Abstract
PurposeThe procurement and supply of crucial healthcare products in the early stages of the COVID-19 emergency were chaotic. To prepare for future crises, we must be able to describe what went wrong, and why, and map out ways to build agility and resilience. How can this be done effectively, given the highly complex and diverse network of actors across governments, care providers and supply chains, and the extreme uncertainty and dynamism in the procurement system and supplier markets? The purpose of this study was to capture learning from practitioners in “real time” in a way that could frame and inform capacity building across healthcare systems with varying procurement and supply management maturity.Design/methodology/approachThis exploratory study involved interviews with 58 senior public procurement practitioners in central and regional governments, NGOs and leaders of professional organizations from 23 countries, very early in the COVID crisis. Following the first, inductive phase of analysis leading to five descriptive dimensions, the awareness-motivation-capability (A-M-C) framework was applied in a further round of coding, to understand immediate challenges faced by procurement practitioners, how the complex, multi-level procurement system that shaped their motivations to respond and critical capabilities required to face these challenges.FindingsDevelopments across 23 countries and practitioners' learning about procurement and supply in the pandemic crisis can be captured in five overarching themes: governance and organization, knowledge and skills, information systems, regulation and supply base issues. Together these themes cover the strengths and gaps in procurement and supply capability encountered by procurement leaders and front-line personnel. They highlight the various facets of structure, resource and process which constitute organizational capability. However, to account better for the highly dynamic situation characterized by both unprecedented rivalry and cooperation, analysts must also pay attention to actors' emerging awareness of the situation and their rapidly changing motivations.Originality/valueThe application of the A-M-C framework is unique in the healthcare supply chain and disaster management literature. It enables a comprehensive overview of healthcare procurement from a system perspective. This study shows how increasing system preparedness for future emergencies depends both on developing critical capabilities and understanding how awareness and motivation influence the effective deployment of those capabilities.
Highlights
Healthcare procurement during crisesThe medical supply system has turned into “Lord of the Flies” [. . .] Every state, major city, and territory, and thousands of hospitals, are being forced into a bidding war, encouraging price gouging and hoarding [1].These are the damning terms in which US Senator Chris Murphy described the state of procurement systems in March 2020, as they struggled to cope with critical shortages in personal protective equipment (PPE), supplies for intensive care and other essential medical devices
This study shows how increasing system preparedness for future emergencies depends both on developing critical capabilities and understanding how awareness and motivation influence the effective deployment of those capabilities
The emergency and disaster management research which uses the previous SARS and Ebola outbreaks as the unit of analysis already shows the risks of uncontrolled healthcare supply chain behaviors, with critical medical products being hoarded, procurement organizations lacking visibility on available inventory and insufficient support provided by national stockpiles (Dasaklis et al, 2012)
Summary
The medical supply system has turned into “Lord of the Flies” [. . .] Every state, major city, and territory, and thousands of hospitals, are being forced into a bidding war, encouraging price gouging and hoarding [1]. The emergency and disaster management research which uses the previous SARS and Ebola outbreaks as the unit of analysis already shows the risks of uncontrolled healthcare supply chain behaviors, with critical medical products being hoarded, procurement organizations lacking visibility on available inventory and insufficient support provided by national stockpiles (Dasaklis et al, 2012). These complex, dynamic healthcare supply chains failed to cope effectively with the impact of the pandemic, showing a lack of responsiveness on the procurement side (Scala and Lindsay, 2021) It becomes imperative, for governments, to learn once and for all from the COVID-19 experience and seriously rethink their procurement systems, increasing their capabilities to coordinate and minimize disruption of supply of critical goods and services and mitigate the effects of emergencies. Healthcare procurement systems’ awareness, motivation and capability to perform 4.1 Awareness Public procurement systems became aware of the emergency and the need to support increased urgent demand for critical medical supplies
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