Medical check-up service for people at the 40-65 age group will be provided by a company that sells cigarettes and alcohol. Companies disqualified from the competition complain about lack of transparency in the calculation of points. There is kept secret the cost of the project where some 475 thousand citizens will be examined every year, while the price of the package per person will be 1650 leke. The Ministry of Health does not do transparency for the 10 year contract even though two official requests were sent to it.
A company that has on focus of its activity the marketing of tobacco, alcohol and stationeries, since January this year and for 10 years in succession will carry out the free of charge medical check up for all the Albanian citizens at the 40 – 65 age group. The Ministry of Health through a committee chaired by the Deputy Minister, Klodian Rjepaj has announced as winner of the concession with a lifespan of 10 years the company “Marketing & Distribution” to perform the “check-up” (examination) for over 400 thousand Albanian citizens. There is still no monetary value on how much they will pay for this service, but according to the preliminary figures this concession will cost 120 million Euros. The procedure for the selection of the company having an activity on trading of tobacco and alcohol, as well as the scoring system for each evaluation criteria are not published by the Ministry of Health, which prefers to remain silent in front of the frequent requests for information from investigim.al.
The whole procedure followed for this concession with strong shades of scandal started after a decision taken by the Council of Ministers about a year ago for the screening of the population, especially in conducting free of charge medical examination for people at the 40 – 65 age group. Last year, in April, the Council of Ministers approved the decision no.185, dated 02.04.2014 “On defining the way on the implementation of the basic medical examination for citizens at the 40-65 age groups”. According to this decision, the Ministry of Health, Ministry of Finance and the Ministry of Interior are appointed to undertake the further steps for the implementation of this strategy, which according to experts will result in failure, as the concession does not provide any further step for people who will be found to have health problems. On 18.08.2014, the Ministry of Health announced officially the concession notice of the “check-up” by defining all the criteria that must be met by the interested companies that would participate in this competition.
At the end of the deadline, i.e. on 11 September 2014, the Ministry of Health received bids from five companies and joint venture companies, which expressed their interest in implementing the project on a free of charge medical examination. According to the bulletin dated 27 October 2014, to the Public Procurement Agency results that for this concession the companies “Genius” ltd, “Natural Pharma Europe”, “Pegasus” ltd, “Marketing & Distribution” and the company “Proton” ltd, have expressed their interest. The Procurement Evaluation Committee had decided to automatically disqualify from the tendering process three companies due to lack of documentation, by leaving in the competition the joint venture companies “Marketing & Distribution” and “Trimed” on one side and joint venture companies “Proton” ltd, ” Hygeia Hospital Tirana “,” Farma Net Albania “and” Tera Solutions ” on the other. In a non-transparent way, as representatives of the disqualified companies claim, the Concession Commission has decided to announce as winners the two companies “Marketing & Distribution” and “Trimed”. The first has as its main activity the distribution of tobacco, alcoholic beverages, food and stationeries, while the second is a pharmaceutical warehouse.
But despite the lack of experience on the implementation of such an endeavour that will last at least 10 years and will cost 120 million Euros to Albanian taxpayers, the concession commission headed by Deputy Minister of Health, Klodian Rjepaj and the members Gazment Bejtja, Aurel Voda, Aleksander Harxhi and Marsela Seriani declared as winner the two above mentioned companies. One of them, “Marketing & Distribution” is licensed for chemical and biochemical laboratory from the National Licensing Centre on September 9, 2014, i.e. just two days before the deadline for submission of documents, a time set by the Ministry of Health in the standard procurement documents. This fact is proved by a copy of the license that has investigim.al, which dated 09.09.2014. Regarding this fact, the Health Minister, Ilir Beqja, during a television programme said that any licensed company can participate in the competition and can win or not.
Beyond doubts on the lack of experience of the winning concession companies, representatives of competing companies which were not selected cast doubt on the way of calculating the points by the commission. Procurement documents show a simple formula on the calculation of points according to the definitions, which are based on six main pillars. The number of laboratories to be built is assessed with 10 points, as there is decided that the company should build at least 18 laboratories across the country. Social and environmental impact is assessed by 3 points, while the highest weight in the evaluation criteria is the price per examination, which is estimated with 45 points. Three other parameters, time of operation, transportation plan of samples to the laboratory and the value of reinvestment in equipment is valued respectively 10, 17 and 15 points.
