The area where few dare to tread is the concept of cost/waste reduction as a means of enhancing revenues or making each Dinar count. Divining cost saving methods requires relevant experience* and hard work. It does not lend itself to slogans and is not particularly glamorous. One remembers the decision of the Water Authority to fix leaking pipes throughout the city of Amman. It was estimated that fixing the pipes is tantamount to increasing the water supply by 30%!

What is required today is a handyman with cross jurisdictional ministerial authority to do the fixing wherever it is required.

A glaring example of a leakage of efficiency is the way the Ministry of Health manages its procurement policy and structures its services contracts. An investigation uncovered that the ministry has a General Supplies Department (GSD), which buys items for all the hospitals in bulk – acquiring anything from nails to equipment to meats and vegetables.

Those items are purchased by the GSD, then stored in GSD’S warehouses and cold stores, then issued, and transported to hospitals where they are stored and issued according to requirements. One can see that items are stored twice and transported twice. It is a rule of thumb that items of perishable nature lose 10% of their freshness when they are transported 10% more when they are stored and 2.50% more are pilfered due to double handling. Let’s call this the 1st Leakage.

Furthermore, GSD, much like the State Trading Agencies of a neighboring country, are famously inaccurate and inefficient in determining or meeting the needs of markets, or hospitals in this context. So, they may over-order or under-order. This is the 2nd Leakage.

Store keepers and transporters are paid employees and even with the best of intentions will not safekeep, handle and transport these itmes as if their life depended on it. This is the 3rd Leakage.

The solution to these leakages is a change of philosophy.

What does that mean?

First, we need to outsource all ancillary services to specialists in catering, housekeeping, janitorial, landscaping and maintenance services. To illustrate the importance of this shift in approach, examine the way the ministry deals with catering services:

The food is supplied to the hospital through the GSD. There may be shortages or overages because of central purchasing as mentioned before. The labor supply contracts, which MOH gives out, are drafted to be mostly concerned with the number of personnel /quantity of laborers on the job at any point of time. No serious consideration is given to the quality or quantity of food served to patients or staff (remember, freshness of food and adequacy of quantity are not the responsibility of the labor supplier).

To rectify this situation, new contracts may be drafted where the caterer is responsible for providing the food items and for serving meals according to a set menu, with measurable quantities in a hygienic and timely manner, and at a fixed price. If the job is even done by two monkeys and a guard, and all is well , who cares?

The advantages of this switch in tactic are plenty:

1. Quantity and quality are controlled by supervisors. Penalties are applied for non performance.

2. Food ordered will NOT be more than required as the caterer’s profit and loss depend on it.

3. Food is purchased, transported and stored only once.

4. Storekeepers are audited by the way they organize their inventory– FIFO (meaning that the oldest items are sold first, and not left to deteriorate) and cleanliness rule. Their jobs depend on this.

Similar contracts can be drafted for maintenance, janitorial and housekeeping fields, where performance and not body count are the true measures of contract execution. Outsourcing those services to specialists allows both cost reduction and better performance. If MOH’S hospitals suffer due to high costs or low performance, the answer is here. Not to mention the fact that outsourcing allows MOH to concentrate on its core business: Staffing the hospitals with the best doctors and nurses for the job.

Saving money means writing new contracts with new specifications and finding different ways of supervising those contracts. It may also mean eliminating or reducing the task of GSD. It involves a change in philosophy where the emphasis is on quality and not quantity. However, it is the critical area to focus on today. I don’t believe there should be a debate on that.

Note:* A person with relevant experience is someone who, while educated in the West, has acquired his experience in the East, in the area of life support services. Particularly, this would be someone familiar with the way things are done in Saudi Arabia, where ancillary services have been outsourced with a large measure of success for the past 30 years.

2. Israel as a strategic ally is a fallacy and U.S. tax payer’s money is wasted. Israel was not able to help out in the first or the second Gulf War and was not able to help itself in Lebanon. Israel is strongest against the weak, but Hezbollah ate their lunch with chutzpah.

3. The assertion of Israel from the river to the sea is a pipe dream. To expand you need to occupy and subjugate. This is no longer in the realm of reason.

4. This war was inevitable and part of a broader strategy to engage Syria & Iran into a wider war. Hezbollah should not carry the blame for it.

5. Hezbollah should not disarm as Israel will attack unarmed people and break U.N. resolutions at will and with impunity.

6. Hezbollah gave us pride and confidence at the expense of destruction to their homes and their peoples. Yes, parts of Lebanon were devastated but Lebanon will be rebuilt with Arab money and within a short period of time and will endure to be the shiniest democracy in the Arab world.

7. Popular resistance is more effective than traditional armies. Ministers of Defense in the Arab World need to retool: Junk your airforce, tanks, destroyers and submarines and buy some useful hand held antitank and antiaircraft missiles and a lot of rockets. Build intricate tunneling, draw your enemy in, and ravage it.

8. Infantry is your lethal weapon, not the air force, nor the Navy, nor the armored units. Build the Man and turn him into a Knight.

9. Two democracies in the Middle East, Palestine & Lebanon, have been habitually violated. Palestine holds the unique position of being the only occupied democracy in the world; an occupation sanctioned by the U.S. Human Rights abuses in both countries are rife. One wonders how the U.S. can stand up to China and Russia henceforth when it advocates for democracy or preaches on human rights abuses.

10. A policy of conflict resolution worldwide is in the west’s interest, not creative chaos, if there was ever a more stupid term or policy. We have seen what creative chaos engendered in Iraq and Lebanon, to name a few.

11. There will not be a new Middle East. However, we suspect and hope that there will be a new America whose power will be curtailed by other peoples aspirations and where reason, common sense, and a sense of history will prevail.

Conclusion: The U.S. has not been an honest broker. The sooner a tamer Israel wakes up to this fact and closes ranks with its neighbors, the better for them. Arabs and Muslims, who are both chivalrous and merciful, may forgive but will never forget.