The Tribune

By DANIEL FERGUSON

Most people judge a hospital by the doctors they meet, the nurses who care for them, or the treatment they receive in an emergency. But behind every functioning hospital is something far less visible — a quiet supply chain that keeps the entire healthcare system alive.

Medicines, gloves, syringes, surgical instruments, disinfectants, paper products, and countless other supplies move through hospitals every day with little public attention. Yet when these items are unavailable, even the most skilled medical professionals are left with limited options.

This is why public procurement matters.

Procurement may sound like a technical government process, but in reality, it is how public money is spent. Every contract awarded for hospital supplies directly affects patient care, taxpayer dollars, and public confidence in public institutions.

One area that deserves greater public discussion is the procurement of pharmaceuticals, medical, and surgical supplies within our healthcare system. Publicly available records appear to indicate that the last major open tender for pharmaceutical, medical, and surgical supplies issued by the Public Hospitals Authority dates back many years. Some industry sources estimate that it may have been more than 15 years since a major publicly advertised tender process of this nature was undertaken.

While procurement activity has clearly continued — because hospitals continue to operate — publicly accessible information regarding competitive tendering for many essential supplies appears limited.

This does not automatically suggest wrongdoing. However, in most modern public systems, open and competitive tendering is considered the foundation of sound procurement. Competition helps governments secure better pricing, reliable delivery, and higher quality goods. More importantly, it promotes transparency by allowing both the public and the business community to better understand how procurement decisions are made.

Without regular open tenders and clearly accessible procurement information, it becomes difficult to demonstrate that the government is consistently receiving the best value for money. Competitive bidding protects both taxpayers and honest suppliers by creating a level playing field.

One supplier, who spoke on condition of anonymity, indicated that the continued lack of a structured tender process by the Public Hospitals Authority has negatively affected his business. He explained that larger companies with substantial financial resources are often able to secure and stockpile pharmaceuticals and medical and surgical supplies in bulk, effectively monopolising segments of the market and influencing prices — sometimes at significant cost to the public purse.

He further noted that a structured tender process provides suppliers with a forecast of projected usage over a specified period. This not only allows businesses to plan inventory and pricing more efficiently but also assists public institutions with budgeting exercises and resource allocation. In the absence of such a system, smaller suppliers may be placed at a significant disadvantage, while public bodies, such as the PHA could lose opportunities for cost savings, transparency, and accountability.

The Public Procurement Act establishes important expectations for public bodies, including the use of approved procurement systems, the publication of procurement opportunities and contract awards above certain thresholds, and regular reporting requirements intended to strengthen accountability and transparency. These provisions matter because transparency is not only about legality — it is also about maintaining public confidence.

In a small country like The Bahamas, where healthcare resources are limited and public finances are under constant pressure, every dollar matters. Procurement is not simply paperwork. It is part of national governance.

I have consistently argued in previous articles that one of the major challenges affecting compliance with the Public Procurement Act is the apparent lack of effective oversight and enforcement by the Public Procurement Department. If The Bahamas is to achieve meaningful progress in public procurement reform, the government must ensure that the department is led by competent procurement professionals who are prepared to actively enforce the principles of transparency, accountability, and competition.

Public procurement cannot function effectively under a culture of indifference or acceptance of the status quo. Strong leadership, consistent oversight, and institutional accountability are essential if the objectives of the Act are to be fully realised.

The quiet supply chain inside our hospitals may not often make headlines, but it affects every Bahamian family sooner or later. Whether through a hospital visit, a medical emergency, or routine healthcare, we all depend on that system functioning properly.

The real question is not whether procurement exists.

The question is whether the system is open enough to assure the public that it is functioning fairly, efficiently, and in the best interest of the Bahamian people.

• Daniel S. Ferguson, FCIPS, CM is the author of Public Procurement in The Bahamas: Lessons Learned from Reform, Practice, and Experience.

He is retired Chief Petty Officer (RBDF), Lead Investigator – 2004 Lorequin Commission of Inquiry, former Chief Supplies Officer, Ministry of Health; Procurement Consultant, Ministry of Finance; Adjunct Facilitator in Public Procurement, University of The Bahamas; former Component Coordinator for the IDB-sponsored Public Financial Management Reform Project.

Mr. Ferguson led the drafting team for the Public Procurement Act 2021 and Regulations, assisted in developing the University of The Bahamas professional procurement officers training framework, and managed the development of the e‑Procurement Supplier Registry.