The Audit Office finds “irregularities” resulting from lack of competence of the general public dialysis service | News from Catalonia | EUROtoday

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The public hemodialysis service, very important for sufferers with kidney failure, is within the fingers of personal operators who received a public tender put out to tender by the Generalitat. In a current report ready by the Audit Office, the auditing physique denounces “facts that could constitute indications of collusive behavior”, an alleged collusion between the profitable bidders that would contain anti-competitive practices and that calls into query the price paid for every service by the Department of Health via CatSalut. “The irregularities described could give rise to events that could be prosecuted administratively and judicially,” the report states in reference to the businesses and people liable for the choice inside the Generalitat.

The Ombudsman focuses this accusation on the out-of-hospital outpatient hemodialysis service, for which 16 tons had been tendered all through Catalonia. It was a 10-year tender for an quantity of 1,142 million euros during which the largest beneficiaries (they achieved 14 territorial packages) had been the giants Fresenius and Diaverum. “There are various factors that denote a lack of competition among the participating companies,” says the report, which signifies that the results of the competition was much like the earlier one, known as in 2006. One of the arguments is the next: “The geographical distribution of the The awarding of the lots suggests a possible geographical distribution of the market between the 4 successful bidders (Renal Systems, Health and Assistance Management of Tortosa, Fresenius and Diaverum).” But it additionally states that monopolistic practices may very well be defined by a “possible agreement on price fixing and the lack of rotation of offers.” In abstract, within the absence of what later stories point out: “They appropriated an illegal extraordinary benefit that harms the contracting Administration.”

The Audit Office has simply signed an settlement with the Catalan Competition Authority, in accordance with which it must ship its report in order that the ACCO can perform its personal investigations.

The contest dates again to 2014 and was carried out via a negotiated process with specialised corporations with out promoting, regardless of being required in accordance with the legislation in drive at the moment. The value of every service, level out the trustees who ready the report, was not established via any pattern or value research. And, regardless of suggestions to make use of residence methods by numerous organizations, peritoneal dialysis is being underused, beneath 9% of complete circumstances in 2022 (and with giant variations relying on the territory). According to the Audit Office, this additionally has a decrease value, of round 29,724 euros, in comparison with 47,744 euros for out-of-hospital hemodialysis and 42,461 euros for hospital hemodialysis.

“Hospitals that provide home techniques have difficulties financing these techniques because the rates paid by CatSalut are lower in the case of peritoneal dialysis compared to conventional hemodialysis and insufficient to cover their costs in the case of home hemodialysis,” factors out the Audit Office, which in one other level of its conclusions factors out an instance of the discretion with which it acts: “The dialysis center that has billed the fewest dialysis sessions out-of-hospital, the Braun center in Martorell, has the most competitive price.”

The report of the Audit Office makes clear from the start the relevance of power kidney failure remedies: as a result of it’s a very important necessity for sufferers, due to the way it impacts the standard of sufferers and, additionally, due to the excessive value which represents for public well being, among the many costliest of power ailments. In 2022, it’ll value a complete of 139.5 million euros (22 million greater than initially deliberate). This is why the supervisory physique determined to hold out a report on the service in 2022, making an allowance for a number of associated actors: along with Catsalut, the Catalan Society of Nephrology, professionals and consumer associations.

Their conclusion is that the plan on which the service is supplied is “obsolete” and that, regardless of the wants having elevated, the contracted exercise has not been up to date. The penalties: ten facilities exceeded the contracted exercise by an quantity of 8.4 million with none contract modification occurring. Likewise, the supervisory physique assaults the dearth, by Catsalut, of an automatic circuit that ensures the companies supplied indicated by the operators: “The name of sessions billed by the providers may not be real.” The Audit Office detected 31,574 information of doubtless duplicate invoices for a quantity of 4.3 million, though CatSalut alleged that a few of these invoices had already been recognized and discounted to suppliers.

The lack of monitoring is comparable within the case of service high quality, during which CatSalut doesn’t management journey occasions and ready occasions in dialysis facilities. 10% of sufferers exceed 7.4 hours between leaving and arriving residence after therapy.

https://elpais.com/espana/catalunya/2025-01-07/la-sindicatura-de-cuentas-halla-irregularidades-por-falta-de-competencia-del-servicio-publico-de-dialisis.html