Removing bottlenecks in bidding, clearing capital sources for socio-economic development

Patients run around to buy medicine and medical supplies.

Patients have to buy each needle and IV line outside the hospital, patients are scheduled for surgery but have to wait for several months due to lack of drugs and medical supplies... this is a reality that has happened before. By early 2024, when the Bidding Law comes into effect, the Government's guiding decree and a series of guiding circulars are issued, this situation will gradually be resolved. However, up to now, there are still difficulties in implementation, leading to local shortages of drugs and medical supplies in some places.

According to Lao Dong reporters' records at the end of October 2024 at Viet Duc Friendship Hospital, the shortage of medicine and medical supplies still exists. "From morning until now, several patients have been transferred to other hospitals due to lack of supplies and cannot be operated on. Some patients were transferred to Bach Mai Hospital, some were transferred to Hospital 108. My relative went to have a spinal examination 2 weeks ago, the doctor scheduled the surgery 2 weeks later" - Mr. Nguyen Van Minh (from Ha Nam), a relative of a patient at Viet Duc Hospital shared.

Patient Nguyen Quang Hung in Soc Son district, Hanoi (character's name has been changed upon request - PV) was prescribed two types of medicine to treat hepatitis: Myvelpa 400/100mg (prescription medicine to treat chronic hepatitis C) and Legalon 70 (indicated for supportive treatment in liver damage). However, Mr. Hung went to all the pharmacies in the hospital but could not buy it. Returning to the department, the doctor said there was no medicine, and told him to go to a pharmacy outside the hospital to get it. Mr. Hung continued to go to pharmacies outside the hospital gate to buy it.

At the Spinal Surgery Department, many patients use the "pain relief package" after surgery, but the patient's family has to go out to buy some supplies and then return to the department for the patient to receive treatment. The medical staff has written some supplies on a small piece of paper and sent the family to buy them. The small slip includes a pain relief Catset, 1 Dafilon 3.0 thread...

"I just went outside the hospital gate to buy some things the doctor prescribed on this piece of paper, then brought them to the department so that my family member could receive pain relief treatment. Because the hospital did not have enough supplies, I had to run around and buy everything, from pain relievers to thread," Vu Van Bach, a family member of a patient who had just had surgery at Viet Duc Hospital, told Lao Dong reporter.

Previously, in early 2024, Lao Dong Newspaper also reported that many patients were tired of waiting for surgery at Viet Duc Friendship Hospital. There was even a time when patients were already on the operating table but were informed by doctors that there was a lack of medical supplies and they had been waiting for nearly half a year without being scheduled.

Patient Nguyen Quoc Anh in Nghe An (character's name has been changed upon request - PV) recalled: "In early 2024, I broke my cheekbone. Initially, I went to a lower-level hospital for emergency treatment with the hope of being treated locally. After examining my condition, the consulting doctor decided to transfer me to Viet Duc Friendship Hospital (Hanoi) with the hope of having the surgery faster. I waited forever to complete the transfer procedure, but when I was admitted to the hospital, the doctor said there were no supplies and did not know when they would be available. I also consulted many patients on community groups, some waited for 6-7 months, so I had to go to a private hospital for surgery."

Many problems in price and bidding

Although the shortage of drugs and supplies does not occur on a large scale and only affects a few irreplaceable drugs, it still affects the rights and causes inconvenience to patients. And one of the reasons for the shortage of drugs and supplies is that pharmaceutical companies or distributors are not interested in participating in bidding. The reason is that the 2023 Bidding Law has given investors the initiative, but medical facilities are worried because they cannot find a price appraisal consultancy unit, do not know how to choose the average, highest or lowest price in the quotation to set the bid price, or are confused with bid packages with large values, many items... so they still maintain the application of the lowest price.

However, for contractors, with such prices they cannot bid because of fluctuating market prices, interrupted raw material sources... if they bid at such prices they will not make a profit. When they do not see economic benefits, they will not bid, leading to an uncertain supply source.

In addition to the price inadequacies, from the implementation practice at the unit, Master Tran Thi Tra Giang, Head of Bidding Management Unit, University of Medicine and Pharmacy Hospital, Ho Chi Minh City pointed out the inadequacies in drug bidding work at the hospital.

