Continuing his interview series of Public Procurement Podcasts (PPP) Dr Pedro Telles of Swansea University talks to leading academics, researchers and graduates who have an interesting viewpoint on aspects of public sector procurement. He recently interviewed Niels Uenk, a part-time Researcher at the Public Procurement Research Centre, a joint interdisciplinary research centre of the universities of Utrecht and Twente. Before joining academia Niels worked as an international consultant in supply chain and logistics optimisation. He specialises in public procurement of long-term / social health care services.
Firstly let’s make a distinction: in the Netherlands, healthcare procurement is distinguished by two types: one is the purchase of the equipment necessary for providing healthcare (like rubber gloves in a hospital for example) and the other is a public body’s buying or commissioning of healthcare services. And Niels’ research is based on the latter – long-term care services (for example, home care and non-medical care, whether for the elderly, youth or disabled).
Expenditure on these kind of services is growing rapidly, he says, and it’s one of the main concerns and challenges for a lot of developed countries. In the Netherlands, for example, he explains, “we spend about 15 billion euros a year on these kind of services, both for adults and for youth and it’s actually growing at a rate of 5% or 6% a year, much faster than our economy is growing, so that provides a challenge. A lot of other countries, the UK, I think, and most countries in the OECD face similar challenges.”
So in his research he looks at what is happening about these rising costs. In 2015 the Netherlands underwent a change in the system where these services, previously centrally managed and procured, were moved to local governments, so the 400 municipalities became responsible for these social care services. From that, he finds that a lot of municipalities are looking for different ways of commissioning the services, and different ways of paying for them.
Social care had been very fragmented in the Netherlands, he explains, where provinces had responsibility for one part, regional offices of healthcare insurance agencies were responsible for a different part, and the local government and the central government were responsible for a another part – and all these different parts have now been combined and made the responsibility of the municipality. That’s a lot of responsibility for them. So investigating how municipalities are approaching the procurement /contracting/payment and the commissioning of these services, and then seeing whether the different approaches actually result in better or worse care, in terms of quality and cost, is the basis for his research. (The results of which are not yet publicly available at time of writing.)
He began collecting procurement documentation on how municipalities actually procure these services. He began compiling a database with all the tender documents, and all the contracts he could find, as most authorities published these. He now has a database of about 95% coverage of tender documents, about 385 of the 400 municipalities. That’s quite an achievement – when you consider most public tenders contain a lot of documents!
Then he interrogated the date – did the municipalities collaborate with the procurements? how many different municipalities joined? what kind of procedure did they follow? what were the dialogues in those procedures? was the procedure open for any kind of care supplier or did the municipality invite a selection? and so on. He also analysed the content of the contracts – what kind of products? did they simply copy paste the product lists that was used before 2015 or did they create new products? what kind of reimbursement method did they apply? How much did they pay? All interesting questions to analyse.
And he has just released his first paper on his findings. It has been accepted at the IPSERA conference and will be presented to the municipalities – then, we’re sure, he’ll share his findings with the world. To read more indepth commentary on Niels’ research, click throught to the PPP website.