Analysis of the Public Sector’s Functioning in the Healthcare Sector: Summary of the Report

17. 06. 2025

This comprehensive analysis, carried out between 2018 and 2022, evaluates corruption risks and irregularities in public procurement processes within secondary-level public healthcare institutions (JZZ) in Slovenia. The initiative was jointly undertaken by the Commission for the Prevention of Corruption and the Ministry of Health, with the goal of improving efficiency, transparency, legality, and cost-effectiveness in procurement operations.

Key Findings

  1. Scope and Methodology:

    • 26 public healthcare institutions were analyzed.

    • Over 330,000 procurement entries and more than 600 pages of internal documents were reviewed.

    • Requests for data were sent to JZZs, government bodies, and oversight institutions.

  2. Identified Corruption Risks:

    • Inadequate inclusion of anti-corruption clauses in contracts.

    • Failure to report gifts and asset declarations.

    • Frequent non-compliance with integrity plan implementation and reporting.

    • Potential illegal influence and lobbying during procurement processes.

  3. Operational and Systemic Weaknesses:

    • Fragmented, non-standardized, and incompatible information systems.

    • Excessive reliance on low-transparency "evidential procurements" (constituting 16% of total procurement value).

    • Evidence of contract splitting, i.e., dividing procurements to avoid legal thresholds.

    • Outdated internal rules and lack of staff training in procurement law.

    • Irregularities in publication and accessibility of procurement data.

    • Overuse and inconsistent pricing of external legal consultants.

  4. Financial Overview:

    • Public tenders: €829.8 million (excl. VAT).

    • Evidential procurements: €162.3 million (excl. VAT).

    • Total analyzed: approx. €992 million (excl. VAT).

  5. Centralized Procurement Deficiencies:

    • Central procurement efforts have been minimal since 2017.

    • Missed opportunities for economies of scale and better oversight.

Recommendations

  • To the Ministry of Health (MZ):

    • Implement standardized, machine-readable procurement data formats.

    • Establish a centralized procurement platform with unique identifiers (e.g., EAN codes).

    • Increase training, oversight, and transparency in procurement operations.

    • Consider founding a national audit body for JZZs.

  • To Healthcare Institutions (JZZ):

    • Update internal procurement regulations in line with current laws.

    • Adopt compatible IT systems and track inventory more effectively.

    • Ensure consistent reporting and monitoring of integrity-related obligations.

    • Consolidate procurement departments where feasible.

  • To Other Stakeholders:

    • Public Administration Ministry (MJU) should expand training programs.

    • Court of Audit should assess potential auditing of JZZ procurement.

    • Greater collaboration between institutions to detect unethical influences.

Conclusion

The report underscores systemic governance gaps, outdated internal frameworks, and a lack of coordination across healthcare institutions. The Commission calls for urgent modernization, greater digitalization, and centralized oversight to enhance public trust and long-term sustainability of the healthcare procurement system in Slovenia.