A team of jour­nal­ists and activists reveals the «pecu­liar­i­ties» of med­ical equip­ment pro­cure­ment dur­ing the pandemic.

The coro­n­avirus pan­dem­ic exposed the deplorable state of Russ­ian hos­pi­tals. The author­i­ties were urgent­ly engaged in pro­vid­ing them with med­ical equip­ment and sup­plies. Ven­ti­la­tors and tomo­graphs turned out to be vital­ly need­ed not in a «dimen­sion­less» three months, but «here and now». That is why the gov­ern­ment allowed hos­pi­tals, region­al min­istries of health, and oth­er author­i­ties to buy goods and ser­vices from a so-called «sin­gle sup­pli­er» bypass­ing all com­pet­i­tive pro­ce­dures. In oth­er words, to sign a con­tract with any com­pa­ny that they liked or was at hand at the right moment. On March 20, 2020 a cor­re­spond­ing let­ter of the Min­istry of Finance, the Min­istry of Emer­gency Sit­u­a­tions and the Fed­er­al Anti­mo­nop­oly Ser­vice was issued. For state pro­cure­ments, the coro­n­avirus was rec­og­nized as a Force Majeure cir­cum­stance and an «emer­gency sit­u­a­tion» for 2020, with the pos­si­bil­i­ty of exten­sion as long as the high-pre­pared­ness regime lasts.

The authors of the inter­re­gion­al inves­ti­ga­tion looked into what this led to. It is also unique in terms of the num­ber of col­leagues involved: Roman Romanovsky, with the par­tic­i­pa­tion of Alexan­dra Alek­san­dro­va, Inna Gres­se­va, Ale­na Dudar, Olga Zabalue­va, Evgeniya Ivanchenko, Iri­na Kovbasyuk, Mari­na Kuznetso­va, Dmit­ry Lyu­bi­mov, Andrey Muzh­schin­sky, Alexan­dra Semen­o­va, Anas­ta­sia Sechi­na, Olga Siro­makho, Eliz­a­beth Chukharo­va, Anna Yaro­va; the edi­tor is Alexan­dra Djord­je­vich. And by the vol­ume of mate­r­i­al, which the team shov­eled over to present the all-Russ­ian pic­ture to the reader.

The work was ini­ti­at­ed by the human rights fund «Tak-tak-tak» (like many respect­ed and effec­tive pub­lic orga­ni­za­tions includ­ed in the reg­is­ter of NGOs per­form­ing the func­tions of a for­eign agent) togeth­er with the media project «Fourth Sec­tor», unit­ing jour­nal­ists and civ­il activists from Khabarovsk to Kalin­ingrad in a team. The team mon­i­tored state and munic­i­pal con­tracts for the pur­chase of med­ical equip­ment and sup­plies in 83 regions (exclud­ing Moscow, St. Peters­burg and the Moscow Region) award­ed dur­ing the first wave of the pan­dem­ic from Feb­ru­ary to August 2020.

The first thing that caught the eye of the inves­ti­ga­tors was the dif­fer­ence in the price of the same med­ical equip­ment by 2 to 3 times or more. And it wasn’t due to the quirks of logis­tics or the remote­ness of one region or another.

Eka­te­ri­na Petro­va, an expert from Trans­paren­cy Inter­na­tion­al-Rus­sia (this orga­ni­za­tion is also list­ed by the Min­istry of Jus­tice as a for­eign agent, due to its high com­pe­tence in its field) notes that the sit­u­a­tion with can­cel­la­tion of com­pet­i­tive pro­ce­dures in the pan­dem­ic has def­i­nite­ly led to high­er prices and increased cor­rup­tion risks. First­ly, the absence of strict reg­u­la­tions allows cus­tomers to choose con­trac­tors at their own dis­cre­tion; sec­ond­ly, cus­tomers, in fact, can set their own prices for goods — the main thing is that they can for­mal­ly jus­ti­fy them.

In most of the cas­es exam­ined by jour­nal­ists, the auc­tions did not take place, either because they were not allowed to take place due to the state of emer­gency, or due to lack of com­pe­ti­tion: one bid­der each applied for the auction.

