The efficacy of procurement policies in the public health care system in South Africa

Abstract

The capacity for most South African hospitals to purchase ventilators presents a worrying situation in dealing with Covid-19 patients. Parastatals including hospitals are faced with non-compliance issues when purchasing medical equipment and poor evaluation of tenders has also increased. The study sought to assess the efficacy of the procurement policies in the public health care system in South Africa with a view to improve the procurement of ventilators in South Africa.

The study took a case study design in which the researcher collected data from four hospitals in the Gauteng Province. Purposive sampling was employed to draw ten interview participants from the hospitals. Data were analysed using thematic analysis. Findings indicated that the procurement policy of South Africa guide the purchase of mechanical ventilators. The procedures and rules are as articulated in section 217(1/3) of the Procurement Act. The results also revealed that due to the uniqueness of the situation, and several challenges, the purchasing criteria were not one hundred percent effective. The findings also illustrate that the hospitals’ procurement process fails to effectively adhere to the five principles of good governance (fairness, equity, transparency, competitiveness and cost-effectiveness. It was recommended that procurement decisions be fairly and openly made, and once the need for ventilators has been identified. Findings show that the tender process must be smoothened while applying the rules as per the demands of the treasury as strictly as possible. An inclusive approach to tender evaluation was recommended as well as widening stakeholder consultations. It was also revealed that the financial delegation of CEOs needs to be increased and reducing bureaucracy since equipment must be purchased quickly. The study has policy and practical implications. There is a need for policymakers to consider the findings of this study to allow hospitals to quickly procure high-risk medical equipment, in particular mechanical ventilators. Coupled with this, policymakers need to increase the financial delegation to allow hospitals to buy at an emergency the right quality and quantity of mechanical ventilators. From a practical standpoint, this study fully endorses and prioritises the importance of having an effective criterion for the purchase of high-risk medical equipment during a crisis. Acknowledging the limitations of a study strengthens the trustworthiness of the results, and helps researchers recognise avenues for future research. The primary limitation of the study relates to its generalizability. Future studies may take the form of quantitative and longitudinal studies across the SADC region or expand the research into the procurement procedure of other medical devices.