2.4 Challenges and opportunities of procurement in long-term care Respondents to the ESN questionnaire provided comments and analyses in relation to procurement processes that have been grouped in challenges and opportunities in Table 2. Indeed, public authorities witnessed significant changes in their practice because both the growth of the LTC sector and the expansion of procurement procedures were taking place simultaneously. More importantly, applying procurement rules to an area in which ‘quality’ is still a shaky concept (see next chapter), has triggered some important lessons or at least insights for potential future strategies.
Respondents mentioned other examples of new opportunities provided by procurement including the promotion of new care models, e.g. by taking advantage of technological innovation. Respondents also mentioned that “social entrepreneurship could be facilitated”, and “coordination between administration and service providers” was improved, with increasing “opportunities for participation” of users and for co-production of relevant stakeholders “in the design and development of long-term care provision”.
For instance, though the move to formal tendering processes replaced previously ‘negotiated local arrangements’, in some areas it became possible to refocus on fairer procurement procedures in the form of more sustainable terms and conditions for staff (as per the practice example in Aviles). Transparency, competition and public monitoring became increasingly enhanced, at best by an explicit focus on social clauses such as decent employment for groups with difficulties to access the labour market, and by involving different stakeholders in the development of goals and indicators.
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