The role of contractual arrangements in improving health sector ...

Morocco
Experience of the Ministry of Health in contracting
Contracting arrangement based on purchase or leasing
Purchase of cares services
This is one of the oldest types of contractual arrangements between the private and
public sectors in Morocco, initiated as a way to address a deficit in human resources,
particularly medical, in the public sector. The goal of this contracting agreement was to assign
physicians, pharmacists and dentists to public health institutions in areas with limited health
care coverage. Such contractual arrangement becomes an agreement. This agreement was
formalized by Ministerial decree in 1972, which defined the legal status of these human
resources.
Such agreements may be signed jointly by the local representative of the Ministry of
Health at the province level, and the health workers practising in the private sector, subject to
approval by the Minister of Health. In 1996, new legislation was introduced requiring
additional approval for such agreements by the National Council of the Medical Professional
Association.
The private practitioner is employed as a part-time health worker within a public health
institution on the basis of the conditions set by the relevant decrees. He or she receives a
monthly salary provided through the budget of the Ministry of Health. The use of such
contractual arrangements is declining considerably with the expansion of public health
services.
Purchase of non-medical services
Contracting for the purchase of non-medical services applies to the purchase by local
public health authorities of equipment or supplies as part of health care (biomedical
equipments, pharmaceutical products), or support services that are not part of health care. This
is regarded as subcontracting, and applies in this case to contracts for services such as
maintenance, cleaning, catering, laundry or security, between the hospital and a private
company.
Such purchasing contracts have a strong legal framework. They are executed in
compliance procedure laid out in the public bids regulations. Depending on the amount
involved, the administration purchases services either through public bid offers or through
purchase orders, with due respect to transparency and fairness in competition. The procedures
require an early financial review prior to implementation of the public bid or purchase order to
be submitted to the Office of Budgeting and Expenditures Control of the Ministry of Finance.
Support and logistic services are subcontracted in accordance with the public bids
procedure. The administration identifies the nature and the quantity of the services, the
payment calendar and conditions, as well as the quality indicators for evaluation of the
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