Public private partnerships and the quality and efficiency of healthcare services

Abstract

Although the use of public private partnerships (PPPs) is endorsed by agencies at the national and supranational levels, there is little guidance for decision-makers on what good outcomes look like and the circumstances in which such outcomes are likely to occur. Enhanced understanding of these issues can improve the governance of large-scale and complex contracting in the health sector. Drawing on a narrative review of the available theoretical and empirical research, this chapter shows that PPPs have the potential to generate a number of benefits, including (i) better investment decisions, (ii) more efficient infrastructure delivery and (iii) higher quality health services. However, PPPs are also associated with additional transaction and financing costs, and may give rise to affordability challenges. And addressing these threats to the public interest requires diligent and competent managerial intervention.