Sylvia's Journal

Last summer the responsibility for a gigantic medical equipment procurement was placed in my hands by a colleague who went on extended leave. I had to learn quickly what it takes to order 100s of pieces of medical equipment for hundreds of health facilities in a place like Afghanistan following US government regulations and Afghan standards.

I learned that there were no standards nor specifications and that someone knowledgeable had to do that. I learned that you need samples and some assurances that what you get is actually the same as the sample you were shown before you ordered and that you had to be alert to dishonest business practices.

I learned that you had to worry about time-to-delivery and whether we would still be around to pay the bill (and if not, who would) and that you needed storage space and figure out how the stuff would get to the facilities far away from Kabul.

The whole enterprise required hiring local staff to do the legwork and international experts to do the oversight and decision making about the quality/price/time to delivery formula. I got involved in the start up phase of this huge assignment by establishing a timeline and writing the job decsriptions for the people to be hired.

In September my colleague returned and I handed the whole thing back over to him, he reluctant, me smiling.

Now, four months later, I watch how the process unfolds, a process that looks more and more like an obstacle race. I have learned a lot since then about procurement. I have a new admiration and appreciation for my colleagues who are in charge of procurement, both local and worldwide and those who have to manage it.

I had no idea how complicated it is to get stuff, the right stuff of the right kind/quality, to the right people at the right price to the right place at the right time without (and this is the kicker) breaking any laws or violating any federal or national regulations.

When I look back at the timeline we developed in August I am astonished how far we were off. The complexity is tenfold of what I perceived at the time. Now, 4 months later many of the things we thought would be done by now, aren’t done and can’t be done for reasons that have to do with control and controls from this then that stakeholder. We are struggling to think of creative ways to get around each next obstacle that is put in our way, a new one around each and every corner.

This experience supports my assertion (adopted from James Q. Wilson’s Bureaucracy – Basic Books, 1989) that the freedom of bureaucrats to take action in the pursuit of efficiency is significantly, if not wholly, constrained by the decisions of their political superiors. The public sector cannot be efficient even if our lives depended on it (it’s own life doesn’t depend on it – a bureaucracy is forever).

In the public sector there is no straight line from A to B, there are no means that go directly and logically to ends no matter how much our plans and concept papers pretend they do.

People are sometimes shocked when I say this in public. Bureaucracies cannot be efficient because they are beholden to powerful stakeholders that care more, right or wrong, about interests and agendas of their constituencies than on managerial efficiency. I marvel how everyone always appears to discover this as an unpleasant surprise even though their daily lives at work are constantly upset by this reality.