Congress report - European Health Forum Gastein

Forum III: Health and the Single European Market
For the contracts that have not been put in the European journal the rules in the Trust’s own
Standing Financial Instructions apply. These lay down rules for the tendering process and
management of contracts and the framework is developed by the Department of Health
(there is local variation about the size of the £25,000 limit depending on the total size of the
organisation’s budget).
A number of routes are possible:
• NHSS may have a series of ‘packages’ which can be bought. NHSS maintains a
database of suppliers for a range of common services and can draw attention to
these ‘packages’, e.g. the management of maintenance for information systems or
ward supplies. NHSS manages the process of supplies throughout.
• NHSS might offer advice for developing a service specification, manage the
tendering process and be involved in contract negotiations e.g. competitive
tendering for cleaning and portering services. Once the tender has been awarded to
a specific company the Trust manages the contract directly or NHSS does it on
behalf of the Trust.
• The Trust organises a contract directly with a supplier.
The main difference between goods and supplies lies in the fact that. In general, it is easier
to specify the quality of goods than of services. However, there are notable exception such
as highly specialist equipment such as MRI or ultrasound that are influenced by medical
‘preference’. In terms of services, the issue of liability (health and safety) has to be
considered.
In general, procurement depends on foresight and sound planning, good negotiating skills,
credibility (expertise) and building up relationships within the organisation (visibility).
Impact of EU directives and regulations
Setting the financial limits has been one of the main influences, and the process for Europewide
tendering has to be followed to the letter. Thus, it is difficult to procure things quickly
(77 days minimum) and long-term planning is essential. Safety issues concerning sterilisation
have been influenced, esp. regarding autoclaves. Another example is the storage of liquid
gases to comply with a 14 days supply requirement. This means the expansion of tank
capacity.
In the UK the Medical devices Agency issues up-to-date bulletins to NHSS and the NHS as a
whole on EU regulations. In general, everyone appears to be well informed of the latest
requirements.
At present, the procurement issue is becoming politically important as the new government
appears to want to move away from the ‘privatisation’ of services. The idea of developing
central coordination across all public services for integrated procurement is gathering
momentum.
6.2 Public procurement of goods and services in Sweden
In Sweden all the health care is decentralised to 21 regions. Because of this, all the buying of
goods and services are decentralised to the regions. In Sweden we follow the directive
93/36 so probably the procurement process is about the same in Sweden and Spain.
The total spending in goods and services during 1998 by your health services in your region
or country
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For example, in Värmland during 1998 we spent about 500 millions in buying goods and
about slightly more than one thousand millions in buying both goods and services.