The State Audit Institution (DRI) determined that the planning of public procurement in the health system of Montenegro is not successful enough, and the lack of strategy and inadequate operational planning make it difficult to procure medical equipment in accordance with needs.
The Supreme Audit found that weaknesses in the system of planning the procurement of medical equipment mean that health institutions are limited in their capacity to meet the needs of patients in a timely and high-quality manner, who are often forced to go for treatment outside the public health system. This causes additional costs that could be avoided in those segments where it is possible and justified to develop capacities.
"For the purpose of treatment outside the Montenegrin health system, according to the Report of the Health Insurance Fund (FZO) in the period from 2005 to 2015, about €137 million was spent. The report does not cover all PHUs with which the FZO has concluded contracts for the provision of health services, so this amount is even higher," the SAI pointed out.
DRI estimated that if part of the money spent on treatment, control and diagnostics outside the healthcare system was invested in the purchase of medical equipment, it could lead to significant savings in the system.
The audit included the Ministry of Health, FZO, KBC, Agency for Medicines and Medical Devices (CALIMS), health centers in Podgorica, Nikšić, Bar and Bijelo Polje, and General Hospitals in Nikšić, Bar and Bijelo Polje. These institutions include 56,74 percent of the total number of insured persons in Montenegro.
Among the irregularities found by the SAI are that the public procurement plan is often adopted without knowing the amount of money available, that public institutions do not adopt plans in a timely manner or change them several times during the year. In addition, adequate market research is not carried out when planning public procurement, that medical equipment market research is carried out by an official who does not have adequate expertise in the field of medical technology,...
The SAI recommended the Ministry of Health to develop a strategy that will be based on the needs of the health system and the available money. In addition, it should establish clear criteria for determining procurement priorities, define the data that health institutions should provide when obtaining approval for the public procurement plan (estimated value of equipment with installation and maintenance costs, number of patients waiting for treatment, waiting time, current working conditions equipment and the frequency of equipment failures...). The Ministry should provide appropriate data on the missing equipment and the condition and level of use of the existing equipment.
The head of this audit and a member of the Senate, Branislav Radulović, told the "News" that this demanding audit was carried out as a parallel audit of success with the expert support of the European Court of Auditors and the National Audit Office of Sweden.
"In addition to the SAI, six other supreme state audit institutions from candidate and potential EU candidate countries participated. We expect that this month the SAI will host the expert team of the European Court of Auditors and the National Audit Office of Sweden and colleagues from the region in the presentation of audit findings and improved methodology in performance audits," said Radulović.
The State Audit Institution (DRI) determined that the planning of public procurement in the health system of Montenegro is not successful enough, and the lack of strategy and inadequate operational planning make it difficult to procure medical equipment in accordance with needs.
The Supreme Audit found that weaknesses in the system of planning the procurement of medical equipment mean that health institutions are limited in their capacity to meet the needs of patients in a timely and high-quality manner, who are often forced to go for treatment outside the public health system. This causes additional costs that could be avoided in those segments where it is possible and justified to develop capacities.
"For the purpose of treatment outside the Montenegrin health system, according to the Report of the Health Insurance Fund (FZO) in the period from 2005 to 2015, about €137 million was spent. The report does not cover all PHUs with which the FZO has concluded contracts for the provision of health services, so this amount is even higher," the SAI pointed out.
DRI estimated that if part of the money spent on treatment, control and diagnostics outside the healthcare system was invested in the purchase of medical equipment, it could lead to significant savings in the system.
The audit included the Ministry of Health, FZO, KBC, Agency for Medicines and Medical Devices (CALIMS), health centers in Podgorica, Nikšić, Bar and Bijelo Polje, and General Hospitals in Nikšić, Bar and Bijelo Polje. These institutions include 56,74 percent of the total number of insured persons in Montenegro.
Among the irregularities found by the SAI are that the public procurement plan is often adopted without knowing the amount of money available, that public institutions do not adopt plans in a timely manner or change them several times during the year. In addition, adequate market research is not carried out when planning public procurement, that medical equipment market research is carried out by an official who does not have adequate expertise in the field of medical technology,...
The SAI recommended the Ministry of Health to develop a strategy that will be based on the needs of the health system and the available money. In addition, it should establish clear criteria for determining procurement priorities, define the data that health institutions should provide when obtaining approval for the public procurement plan (estimated value of equipment with installation and maintenance costs, number of patients waiting for treatment, waiting time, current working conditions equipment and the frequency of equipment failures...). The Ministry should provide appropriate data on the missing equipment and the condition and level of use of the existing equipment.
The head of this audit and a member of the Senate, Branislav Radulović, told the "News" that this demanding audit was carried out as a parallel audit of success with the expert support of the European Court of Auditors and the National Audit Office of Sweden.
"In addition to the SAI, six other supreme state audit institutions from candidate and potential EU candidate countries participated. We expect that this month the SAI will host the expert team of the European Court of Auditors and the National Audit Office of Sweden and colleagues from the region in the presentation of audit findings and improved methodology in performance audits," said Radulović.
Prepare a procurement plan in advance
The SAI recommended the Health Insurance Fund to make a decision on the distribution of money immediately after the adoption of the Law on the Budget, so that health institutions could prepare a public procurement plan in a timely manner. The fund was also recommended to analyze in cooperation with the Ministry of Health whether it is more effective to acquire equipment or to provide services to patients through a contract with private health institutions before making decisions. Health institutions were recommended to make short-term and long-term procurement plans and determine the dynamics of their implementation, to make plans in accordance with the money they have and to take into account the age of the equipment and maintenance costs.
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