Even the Internal Auditor finds that equipment for the paralyzed was purchased more expensively

After reporting by KOHA that the University Clinical Hospital Service did not respect the Administrative Instruction when purchasing assistive devices for people with paralysis, the violation was also confirmed by the Internal Auditor of this institution. The report stating the differences in price was presented on Tuesday before the Board of Directors of SHSKUK.

The Internal Auditor of the University Clinical Hospital Service (SHSKUK) has confirmed the findings in the KOHA investigation for non-compliance with the administrative instruction that limits the price for the purchase of equipment for people with paralysis.

Through the tender for assistive devices for paraplegic and tetraplegic people, a simple cane, which costs from 3 to 6 euros on the online market, was purchased by SHSKUK for 98 euros. Meanwhile, the Instruction allows for spending from 10 to 50 euros on it. 

Four months after the audit request, the report stating the price differences was presented on Tuesday before the SHSKUK Board of Directors, by the deputy director of the internal audit unit, Besnik Zejnullahu.

"During the audit, differences were noted between the approximate unit costs offered and those specified in the instructions. These differences may have occurred because the equipment was planned to be purchased as a whole, while the procurement procedure was developed with the 'cheapest price' evaluation criterion, where the evaluation of the bids is based on the total amount of the bid and not on the individual unit prices. However, an alternative practice would be to divide the equipment into separate lots," said Zejnullahu.

Neither for this nor for the auditor's other finding that punitive measures for the delay in the delivery of equipment were implemented, was the general director of SHSKUK, Elvir Azizi, held accountable.

Auditor Zejnullahu mentioned that in one of the purchase order invoices within the framework of the contract for the supply of auxiliary equipment, he noticed a delay in the delivery of the goods.

"The test found that for invoice no. 802-24, dated 23.12.2024, in the amount of €334.000.00, the economic operator did not adhere to the deadline set in the contract for the delivery of the goods, which was 90 days from the date of issuance of the purchase order by the contracting authority. Although the contract provided for the application of penalties in case of delays, no fine was imposed on the economic operator for exceeding the deadline. This is due to the report of the contract manager where there were difficulties in arranging the goods in the warehouse until adequate space was provided", said Zejnullahu.

And, regarding the issue of equipment costs, Board member Dren Boshnjaku raised questions.

"How did the procurement continue without setting the price threshold for the equipment, and why weren't the penalties for suppliers set if they didn't supply the equipment on time? Another issue is that since the range of equipment is very large, why weren't they divided into lots?" said Boshnjaku.

Zejnullahu said that this was determined by the evaluation committee appointed by the Ministry of Health, whose members the committee did not have the authority to hold accountable.

"This work is legally determined by the requesting units as to how they are evaluating a certain product, whether they want to buy it separately, or whether they want to buy it as a whole... In this case, it came as a total lot. That is, it was a procedure to be developed completely. The requesting unit is the evaluation commission determined by instruction 11/2022. It was appointed by the Ministry of Health and there were various actors there. It remains to be evaluated by those other actors who I was not able to officially ask questions to those persons, to send official questions, there remains to be evaluated," said Zejnullahu.

Another finding in the report was that SHSKUK initiated the tender without budget planning.

"The activity was initiated without being planned in the SHSKUK PVP for 2024, due to the specific and unexpected nature of the request stemming from the implementation of AI no. 11/2022," the report states.
The Administrative Instruction indicating the prices at which assistive devices for people with paralysis should be contracted, foresees that the implementer of this document is the SHSKUK. 

The contract worth almost 6.5 million euros was signed on June 28, 2024. Although a year has passed since the contract was signed, the equipment has still not been distributed to paralyzed people, despite promises made weeks ago.

On Tuesday, at the meeting of the SHSKUK Steering Board, chairwoman Tetore Olloni raised questions about the process of their distribution.

Although the Instruction provides for SHSKUK as the competent institution for the assessment and provision of equipment and allows it to contract professional associations that provide assistive devices for movement, prevention and assistance for the purpose of their provision and maintenance, the general director, Elvir Azizi, has said that distribution is not the competence of SHSKUK. 

"The instruction did not clearly foresee how this work is going to go and it is actually not within the mandate of SHSKUK, because SHSKUK actually does not have the competence to deal with such a process, because it is a more complicated process. That is, there is a need for a person to customize the equipment, there is equipment that needs to be installed in the house, there are elevators and the request was from the ministerial commission to have only certified personnel who can deal with this work. So, for the moment, we have found certified experts on a voluntary basis who have started the distribution and installation process. In the meantime, we need to look into it, the commission has made a request to perhaps engage a professional organization in this regard, so SHSKUK is looking into engaging a professional organization," said Azizi.

The "Handikos" association, which drafted the specifications of the tender for equipment, also reacted to the delays in distribution weeks ago.