What will France’s new GHT system change for purchasing?
The implementation of GHTs (regional hospital consortia) means that purchasing will be performed by a support establishment designated by the other hospitals in each GHT, resulting in all of these hospitals losing their autonomy in this regard. What will be the consequences of this restructuring? What should we expect? Here are some answers.
The role of purchasing departments, as the GHTs are set up, is two-fold: to help to provide ever more effective and accessible treatment for all, and to ensure compliance with overall government policy, whether this be to promote local employment and innovation, or to give SMEs opportunities for development by providing them with an outlet.
The consolidation of the purchasing function must, however, allow for the fact that, in legal terms, a GHT is an entity that does not have legal personality and therefore does not have the statutory status of a public purchasing body. In concrete terms, this means that the support establishment responsible for coordinating the purchasing policy can only lay the groundwork (by setting out a global strategy and contractual conditions, defining the needs of the GHT, implementing monitoring tools, etc.), but that on no account can it originate purchase orders or execute the purchasing policy itself. It is each establishment belonging to the GHT that performs these roles.
Business for local VSEs and SMEs
For the most part, as the consolidation of purchasing is only due to take effect from 1 January 2018, it is difficult to predict whether the establishments will change their purchasing habits, whether in terms of quantity or choice of products. However, the framework for operations is known, as are the preliminary requirements to be fulfilled. In the first instance, items must be classified and a distinction made between purchases that can and cannot be consolidated, and those that are common to all hospitals, so as to potentially entrust such purchases to central hubs and leave each GHT to make the purchases that are specific to its own situation. This latter possibility opens the door to local VSEs and SMEs, giving them the opportunity to demonstrate their know-how and the added value that they may be able to offer.
Sébastien Taupiac, Healthcare Director at UGAP (union of public purchasing consortia) recommends “an overall cost approach”. He explains that: “When a purely budgetary approach is taken to purchasing, we turn to the mass-market to reduce the price, even if that means resorting to standardised and industrialised solutions. However, the healthcare sector is extremely complex and, in many cases, it is necessary to use the latest technologies and innovations, and allow for pay-per-use services. Therefore, if we do not take sufficient account of the specificities of each hospital in the GHT and the impact in terms of overall cost (i.e. training for users, use of consumables, additional logistics costs, maintenance, etc.), the savings will necessarily be very short-lived.” Clearly, the aim of the GHTs is to take a broad and long-term view.
Support for purchasers
“Our function is not just to compile a catalogue”, reiterates Sébastien Taupiac, UGAP Healthcare Director. Faced with the revolutionary change that the creation of GHTs represents for purchasing departments, the establishments are in need of support. RESAH (the hospital purchasers network), among others, fully intends to be proactive and assist with the change that is under way. At its last general meeting, held on 8 December 2017, its chairman, Dominique Legouge, confirmed that its aim is to “support the teams” by “implementing a collaborative and high-capacity system” whereby the “support establishment should enable the establishments in question to act as partners”.
The central theme is regionalisation. To this end, RESAH wishes to “offer the establishments a wide range of solutions so as to help them create an effective regional shared purchasing structure”.
This represents an evolution in relations with the establishments, which the various parties will have the opportunity to explore further during Paris Healthcare Week 2018.