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EIB Report “Public-private partnerships (PPPs) financed by the European Investment Bank from 1990 to 2019”

This report is part of EPEC’s work on monitoring developments on the public-private partnerships (PPPs) market. It is intended to provide an overview of the role played by the EIB in financing PPP projects inside and outside Europe since 1990. The report mentioning the following PPP programmes and projects in the healthcare sector:

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Call for Members of PPPHealth4All Advisory Board

PPPHealth4All sees as a priority to set up an Advisory Board that will act as an external consultation body to the initiative, to steer the PPPHealth4All initiative in the right direction and to make sure that the voices of key stakeholders groups are heard and taken into account. The Board will provide a leadership, strategic governance and advice and will ensure a high level of accountability, transparency and competence. The members of the Advisory Board will work in close cooperation with the PPPHealth4All team and will support them to achieve the objectives of the project. Advisory Board does not have any legal authority.

The AB is composed of at least 4 and up to 7 members. The AB members will be selected for a 1- year term, considering their geographical origin (at least 50% from developing countries), field of experience (50% from independent NGOs and 50% from industry) and gender (at least 50% female).

Responsibilities assigned to the Advisory Board include the following:

  • Strategic advice and validation of approaches, “wise counsel”;
  • Exploration of new services to the PPPHealth4All membership and ecosystem;
  • Co-definition of the key performance indicators to be used for assessing the performance and results of PPPHealth4All;
  • Validation and improvement of the business models designed for the rollout of PPPHealth4All activities;
  • Funding Leadership.

We invite our partners, members and stakeholders to nominate prominent individuals that could bring value to PPPHelath4All initiative. The deadline for nominations is 20 June 2020.

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PPPHealth4ll Personas – Sacira Coric

Dear Sacira,  could you be please briefly introduce yourself and your experience with PPPs in the healthcare sector?

I am Director at Turner & Townsend Infrastructure Advisory business and lead PPP advisory services (UK). I  have been working in the PPP advisory space for 20 years across economic and social infrastructure and  have advised top-tier global infrastructure project sponsors, lenders and public sector procurement authorities across EMEA and North America on all aspects of the infrastructure project life cycle, ranging from strategy, appraisal, development, Project Finance, delivery,  O&M and exit. I have advised on a number of healthcare projects of different size and complexity, procured in the UK as project finance transactions (i.e. PFIs  and Local Improvement Financial Trusts LIFTs) and care homes more recently.

My particular expertise is with early stage identification of investment opportunities and defining legal, policy and regulatory enablers, while understanding thoroughly public sector value for money drivers and private financiers’ interests and concerns.

I am passionate about the way we deploy private capital to meet growing infrastructure demands and deliver not only economic, but also environmental and social value.

What are the current challenges for PPPs in the healthcare sector from your point of view?

The majority of PPPs in healthcare have been performing successfully for both the procuring authority and the Project Company.  I am also hearing that a true spirit of partnership and commitment to project objectives are now being demonstrated on PPP healthcare projects during the covid-19 pandemic.  However, there have been some major failures PPPs and PPP contractorswhich have attracted negative publicity.   PPPs have therefore been criticised for poor value for money,  lack of true partnership and conflicting interests between the public and private sector, data asymmetry, lack of customer focus, social value and community benefits.  PPPs in developing countries face ongoing challenges associated with the public sector capability and capacity, legal and regulatory frameworks, lack of standardisation and benchmarking data, lack of leading practice guidance, which all lead to long and costly procurement timelines and suboptimal value delivered to the public sector and end-users.  PPP contract management presents an ongoing challenge globally for a variety of similar reasons.

How platforms like PPPHealth4All could contribute to solving the challenges mentioned above?

PPPHealth4All platform is being launched at the time when we face unprecedented crisis in public health, an increased risk of catastrophic consequences of climate change, major social inequalities, increased nationalism and lack of cooperation between major stakeholders globally as well as regionally and nationally.   We are also at a crossroads in terms of the need to improve the way the public and private sector work together and jointly use its respective capital to recover the stalled economy and public services in a more sustainable and equitable manner. 

I feel very excited about the PPPHealth4All potential as it is aiming to improve public healthcare services, which the COVID-19 pandemic has exposed as lacking the standard required.  No doubt, investment in healthcare will be a priority in the coming years and the demand for  platforms such as PPPHealth4All will only grow.   PPPHealth4All will be providing access to data, performance benchmarks, standards and leading practice for delivering healthcare projects with long-term sustainability at its heart.  Reducing carbon footprint and improving resilience against climate change cannot any longer be just considered as “a nice to have” but must drive the decision making process from the project outset.  Most importantly, the key objective of PPPHealth4All is to improve the value delivered to the end users. 

