Support Services A. Administration The effective administration of this division is critical to the success of the health care delivery system. supplies, the, providing Under this division the purchasing of of preventive and required maintenance, coordination services for health care is domiciled. to work closely with all the other divisions and the This division will have to meet their needs in an economical and efficient manner. In the discussion which follows each area is defined providing their respective concerns and responsibilities. The general area of support services has been a major problem for the present health delivery system. It is felt that by having the support services as a free-standing division a more uniform and efficient system can be put into place. B. Supplies Supplies have been a perpetual problem for the Marshall Islands health care system. Because of the lack of supplies some services have been discontinued, compromised in quality, or delayed in delivery. At or near the root of this problem is the fact that bills are not consistently paid and the outstanding debts have caused many suppliers to discontinue service to the Marshall Islands. This has resulted in shortages in various areas from time to time, both in the hospitals and outlying clinics and also in premium prices being paid for those supplies which are purchased. Another difficult area is that surrounding distribution, and consumption of supplies. the inventorying, There is essentially no system of monitoring and control, particularly with the outlying clinics, but also in the hospitals. There have been times when departments would need certain supplies and they have been told that there was none, only to discover later that a significant quantity was on hand. The Adventist Health Services has recently begun working on this problem by taking complete inventories of their hospital supplies. Delivery of supplies to outer clinics has been a problem from time to time since it is largely dependent on the copra field ships. These ships routinely make stops at the various atolls for the purpose of picking up copra, but can be used to carry supplies to the atolls. Their schedules, however, are somewhat tentative, and breakdowns periodically occur which can drastically alter their arrival.