Discounts controversial$10 Million

Photo archive
A recent tender for the purchase of prostheses such as hip and knee provides for a rebate is required in excess of $ 5 million, which will be paid by the manufacturer to the hospitals with which it does business. We can see in this photo, an operation for installing a knee prosthesis performed in a hospital centre in québec.

Eric Yvan Lemay

Tuesday, 6 march, 2018 01:00

UPDATE
Tuesday, 6 march, 2018 01:00

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Hospitals in Quebec, share $ 10 million per year in dividends hidden from medical equipment manufacturers, a situation unique in North America.

A supplier of prosthetic hip and knee is about to make a cheque of at least$ 5 Million to its customers, a handful of hospitals in the Montérégie, the Laurentians and west Quebec.

Illegal act ? Attempted bribery ? Not at all. It is a discount required in the tender which has just been launched jointly by these institutions of health, discovered our Bureau of investigation.

“There is only in Quebec that there are discounts, such as it “, said Benoît Larose, vice-president of MEDEC, an association that represents several suppliers of medical equipment.

Inflated prices

This is not gaiety of heart, that the firms he represents agree to pay rebates to health-care institutions in quebec.

Some american companies are afraid even to work around the anti-corruption rules of their country by doing so. Moreover, no other canadian province has this type of requirement.

The Quebec government prefers to call these rebates ” contributions to the partnership “. They correspond to between 10% and 12% of the company’s sales winner, who must take that into account when they set their prices.

“It is seen as a tax. It [the government] would have better prices if there were no patronage dividends “, said Benoît Larose.

Lack of transparency

In the case of the tender for the prostheses of hip and knee launched a few weeks ago by the Group of supply common to the West of Quebec (GACOQ), the dividends will reach so more than$ 5 Million, because the contract is estimated to be at least$50 Million.

Many suppliers complain that they do not know what exactly the millions paid to hospitals.

“There is a lack of transparency and insurance. No one has any idea [what is money], ” says a representative of a supplier who wants to remain anonymous.

And even if the hospitals have to be accountable for their spending to the government and to the procurement groups in common, such information is never made accessible to the public.

Examples of dividends that are received by hospitals

CISSS of the North-of-the-island-of-Montreal

(hospital of the Sacred Heart, Jean-Talon hospital and hospital Fleury)

• 280 301 $ $ $ $ 2016-2017
• 350 007 $ in 2015-2016

► The money was used primarily for research projects on atrial fibrillation and syncope night, but it was impossible to have a complete list.

CISSS de Laval

(City of Health)

• 274 428 $ since 2015

► For the time being, only 66 000 $ have been used for the purchase of equipment of perimetry and devices for cardiac massage automatic.

They don’t know what to do with the money

Two years after the entry into force of the first contracts at a discount, some hospitals still do not know how to use the hundreds of thousands of dollars that they receive.

It is thus that in April 2017, the Centre for integrated health and social services (CISSS) Lanaudière has indicated, in response to a request for access to the information, that the money had been placed in a trust account.

Our Bureau of inquiry, posed questions to three CISSS on the use of funds they receive from the manufacturers.

Only two have provided responses after several days of research (see page 5). However, it was general information and not a detailed list of expenditures made with the dividends.

The health facilities to ensure that the process of grant monies is well-managed.

“The allocation of the amounts derived from the contributions to the partnership is rigorous and we follow the guidelines issued by the ministry,” says Hugo Larouche, advisor, media relations for the integrated Center for academic health and social services (CIUSSS) North-of-the-Island-of-Montreal.

Accountable

The general director of Group procurement in common of the West-of-Quebec ensures that each hospital must make the accounts with the millions paid by the industry, but that it was sometimes necessary to call them to order.

“There is a policy on the use of these are here. It is not used to anything “, said Nathalie Chartier. “Those who have not put in place policy have been called to order. “

It ensures, however, that person does is put money directly in the pockets.

According to her, this is an incentive for physicians and facilities to participate in joint purchases.

Ms. Chartier indicates that the treasury Board must give its permission each time that a tender includes a clause for ” contribution to the partnership “.

It is, however, aware that this is a result of frustration in the industry.

“We will not do that in life, we look for other solutions,” she said, recalling that sums of money already circulating in the network from suppliers, and that this was not always transparent.