Report On Public Procurement Monitoring At The Ministry Of Health Supply Of Consumables For Haemodialysis
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The Democratic Institute of Kosovo is the Transparency International Chapter in Kosovo. It empowers citizens to demand transparency and public accountability and to engage in policy-making.
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Global Partners:British Embassy in Pristina
Theory of Change
Policy & Insititutional ChangeBetter Institutional Processes
The health sector in Kosovo is subject to rumours of mismanagement and monopolisation in the supply of medicines and consumables. This was especially evident in the haemodialysis sector where the consumables were all provided by the same company at an unusually high price, with the contracts being awarded in non-disclosed and non-transparent procedures. In April 2018, the Ministry of Health began to draft secondary legislation which addressed the price ceilings for medicines, the revision of the Essential List of Medicines, and opportunities for opening up the tenders which had previously been conducted by single-source, closed procedures. Further, it introduced punishments for conflict of interest and abuse of office within the ministry.
With the aim of increasing transparency and accountability in public procurement processes, 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 resulted in KDI analysing public contracts related to the supply of consumables for haemodialysis from 2018.
KDI found that one in three contracts of the Ministry of Health had been awarded through an open tender procedure, whereas the two remaining ones were negotiated as emergency contracts without the contract notice having been previously published. The need to sign emergency contracts arose from delays due to complaints by the supplier, and resulted in higher prices compared to the contracts awarded through an 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 research methods were used to present the results in the most accurate way possible. This research aims to measure the implementation progress of public procurement legislation by the MoH by analysing the processes through which contracts for the supply of medical consumables for haemodialysis were awarded in 2018.
- By breaking the nearly 20-year monopoly on supply of consumables for haemodialysis, the Ministry of Health saved nearly 80% of the price that had previously been paying for the 5 out of 6 tendered lots.
- Signing contracts for the supply of consumables for haemodialysis was delayed for over 8 months as a result of claims filed by the supplier. Given the legal deadlines for each procedure, including the dealing with claims, the Ministry of Health did not start the tendering process early enough to avoid emergency needs.
- After analysing and comparing the contracts awarded in an open procedure tendering, KDI noted that the negotiated 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 started early enough to be able to meet the deadlines stipulated by law concerning public procurement in order to avoid having to negotiate emergency contract and lose considerable amounts of public funds.
- 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 in the case of the supply of consumables for haemodialysis.
- When negotiating emergency contracts, KDI recommends that the Ministry of Health should comply with the Rules and the Operational Guidelines for Public Procurement. According to them, in cases in which a negotiated procedure is absolutely necessary, this should be carried out as a competitive process to ensure an optimal number of bids from as many suppliers as possible.
- The Regulatory Public Procurement Committee should draft procedures complementary to the current legislation in order to categorise and define the deadlines for reviewing claims by the Procurement Review Board.
- The Procurement Review Board should prioritise the handling of complaints that are emerging from tenders related to the supply of drugs and materials which are of vital importance for public health.