Until the start of the new century, efforts to strengthen health systems focused solely on the public sector and health programs overseen by public bodies. The private sector was sidelined in certain countries and even banned in others. At the same time, some private-sector stakeholders readily adapted themselves to this special situation so as to avoid becoming part of a structured health system. This volume notes profound changes in health care around the world in two areas. The stakeholders involved in the health sector are increasing in number and diversifying as a result of the development of the private sector. They are also responding to a process of democratization and decentralization. These developments have been paralleled by greater functional differentiation. Various stakeholders are increasingly specializing in particular areas of the health system: service delivery, procurement, management, financing, and regulation. The interdependence of health stakeholders becomes more evident along with the increased complexity of delivery systems as these respond to changing demand. There is a compelling need to forge relationships. Such relationships are in fact emerging in developed countries and, more recently, in developing countries. They may be informal, but are increasingly organized and structured.In comparison with the forms of contract explored above, PPP is distinguished by the fact that the private operator is not remunerated ... the infrastructure (in all respects: maintenance of the buildings and equipment, but also catering, caretaking, laundry services etc.) ... It will finance, design, build and maintain the infrastructure; to use the infrastructure, the public actor will pay a fee to the private company.
|Title||:||Strategic Contracting for Health Systems and Services|
|Publisher||:||Transaction Publishers - 2012|