Το σύστημα προμηθειών υγείας στην Ελλάδα (στην περίοδο 1980-2010): μια θεωρητική και εμπειρική προσέγγιση
The healthcare supply system in Greece (within 1980-2010): a theoretical and empirical approach
Ζηκίδου, Σταυρούλα Χ.
The healthcare supply chain is a very hard and unknown field for most of people, even for those who get involved in the supply chain. It requires readiness and proper management in order to handle sensitive materials, from the plainer syringe to the most complicated medical-technological equipment. In reference to the healthcare supply field of public sector (hospitals), there are plenty of technical, law and managerial obstacles, such as: superabundance of laws, multiplicity and complexity of materials, weakness in defining the real needs for supplies and their quantities, lack of commodities recording and unified codification material system, lack of relation between the ordered materials, deficiency in maintaining control over material usage, inflation of out of contract supplies, prolongations of the contracts which are in force, small negotiating effectiveness and of course delays in the completion of the contests (big supply circles for programed purchases). One thing is for sure; much more are spent than what is needed. Furthermore, in most of the hospitals, the supply procedures are being conducted under the traditional handwritten manner (non-existence of unified IT systems) which leads, consequently, to errors, omissions and delays in the completion of the contests. On top of that, the absence of skilled executives with specialized education, which will modernize the management and oppose to interests, and surely the shortage of financial resources for strengthening the system, make the whole situation more difficult. So, it goes without saying that the absence of governmental control in combination to the lack of computerization and especially with the non-implementation of double-entry system in public hospitals (which would offer a higher degree of transparency and flow and consumption control) are in favor of the existence of high risk of corruption. On the contrary, the health care supply chain of the private sector does not come up against any of the above mentioned distortions and weaknesses, as long as the spirit of free market prevails and cost restrain policies are strictly being followed. Consequently, there are a lot of best practices of the private healthcare sector which could be, perhaps, transferred to the public, provided that the social character of Public Health is not forgetful. Such practices are: the adoption of organized supply systems "Just In Time"/ "Kanban", the possibility of direct sale of the stock material which is close to expiry date, the formation of proper, closed, spherical (and perhaps sectional) operation budget of the hospital, the adaptation of other financial, administrative and control tools with the implementation of advanced IT systems, the usage of 3PL/ Outsourcing and Leasing methods. Exception makes the "E-Procurement" method, as a way of supply, the application of which is in a very early stage of development in the Greek health territory, either public or private. Having weighed up the evidence, the reforming of healthcare supply chain of public sector is not constituted to constant legislative amendments, since the excess of laws from 1980 up to this day confirms it, but to the political will of the governments in combination to the simultaneous implementation of individual policies, social and financial. Besides, every reforming intervention will be judged by the wish of those in office to maintain Health as social possession. The conclusion is that all hospitals, private and public, could reduce their total operational cost, through better processes and management of the supply chain. Let's not forget that the proper structure of Public Supplies signalizes respect towards the taxpayer citizen and leads to proper allocation of resources and maximum value for money.