gained access to the hospital’s tax-exempt privileges. As one of the Caribbean’s leading public teaching and referral hospitals, the ongoing governance and financial irregularities at UHWI have sparked growing public concern about oversight of state-funded health institutions, and the PAC is expected to continue its review of the audit findings in upcoming hearings, with further questioning of hospital leadership planned.