Montenegrin pharmacies and health institutions could face a shortage of medicines if the Ministry of Finance does not change the decision on temporary financing in the field of health in the part related to the preparation of public procurement plans until the adoption of the budget for 2021.
This results from the documentation, which "Vijesti" took from the platform of the Syndicate of Medical Doctors - dialogues.me.
On January 14, Finance Minister Milojko Spajić was warned by the Health Insurance Fund (FZO) that the field of health care is specific, especially when it comes to the procurement of medicines and medical equipment.
On January 22, the Minister of Health, Jelena Borovinić Bojović, sent a request for an opinion on the development of public procurement plans for the needs of the health system to the Department of Finance.
According to confirmed information, the FZO did not receive a response from the finance department to its letter until yesterday, while the Ministry of Health did not respond to the request of January 22.
The Ministry of Finance did not respond to the questions of "Vijesti" regarding how they were determined according to the letters of colleagues from the Department of Health and the FZO.
According to "Vijesti" unofficial information, the finance department suggested to the Ministry of Health that they find a way to overcome the possible problem in accordance with their competences, respecting the law, and that one of the models is to not work on the plans on a monthly basis, but on a long-term basis.
The Ministry of Finance issued a decision on temporary financing for January 2021, according to which spending units financed from the budget of Montenegro are granted funds up to the amount of one twelfth of actual expenditures in the previous fiscal year.
The Ministry of Health and the FZO proposed to the Ministry of Finance that procurement for the needs of the health system should be made for a longer period compared to the period of temporary financing, i.e. on an annual basis, but also that, during the period of temporary financing, "the procurement of 'Montefarm', FZO and health institutions, they contain only procurements for which concluded contracts have expired or will expire during the period of temporary financing, as well as other priority procurements".
They also asked for an extension of the deadline and submission of public procurement plans.
The letter from the Ministry of Health states that the current budget for January in the amount of 15.419.272 euros was submitted to the Health Insurance Fund for four programs. One of the four programs is health care, within which public health institutions are financed, and consists of three positions, among which is the position of transfers for health care.
"In the position of transfers for health care, funds for January in the amount of 9.333.429,69 euros have been allocated, and public health institutions are financed from this amount, namely for: drugs and medical devices for the needs of the Health Care Center, drugs issued on prescription to citizens through state pharmacies 'Montefarma', material costs and joint programs - national preventive programs, medical waste, medical education, transplant programs...", according to the letter of Minister Borovinić Bojović.
He also reminds that the Law on Public Procurement stipulates that contracting authorities are obliged to prepare and submit a public procurement plan to the Ministry of Finance and Social Welfare - Directorate for Public Procurement Policy by January 31 of the current financial year. Borovinić Bojović also states that the Directorate, through its website, instructed the contracting parties financed from the budget that the public procurement plan until the adoption of the Law on the Budget contains only procurements necessary for smooth functioning.
Also, it is stated in her letter, it is recommended that the public procurement plan envisages simple procurements, which will be realized during 2021, in the scope in which it is possible to plan on the day of adoption of the plan.
"The health system cannot fit into the concept of creating a public procurement plan, which is proposed until the adoption of the Law on the Budget for 2021, because this would mean that the balance of the need for drugs and medical devices is determined on a monthly basis up to the level of approved funds, which is neither rational nor justified, and such a way of planning and carrying out procurement would threaten the supply of the health system with medicines and medical devices, as well as other products. Also, given the fact that these are high-value procurements for which tender procedures are carried out, which are complex and take longer, they cannot be completed on a monthly basis, and the needs of the health system cannot be covered through the implementation of simple procurements. explained Borovinić Bojović in a letter to Spajić.
Director of the FZO Sead Čirgić also warned of a possible problem yesterday.
"With the best intention to prevent the problem, given that there is no reaction to the Fund's appeal, we would like to point out that this method of procurement can lead to disruptions in the supply of medicines to the health system... This especially applies to the procurements carried out by Montefarm for the needs of the health system , the Institute of Public Health for the procurement of diagnostics and consumables for PCR testing, the Clinical Center of Montenegro, the Podgorica Health Center, the hospitals designated as covid hospitals...", Čirgić said in the announcement.
How much is planned for medicines for this year
According to the letter to Spajić, the Ministry of Health determined the need for medicines and medical supplies for the health system for 2021 up to the level of the total funds projected by the draft budget of the Fund, in the total amount of 91.383.700 euros.
EUR 40.875.600 is planned for medicines and medical consumables of public state institutions, EUR 26.000.000 for prescription medicines in Montefarma pharmacies, and EUR 24.508.100 for other medical supplies.
"Funds for drugs issued on prescription through private pharmacies were projected as part of the other health care program, in the amount of 17.000.000 euros... In order to ensure continuity in the supply of drugs and medical devices, as well as energy sources, products for patient nutrition, and other products of higher value, this cannot be achieved through procurement on a monthly level or simple procurement, but it is necessary to plan procurement for a longer period, especially in the case of procurement where concluded contracts have expired or will expire during the period of temporary financing", the Ministry noted of health.
Radulović pointed out a possible problem at the end of December
The director of the Clinical Center, Ljiljana Radulović, was the first to warn about possible problems, informing the Ministry of Health about it at the end of December and asking for an extension of the deadline for the adoption of the public procurement plan.
"Given that we are aware that the Government has made a decision on temporary financing, and that the budget will be proposed in March 2021, which also includes the health system, the KC is not in a position to implement public procurement procedures that expire contracts in the period January - April 2021, and the fact that for all procedures there is a significant period of time from the moment of the announcement to the moment of concluding the contract... We are also requesting, based on the already mentioned agreement, that the KC be approved one quarter of the previous year's budget for the current year, in order to ensure continuity in the provision of health care. It is necessary to provide the same to all health institutions, including Montefarm and the Institute for Public Health," the KC letter states.
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