Public procurement rules in the EU follow a weird path under ESA-2010 accounting rules. You can check it on p.22 of the Manual on Government Deficit and Debt. Implementation of ESA 2010. and the decision tree in p.25 showing a complex labyrinth.
This is the reason why in the UK (p.2 of the Kings Fund Report):
If Labour wins the general election, it has committed to repealing the procurement and competition provisions in the Health and Social Care Act 2012, including the Procurement, Patient Choice and Competition Regulations made under Section 75 of the Act.And even more than that:
In his speech at The King’s Fund on 27th January, Andy Burnham, Shadow Secretary of State for Health, committed to ‘claiming a full exemption for the NHS from EU procurement and competition law’This is precisely the reason why we should do the same and put all the effort to succeed in our attempt. We have to ask for full exemption from rules created for a different purpose and adjust them appropriately to our health context. These are rules created for public accountants that constraint adequate decision making. Accounting is devoted to measurement of the costs and benefits of decisions. Rules for decision control are related to governance and audit procedures, not accounting. This is the main reason why we should ask for exemption, they were created from a wrong perspective.
We are not alone in this position, in the NHS they are concerned with the same problema.