A description of existing public-private partnerships in DOH-retained tertiary hospitals in NCR and selected secondary and tertiary hospitals in key cities outside NCR.

The Philippine government has proposed the formation of Public-Private Partnerships (PPPs) among government hospitals to address the burden of limited access to health care. This qualitative study described the current state of existing PPP's in DOH retained tertiary hospitals and selected tertiary and secondary hospitals in the NCR and the cities of Surigao, Capiz, Calapan, General Santos. Koronadal, Tacloban, and the municipalities of Palo, Roxas, and Mambusao. One tertiary and one secondary hospital with past or existing PPPs were included in the cities outside NCR.

Thirty six hospitals were included in this study, 28 had past or existing Public-Private Partnerships. Eighty four PPPs past and present were documented. Majority of the hospitals go into PPPs to provide for services that are unavailable (25), and improve efficiency (18). Provision of non-health support service (20) and provision of technical service (19) were the most common types of PPPs. Eighty-seven percent of contractual arrangements are binding Memorandums of Agreement/Understanding (MOA/MOU). Fifty one percent of partner selection was done thru competitive bidding. Most partnerships have monitoring and evaluation schemes in place, as well as sanctions for non-compliance to contract. Hospitals with partnerships stated that there was a general improvement in efficiency and health care delivery. Project managers suggested that partners should shoulder the risks and benefits of the partnerships equally in order to ensure the sustainability of the program, while the major difficulty encountered was overcoming the existing bureaucracy in the government.

This study shows that PPPs have been widely used by hospitals for a variety of purposes. To be effective, partnerships should have time-bound, measurable effects on the health of the community. Corporate social responsibility programs and outright donations should not be considered as PPPs, as they have little measurable impact on the health of the intended recipients. Effective partnerships share several features, including clear structure, adequate staffing, sufficient core resources, and transparent decision-making processes. Partnerships should look at experiences with PPPs on health globally, as there have been numerous accounts of successful partnerships in improving the health status of their stakeholders.