| Country |
Forms and models of PPP implementation in healthcare |
| France |
The successful example of the hospital centre “Sud Francilien" demonstrates PPP's effectiveness for both public and private sectors. This form of cooperation is mutually beneficial: as the operator takes responsibility for the risks, the project is implemented within the shortest time, creating a new hospital complex that provides patients with affordable and high-quality medical care and services. |
| United Kingdom |
The British PPP model is characterized by the possibility to choose between different contractual forms: 1) corporatization; 2) Private Finance Initiative (PFI) in the form of long-term agreements between the public and private partners to construct, fund, maintain and operate infrastructure facilities; 3) outsourcing or transfer of the government functions to business (Fadyushin, 2019). Currently, the PFI model is being revised and renovated (Zavyalova & Dabagyan, 2019). |
| Turkey |
Turkey prefers such a form of PPP as outsourcing, which is gradually becoming more important. Over the years, the number of medical facilities that implemented outsourcing has only increased. At first, only non-core functions were transferred to third-party organizations; now the transferred functions partly include the main ones (see https://rmbic.ru/upload/iblock/ac0/Gosudarstvenno_chastnoe-partnerstvo-v-zdravookhranenii-_daydzhest-za-2016_2017-g.g.pdf). |
| Canada |
Despite various problems, such as the lack of public awareness, resistance from trade unions, complexity of transactions, the implementation of PPP mechanisms in Canada has yielded positive results. They include high-quality construction and timely completion of more than 50 medical facilities, increased hospital bed capacity, creation of the most comfortable environment for patients and employees. Transferring risks to a private partner resulted in saving taxpayer funds and generating an economic effect at the community level. Thus, Canada's public-private partnership sector is considered one of the most developed in the world (see https://investinfra.ru/mezhdunarodnaya-praktika/gchp-v-sisteme-zdravoohraneniya-kanady.html). |
| Germany |
Germany has the practice of transferring state medical institutions to private investors for a nominal price. The most commonly used forms of public-private partnership projects in German healthcare are: the acquisition of a medical facility by the state after the end of the contract; the relationship between public and private partners based on the "leasing model"; leasing of a hospital by a private partner, etc. (Panova, 2015). |
| Spain |
The public-private partnership model Alzira, implemented in the La Ribera hospital, defines the responsibilities of public and private partners in the healthcare sector to improve the quality of medical services:•On the one hand, the hospital is on the state-owned land, belongs to the state healthcare system; it operates according to the model of State per capita funding; the public partner monitors the quality of provided medical services;• On the other hand, for a certain period, the state agrees with the private company/concessionaire that is obliged to provide high-quality medical services and patient care. |
| Peru |
Peru is the Latin American country that widely uses the public-private partnership instruments, including in healthcare; most of the projects focus on renovating the infrastructure of medical facilities (Zavyalova & Dabagyan, 2019). Some PPP projects (for instance, the renovation of the Torre Trecca hospital) are implemented according to the “design-build-operate-deliver” model, which includes not only design, construction, and operation, but the provision of medical services. Various countries such as Italy, the Philippines, the Republic of Korea, etc. increasingly use this model. The public-private integrated partnership model includes various types of healthcare services: medical research, non-medical services, catering, transport services, etc. (Zavyalova & Dabagyan, 2019). |
