Philippines Announced Two Healthcare PPP Projects “to Boost Access to Top-rated Medical Facilities”

The University of the Philippines – Philippine General Hospital aims to its ambitious plan to expand medical services by building new Cancer Center and a world-class 700-bed hospital. Both projects are a part of the government’s line-up of critical healthcare projects under PPP scheme, providing world-class medical facilities especially for vulnerable citizens. 

The first project is the Cancer Center with 200 to 300-bed, will be located in the Philippine General Hospital Manila and will be the first dedicated cancer hospital in the national capital region. The hospital will provide affordable and international quality cancer treatment for public and private patients as well as support for teaching and research activities. The Cancer Center will be equipped with surgical oncology operating rooms, diagnostic imaging and laboratories with multi-specialty outpatient care. 

The second project is Diliman Project, a world-class 700-bed hospital with integrated healthcare, teaching and research facilities and specialized services that are not usually available in other public hospitals.

Both projects are undergoing National Economic and Development Authority (NEDA) Investment Coordination Committee evaluation and approval process. 

Image credits and press release by PPP Center of the Philippines.

PPPHealth4All Persona – Celso Manangan, Senior PPP Advisor at PPPHealh4All

In our series of PPPHealth4All interviews with prominent PPP experts around the world we are proud to have today our senior PPP advisor, Celso Manangan, who is Asia regional representative for PPPHealth4All. He was formerly the project director of the UNECE-affiliated International Specialist Centre of Excellence for PPP in Health, Philippines. Long before, Celso was the director of the Special Concerns Department and Administration & Finance Department, Build-Operate and Transfer Center (BOTC), later renamed to Philippines’ PPP Center. He is a recipient of the European Commission’s Erasmus Mundus Scholarship Program and holds a postgraduate degree from the University of Trento, Italy.

Interestingly, you  have chosen to discuss Public-Private Partnership in Dialysis. Could you please explain why?

PPP Dialysis has been a significant project, where I worked in 2003, my stint working in the Philippines’ Build-Operate and Transfer (BOT) Center (now renamed PPP Center).  

The project concept was simple. The Philippines’ National Kidney and Transplant Institute (NKTI), a specialty hospital, established a partnership with a proponent/company with the necessary experience and capability to provide dialysis machines through a lease agreement. In addition, the company was responsible for maintaining the devices throughout the contract and for training the medical staff responsible for using the machines.

The project assumed that the increased efficiency of the machines would let more patients be treated, and therefore, more revenue will be generated. In addition, the hospital took off the table procurement of the devices.

It was the first successful PPP project in the health sector in the country, delivered by a professional team from the BOT Center and the NKTI. Other hospitals in the country had also replicated the project successfully. I am glad to know that other countries have also replicated such

What were the challenges that you experienced in developing this project in the Philippines?

Developing a PPP project in the health sector was a challenge for the following reasons:

  1. People perceive PPPs as wherein assets of the private sector are shared without risks and costs. It must be emphasized that governments must share the risks and provide their contributions for the project to be successful.
  2. Developing countries (like the Philippines) show that the private sector charges more regarding payment for their investments. Therefore, a significant challenge was the ability of the government to pay its obligations in such a PPP project. 
  3. Since this was our first PPP health project, we need to review and examine all relevant laws for the project to be implemented successfully. 

In our research, we found out that the implementation of the project was successful. What were the factors that contributed to its success? 

Let me share with you the findings of several organizations that reviewed and evaluated the project.

“Although relatively small in scale compared to some of the other projects considered, the NKTI Hemodialysis Project in the Philippines proved popular among the judges due to its more personable impact and its innovative procurement of equipment.” –  Emerging partnerships : top 40 public-private partnerships (PPPs) in emerging markets.

“The NKTI Hemodialysis Project offered improved service and top-quality hemodialysis with the acquisition of the latest available technology in dialysis treatment and expanded its services to more patients at the same time cost of treatment and less risk to the government.  And because of more machines and higher reliability of these machines, hemodialysis treatment was extended to more Filipinos.” – Infrastructure Public-Private Partnership Case Studies of APEC Member Economies 

“This was the first PPP in the health sector in the Philippines, and it was hugely successful.  Patients welcomed the improvement in the quality of their care. The NKTI project, as a pro-poor PPP, achieved this through generating more resources from a better quality of care, keeping costs down relative to the private alternatives, and widening access to top-quality care, even those who could not pay. The NKTI case demonstrated that the doctors chose the PPP, not because of ideological preference but simply because the PPP was the best and only way to give their patients a better quality of care.” – Ensuring Healthier Lives Through Public-Private Partnerships. Global Health and Diplomacy.

After receiving such high appreciation from the PPP community, do you have other plans promoting such initiatives and other PPP Health Projects?

