Experienced medical professionals at state hospitals are increasingly distancing themselves from Technical Evaluation Committees (TECs) involved in procurement decisions, citing undue pressure to approve the lowest bids without due regard for patient welfare, the Sunday Times learns.
Senior and experienced medical specialists, who play a critical role in evaluating tenders for essential medical supplies, are either stepping down or reluctant to join TECs. Their concerns stem from growing pressure exerted by certain health officials who push for the lowest-priced items to be selected, regardless of quality, sources confirmed on condition of anonymity.
“These pressures place us in an ethical dilemma,” one specialist stated. “We cannot, in good conscience, recommend low-quality items simply because they are cheaper. Our responsibility is to protect patients, not compromise their safety.” Many echoed this sentiment, emphasizing that patients attending state hospitals place immense trust in the public healthcare system, and that trust must not be betrayed.
A visibly distressed specialist remarked, “We’re constantly being urged to go with the cheapest option. But in complex surgeries, the consequences can be catastrophic. We’re not demanding the most expensive items, only those that meet an acceptable quality standard.”
The specialists emphasized that they are not seeking luxury or top-of-the-line products but rather reliable and safe materials that won’t jeopardize patient outcomes.
Amidst growing concern, calls are intensifying for the health authorities to immediately convene a broad-based stakeholder discussion. The objective: to reach consensus on procurement standards that balance cost-effectiveness with patient safety.
Understanding the Procurement Process
Medical professionals explained that each hospital unit begins the process by submitting an annual indent—a projection of their expected supply needs. This indent is reviewed by the hospital Director and forwarded to the Medical Supplies Division (MSD) of the Health Ministry.
A doctor confirmed that annual indents for 2027—two years ahead—have already been submitted to the MSD.
The MSD, in turn, sends these projections to the State Pharmaceuticals Corporation (SPC), which publishes tender calls and schedules procurement accordingly.
Procurement needs are divided into three categories:
- Medicines: Including tablets, liquids, and intravenous drugs.
- Consumables: Such as sutures, scalpels, gauze, gloves, and needles.
- Devices: Including brain or kidney shunts, heart stents, pacemakers, joint replacements, and eye lenses.
When the SPC receives sample items in response to tenders, these samples are assessed by the TECs. For surgical items, TECs include two specialist end-users—typically surgeons—alongside Health Ministry officials. These specialists are nominated by the relevant academic bodies to represent the interests of patients.
After review, the TEC makes its recommendation, and the SPC proceeds with the procurement and dispatches the items to the MSD for hospital distribution.
The Core Concern
Many specialists pointed to this final stage as the most problematic. Authorities, they claim, expect TECs to select the lowest bid, even when the item may be unsuitable or unsafe. For instance, while a low-cost suture may suffice for skin stitching, its use in critical procedures—like cardiac, orthopedic, transplant, vascular, or plastic surgeries—could be dangerous.
“If we choose poor-quality items, patients might pay with their lives, and we will be held accountable,” one doctor warned.
In addition to life-threatening consequences, substandard tools increase operational time. “A surgery that usually lasts four hours might drag on for eight because the surgeon is struggling with low-quality materials,” another specialist noted. This also wastes valuable theatre time in an already burdened state hospital system.
Unjustified Attacks and Mental Strain
Beyond procurement pressures, specialists also highlighted a rise in unfounded accusations on social and mainstream media.
“We are serving on TECs voluntarily, going beyond our regular duties. Yet we are subject to unfair and baseless allegations of corruption,” a specialist said, describing the experience as deeply demoralizing.
Delays and Systemic Issues Behind Shortages
As for the widespread shortages of medicines, consumables, and medical devices, many attributed the crisis to a sluggish and ineffective procurement process.
“Local purchases, which should take days, are now taking months,” one doctor explained. They noted that while international bulk tenders reduce costs, the delay often forces the state sector into emergency local purchases, which are both more expensive and less efficient. If the public then has to buy from pharmacies, prices rise even further.
To illustrate the absurdity of cost-focused procurement, a doctor offered this analogy: “It’s like a housewife buying the cheapest rice in the market, only to find it’s rotten and inedible. She ends up throwing it away and returning to buy something better later—doubling the cost and waste.”
The Path Forward
Experts unanimously agree: the solution lies in collaboration. A multi-stakeholder forum is urgently needed to identify and resolve procurement bottlenecks, ensure quality assurance, and uphold the integrity of Sri Lanka’s state health sector—for the sake of every patient who depends on it.
