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The concession of laboratories goes out of control, the government goes in search of consultancy

2023-06-28 10:21:41Biznes SHKRUAR NGA REDAKSIA VOX
The concession of laboratories goes out of control, the government goes in
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The government has provided a number of services in the health system with a concession, and year after year, reports of the State Audit Office have shown that there were also payments for incomplete services or more frequent uses than the plan of these services.

This has caused millions of Lek to be spent on private individuals, causing the initially planned budget to be exceeded in some cases.

Recently, an announcement by the Ministry of Health and Social Protection shows that it is intended to take control of one of these concessions related to laboratory services. In 18 hospitals of the country, this service is provided by a public-private partnership contract.

"IFC has been engaged by the Government of Albania (GSH), through the Ministry of Health and Social Protection (MSHMS), to structure and implement a public private partnership (PPP) for Laboratory Services covering eighteen regional and tertiary hospitals" it says in the publication.

In the announcement "Management of the volume of prescriptions of laboratory tests, the annual limit of the hospital budget and the fee for service performance payments, it is clarified that the MSHMS needs technical assistance to develop protocols of laboratory prescriptions for the most frequent diagnoses, as well as to establish rules to control the adequacy of prescriptions for laboratory tests, a much-needed step in ensuring fiscal control of the project and limiting the misuse/overuse of laboratory tests.

"The overall objective of the task is to provide assistance and develop the capacities of the Ministry of Health and the Hospitals to adequately address the risk of misuse/overuse of laboratory tests and therefore stay within the authorized budget limits," the document states. .

Main duties and responsibilities of consultancy

"The specific objectives of the technical assistance consist of:

1. Review of the order forms in accordance with the range of tests available in public hospitals, in accordance with the PPP Lab Concession Agreement, identifying the so-called emergency tests;

2. Development of Albanian instructions/protocols for prescribing laboratory tests, as well as bureaucratic rules established to rationalize prescriptions for laboratory tests;

3. Recommending a monitoring system for the guidelines/protocols, including detailed roles, activities, tasks and action plan for MSHMS, hospital managers, department heads and laboratory specialists to check compliance with the guidelines/protocols recipes;

4. Recommending an implementation strategy in the MSHMS;

5. Development of the trainer model and training of the first wave of trainers;

6. Assessing the implementation of all activities in 3 and 6 months and recommending how to improve compliance;

7. Reevaluation of guidelines/protocols in 6 months in light of prescribing practice and budget constraints for laboratory tests," the document states.

Concession and increase in payments beyond the forecast

The PPP contract for the laboratories started in 2019 and ends in 2028 with a financing amount of ALL 13 billion without VAT. But in the first two years, payments are exceeding forecasts.

The Ministry of Health reported that in 2022 the concession of laboratory services, which is administered by the company "Laboratory Network", was financed with 1.6 billion lek (14 million euros) with a 47 percent increase compared to the funding of 2021 and almost 20 percent more than the original program.

At the beginning of 2022, in the draft budget, the financing of this service was foreseen with 1.36 billion ALL, but with a normative act in the middle of the year, the government brought the fund for the PPP laboratory to over 1.6 billion ALL, which amount was fully disbursed.

A report of the High State Control found numerous problems in the contract that provides for the provision of laboratory services for a period of 10 years, with a total cost of about 106 million euros, but probably much higher in reality, according to the payments of I did in the second year of the contract.


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