PPPs in Health: Static or Dynamic?

Abstract

Public‐Private Partnerships (PPPs), or in the Private Finance Initiative (PFI) form throughout the Anglo‐Saxon world, are gaining in popularity for the provision of hospitals. Increasingly common around the world and seen as a potential solution that will both overcome the bottlenecks associated with more conventional approaches to hospital provision and generate ‘value for money’(VfM), these PFI‐PPPs represent a major, but so far under‐evaluated, concept. This article analyses whether public‐private partnerships do deliver the benefits claimed. It endeavors to assess the potential of hospital PFI‐PPPs, and their empirical performance on achieving VfM, through addressing the way the contractual arrangements are structured and the extent of flexibility they generate. Initial lessons arising from the current provisioning of English and Australian hospital facilities by PFI‐PPPs are identified so they can be taken into consideration in future projects.