Democratic Party MP and Chairman of the Health Committee, Bardh Spahia, has made strong accusations against the government for the way the hemodialysis concession has been managed, describing it as another example of the clientelistic model in healthcare. Spahia raises questions about the tendering procedure, the selection of the winning company, the value of the contract and its implementation.
Referring to the findings of the Supreme State Audit Office, the Democratic MP claims that payments for unperformed services and non-use of existing public infrastructure have been identified. Spahia demands that justice institutions investigate all links of the concession, from tendering and scoring of bids to payments and real beneficiaries, considering transparency and institutional accountability necessary.
Statement by DP MP, Bardh Spahia:
The hemodialysis concession is another proof of how Edi Rama has used healthcare not to solve citizens' problems, but to create clientelistic schemes and costly contracts that weigh on Albanians' pockets.
Before this concession, there was a decentralized, flexible and competitive model, where public hospitals provided services where they had capacity. And the need was met by private operators licensed, contracted and paid by FSDKSH.
So, what changed with Edi Rama?
The needs of patients did not change. Hemodialysis was not invented. A new market was not created.
The model was changed, moving from a decentralized system with periodic contracting to a 10-year contract, centralized and focused on a single operator.
Although several operators participated in the procedure, the selection of the winner still raises serious questions today.
The company did not submit the lowest bid. On the contrary, it was 11.1% higher than the lowest bid. Nevertheless, it was declared the winner.
Even more problematic is the fact that this company received maximum points in the experience criterion, while the documented data in the material does not indicate that it had previously managed hemodialysis centers, thus bypassing other bidders who had direct experience in hospital and dialysis services.
But the question that has not yet been answered, not even by the Albanian judiciary, is how can a company created just two years before the tender, with an initial capital of only 100 thousand lek, receive maximum points for experience and win a contract worth around 75 million euros?
These are not circumstances that can be passed over in silence. They require transparency and accountability.
But the problems do not end with the tender. The implementation of the concession has also produced abuses and unjustified costs to the budget.
The SAI has found cases where the concessionaire has invoiced services for periods when dialysis centers did not yet exist and when the service continued to be provided by public hospitals. In other words, the state was paying the concessionaire, while for the same patients the service was provided by the public hospital with its own funds.
In the audit of FSDKSH, the KLSH found that even in 2022, i.e. in the 6th year of operation, the concessionaire was paid based on billing and not only on the service actually performed. For 8,854 cases under and over the centers' projection, payments amounted to 99 million lek or about 1 million euros, recorded as payments for unperformed service.
The SAI requested a review of the projections and a transition to the "Pay x Use" principle, precisely to eliminate payments for services that are not performed.
Another absurdity is the non-use of existing infrastructure and equipment in public hospitals. The case of the Shkodra Regional Hospital, identified by the Albanian Supreme Audit Office, raises concerns about the non-use of existing public investments, duplication of infrastructure, inefficiency of funds and economic damage to the state budget.
This is the essence of Edi Rama's health PPPs: not to solve the problem, but to create a long-term contract to line the pockets of Albanians' taxes.
But even when the SAI has requested that the Ministry of Health and FSDKSH negotiate with the concessionaire to review projections according to real needs and to change the payment method, with the aim of eliminating payments for unperformed services, these requests have fallen on deaf ears and nothing has changed.
Hemodialysis is not an isolated case.
All concession contracts in healthcare continue to consume hundreds of millions of euros of public money, while the Albanian healthcare system still faces a lack of capacity, equipment, personnel, and quality services.
Where is justice?
This concession has been the subject of scrutiny and investigation for years. But Albanians have still not seen justice for a scheme that raises so many questions about the selection method, the connections between entities, the implementation of the contract, and the use of public money.
The Democratic Party does not seek selective justice.
It demands that justice investigate every link in this scheme to the end: from political decision-making, to the tendering procedure, the scoring of bids, the creation of the concession structure, the real beneficiaries, and every payment made with Albanian money.
Because when an existing service turns into a 10-year monopoly, when the winning operator did not have the expected experience, when a special company is created just a few days before the winner is announced, and when the Supreme Audit Office finds payments even for services not performed, institutions cannot act as if they have not seen anything.
Edi Rama can no longer hide behind propaganda.
Healthcare is not the government's private business. Healthcare is the right of the citizen and the obligation of the state.
The Democratic Party considers the hemodialysis concession one of the examples of the clientelistic model that must end.
Edi Rama must resign and pave the way for institutions to investigate corruption without hindrance and enable citizens to have a healthcare system at their service, not a handful of beneficiaries.