PPPHealth4All is proposed as a blockchain based platform designed to improve cooperation, knowledge share, standardisation and access to healthcare projects and data.  The platform is to capitalise on the best principles of public – private partnerships and is paving the way for improved collaboration between the public sector,  the investor  and developer market and advisors  in their quest for an optimal and sustainable healthcare solution.

What is appealing to you in the platform PPPHealth4All?

PPP Health4All is addressing three aspects of infrastructure delivery close to my heart:

  • Improved partnerships between the public and private sector and improved collaboration globally,  which is of paramount importance in the post covid-19 recovery;
  • Delivering social value and sustainable healthcare with the end-users’ interests at the heart of the solution;
  • Offering visibility and transparency of healthcare opportunities globally.
Last but not least: how you feel as a  successful woman working in infrastructure sector- what kind of advice you could give your peers in the developing countries?

I enjoy working in infrastructure sector and find it of great interest to take part and shape the way infrastructure is driving the economy, improving our lives and meeting our ever changing demands.  It is constantly evolving in terms of the delivery models, underpinning technology, skillset required and most importantly outcomes delivered. More recently, delivery of infrastructure is being re-evaluated in terms of its role in generating not just economic value, as its primary objective, but also sustainably protecting the environment we live in and reducing major social inequalities.  Being an engineer by profession I am inspired by tangible benefits of my work.  Working in infrastructure has enabled me to witness how major and complex engineering endeavours have shaped and improved the life of local communities. 

I am deeply committed to supporting the global infrastructure industry improve its performance through innovation and initiatives, such as PPPHealth4All which, in particular encourage improved collaboration between government, private capital and delivery market. This joint triangle of delivery is fundamental for meeting the SDGs and would help us all live more purposeful lives.  Working in developing countries is a great opportunity to address unique challenges by adopting best practice from the countries which have faced similar challenges.  There is also an opportunity to address growing urbanisation demands by delivering new sustainable infrastructure from the outset.   I would advise my peers in developing countries to have an open mind about possible solutions, understand thoroughly local challenges and interests and search for ways to improve existing practices.  There is never one solution fits all.

Thanks a lot! We wishing you a lot of success in your work! Questiones asked by Natalia Korchakova-Heeb
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New Publication of the World Bank “Public-Private Partnerships for Health in Vietnam: Issues and Options”

This book published by the World Bank describes the nature of public-private partnerships (PPPs) in the health sector in Vietnam. It defines health-related PPPs, describes their key characteristics, and develops a taxonomy of the different types of PPPs that exist in practice, illustrated by international examples. It also assesses the regulatory and institutional framework for the health PPP program in Vietnam, as well as financing and accountability mechanisms for PPPs at its national and subnational levels. It provides an overview of the PPP project pipeline in Vietnam and analyzes important issues in the health PPPs’ design, preparation, and implementation, using eight case studies involving projects in different phases of the project cycle. This book also examines barriers that have hampered the successful design and implementation of health care PPPs in Vietnam. These barriers may be broadly categorized as barriers in the PPP policy and regulatory framework, in the public sector, in the private sector, and in the financial sector. It proposes feasible and actionable recommendations so that the government can consider tackling the identified barriers and advance the successful design and implementation of health PPPs.

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EIB supports Irish community nursing PPPs

Photo by Laurin Grether

The EIB project for the Ministry of Health of Ireland will finance the design, construction, equipping and maintenance of up to nine Community Nursing Units (CNUs) across different regions of Ireland using a Private-Public Partnership (PPP) framework. These units will replace the existing ones that are no longer compliant with the HIQA (Supervision Authority for Acute and Community Services) regulations.

The aim is to improve access to high quality elderly and long term care throughout Ireland. The new CNUs are based on a person-centred approach giving to the residents the opportunity to lead their own lives in an environment reproducing the comforts of home, according with their cognitive and physical abilities. The main purpose is to normalise care and promote the person’s autonomy in everyday tasks, while providing care and assistance.

It is expected that the project will bring wider benefits to the community as social and healthcare are elements of social cohesion and economic development. The EIB will verify that the project respects the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), as ratified by the host country and included in national legislate framework. The Bank will encourage the Promoter to take into account the circular economy principles during the development and future operation of the project.

Procurement

The promoter has to ensure that contracts for the implementation of the project have been tendered in accordance with the relevant applicable EU procurement legislation, Directive 2014/24/EU, where applicable, as well as Directive 89/665/EEC as interpreted by the Court of Justice of the EU, with publication of tender notices in the EU Official Journal, as and where required. A prior information notice has been published by the Promoter, reference 2019/S 152-373937.

