Audit: Tartu University Hospital procurements made without public tender

Tartu University Hospital main entrance.
Tartu University Hospital main entrance. Source: Tartu University Hospital.

An audit conducted at the University of Tartu has revealed that in 2022, Tartu University Hospital made €9.3 million worth of procurements without organizing a public tender procedure, as required by law.

The audit was conducted to assess the accuracy and legality of the University of Tartu Hospital Foundation's annual accounts for 2022. €9.3 million of transactions were identified as having taken place without the legally required tender procedures. The transactions in question relate to purchases from external companies, as well as acquisitions from the hospital's subsidiaries and other healthcare providers.

In a written statement, University of Tartu Hospital Board Chair Priit Perens said that ensuring the proper tender processes take place is a priority at the hospital. However, he added that the hospital was not able to eliminate all the instances non-compliance in 2022 for three reasons.

First, the inventory program, which is currently in use at the hospital, has limited capacity. This in turn makes it difficult to gather the information needed for the procurement process, explained Perens.

Second, there are no monopoly operators. Companies, which provide transport for organs for instance, are not prepared to participate in public procurement procedures nor commit to contracts. If such companies did participate, they would request prices that the hospital cannot afford, Perens said.

The third reason cited by Perens is the cooperation between state-funded healthcare providers. In his view, the problem is that the provision and supply of healthcare between different state-funded hospitals is also subject to public procurement regulations. At the same time, inter-hospital sales healthcare costs are calculated cooperatively by the Estonian Health Insurance Fund (Tervisekassa) and professional associations and are fixed in the Health Insurance Funds' price list.

Organ transplants are performed at the University of Tartu Hospital for instance, with the hospital also required to fulfil its obligations as a transplantation center as outlined in the Estonian Procurement, Handling and Transplantation of Cells, Tissues and Organs Act.

When such procedures take place, hospitals receive the amount of funds stated in the Health Insurance Fund's price list in order to cover the cost of managing the transfer of the required organ(s) to other hospitals.

As the sums involved are large, this process should also be subject to a public tender in accordance with Public Procurement Act. However, this may unfortunately lead to a situation where public procurement becomes a formality rather than a means to achieving the objectives of the Public Procurement Act," explained Perens.

According to Perens, it is worth asking whether, in cases where hospitals buy services from each other, the Health Insurance Fund's price list is sufficient and therefore there is no need for a public tender. Transactions made between hospitals are important however, as they often allow patients to receive healthcare closer to home, he added.

Last month, the National Audit Office also sent a letter of formal notice to the Ministry of Social Affairs regarding the hospital's non-compliant transactions. At the time the story was broadcast, the Ministry of Social Affairs was yet to provide a comment to ERR.


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Editor: Michael Cole

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