Social sustainability of aged care public-private partnership projects in China: Critical practices and realisation paths

Abstract

The profound changes in China's population, economy and social structure have significantly impacted traditional home-based aged care and social welfare, leading to the emergence of Aged Care Public-Private Partnership (PPP) projects for institutional care. Social sustainability is crucial for these projects as it greatly improves stakeholders' quality of life and well-being. Adoption of social sustainability practices enhances elderly and employee satisfaction, offers competitive advantages, and fosters community development. This study aimed to establish a socially sustainable development process for aged care PPP projects. A multiple case study was conducted, and an improved critical incident technique was adopted. Forty-two first-level critical practices that should be adopted by government departments, private investors and Special Purpose Vehicles (SPVs) at different stages in the lifecycle were identified from three main cases and seventeen parallel reference cases. Twenty-one realisation paths and a consolidated realisation path were established based on analysing the enabling relationships between critical practices. The preparation phase is pivotal, with ten of the 21 more important critical practices (i.e., critical practices that appear in all realisation paths) adopted at this phase. The behaviours and decisions of government departments played a key and decisive role, with eighteen more important critical practices adopted by them alone. This study contributes to enhancing knowledge of social sustainability in aged care. The critical practices and the realisation paths provide a complete picture of realising social sustainability of aged care PPP projects. The public and private sectors can adopt corresponding behaviours and decisions at different project stages to deliver projects successfully. The empirical data shows the applicability of stakeholder theory in social sustainability research on aged care. In addition, the results provide insights into the achievement of social sustainability of aged care projects in other countries and the understanding of social sustainability of other public service projects. However, potential biases exist in the study, arising from considering aged care PPP projects as a whole, neglecting lessons from failure cases, and subjective judgments in qualitative research.