PHILIPSBURG, Ombudsman Gwendolien Mossel recently concluded the Systemic Investigation into the procurement procedure of SZV for the selection of medical aid equipment (glucometers).After providing a Preliminary Findings Report, the Final Report was submitted on 30 December 2021 to the Director of SZV, Mr. Glen Carty. The Minister of Public Health, Social Development and Labor (VSA), Mr. Omar Ottley, was also provided with a copy of the report.
Faulty Glucose Testers
On 26 May 2020, a complaint was filed by a member of the general public regarding alleged faulty glucose testers being allowed as the sole option under the insurance of SZV. During an investigation into the complaint, the Ombudsman became aware of a number of concerns that were raised by healthcare providers and SZV insured regarding the accuracy of the newly introduced Perfect 3 glucometer. Subsequently, a systemic investigation was launched by the Ombudsman regarding the procurement procedures used by SZV and the process leading up to the decision to switch from the Freestyle to the Perfect 3 (glucometer), and the complaint handling process as well as the procedures, legislation and polices employed by SZV and the Ministry of VSA.
The investigation concluded, and SZV has acknowledged, that the new glucometer was not properly introduced to its insured clientele (persons living with diabetes). There was no information provided to properly facilitate the transition from the Precision Freestyle to the Perfect 3. According to SZV’s interpretation of the results, based on research conducted by Sint Maarten Laboratory Services (SLS) in January 2020, human error was the (likely) cause of the many complaints of irregular reading on the glucometer. SZV further informed the Ombudsman that a new glucometer would be introduced to SZV insured in the future.
SZV Duty of Care
SZV has a duty of care towards its insured population in accordance with the law, thus SZV is required to ensure that each medical aid and artificial aid device being provided to SZV insured has been thoroughly reviewed before being introduced. The Ombudsman understands that in order to keep healthcare affordable cost must be contained, however the quality of care must be maintained. A short-term saving on diabetes aids can result in an increase in costs in the longer term due to an increase in diabetes-related complications.
The assertion by SZV that information on the procurement procedure was not relevant for the scope of the investigation is incorrect. The procurement documents contain pivotal information regarding the requirements and guidelines set by SZV during the process and is thus an integral part of the investigation. Furthermore, the inquiry by the Inspectorate of Health also included a request for the procurement documents to which it appears SZV did not comply.
While SZV is independent in its functioning, it is an administrative public entity governed by the laws applicable to it. Considering the evasive answers provided by SZV regarding SZV’s procurement policy, the Ombudsman was unable to make a determination of the adherence of SZV’s procurement policy to the fundamental principles of good governance and more specifically the principles of public procurement. Hence, the Ombudsman concludes that the procurement procedure of SZV is not transparent.
The investigation also identified a number of serious concerns regarding how the complaint procedure had been addressed, not only by SZV but the functionally responsible departments within the Ministry of VSA as well.
Considering the facts and findings the Ombudsman concludes in the report that the standards of proper conduct not being observed are: Active and adequate information provision, active and adequate information gathering, adequate organization of services, reasons and proportionality.
The feedback received by SZV regarding the recommendations and findings was largely positive, however their refusal to provide information regarding the procurement procedures does raise concern. The Ombudsman looks forward to receiving an update from SZV and the Minister of VSA regarding the recommendations and issues highlighted in the report. The entire report will also be made available via www.ombudsman.sx under the ‘Reports and Articles’ tab ( ‘Final Reports’).