A European expert group led by Prof. Jan De Maeseneer (Belgium) has prepared a document entitled "Public Procurement in Healthcare Systems" for the European Commission, DG Health & Food Safety, on the topic of "effective ways to invest in health".
Every year, more than 250,000 public authorities in the EU spend about 14% of GDP (about €2 trillion) on the purchase of services, works and supplies. Many of these are in the health sector, an area where the public sector is the main procurer in many countries. When these procurements exceed certain thresholds, EU public procurement rules apply. With rising healthcare costs across the EU, public procurement is increasingly being promoted as a tool to increase efficiency as well as contribute to better health outcomes. The Public Procurement Directives 2014/24/EU "on public procurement and repealing Directive 2004/18/EC" and 2014/23/EU "on the award of concession contracts" provide an EU framework for public procurement in the EU. Its core principles are transparency, equal treatment and non-discrimination. Against this backdrop, the expert panel was asked by the European Commission to examine the challenges faced in public procurement and possible solutions to these challenges in the health sector. The experts looked at tendering for medicines, health technology and e-health. In each of these areas, they have identified a number of challenges related to the complexity of the procurement process, power imbalances on both sides of the transactions, and the role of procurement in advancing broader policy goals. The expert group recommends a number of actions to strengthen the procurement process, emphasising the importance of using procurement to advance health system objectives and, in particular, the interests of patients; to advance broader social, economic and environmental public policy objectives; and to build capacity within organisations involved in public procurement to ensure they have the necessary skills and expertise. A further three recommendations relate to specific issues and emphasise the need to strengthen anti-corruption measures at all stages of public health procurement, improve public procurement in emergencies and promote collaborative procurement where appropriate.