Difficult to select contractors
After 13 years of implementation, the project "Improving the capacity of the Quang Nam health sector" (ODA capital from the Italian Government) has only completed, handed over, and put into use the construction and installation component.
The component of purchasing medical equipment worth more than 2.25 million EURO (nearly 3 times the construction value) at Quang Nam Provincial General Hospital, Nong Son and Hiep Duc Medical Centers, and 115 Emergency Center cannot be implemented, even though the investor has promoted and surveyed the implementation since 2020.
With no other choice, the Quang Nam government was forced to propose a review and agree to cut the medical equipment procurement component and end the project.
This project is not the only one facing difficulties. Many other healthcare investment projects are at risk of only finishing the construction and waiting for equipment, not knowing when the project can be completed for use.
The confusion and overlap of circulars and decrees have left contractors without a basis to carry out the appraisal and approval of estimates, as well as to submit plans for selecting contractors for medical equipment packages. Projects with medical equipment items that have encountered difficulties in re-appraising prices have had to continue to extend the implementation time.
Specifically: Renovation and upgrading of Phuoc Son, Que Son and Nam Giang Medical Centers; 76 commune-level medical stations; 7-storey high-tech treatment building of Quang Nam General Hospital.
Cha Val General Clinic (Nam Giang) has had to adjust and reduce 7/14 medical categories for many years to meet standards. Even the medical equipment procurement package of 2 projects under the Socio-Economic Recovery and Development Program worth nearly 40 billion VND is at risk of not being able to disburse, and the capital must be returned to the central government, when the deadline is December 31, 2024, but up to now, it is still struggling to review and determine the equipment configuration of the centers or medical stations.
Mr. Huynh Xuan Son - Director of the Provincial Construction Investment Project Management Board - investor of 11 health investment projects with medical equipment bidding packages - said that it is very difficult to choose a medical equipment valuation unit.
Many valuation units refused to appraise prices despite having signed contracts with investors because they could not find quotes from businesses and medical equipment manufacturers.
Not only will no medical equipment bidding packages select contractors in 2023, the bidding situation for drugs, chemicals, and medical supplies is similarly difficult while hospitals are facing shortages.
The Department of Health said that in 2023, the Provincial People's Committee approved the plan to select contractors for 10 local-level concentrated drug, chemical, equipment, and medical supplies packages, but only 2 packages had contractor selection results (generic drugs and medical supplies for artificial kidneys - ultrafiltration - artificial heart and lung). The remaining chemical and medical supplies packages have not yet announced the results of contractor selection.
Is there an opening?
The inability to select contractors to supply medical equipment, supplies, and medicines has become a burden for hospitals and patients. The 2023 Bidding Law, which will take effect from January 1, 2024, is expected to remove many obstacles, ensuring the supply and procurement of medicines and medical equipment.
Difficulties and obstacles in medical bidding have been identified. The law will create more initiative and flexibility for investors in bidding for equipment packages, medical facilities in purchasing drugs and medical supplies, in accordance with the reality, examination and treatment capabilities and payment capacity of each hospital.
One notable thing is that Decree No. 24 of the Government has provided detailed regulations for drugs on the national and local bidding list.
In particular, if there are no bidding results or the unit has not selected a contractor, hospitals have a proactive mechanism to self-purchase to provide medical examination and treatment services for people.
Hospitals can apply the option of purchasing additional drugs and medical supplies without having to organize a tender. Some cases are assigned tenders; some advanced forms of procurement (online shopping, online bidding, etc.).
In a short time, hospitals can immediately purchase materials, components, and installation parts to replace broken machines. Decree No. 24 has simplified and shortened the bidding process. It allows investors to choose more than one winning bidder, based on only one quotation. If there is more than one, the higher quotation is allowed to be used to build the estimate. This is unprecedented.
According to the Department of Planning and Investment, the Ministry of Health and the Ministry of Planning and Investment are currently urgently completing circulars on sample guidelines for bidding, price negotiation for centralized procurement... in the health sector. When issued, applying these samples will be simple, convenient and ensure consistency.
Mr. Huynh Xuan Son said that there has been some light in the organization of determining the bid package estimate for projects with medical items. Article 16, Decree No. 24 has resolved many problems regarding equipment valuation. Bidding will be more effective.
It can be seen that the regulations on medical bidding are quite clear. The theory can be implemented immediately, paving the way for equipment, medical supplies, drugs... to enter hospitals more easily.
However, investors and hospitals said that drugs, supplies and medical equipment are special goods. They cannot be bid on like other common goods.
Mr. Huynh Xuan Son added that in order to soon build an estimated equipment price, support and coordination from management agencies and medical experts are needed.
At the same time, it is recommended that projects with medical equipment of low value and common configurations need management agencies to coordinate with investors in building medical equipment configurations that ensure compliance with current regulations as a basis for posting and collecting quotes.
Projects with high-value medical equipment, complex configuration, requiring high expertise need to establish a scientific council to select equipment configuration...
Mr. Mai Van Muoi - Director of the Department of Health said that medical bidding will no longer be as difficult as before. However, almost all personnel carrying out the procurement and bidding of medical equipment, supplies, drugs, etc. are often lacking.
Because they almost all hold multiple positions and have no expertise (even the dispatched personnel have no experience or expertise in bidding...), it is easy to make mistakes. Meanwhile, the prices of goods, especially medicines and medical supplies, vary from place to place and are not unified nationwide.
Source: https://baoquangnam.vn/quang-nam-va-anh-sang-cho-hoat-dong-dau-thau-y-te-3136835.html
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