Representatives of the non winning companies without wanting to be identified said that the commission has not made transparent calculation of concession points as defined by the Ministry. The unit “price for each medical examination” that has the highest weight in the final evaluation score is calculated on the basis of the bid submitted, which is divided by the total number of citizens who will undergo “the check-up” for free. Referring to the data in the bulletin of the Public Procurement Agency dated October 27, 2014, the joint venture of the companies represented by the “Marketing & Distribution” has offered the value of 75 thousand 730 million lek for this service. While the joint venture of the companies that are represented by “Proton” ltd, part of which is also a renowned hospital in Tirana has offered the value of 617 million and 25 thousand ALL. So, the price difference to the performance of the service offered by the two joint venture companies is evident although it remains unclear why the Ministry of Health selected the company that offered the highest price for providing the service. While the Ministry itself, before selecting the winning company, had set the standard concession documents / public-private partnership for the service package on the basic medical examination for the age group 40-65 years and the company that would present the lowest price for the check-up package would take the maximum points. “The check-up price is the price of the service that will offer a bidder for the check-up package according to the object of the contract. The maximum price that can be offered for this service is 1650 leke without VAT. The bidder who submits the lowest price of the check-up package will be evaluated with the maximum points”, is written in the official document of the Ministry of Health.
Referring to the documents of the concession published by the Ministry of Health results that this project will be financially supported to carry out a certain number of examinations, calculated into 475,000 examinations in a year. The examination for this number of citizens has been calculated with a higher cost according to the Ministry, even though a considerable part of services will be offered by the physicians of the health centres, who will have the main burden of this process. Even though the documents compiled by the Ministry of Health show that the company that offered the lowest price would be assessed with the maximum scores, the representatives of the companies accuse the Concession Commission and the Ministry for lack of transparency on calculating the points as per offer submitted to them. According to a simple calculation of the price of the service per each person that is 1650 leke with the total number of the examinations in a year i.e. 475 thousand leke, results that the maximal cost foreseen from the Ministry of Health is 783 million and 750 thousand leke, without the VAT that is at the amount of 20 per cent.
After the Ministry surpassed even this “obstacle”, it called the winning company given the right to negotiate the contract that has not become public until nowadays. It left a 10 day deadline for the negotiation of the contract, where the commission had the right to postpone it. Even though this notification is done last year in October, the contract between the Ministry of Health and the winning company was signed by beginning of January this year, hence four months after the selection of the winning company. The Ministry of Health does not give any information on what has happened during this time and it also keeps secret the concrete terms of the 10 year contract. According to the definitions compiled by the Ministry itself, a part of these services will be carried out to the health centres, which must be supplied with the foreseen means for the finalization of the project financed with the money of the Albanian taxpayers. “The reception of the blood sets will be taken to the health centres by the current staff and the answers will be registered in the central system of the data processing. The family doctor will have access to the central system of the data processing to communicate the results of the examination to every citizen”, is explained in the documents of the Ministry on regard to the free of charge examination.
In fact the central data system for the citizens that will undergo the health examination free of charge is another important issue of the process, as initially there is required the setting up of a database which can be implemented only by two companies. The first has been disqualified from the competition as it was part of the joint venture of the companies that failed, whereas the second is allegedly the former company that has been on the possession of the Minister of Health, Ilir Beqja. These data are still unconfirmed, but out of the information received from some health centres in the country there results that the system with the database for the citizens at the 40-65 age group, who will undergo the medical examination for free has not been set up yet. Only after this database will be constructed, it is expected to initiate the implementation of the project, firstly by setting up 18 laboratories of medical examination across the country and later on with the notification of the people who have to come to the health centres on their date of birth. This process was supposed to start by beginning of 2015, but the Ministry of Health has not publicized any information to show if it has started or not the completion of the concession for the free of charge “check-up”. Investigim.al will continue to have on its focus this issue by following step by step the whole foreseen process, which even though it does not have any initial defined cost, it is doubted to surpass the amount of 120 million of Euros.
Ministry does not do transparency
Investigim.al has sent two official requests to the Ministry of Health with a subject on getting the information on the issue of free of charge medical examinations. But even though all the foreseen deadlines stipulated on the Law for the Right of Information have been met, they have not received any answer yet. The first request has been sent via e-mail to Mrs. Aida Hasmeta, after the phone contact with the Media Advisor of the Minister of Health, Thanas Goga. The later suggested the questions to be sent via e-mail in the official address of the employer of the Ministry of Health. On 4 February there were raised nine questions about this concession, which were sent to Mrs. Hasmeta. By the end of the 10 day deadline, the journalists of investigim.al have asked about the response to the media advisor of the Minister Ilir Beqaj, who has declared that the information is being gathered. But investigim.al has not received any answer even for the copy of the contract signed between the Ministry of Health and the winning company of the concession. On 5 February 2015, the journalists of investigim.al have registered in the registry book of the Ministry of Health the request with subject on providing the contract between this institution and the winning company of the 10 year concession. But even this one has not been provided to us by the ministry even though there was not needed as much time to make the copy of the contract as needed to collect the information they pretended for the questions raised to them by investigim.al. Furthermore, even though there have passed more than 23 days, investigim.al has not received any answer from the Ministry of Health. In the compliance to the Law on the Right to Information, the Association of the Journalists for Justice (SHGD) has addressed the issue to the Commissioner for the Right to Information and Protection of Personal Data and it is waiting for an answer from this institution. All the steps followed to get the information have been registered from SHGD, which possesses all the necessary documentation.
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