Report On Public Procurement Monitoring At The Ministry Of Health Supply Of Consumables For Haemodialysis
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Democratic Institute of Kosovo is the Transparency International Chapter in Kosovo. It strengthens citizens to demand transparency and public accountability and to engage in policy making.
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Theory of Change
The health sector in Kosovo has been subject to rumours for many misuses and monopolies in supplies with medicines and consumables. This was greatly evident in the haemodialysis sector where the supply of consumables was made by the same supplier at an unusually high price and using closed procedures and therefore poor transparency. In April 2018, the Ministry of Health had begun the process of drafting the secondary legislation, which addressed the price ceilings of medicines, the revision of the Essential List of Medicines, and the opportunities for opening the tenders, which had historically have been conducted by single-source closed procedures, as well as initiated punitive proceedings for conflict of interest and misuse of official duty within the ministry.
With the aim at increasing transparency and accountability in the public procurement process the Ministry of Health signed a cooperation agreement with Kosova Democratic Institute (KDI) to enable the exchange of information and good practices that would contribute to the advancement of the public procurement process. This took the form of KDI analysing public contracts related to the supply of consumables for haemodialysis from 2018.
KDI found that our of the three contracts the Ministry of Health had used one open procedure and two negotiated procedures for emergency contracts without publishing the contract notice. The need for these emergency contracts were borne out of delays arising from complaints of the supplier and resulted in higher prices compared to the open procedure, despite the same supplier ultimately winning the bid. This highlights the lack of business sincerity in closed procedures and demonstrates the need for open and transparent contracting processes.
Quantitative and qualitative analyses were used to present the situation in the most correct way possible regarding procurement activities for the supply of consumables for haemodialysis at the Ministry of Health (MoH). This research aims to measure the implementation of public procurement legislation by the MoH, through reviewing of the contract award process for the supply of medical consumables for haemodialysis for 2018.
- By breaking the nearly 20-year monopoly of supply of consumables for haemodialysis, the Ministry of Health saved nearly 80% of the price that had been paid before for the 5 out of 6 tendered lots.
- Signing of contracts for the supply of consumables for haemodialysis was delayed for over 8 months from the date of publication of the contract notice, as a result of claims filed by the supplier. Given the legal deadlines for each procedure, including claims, the Ministry of Health had not started the tendering process at a sufficient time to avoid emergency needs.
- After analysing and comparing the contract awarded based on an open procedure tendering, KDI noted that the contracted prices for the emergency supply contract were up to 209% higher than the prices that same EO had bid, which makes us understand the importance of open competition.
- The Ministry of Health should ensure that procurement procedures are initiated in sufficient time to envisage the fulfilment of all deadlines set forth by the law on public procurement, in order to avoid the use of negotiated procedures.
- The Ministry of Health should conduct a market analysis of all single source purchases, to make sure that we are not dealing with a similar monopoly situation, as it was the case for the supply of consumables for haemodialysis.
- When using negotiated procedures, KDI recommends that the Ministry of Health should comply with the Rules and the Operational Guidelines for Public Procurement. According to these rules and guidelines, when a negotiated procedure is absolutely necessary this should be carried as a competitive process to ensure an optimal number of bids from as many suppliers as possible.
- The Regulatory Public Procurement Committee should initiate procedures for supplementing the current legislation, to categorise and define the deadlines for reviewing claims by the Procurement Review Board based on priorities.
- The Procurement Review Board should prioritise the complaints handling emerging from tenders related to the supply of drugs and materials of vital importance for the health of citizens