Bahrain - What is GIS

Bahrain Role of contractual arrangements in improving health system performance
Developing the private sector.
Utilization of economies of scale enjoyed by the contractor (maintenance of
equipment).
Avoiding investment in expensive tools and diagnostic equipment.
Access to highly skilled personnel (especially in information technology) without
employing them.
In the case of cleaning of hospitals, health centres and other facilities, the
Ministry had experienced problems in supervising the cleaning of its facilities, which
resulted in deterioration in quality. With 20 health centres spread across the country, it
was very difficult to closely supervise the cleaning without putting a foreman in each
health centre. Absenteeism was another major factor which prompted the Ministry to
look for contracting alternatives. At the time when cleaning was contracted out, it was
less expensive to use contractors, as they had access to the expatriate workforce. This
has now changed as new regulations require contractors to employ only Bahrainis and
to pay them a minimum wage. This has resulted in an enormous increase in the
contract cost (an increase of between 150% and 200%).
In the case of maintenance of equipment, the maintenance of highly specialized
equipment is contracted out because the repair and maintenance requires expensive
tools and software and highly skilled personnel. Employing such personnel is not
economical. Maintenance of computer networks, hardware and software has also been
contracted-out for similar reasons. Similarly, in the case of medical waste disposal, the
old incinerator needed replacement and the amount required for a new incinerator was
substantial. It was therefore decided to contract out this service. The Ministry has a
10-year contract.
In the case of vehicles, the Ministry used to buy vehicles from the private sector.
However, high maintenance and repair costs and frequent breakdowns resulted in the
Government changing its policy. It was decided that all the Ministries would lease
vehicles from the private sector. The contractor has to maintain and service the
vehicles and provide replacement vehicles when a vehicle is out of service. This has
removed a significant financial burden from the Ministry. The Ministry has secured
better rates by offering longer contracts.
Quality of contract design
Poorly specified contracts, particularly with respect to quality, were found in
virtually all cases analysed in a 1998 study on contracting in the health sector [2]. The
various contracts signed by the Ministry of Health were generally designed very well
and contained standard and specific clauses in consultation with legal experts from the
Ministry and Finance and National Economy.
Contract legal framework. The legal framework is quite strong and robust enough to
facilitate contracting between the public and private sectors. All the contracts
contain on the governing law and on arbitration clauses.
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