Overpriced contracts infect health care

FOUR state-owned hospitals involved in the scandal tied to overpriced meals will have to pay two private companies for food deliveries and catering – even if they never make it to patients. Health Ministry officials say they are looking into the possibility of cancelling the contracts.

FOUR state-owned hospitals involved in the scandal tied to overpriced meals will have to pay two private companies for food deliveries and catering – even if they never make it to patients. Health Ministry officials say they are looking into the possibility of cancelling the contracts.

The Sme daily and Transparency International Slovensko (TIS) reviewed contracts of four large state hospitals in Trenčín, Banská Bystrica, Trnava and Poprad and found that they will pay external caterers nearly €81 million including VAT over the course of 10 years. The contracts show that while most hospitals obtain food for patients for less than €5 per day, in these four state hospitals the sum oscillates between €8.30 and €10.80, Sme reported on December 8.

Heads of state-owned hospitals in Banská Bystrica, Trnava and Poprad, together with the Health Ministry’s service office head Martin Senčák, were forced out due to the scandal.

According to TIS, contracts stipulate that if the hospitals do not consume at least 95 percent of the amount agreed, they will pay also for the unconsumed servings. Hospitals already paid €380,000 for unconsumed meals this year, although contracts have been valid for only a few months. The contracts have been assumed for 10 years, despite a potential decrease in the number of hospital beds, Sme reported on December 13.


Difficulties with cancelling of contracts


The Parliamentary Committee on Health Care requested from the Health Ministry an analysis of legal possibilities about how to cancel contracts which the ministry is currently preparing. Health Minister Viliam Čislák hopes to be able to change the contracts, while lawyers on both sides elaborate them, according to Sme.

However, the ministry has not revealed additional steps and has not said whether it will ask hospitals to cancel the contracts, Pravda daily reported.

“Since the Health Ministry is not a participant in those concession contracts the further legal approach is in hospitals’ competences,” ministry’s spokesperson Martina Šoltésová told Pravda.

TIS claims that it is not a problem to cancel them, as hospitals violated the law on budget rules because they did not submit contracts to the government for approval. The Slovak legislation stipulates that a legal act which violates or avoids the law is not valid, according to Sme.

Čislák used the same argument when recalling heads of state-owned hospitals.

“Contracts were signed unlawfully because the government should approve them,” Čislák said at a press conference, as quoted by Sme. “Those contracts do not exist for the Health Ministry and specific persons are responsible for violating the law.”

However, Tomáš Kamenec, the lawyer with Dedák & partners law firm questioned such a possibility.

“The lack of government’s approval of the signing of the concession agreement is not explicitly the reason for the contract’s invalidity, according to legislation,” Kamenec said, as quoted by Sme.

He added that there is a risk that hospitals which are responsible for this may have to pay compensations for cancelling of contract.

Peter Kubovič of HKP Legal law firm shares his doubts.

“In this case we are [talking about] absolutely unpredictable results,” Kubovič said, as quoted by Sme. “It [invalidity] is usable but without guarantee how it will end.”


Smer nominees leading hospitals


A few days after Čislák forced hospitals’ heads to leave, independent MP Miroslav
Beblavý called on Parliament Speaker Peter Pellegrini of Smer to ask Smer MPs Jozef Valocký and Jozef Ježík to leave their posts at the helm of state hospitals in Nitra and Ružomberok respectively, on December 15.

If they refuse, they should pass their seats in the Parliamentary Committee on Health Care to someone else since currently as committee members they supervise the ministry responsible for hospitals and at the same time they are its direct subordinates, according to Beblavý, the TASR newswire reported.

“It’s direct violation of power-sharing principles and it weakens supervision of government by parliament which is low even now,” Beblavý said, as quoted by TASR. “Using the term ‘conflict of interest’ for this situation is too insufficient and it doesn’t describe the situation which has never occurred in the history of the Slovak parliamentary system.”

For example, the committee member Vladimír Baláž of Smer signed the catering contract for Banská Bystrica hospital and thus had to leave. During the committee discussion about the contracts he was defending the contract with Banská Bystrica hospital and did not approach Čislák with any questions on the case, public service RTVS reported.

“It personally offends me,” Baláž told RTVS. “…I refuse to be attacked by someone [who is suggesting that idea] that I wanted to steal something from patients’ catering.”

Pellegrini’s spokesperson Pavel Chovanec refused to comment on the cause, pointing out that the Parliament Speaker travelled abroad, TASR reported.

Meanwhile the head of Poprad hospital Jozef Tekáč who refused to leave arguing that the hospital in Poprad was transferred to a joint stock company, and therefore aforementioned legislation does not apply to it changed his opinion.

“Mr Minister [Čislák] agreed with the director [Tekáč] that he will leave,” the ministry’s press department wrote to Sme.


How to deal with shady catering


The Health Ministry does not have an exact plan about how to deal with caterers in general, according to Sme.

“The needs of hospitals are individual and specific,” reads the ministry’s statement, as quoted by Sme. “Each one of them has to take care that money is spent effectively and the whole process of providing services is in line with the law.”

Unlike four state hospitals involved in the catering scandal, university Hospitals in Bratislava and Košice, faculty hospitals in Žiline and Nové Zámkoch provide food on their own. However, they deal with the problem that if they want to have a balanced budget they do not have money for reconstructions of canteens which were included in contracts of those four hospitals.

There are several causes of this situation particularly the lack of managers’ ethics and the fact that the state owns those hospitals. To solve it hospitals should make procurements in an economical and ethical way, according to Dušan Zachar of the non-governmental Institute for Economic and Social Studies (INEKO) think tank.

“But what is the motivation of state managers to do that,” Zachar said, as quoted by Sme. “They are recalled after two years of service in general therefore some of them are motivated to steal as much as they can and others to survive it without harm.”

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