Public Private Partnership Model

Public Private Partnerships in Health A Comparative Study University of Durham

Report prepared for the Netherlands Board for Hospital Facilities By The EU Health Property Network in collaboration with The Centre for Clinical Management Development University of Durham Authors Barrie Dowdeswell

Research Fellow University of New South Wales

Michael Heasman

Research Associate CCMD University of Durham

June 2004

CONTENTS

EXECUTIVE SUMMARY

I

INTRODUCTION

1

SECTION 1 1.1 1.2 1.3 1.4 1.5 1.6 1.7 Public Private Partnerships – structure, aims and models What do partnerships mean? PPP, Generic Principles and Diversity Non-Health Application of PPP The ‘Justification’ for Public Private Partnerships in Health The ‘challenge’ to the public service ethos PPP in action in the Health Sector 2 2 3 4 5 6 7

SECTION 2 2.1 Build, Own, Operate (and Transfer) Partnerships - the integrated capital and clinical service model in Australia 2.2 The Generic Lessons 2.3 Analysis - the links between cost pressures, quality and equity of service to the population 2.4 Trends in Australian PPP 2.5 Summary

8 9 11 12 13

SECTION 3 3.1 3.2 3.3 3.4 3.5 3.6 The Private Finance Initiative PFI and “the only game in town” The interaction between PFI and Health Policy Measuring Value for Money The Public Sector Comparator and Risk Transfer PFI characteristics and outcomes for hospitals so far commissioned under PFI conditions 3.7 The Changing Nature of PFI 14 14 15 16 17 19 20

SECTION 4 4.1 4.2 4.3 4.4 4.5 4.6 The future of PPP in Healthcare Reconciling trends in health care with PPP systems and structures – the critical factors Value for Money (VFM) Other International Comparators PPP (PPS) and changes in the structure of the Netherlands health system Conclusion 22 23 24 26 29 30

Bibliography

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Public Private Partnerships in Healthcare – a Review of Policy and Practice Executive Summary

Principles Public Private Partnerships have been a well established...