OECD Public Governance Reviews

2219-0414 (online)
2219-0406 (print)
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This series includes international studies and country-specific reviews of government efforts to make the public sector more efficient, effective, innovative and responsive to citizens’ needs and expectations. Publications in this series look at topics such as open government, preventing corruption and promoting integrity in the public service, risk management, illicit trade, audit institutions, and civil service reform. Country-specific reviews assess a public administration’s ability to achieve government objectives and preparedness to address current and future challenges. In analysing how a country's public administration works, reviews focus on cross-departmental co-operation, the relationships between levels of government and with citizens and businesses, innovation and quality of public services, and the impact of information technology on the work of government and its interaction with businesses and citizens.


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Improving ISSSTE's Public Procurement for Better Results

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22 Jan 2016
9789264249899 (PDF) ;9789264249882(print)

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OECD countries are increasingly attempting to achieve savings through their public procurement systems, in particular in healthcare. In 2012, the State’s Employees’ Social Security and Social Services Institute in Mexico (ISSSTE) asked the OECD to review the effectiveness and integrity of its procurement system and to address bid-rigging. Many of the OECD’s recommendations led to enduring reforms at ISSSTE. In 2015 the OECD conducted a new review focusing on planning and coordination of procurement activities, market research and improvement of medical services. This report presents the findings of the review and notes the ISSSTE’s recent achievements. It also makes recommendations to support the alignment of the ISSSTE’s procurement practices with the 2015 OECD Recommendation of the Council on Public Procurement and includes action plans for priority activities.

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  • Foreword and acknowledgements

    OECD countries are increasingly attempting to control healthcare spending and reduce fiscal strains caused by an ageing population, the rise of certain chronic diseases and public savings targets which, as a result of the global financial crisis, often imply significant spending cuts. Since 2009, total health spending per capita has fallen in 11 out of the 34 OECD countries. Mexico devotes around 6% of its gross domestic product to health, which makes it one of the OECD’s lowest per capita spenders on health.

  • Acronyms and abbreviations
  • Executive summary

    Public health accounts for around 9% of GDP in OECD countries and is a spending area facing increasing challenges from ageing populations and difficult socio-economic environments. At the same time, reforming public procurement is often an important part of government efforts to improve transparency, integrity and effectiveness in the use of public funds. In public health in particular, improved procurement practices can both contribute to the control of healthcare spending and also help improve provision of highquality healthcare.

  • Healthcare procurement at the ISSSTE

    This chapter provides an overview of the scope and methodology of this public procurement review. It explains the role of the State’s Employees’ Social Security and Social Services Institute (ISSSTE) in the Mexican healthcare system. It presents the challenges as well as recent initiatives by the ISSSTE to improve its procurement structures, optimise human and financial resources, and improve healthcare results.

  • Strategic co-ordination of the ISSSTE's procurement

    This chapter describes how procurement is organised and conducted at the State’s Employees’ Social Security and Social Services Institute (ISSSTE) in Mexico. The analysis focuses on centralised purchases carried out by the units of the ISSSTE’s Administration Directorate. The chapter includes an overview of the regulatory environment; assesses planning, budgeting and co-ordination processes and challenges at the ISSSTE; and provides recommendations for improvements. An action plan for the establishment of a Procurement Co-ordination Unit at the ISSSTE is annexed at the end of this chapter.

  • Achieving value for money: Market intelligence in the ISSSTE

    This chapter looks at market research in procurement at the State’s Employees’ Social Security and Social Services Institute (ISSSTE) in Mexico. The chapter provides recommendations for improving market intelligence to identify cost-effective opportunities and develop strategies that meet buying needs, based on OECD good practices. An action plan for the formalisation and reinforcement of the ISSSTE’s Market Intelligence Unit is annexed at the end of this chapter.

  • Improving comprehensive medical services procurement in the ISSSTE

    This chapter analyses procurement aspects of the supply, by external contractors, of comprehensive medical services to the State’s Employees’ Social Security and Social Services Institute (ISSSTE) in Mexico. The chapter makes recommendations for further action. It also provides concrete examples of criteria to evaluate bids for medical services and two case studies on the procurement of medical services, one from the ISSSTE and one from Chile.

  • The way to competition: Measuring direct awards

    This chapter focuses on the use of exceptions to public procurement procedures by the central units and regional delegations of the State’s Employees’ Social Security and Social Services Institute (ISSSTE) in Mexico. It analyses the frequency of directly awarded contracts and the most common grounds for not opening them to competition. The chapter provides recommendations to increase competitive tendering and highlights the importance of professionalising the ISSSTE’s workforce, improving tender design and collecting consistent data.

  • Actions to promote transparency and efficiency in ISSSTE's procurement system

    In order to move towards the implementation of the recommendations proposed in the OECD study, the ISSSTE has established a series of actions to promote transparency and efficiency in its procurement system. Each of these actions is part of the agenda that has been built by the Institute, which is immersed in a process of continuous and deep transformation.

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