PPP IN HEALTH SECTOR: POLICY FRAMEWORK & INSTITUTIONAL CAPACITY

Transcription

1 PPP IN HEALTH SECTOR: POLICY FRAMEWORK & INSTITUTIONAL CAPACITY 14th Arab Conference 7th Dec, 2015, Amman A.VENKAT RAMAN FACULTY OF MANAGEMENT STUDIES UNIVERSITY OF DELHI A.VENKAT RAMAN FMS-DU 1

2 PPP MODELS IN HEALTH SECTOR (Venkatraman, 2012) INFRASTRUCTURE PPPs Variants of Design, Build, Finance, Own, Operate, Lease, Transfer Models (DBF, BOO, BOOT, BOLT) Joint Ventures Financing (PFI, VGF) Land/ Tax Concessions FINANCING / PURCHASING PPPs DSF (Vouchers/ Health Cards/ Coupons Conditional Cash) SSF (Incentive) Community Based Insurance Social Insurance/ Illness Assistance fund PPP MODELS SERVICE DELIVERY PPPs (Clinical/ Non Clinical Services) Contracting ('in' & 'out') Management Contract Co-location Franchising OTHER PARTNERSHIP OPTIONS Public Private Mix Technology Demo. (e,g. Telemedicine) Social Marketing Drug Research Capacity Building/ Human Resource Self Regulation (Networks/ Alliances) A.Venkat Raman, FMS-DU 2

3 PPP: Ideal Strategy (Venkatraman,2012) Institutional System (Policy, Unit, Capacity- M&S, Payment) PPP (Infra, Delivery, E Financing) Accreditation & Quality A.Venkat Raman, FMS-DU 3

4 KEY STAKEHOLDERS IN PPP Political Regulator/ Legal Bureaucracy Civil Society (Poor) Patients Public Health System DEVT. PARTNERS Private Sector A.Venkat Raman, FMS-Delhi Univ 4

5 PPP Policy: A Template Background to the country s health system Past Efforts and Present Situation Problems and Challenges Need for a New Policy Vision, Mission and Objectives Strategy and Working Models Institutional Structure Financial Aspect Legal Aspect Monitoring and Evaluation Risk Policy revision Annexure: Governing principles of PPP in health sector Annexure: Types of PPP in health sector Annexure: PPP policy framework Annexure: SNP Evaluation Framework Model Process: A Draft Policy Consultation process Delineation of Infra to Service delivery Steering group Cabinet approval

6 Responsibilities of PPP Unit in the MoH Policy, Scoping, Advisory Conceive, Structure, Implement- Manage Capacity Building Monitor / Evaluate/ VfM Analysis Dialogue/ Gather Evidence Disseminate

7 Main functions of the PPP unit is: I. Development of PPP Policy and Guidelines II. Project Conceptualisation/ Planning III. Designing individual projects IV. Transaction V. Contract Management VI. Monitoring and Evaluation

8 ToR for PPP Cell: Overall Mandate Develop and execute a pipeline of PPP projects that will contribute to improvements in the health of the population of the province. Overall mandate : Function as a nodal agency for all private sector engagement initiatives in health sector in the state/ province; Identify, design, negotiate, contract, monitor, manage and evaluate PPP schemes/ projects, in accordance with the PPP policy Develop systems and SOPs to facilitate private sector engagement / PPP in health sector Generate and deploy appropriate resources for effective management of PPP Liaison with key stakeholders, create awareness and promote an eco system Monitor and evaluate the outcomes of any private sector engagement initiative

9 What kind of capacity PPP enabling framework Develop PPP policies, guidelines, fiscal rules Draft PPP-related legal / regulatory framework Streamline PPP institutional set-up Rules on fiscal impact, VGF, and risk-sharing mechanisms Financing & Risk guarantee mechanisms Protocols of setting up & utilizing guarantee fund to cover risks Develop policy, regulatory measures on long-term health investment financing Build Capacity on financing mechanisms and norms PPP best practices Conduct training of PPP staff and other departments and agencies Analyze PPP models ( successes and failures) at national and local level; - Identify lessons, best practices a

10 PPP Unit: Staffing Options Hire Quickly appointed Challenge of selecting effective consultants May be be expensive Risk of possible conflicts of interest. Civil service rules restricts autonomy of the consultants Train and/ or Hire staff Builds Capacity Time and resource intensive; Outside consultants may still be needed to start. Govt. staff may not want to or lack incentives or background to learn new subjects Govt Staff Can look after the entire PPP project cycle Reassure private sector that there is a dedicated unit and continuity But PPP projects are likely to be less frequent -may not justify dedicated unit;

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12 Consultant: Planning and Transaction Management Duties & Responsibilities (Competencies) PLANNING: Assess the demand for health services and identify service delivery gaps across the province based on demographic and epidemiological profile of the population; Identify and map health sector resources (both public and private sectors) across the province; identify alternative and innovative models in service delivery mechanisms to overcome problems of access to quality services Identify and develop proposals for appropriate models of engaging the private sector that are contextually appropriate to address service delivery gaps, including scope of services, scale of partnership, budgetary and financial outlays for such partnership ; coordinate with officials of health directorate and the secretariat and other experts / consultants in PPP cell in the design, implementation and evaluation of PPP transactions. Facilitate Private sector consultation / dialogue, support development of policy guidelines and plans Create awareness and disseminate PPP programs/ Schemes to the beneficiary population

13 TRANSACTION MANAGEMENT Work closely with the procurement team of the directorate to support in preparing transaction documents and support in transaction process, including identification and appointment of transaction consultants, monitoring of contract design, verification of proposals, and in shortlisting of private partners. Undertake and / or support pre-feasibility/ feasibility studies on PPP projects; develop concept notes (case briefs) for new PPP projects and prepare detailed project plan / proposal Compile evidence on appropriateness and merits of various PPP models and lead the process of documenting PPP models to help in developing locally appropriate PPP model Prepare guidelines and standard operating procedures under the project as required by the concerned authorities Prepare bid/ transaction/ contract documents (EoI, RfP, RfQ, MoU and Contract) and liaise with procurement cell, legal cell, transaction advisor). Prepare periodic report regarding the overall functioning of PPP planning system and its outcomes.

14 Hold stakeholders consultation on PPP policy, guidelines, design, and implementation of PPP Projects Undertake assessment of financial sustainability, identify relevant parameters for financial modelling and help in evaluating value-for-money in PPP projects. Support the procurement officer in defining criteria for the pre-selection procedure and other PPP procurement process Contract Period (Contractual Post)

15 Key Competencies: Demonstrated experience in program design, project planning, developing feasibility report, proposal development in health sector. Experience in design and management of public-private partnership (PPP) projects in health sector including planning, contract design, proposal development, contract management, etc. Experience in conducting population based studies, needs assessment and complex program modelling for health sector projects, experience working on the development of health plans. Experience in organizing and facilitating stakeholder / private sector consultations Proficiency in office / data base software. Knowledge of project management software applications

16 THANK YOU!!! DISCUSSION.