Representative Tran Khanh Thu ( Thai Binh Delegation) expressed concern about the amendment and supplementation of the Law on Bidding, specifically Clause 2, Article 55, regarding the regulation on retail sale of medicines at pharmacies of public hospitals.
Ms. Thu argued that purchasing medicines for retail sale at hospital pharmacies, while using legitimate revenue sources, is still subject to Article 2 of the Bidding Law, thus creating difficulties in implementation.
Furthermore, according to Ms. Thu, if the draft law is amended to apply direct procurement, it will not be able to resolve the difficulties in procurement at public healthcare facilities, including the purchase of medicines for retail pharmacies in public hospitals.
Ms. Khanh Thu raised two issues. Firstly, direct procurement is not a price-fixing method. “There is no price-fixing method in the bidding regulations. Direct procurement is also a form of contractor selection, so it requires following the procedures and processes of contractor selection, such as: developing a plan (and it's difficult to determine the needs for planning); organizing the evaluation and approval of the contractor selection; issuing documents, evaluating documents, proposals, and evaluating and approving the contractor selection results. The time for these steps cannot be shortened,” Ms. Thu assessed.
Specifically, Ms. Thu pointed out that while hospital pharmacies serve not only inpatients but also outpatients, their families, and other individuals, there is currently no standardized form for direct procurement.
Secondly, Ms. Thu mentioned that hospital pharmacies operate as tax-paying businesses, so the cost of goods sold there includes the bidding process and other business expenses and taxes, which are added to the product price. Consumers will then have to bear this additional cost. “Legitimate revenue sources for autonomous public institutions include other income sources such as canteens and grocery stores. If the scope of Article 2 of the Bidding Law is applied, then the products sold there would also be subject to it,” Ms. Thu explained.
According to National Assembly Deputy Tran Thi Nhi Ha ( Hanoi Delegation), we are currently witnessing a clear disparity in the bidding and procurement of medicines and medical equipment between public and private healthcare facilities. While public facilities face many difficulties in bidding, leading to shortages of medicines and medical equipment, private healthcare facilities ensure sufficient supplies of medicines and equipment, even including rare drugs and modern medical equipment.
Furthermore, Ms. Ha cited that although one of the principles of bidding is to ensure economic efficiency, private facilities using conventional procurement methods are able to purchase some medical equipment at lower prices than public facilities. "The question of why this is the case remains unanswered and continues to pose a significant challenge to the bidding process," Ms. Ha stated.
Therefore, Ms. Ha proposed adding a regulation to the Bidding Law requiring not only public but also private medical facilities to publish information on procurement results. This would be an important database valuable for management and reference, creating transparency and limiting negative practices in bidding, ensuring sufficient medicines and medical equipment to serve medical examination and treatment.
Hospitals are struggling to procure medication.
Ms. Tran Thi Nhi Ha also argued that the regulations in Clause 1, Article 2 and Clause 2, Article 55 of the Law on Bidding have caused considerable confusion for hospitals because the purchase of medicines by hospital pharmacies also uses legitimate revenue sources.
“According to Clause 1, Article 2, all contractor selection activities using funds from the unit's legitimate revenue sources must apply the bidding law, while Clause 2, Article 55 allows the facility to decide on procurement independently. In practice, many health departments and medical facilities have sent letters to the Ministry of Health and the Ministry of Planning and Investment reflecting difficulties and inadequacies, requesting guidance on this matter,” Ms. Ha analyzed, adding that the current situation is that hospital pharmacies are lacking many types of medicines and medical equipment to serve the needs of patients.
Therefore, Ms. Ha proposed amending Clause 2 of Article 55 as follows: "For the purchase of vaccines for vaccination services; the purchase of medicines, medical equipment, cosmetics, functional foods, and other essential goods at retail outlets within the premises of public medical examination and treatment facilities, the medical examination and treatment facilities may independently decide on procurement ensuring transparency, economic efficiency, and accountability without having to apply the contractor selection methods stipulated in the Law on Bidding."
Representative Pham Khanh Phong Lan (Ho Chi Minh City delegation) also pointed out that pharmacies and drug retail outlets at hospitals no longer lack any means of management. In fact, some people ask why there was no drug shortage for so many years, but now there is?
According to Ms. Lan, we cannot blame Covid-19 or the disruption caused by war; instead, we must acknowledge that we are creating difficulties and hardships for ourselves. “No other country manages the supply chain for a single pill in a hospital so haphazardly. Ultimately, the number one goal is to ensure improved public health and quality medicines. As for pricing, what savings have we seen after years of relentless bidding? Or have numerous officials been corrupted by the bidding process? Bidding is not the only or best solution. If we only focus on price reduction, it will be the foundation for a decrease in quality,” Ms. Lan stated.
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