Status: Approved – 23/04/2020

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WEBCAST | Healthcare in a Post-COVID-19 Brazil: Pathways for Public-Private Partnerships

The Wilson Center’s Brazil Institute and the Institute for Health Policy Studies hosted a discussion of what better integration of the public and private healthcare systems could mean for Brazil, during COVID-19 pandemic and beyond. Brazil, which guarantees universal access to healthcare through its public system (SUS), is also home to the second largest private healthcare market in the world. The two systems essentially operate in parallel, and have often competed against each other. In recent weeks, however, the COVID-19 crisis has shown that public-private collaboration is possible, and brings real benefits—not only in the immediate context, where collaboration means more hospital beds, doctors, and equipment made available where Brazil needs them most; but also in the longer run, where public-private partnership can help drive innovation and improve efficiency. The panelists discussed the benefits of public-private partnerships, and what obstacles, such as Brazil’s stark inequality and the need for improved management within the systems, must be addressed.

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Webinar: PPPs in the healthcare and COVID-19

The Infrastructure Concession Regulatory Commission (ICRC) , an agency of the Federal Government of Nigeria responsible for the development and implementation of Public Private Partnership framework for the provision of infrastructure services, has organised a webinar to reflect on impact of  COVID-19 on PPPs,   international experience and how PPPs could be applied to combat COVID-19. The discussion includes Nigerian and international experts from India, Germany, etc. The webinar was moderated by Engr. Chidi K. C. Izuwah, Ag Director General.

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Boat clinics PPP project scans remoted islands for COVID-19 in the state of Assam, India


Photo from Jorhat Boat Clinic

Government of Assam (India) partnered with the NGO “Centre for North East Studies and Policy Research ” under the NRHM-Public Private Partnership (PPP) to set up a boat-clinic service which is helping to reach the far-flung areas of the state.  In these districts, the boat clinics are reaching the poor and marginalized population with sustained health care since last two years. The boat clinics provide both preventive and curative care to the population residing in the islands.

“The boat clinics have pitched in to deal with the novel coronavirus disease by carrying out door-to-door community surveillance in the river islands” writes Nabarun Guha.

Under this PPP the operational cost and human resource remuneration are borne by the NRHM, Assam whereas the infrastructure meaning construction of the boats is the responsibility of CNES along with the insurance of the boats. The medicines, vaccines and family planning consumables are supplied from District Health Society. Monitoring mechanism: Under this PPP the partner implementing agency submits monthly action plan and physical & financial progress report to the State. Besides the regular reporting system quarterly review meeting were performed to understand the progress and difficulties arises while implementing the programme.

Progress achieved: The response to the service being provided by the boat clinics for the marginalized population is overwhelming as the community was deprived from the basic health services due to non availability of the health infrastructure. Before the NRHM-PPP these island dwellers had a rare chance to visit health personnel and seek treatment for their illness.  A total of 2,08,203 general health checkups were done and 8,109 pregnant women received the ante-natal checkups, 2,002 women receives post-natal follow-up and 15,818 children were immunized.

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Call for applications to participate in a pilot project on stakeholder consultations

Photo by Bill Hamway

PPP initiatives address different players, directly and indirectly, and at different timescales, from immediate to longer term. In order to be successful, the PPP must have an agreed stakeholder engagement and communication strategy which includes an appropriate approval process. PPPHealth4All is working on development of a digtial tool for stakeholder consultations tailored to PPP healthcare projects. It is planned to implement several pilots to test the module of stakeholder consultations with beneficiaries and market participants. For this purpose, interested state or local authorities are invited to apply for the pilot. Requirements for the pilot project:

1. The PPP project in the healthcare sector is at the initial stage of preparation (preferably at the stage of preparation of pre-feasibility study).

2. The public partner will ensure the access to the Internet, video-confereing tools and will assign an a staff emember with good command of English.

3. The public partner is prepared to sign the Memorandum of Cooperation on Pilot Project.

Interested public organisations are invited to submit their applications to info@ppphealth4all.de. PPPHealth4All will provide the following services (free of charge): methodology on stakeholder consultations and mapping of stakeholders for a particular project; identifying issues of concern from the perspective of each group of stakeholders; visualization of stakeholders and market participants networks protocols and findings in final report.

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Bringing together public and private sectors to lead a mental health and suicide prevention response during COVID-19

Photo by Priscilla Du Preez

Through the Mental Health & Suicide Prevention National Response to COVID-19 (National Response), diverse partners are bringing their best in science, innovation, and leadership to create sustainable and comprehensive solutions to the mental health impacts of this pandemic.

As a national convener, the National Action Alliance for Suicide Prevention (Action Alliance)—the US nation’s public-private partnership—is mobilizing diverse sectors to collectively lead a coordinated mental health and suicide prevention response effort during and in the aftermath of COVID-19.

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