The authors of the inves­ti­ga­tion also came across a num­ber of «strange con­tracts» con­clud­ed at the height of the pan­dem­ic with a sin­gle sup­pli­er, in which it is dif­fi­cult to dis­cern a causal link with the coro­n­avirus and the «emer­gency sit­u­a­tion». For exam­ple, the author­i­ties in Chech­nya, when the res­i­dents were sit­ting on self-iso­la­tion, urgent­ly need­ed to build facil­i­ties for pro­hib­it­ed pub­lic events: The republic’s Min­istry of Phys­i­cal Cul­ture and Sports, on March 13 and 31, 2020, signed con­tracts for the con­struc­tion of a soc­cer are­na in Grozny and a sports and fit­ness com­plex in the vil­lage of Bachi-Yurt. In the city of Nizh­neudin­sk of the Irkut­sk region the local author­i­ties also are con­cerned about the state of the sports facil­i­ties: They signed a con­tract for the recon­struc­tion of the sports and health cen­ter Trud, and in Tobol­sk the local gov­ern­ment sud­den­ly need­ed to apply road mark­ings and make improve­ments to the urban space.

But espe­cial­ly impres­sive, of course, is the dif­fer­ence in pur­chas­ing prices of the men­tioned med­ical equip­ment dis­cov­ered by jour­nal­ists. For exam­ple, in April of 2020, the Chelyabin­sk region­al Min­istry of Health signed con­tracts for the pur­chase of three OPTIMA CT 540 scan­ner sys­tems from three dif­fer­ent providers: Med­pro­ject-Zau­ra­lye LLC for 54 mil­lion rubles; Med­ical Tech­nolo­gies LLC for 60 mil­lion rubles, and URAL MED RESERV LLC was going to sell the scan­ner to the Min­istry of Health for 60.5 mil­lion rubles. A month lat­er, the min­istry signed addi­tion­al agree­ments with all three sup­pli­ers, slight­ly reduc­ing the amount of con­tracts. Thus, the most expen­sive con­tract worth 60.5 mil­lion was slight­ly «slimmed down» to 47. To com­pare, the Irkut­sk region bought a sim­i­lar scan­ner for 29.3 mil­lion rubles.

Or this fact: the neigh­bor­ing Vladimir and Ivano­vo regions bought a Matrix IBIS s.r.l. mobile X‑ray unit 23 days apart, with the same fit­tings: the Petush­ki region­al hos­pi­tal spent 5.8 mil­lion rubles for one unit, and the munic­i­pal clin­i­cal hos­pi­tal #4 in Ivano­vo spent 8.5 mil­lion.
Accord­ing to Eka­te­ri­na Petro­va, if there is an appar­ent over­pric­ing, there may be col­lu­sion between sup­pli­ers and cus­tomers, and law enforce­ment agen­cies must deal with these sit­u­a­tions. How­ev­er, it is already being dealt with in some places. Accord­ing to jour­nal­ists, in late Jan­u­ary 2021, the Omsk region Inves­tiga­tive Com­mit­tee opened a crim­i­nal case against for­mer health min­is­ter Iri­na Solda­to­va and Vic­tor Babikov, head of the state Health Care Ser­vice Direc­torate. Accord­ing to the Inves­tiga­tive Com­mit­tee, offi­cials exceed­ed their author­i­ty by con­clud­ing con­tracts for the sup­ply of med­ical equip­ment with affil­i­at­ed com­pa­nies at «clear­ly over­stat­ed cost», the dam­age is esti­mat­ed at 105 mil­lion rubles.

The authors of the jour­nal­is­tic inves­ti­ga­tion point­ed out that most of the cus­tomers pre­fer to buy equip­ment not from offi­cial man­u­fac­tur­ers and their dis­trib­u­tors, but from inter­me­di­ary com­pa­nies which often have nev­er dealt with med­ical equip­ment before, and, in fact, re-buy it from dis­trib­u­tors, mark­ing up their mar­gin. Why? Expert Eka­te­ri­na Petro­va sug­gests a cor­rup­tive motive: «Cus­tomers may con­clude con­tracts with lit­tle-known one-day com­pa­nies at inflat­ed prices, and then with­draw the mon­ey — it is impos­si­ble to nego­ti­ate on such terms with seri­ous sup­pli­ers. Or an unknown sup­pli­er is some­one else’s com­pa­ny, already involved in the scheme in advance.

