Public private partnerships as an alternative service delivery option : a multiple case study of the healthcare sector

Haarhoff, Kosie Jacobus (2009-03)

Thesis (MPA (School of Public Management and Planning))--University of Stellenbosch, 2009.


This study examines the key success factors in the Public Private Partnerships (PPP) field in the Healthcare Sector in South Africa. It gives health departments insight into the factors which should be considered when using PPP procurement and when looking at possible PPP opportunities. The development of PPP’s around the world has urged governments to look at alternative service delivery methods because of increased pressures on government budgets. Public Private Partnerships presents governments with a means of generating private funds for health service delivery whilst government manages the relationship via a negotiated PPP agreement to monitor the quality of services rendered. Different PPP models are applied all over the world depending on the specific needs of countries. Different factors impact on the success of these partnerships and it is essential that government share knowledge and best practices. The study showed that in order for PPP’s to be successful the public institution must do its homework thoroughly and that the legal framework should be conducive for private sector involvement in service delivery. The study showed that the government of a country plays a pivotal role in the PPP process by giving the necessary political support to ensure the trust of foreign investors. The legislative framework is a critical factor in the advancement of PPP procurement and the allocation of risk as an important consideration when pursuing this type of procurement. The study examined three concluded PPP Health Sector agreements in South Africa and looked at lessons learnt, mistakes which were made and what should be avoided in the future. The three PPP’s in South Africa in this study were the first though there are other health sector PPP agreements concluded. The other PPP’s are still in the commencement stage and it is too early to make an assessment at this stage. However, the three case studies conducted give departments a clear picture of the process, the lessons learnt and the impediments in the PPP process. The uniqueness of the South African Health sector also prompted the Government to look at a model which will be best suited to the local market. Best practices from other countries provide useful information and lessons learnt from other countries are also important in a developing PPP environment.

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