"Delays in tenders do not accompany the needs of the hospitals." And the Auditor General of the City of Buenos Aires (AGCBA, for its acronym in Spanish) completed its work after detecting significant delays in the procurement of services such as collection and treatment of medical waste and service provision bedding, just to name a few. In many cases, direct contracting was the way to cover the lack of foresight.

The auditors concluded that "there are delays in opening dates, changes in the evaluation committee members and price re-determinations delay the bidding process, but to have it extend to 860 and 1350 days is overstated."

Specifically it refers to a case in which the tender for the Service Management, Operation and Maintenance of Physical Resource at the Sardá Hospital, which included land, infrastructure, civil works, plant and equipment, was processed. The delay here "was 1353 days between the first opening date and the award."

Another file, containing the same contract but for the Burn Hospital "took 869 days to go from one instance to the other."

Added to this it’s that the infrastructure of the Buenos Aires hospitals "are inadequate, outdated and poorly maintained which prevents providing quality care and respect the right to health."

The purpose of the Watchdog was to identify weaknesses and critical areas in the outsourced contracts of the Health System of the City of Buenos Aires. Agreements made between different companies and the Marie Curie Oncology Hospital, the Burn, the Maternity and Children’s Hospital Ramón Sarda and the Udaondo Gastroenterology.

In addition to registering delays in calls for tender, once they overcome the cumbersome process, the paperwork remains the same.

The report, approved in November 2014, states that the Ministry of Health of the Government of the City "made no new calls for tenders to cover the service of collecting, transporting and treating medical waste prior to the expiration of the contract extensions."

It makes it clear that the expiration of the contract period for which the services were hired and even after this second deadline had to be paid through an "exception mechanism provided for in Decree 556/10." I.e., "as services continued to be provided the payment is authorized, but there is no new hiring."

It is important to note that in this case "a new call was called a month after the expiration of the extension" which reveals the lack of foresight.

Something similar happened with the service provision of washing and ironing linen. In this case the Ministry "did not make new calls for bids” so that from November 2012 to July 2013 it is not known under what contractual arrangement the provider continued to provide the service."

On the maintenance of medical equipment in the Maternity Sarda the auditors "could not establish whether from January to April 2012 the service was provided" considering that direct contracting is dated May 23 of that year.