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

Morocco
In the context of reinforcing the responsibility of the external institutions, legislators
considered two types of contracting arrangements adapted to these two statutes: the work-plan
contract and the program budget.
The work-plan contract
The first contracting experience between the Ministry of Health and autonomous public
institutions was carried out in 2002. Two work-plan contracts were made between the State,
represented by the Ministry of Health and the Ministry of Finance and Privatization, and two
university hospitals, Ibn Sina (Rabat) and Ibn Rochd (Casablanca).
These two work-plan contracts were developed to reinforce the links between the State
and these centres. Therefore, the objectives assigned to these centres are defined for the period
of the contracts as well as the periodic evaluation of the degree of fulfilment of the terms of
these contracts.
These two work-plan contracts illustrate the willingness of the State to introduce new
contracting relations aiming at:
supporting the university hospitals in focusing on their statutory responsibilities for care,
education, training and research;
maintaining these university hospitals as national hospital centres of reference providing health
care services at the tertiary level;
adoption of modern management based on accountability;
optimization of the university hospitals’ resources and expenditure;
adapting the institutional and judicial contexts of these two centres to ensure harmonious
development with their environment.
A special monitoring committee conducts monitoring of the work-plan contract. Its
membership includes representatives of the contracting parties, with the Minister of Finance
and Privatization as its president. The monitoring committee meets at least twice a year to
examine:
reports of independent experts regarding the quality of services, the hospital hygiene
programme and the environmental protection measures;
external auditors’ reports;
annual reports of the work-plan contract implementation
performance and results obtained by the hospital centre.
The programme budget
The programme budget is the second form of contracting between the State, represented
by the central health administration, and external services. It is an outgrowth of public
spending reform in the form of results-based budget management.
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