According to the provisions of the 2023 Bidding Law, each winning bid product in a hospital pharmacy can only be purchased directly once. Such a provision is inappropriate and may cause difficulties in supply. Because it also depends on the needs of the patient, if only purchased once, there may be a situation where at peak times many of these drugs are needed, but cannot be bid immediately. Therefore, the regulation should be amended in the direction that hospital pharmacies are allowed to call for goods and import drugs with publicly available prices online without having to bid. This provision must be amended immediately, otherwise hospital pharmacies cannot serve patients in a timely manner.

Regarding the problems arising from the shortage of drugs and medical supplies at medical facilities, Dr. Vuong Anh Duong - Deputy Director of the Department of Medical Examination and Treatment Management (Ministry of Health) - said that the shortage of drugs and medical supplies at medical facilities in recent times is due to many different subjective and objective reasons. According to the survey results from more than 600 hospitals, about 30% of the rare drugs that hospitals are lacking are not on the list of rare drugs covered by health insurance. The Ministry of Health will propose to amend some inappropriate regulations in the Law on Bidding related to the health sector, as well as provide additional guidance on the implementation stage so that the law can be put into practice.

Many resources are congested.

Not only in the health sector, many other areas in economic and social life are also facing obstacles, partly due to institutional problems, and partly due to the fear of making mistakes and taking responsibility of the implementers. This has caused the 2023 Bidding Law, which was once expected to resolve barriers, to allow public investment capital to flow into the economy early, to still be stuck. These are bottlenecks that need to be synchronously removed to unleash development resources.

For example, in the investment sector. According to data provided by the Ministry of Finance, as of September 30, 2024, the total amount of foreign capital (ODA) that has not been allocated in detail is more than VND 2,000 billion (out of the total approved VND 20,000 billion).

Regarding disbursement progress, since the beginning of this year, ODA capital has only been over 4,800 billion VND, reaching only 24.33% of the plan assigned by the Prime Minister. This situation is quite similar to the same period in 2023 (also only reaching 28.37%)...

Many analysts say that capital allocation has not progressed as expected mainly because many projects have not completed investment procedures according to regulations, there are problems in equipment valuation and the bidding mechanism is not effective.

For example, in Ben Tre province, there are 2 projects using ODA capital: Ben Tre General Hospital and the Project to develop a smart technology chain suitable for climate change. By May 2024, the disbursement rate of foreign investment capital for these 2 projects reached 26.6 billion VND. The disbursement rate is low because in 2024, Ben Tre province was allocated capital but in 2023, the bidding organization did not pass. Currently, the province is completing the bidding documents to continue implementing the project.

Problems in the current Bidding Law make it difficult for many economic activities to be put into practice. A representative of the State Bank said that the banking sector has many special factors, so it is impossible to apply the form of open bidding.

A typical package is the procurement of services from a credit rating company (purchasing the right to exploit information online from reputable rating companies in the world). This package is highly specialized in the field of international financial analysis and requires a modern technical platform, allowing access to large volumes of data, and customer information security, which not all credit rating companies can meet.

Currently, only three companies, Moody's, S&P and Fitch, meet the requirements of the State Bank and the use of the services of these companies in the coming time is necessary to ensure the safe and effective management of foreign exchange reserves. However, if the organization selects a contractor according to the provisions of the Bidding Law 2023 and a small rating company wins the bid, some partners of the State Bank will not be rated, affecting the investment portfolio and the effectiveness of foreign exchange reserve management.

Or with the bidding package for purchasing international payment system services, selecting a contractor according to the current regulations of the Bidding Law is also not feasible. The reason is that the SWIFT Association is not a contractor and will not participate in the bidding. Furthermore, the Service via the SWIFT system is an exclusive service. The form of direct ordering (e-order) via the SWIFT Association's website is not similar to any form of contractor selection according to the provisions of the Bidding Law.

The above problems have caused many projects to not be put into operation, the disbursement of public investment capital has slowed down, causing difficulties in the process of socio-economic development.