I am not an expert from public health issues, but I can imagine what it means for a citizen to wait for up to five years for scheduling a medical imaging exam. How much suffering, recoveries made difficult and even death must have happened during this period which, according to the Municipality, summed up a 485k waiting list. 
Before anyone points a finger, this analysis has nothing to do with political parties. But this debate also serves, by analogy, for other priority areas in public sector, such as geotechnical risk areas, sanitation or road interventions in order to protect lives. 
Obviously, it is essential to respect rites and legislation which establish the procedures for hiring services with public resources. They have been created for our protection, to make corruption more difficult. But they also result in various complications faced by each public manager when trying to innovate and offer faster services. There is a risk of being questioned and sued by the Court of Accounts, Public Ministry or Public Defense, our system of “checks and balances”. Professional hazards, and tough ones! 
Exceptions must be treated as such and urgencies exist in real life. During this week, a couple of articles have been published by the press regarding the analysis presented by the Municipal Court of Accounts (TCM) on program called “Corujão da Saúde” (Health Owl, relating to the night shift) released last month by the São Paulo City Hall, as promised by the mayor during his election campaign. Among the irregularities raised by the evaluation, the TCM criticizes the way the services have been commissioned, stating that a registration of various companies can only be justified when one cannot establish proper criteria to select and hire a single company, which hasn´t been sufficiently done in this case. I don´t know how the City Hall has based the decision, but shouldn’t the urgency of ending the 485K waiting list, with multiple companies working simultaneously, suffice? 
The same urgency should be enough to explain why the administration has chosen to skip the previous public announcement phase. Experts will be able to estimate the financial costs (not to mention those imposed to human lives of each person and families) already faced or yet to occur because of how long they have been waiting for a medical exam. Also, if the R$12 million-limit for demanding a previous public announcement determined in 2006 by a decree were indexed to inflation the numbers would go higher than R$21 million, more than the R$16 million of this service. Yes, it is up to the administration to adjust those limits if one finds it appropriate, but there is also the option of justifying an exception, case by case. 
According to the Department of Health responsible for the program, over 141K exams have already been processed during the first 30 days of contract, which uses the federal public prices for paying the companies. Also worth mentioning that the municipal budget dedicated to the health department in 2016 was of R$10.5 billion and R$9.9 billion in 2017. 
May the irregularities raised by the analysis be quickly explained and solved so that the ones who rely on the program will not be harmed once more! And that the bureaucracy stops representing fear to those who search for new ways for planning and executing public services, especially the priority and essential ones.