For this project, I am encouraged to form a Working Group on People-first PPP in Dialysis.  The Working Group will address the following broad desirable outcomes on this topic about the UNECE Guiding Principles on People-first Public-Private Partnerships in support of the UN SDGs. The five People-first PPPs outcomes are designed to:

  • Increase access to essential services and lessen social inequality and injustice. It implies increasing access to [health], water and sanitation, energy, etc., focusing on projects that consider the socially and economically vulnerable needs and contribute to eliminating inequalities.
  • Enhance resilience and responsibility towards environmental sustainability. It implies developing resilient infrastructure and improving environmental sustainability by cutting greenhouse gas emissions and developing “circular” rather than linear projects.
  • Improve economic effectiveness and sustainability. It implies successfully delivering projects that achieve value for money and fiscal sustainability and are transformative, meaning they have a sustainable, measurable impact.
  • Promote replicability and the development of further projects. It implies that projects be replicable and scalable to be repeated and/or scaled up to have the transformational impact required by the 2030 Agenda for Sustainable Development. This criterion also needs to consider whether the local staff and the governments can receive the necessary training and knowledge to do similar projects.
  • Fully involve all stakeholders in the projects. Engaging all stakeholders directly involved in the PPP project or directly or indirectly affected in the short and/or long run and creating new means for integrating special groups who have played a limited role to date.

Lastly, I will be glad to receive feedback from our subscribers and readers of their interest in joining us in this Working Group towards attaining the SDGs through People-first PPPs. For any inquiries, please communicate with me through my email address: celso@ppphealth4all.de.

Thank you very much, Celso. We wish you success on your initiative and we hope to work with you on implementing people-first healthcare PPPs worldwide.

Thank you.

The Public-Private Partnership Center of the Philippines publishes new investment opportunities for healthcare PPPs.

The PPP Center of the Philippines publishes a new investment broshure that presents a row of PPP healthcare projects

-1 project to be approved by the relevant governmental authorities (University of the Philippines Philippine General  Hospital (PGH) Manila Cancer Center Project)

– and 5 projects under development:

  • Philippine General Hospital (PGH) Diliman Project;
  • Mental Wellness Center and ancillary facilities in the Mariveles  Mental Health and General Hospital (MMWGH) compound;
  • Baguio General Hospital and Medical Center (BGHMC) – Renal Center Facility Project;
  • Cagayan Valley Medical Center (CVMC) Hemodialysis Center Project;
  • Bicol Medical Center’s (BMC) Medical Arts Building and Upgrading of Health  Services Project.

Investment Opportunities Brochure (September 2020)

Ministry of Health and Wellness (MOHW) of Jamaica will be implementing a non-communicable disease shared care PPP initiative

As the number of COVID-19 cases continue to increase, the Ministry of Health and Wellness (MOHW) will be implementing a public-private partnership non-communicable disease shared care initiative. This initiative will seek to maintain essential primary care services for non-COVID-19 clients with diabetes (DM) and hypertension (HTN); enabling them to access routine care through private physicians and to free the resources of the health centres to focus on critical cases and the pandemic response.

The purpose of this initiative is:

  • to minimize exposure of clients with chronic illnesses to COVID-19 at public health facilities;
  • to maintain routine clinical management of non-COVID-19 clients with diabetes and/or hypertension in the context of scaled-down access to primary care services at public health centres during the COVID-19 outbreak in Jamaica;
  • to identify and engage suitable private physicians in the selected areas to participate in a project for the medical management of public patients who are diabetic and hypertensive for a fixed fee to be paid by the NHF.

TERMS OF REFERENCE

Engagement of Private General Practitioners for the Provision Of Service to Public Patients With Diabetes And Hypertension

PPP Bicol Medical Center (BMC) – Medical Arts Building and Upgrading of Health Services in the Philippines is approved for further project development.

Photo by Sam Balye on Unsplash

The Bicol Medical Center (BMC) – Medical Arts Building and Upgrading of Health Services aims to decongest the main hospital’s out-patient department (OPD) patients and laboratory requests effectively enhancing the quality of services of BMC, providing better health outcomes and achieving equitable access to healthcare in Region 5. Further, it will create sustainable revenue sources leading to BMC’s reduced dependence on national subsidy for its operational needs.

The PDMF is a revolving fund that supports pre-feasibility studies, feasibility studies, and other necessary pre-investment activities to help develop bankable PPP projects, as well as assistance in the PPP bidding process and for effective monitoring of PPP project implementation. Under the administration and management of the PPP Center, the PDMF provides government agencies with the required expertise and strategies to prepare well-structured projects that are selected to be undertaken as PPPs. The Facility is available for all national government agencies, government corporations, local implementing entities and state universities and colleges (SUCs), throughout the country. On the other hand, the PDMF Committee is the approving body for project support applications to the PDMF.

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