Consequences if hospitals are forced to buy cheap, doctors warn

A renowned surgeon at an unidentified hospital in the north, returning home after midnight one day, could not sleep: His conscience was troubled by the fact his patients’ condition could be affected because of low-quality sutures.

Cheap, low-quality sutures makes it difficult for doctors to knot them, and they can break if tugged too hard, he said.

More expensive, better quality sutures are much easier to work with, but his hospital is no longer able to purchase them through bidding, he said.

“Cancer surgeries in the head, face and neck are truly difficult as they are very complex. If a vein is accidentally injured, the patient could die within minutes without proper medical intervention. The use of low-quality sutures to stitch wounds is risky.”

The shortage of high-quality sutures stems from new tender regulations that require hospitals to buy the cheapest products rather than the best.

The doctor said: “So we have no choice but to buy products whose quality we know are subpar. It means our patients get the short end of the stick, and we have to deal with our conscience.”

At a health conference earlier this week, Nguyen Tri Thuc, director of HCMC’s Cho Ray Hospital, too highlighted this problem, pointing to it as the reason why hospitals have to buy scalpels that require three tries to cut through skin.

Low-quality items affect all aspects of medicine and have far-reaching consequences.

Tan, a dentist in Hanoi, said a good scalpel cuts through skin in a single stroke while a low-quality one requires three.

When it comes to anesthetics, a cheap one often means lower quality, which could cause side effects like fatigue, nausea and shock, he said.

Doctors at an HCMC hospital also reported having trouble with low-quality urinary catheters after surgery. High-quality ones allow doctors to handle them easily and quickly, while low-quality ones are much harder to use and sometimes require less-than-ideal methods, potentially causing pain to patients.

Even something as simple as a bag to measure the quantity of urine a patient passes depends on quality as cheap ones provide less accurate readings, making it harder for health workers to evaluate a patient’s health and treat them.

A doctor said: “The problem is that the price difference between a good and bad product is not much, but regulations require hospitals to choose the cheaper one. Not much money is saved in exchange for patients’ safety.”

Thuc said bidding regulations need to be changed allowing hospitals to choose products with the best prices, and not the lowest, depending on their needs.

The regulations, part of a circular issued by the Health Ministry in 2020, came in wake of major scandals involving the purchase of medicine and medical equipment.

Nguyen Quoc Anh, former chief of Hanoi’s leading public hospital Bach Mai, was arrested in September 2020 and sentenced to five years in jail last January as he was accused of inflating the price of an imported neurosurgery robotic system.

In March, former deputy health minister Cao Minh Quang was detained pending investigation of “negligence” after he failed to check implementation of drugs imported by a pharmaceutical company.

Police said Quang had failed to check and evaluate terms to buy drug ingredients at discounted prices negotiated by the Cuu Long Pharmaceutical Joint Stock Company.

The failure led authorities to miss the fact that the drug firm was able to get a discount of $3.848 million on a purchase between 2006 and 2010.