Strategic partnerships for healthcare

Last week, the country hosted a gathering of experts on public-private partnerships (PPPs) in Manila which aimed to develop a sustainable model for healthcare delivery in countries like the Philippines.

The Asian Development Bank (ADB) and the United Nations Economic Commission for Europe (UNECE) have been at the forefront of healthcare PPPs worldwide and they organized this regional event in collaboration with the World Health Organization, Department of Health, PhilHealth and the Development Bank of the Philippines to offer fresh perspectives on PPP from Europe and the other Asia-Pacific countries. After all, one does not have to reinvent the wheel. Building on the success of other countries which have successfully carried out PPPs would make an ideal starting point.

Forging strategic partnerships with the private sector would definitely make a practical alternative to fill in the various public service “gaps” the government cannot possibly fill in adequately by itself.

“PPPs in the health sector can help meet infrastructure needs and improve service delivery,” said Stephen Groff, ADB vice president for East Asia, Southeast Asia and the Pacific.

Benefits

Last week’s summit on PPPs brought together policymakers, local and international health advocates, private health investors and local chief executives and the participants discussed the benefits, challenges and opportunities of PPP, especially in similarly situated countries like the Philippines.

The ADB is providing technical assistance to assist the Philippine government in developing and promoting PPP programs in the health sector, with funds donated by the Japanese government. Strategies to strengthen the PhilHealth to enhance its capacity to effectively deliver health services are also being developed.

Based on other countries’ experiences, PPPs have provided innovative, long-term contractual arrangements for developing infrastructure and providing public services through infusion of private sector funds and expertise in areas that are normally the responsibility of the government.

Foreign and local resource persons during the PPP summit shared their experiences and insights on how to effectively execute a successful healthcare PPP. We hope our health policymakers and decision-makers learned from the wealth of information and insights on PPP “best practices” during the regional event.

There is no question that PPPs would play a vital role in improving the quality of healthcare in the country and hopefully, improving access to it by the marginalized sectors of society. Whatever progress in healthcare delivery which the PPP could achieve would be meaningless unless it trickles down to those who need them most.

It can always be argued that it is the government’s responsibility to ensure quality healthcare and make them accessible to the poor. But we have to be humble enough to accept the reality that this is not feasible despite the government’s best intentions and efforts. Even Health Secretary Enrique Ona admits that the government’s health budget allocation would never be enough to achieve universal healthcare.

Provided that PPP arrangements are planned and executed appropriately based on international “best practices,” there is no question that it can deliver what it promises to deliver—quality healthcare for everyone including the poor. It will ensure that the poor do not only have an empty sense of assurance that they are PhilHealth members and carry its card, but that this membership will really entitle them to the healthcare benefits they need and assure them that there are enough facilities in the country to provide these services.

Objective assessment system

The PPP program indeed looks excellent as it is, but any plan is just as good as the manner it is executed and its effectivity in achieving the desired results. During the summit, Geoffrey Hamilton from the UNECE hit the nail on the head when he highlighted the importance of an objective assessment system to evaluate the success of any PPP. Such system for evaluating the performance of any PPP must be in place before making any long-term contractual arrangements, so there would be leveling of expectations and a mechanism to gauge whether it’s doing as well as it was expected so the necessary adjustments could be made to improve it.

During the summit, an international PPP specialist center on health was launched. The center will be under the auspices of the DOH and will serve as the focal point in identifying, collecting, analyzing and disseminating best PPP healthcare practices worldwide. The center is a joint effort of the Philippine government and UNECE.

It’s quite unfortunate that just a few days after the successful PPP summit, close to a thousand government health workers staged a walkout to register their protest for PPPs, which are perceived and feared as a mere ploy to “privatize” government hospitals.

It’s really unfortunate that despite the government’s earnest intentions and efforts, its own health workers seem not to understand and appreciate the beneficial role that PPPs could offer the country, especially the marginalized sectors. This highlights the importance of communicating this message clearly to all stakeholders including the government health workers and the public.

These stakeholders must be assured that the PPPs do not mean that the government is abdicating in its responsibility to its people including the poor. It’s just that the government is just being realistic and exploring alternative options to be able to deliver quality healthcare for all. We just have to trust the government that it will deliver this promise to everyone, especially the poor.