Final­ly, jour­nal­ists iden­ti­fied the top 10 inter-region­al sup­pli­ers with the thick­est port­fo­lios of state orders, and accord­ing­ly, the most prof­itable on the coro­n­avirus. The leader here is Radio-Elec­tron­ic Tech­nolo­gies JSC (KRET JSC), a sub­sidiary of Ros­tec. The sub­sidiary man­u­fac­tures and sells the much-demand­ed Aven­ta brand ven­ti­la­tors. Inves­ti­ga­tors recall that at the begin­ning of the pan­dem­ic, the Russ­ian author­i­ties, hav­ing rec­og­nized the short­age of ven­ti­la­tors, promised to increase their pro­duc­tion in Rus­sia. In March 2020, the Russ­ian gov­ern­ment secured the bulk of the state order by pur­chas­ing 5,700 ven­ti­la­tors and ECMO for 7.5 bil­lion rubles, KRET JSC was appoint­ed the only sup­pli­er with­out any ten­ders. But, as we remem­ber, it was not with­out prob­lems: the Aven­tas caught fire at sev­er­al hos­pi­tals, which caused some regions to refuse sup­plies. Rosz­drav­nad­zor tem­porar­i­ly restrict­ed the cir­cu­la­tion of some «Avent» ven­ti­la­tors, lat­er spec­i­fy­ing that there were «vio­la­tions of pro­duc­tion process­es, as well as non-com­pli­ance of Avent with oper­a­tional and tech­ni­cal doc­u­men­ta­tion, but did not estab­lish a direct link between the iden­ti­fied vio­la­tions and the fires…

The authors of the inves­ti­ga­tion col­lect­ed infor­ma­tion on all makes and mod­els of ven­ti­la­tors, CT scan­ners, X‑ray machines, mon­i­tors and oth­er med­ical equip­ment that were pur­chased for Russ­ian hos­pi­tals dur­ing the pan­dem­ic and com­pared their costs between regions and sup­pli­ers. This pro­duced detailed charts that per­fect­ly illus­trate the abun­dance of facts and figures.

Novaya Gaze­ta sent inquiries on the sub­ject to all the regions in ques­tion. Only Alex­ei Muza­lev, head of the admin­is­tra­tion of Bol­shevru­da Rur­al Set­tle­ment, respond­ed. The oth­ers respond­ed with silence.

Search tech­nolo­gies used by the authors: work with the state pro­cure­ment data­base and own sources.

Tech­niques used: analy­sis of col­lect­ed data, inter­views with experts, sum­ma­riz­ing the avail­able mate­r­i­al, draw­ing up graphs-tables.

Expert Analy­sis and Assessment
Galina Sidorova
Gali­na Sidorova
Ask a ques­tion
Pub­lic Value
100 /100
Entire­ty of the Investigation
90 /100
Rel­e­vance
100 /100
Com­plete­ness
80 /100
Reli­a­bil­i­ty of Sources
95 /100
Read­abil­i­ty
90 /100
Итого
92.5
Strengths & Weaknesses
Inter-region­al inves­ti­ga­tion, the coop­er­a­tion of jour­nal­ists and activists from dif­fer­ent regions in the work on the mate­r­i­al allowed to col­lect and com­pare a huge amount of data; excel­lent work with the data­base of pub­lic pro­cure­ment; detailed analy­sis of the infor­ma­tion pro­vid­ed by experts; vis­i­bil­i­ty — pro­fes­sion­al­ly made charts. 
the lack of infor­ma­tion on Moscow, the Moscow region, and St. Peters­burg. And, although the authors imme­di­ate­ly make an appro­pri­ate ref­er­ence, giv­en the fact that the data are col­lect­ed from 83 regions, it looks like a short­com­ing. The abun­dance of num­bers is infor­ma­tive, but some­times reduces readability 

The orig­i­nal text of the arti­cle is Russ­ian. Trans­lat­ed by arti­fi­cial intel­li­gence systems.