Public–private partnerships to improve primary healthcare surgeries: clarifying assumptions about the role of private provider activities

Article


Mudyarabikwa, O., Tobi, P. and Regmi, Krishna 2017. Public–private partnerships to improve primary healthcare surgeries: clarifying assumptions about the role of private provider activities. Primary Health Care Research & Development. 18 (04), pp. 366-375.
AuthorsMudyarabikwa, O., Tobi, P. and Regmi, Krishna
Abstract

To examine assumptions about public–private partnership (PPP) activities and their role in improving public procurement of primary healthcare surgeries.

PPPs were developed to improve the quality of care and patient satisfaction. However, evidence of their effectiveness in delivering health benefits is limited.

A qualitative study design was employed. A total of 25 interviews with public sector staff (n=23) and private sector managers (n=2) were conducted to understand their interpretations of assumptions in the activities of private investors and service contractors participating in Local Improvement Finance Trust (LIFT) partnerships. Realist evaluation principles were applied in the data analysis to interpret the findings.

Six thematic areas of assumed health benefits were identified: (i) quality improvement; (ii) improved risk management; (iii) reduced procurement costs; (iv) increased efficiency; (v) community involvement; and (vi) sustainable investment. Primary Care Trusts that chose to procure their surgeries through LIFT were expected to support its implementation by providing an environment conducive for the private participants to achieve these benefits. Private participant activities were found to be based on a range of explicit and tacit assumptions perceived helpful in achieving government objectives for LIFT.

The success of PPPs depended upon private participants’ (i) capacity to assess how PPP assumptions added value to their activities, (ii) effectiveness in interpreting assumptions in their expected activities, and (iii) preparedness to align their business principles to government objectives for PPPs. They risked missing some of the expected benefits because of some factors constraining realization of the assumptions. The ways in which private participants preferred to carry out their activities also influenced the extent to which expected benefits were achieved. Giving more discretion to public than private participants over critical decisions may help in ensuring that assumptions in PPP activities result in outcomes that match the anticipated health benefits.

JournalPrimary Health Care Research & Development
Journal citation18 (04), pp. 366-375
ISSN1463-4236
Year2017
PublisherCambridge University Press
Accepted author manuscript
Digital Object Identifier (DOI)doi:10.1017/S1463423617000147
Web address (URL)https://doi.org/10.1017/S1463423617000147
Publication dates
Print02 May 2017
Publication process dates
Deposited05 Sep 2017
Copyright informationPrimary Health Care Research & Development, https://doi.org/10.1017/S1463423617000147. This version is free to view and download for private research and study only. Not for re-distribution, re-sale or use in derivative works. © 2017 Cambridge University Press
LicenseAll rights reserved (under embargo)
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