Training workshop PPP in health sector

Transcription

1 EU Health Facility, Vietnam Training workshop in health sector Session 8 Tran Duy Hung Senior and Finance Expert Da Nang, 1-3 December,

2 Content Healthcare considerations project phases 2

3 Healthcare s are complex and have unique challenges High political profile Staffing and employment considerations Balancing risk profile between public and private sectors, in particular the revenue stream Private sector will most likely need to form consortia in order to be able to respond 3

4 Concerns need to be addressed in Healthcare s Clearly defining services that will be delivered by the Private Sector partner Understanding the population s willingness to pay for the proposed services Establishing a standard reimbursement structure for services to be provided, and Establishing an accreditation mechanism (prequalification) that only allows accredited providers to respond to government contract tenders 4

5 Why s in health sector s let each partner focus on doing what it does best Private: Overall innovation, technology Entrepreneurship and asset exploitation Professional management Design, Construct, Project Management Operational efficiency Maintenance and lifecycle optimization Financing Public: Securing the public interest Policy & planning Sector management Competitive procurement Compliance management & regulation Public budget Private performance that is driven by profit/risk purpose...can create public value and benefits...but only when the public manages the process effectively 5

6 Optimum balance in Healthcare s: depend on market and public conditions Value for money Bankability (Market and bank/equity requirements) Affordability (Patient affordability and public budget capacity) 6

7 s can offer a mechanism for government to finance improved healthcare provision Private Provider Contract Ministry of Health/PPC Assets (e.g.$, facility, skills) New healthcare facility or services Assets (e.g.$, land, facility) 7

8 Legal process of project (1) ASA to prepare project proposal (Art.16 Decree15) ASA to prepare FS (Art.24.1 Decree 15) Bidding on the selection of investor (Decree 30) Investor to prepare project proposal (Art.20 Decree 15) ASA to approve project proposal within 30 days (Art.17, Art.22 Decree 15) Investor to prepare FS (Art.24.2 Decree 15) ASA to approve FS within 30 days (Art.26.4, Art.27 Decree 15) Publicize project on national procurement network (Art.23, Art.18.1 Decree 15) Direct award to investor (Art.23, Art.29.1 Decree 15) 8

9 Legal process of project (2) 9

10 Legal process of project (3) Requirements to establish SPV? BT projects and projects in Group C (Art 42. Decree.15) 10

11 Key Phases of the Project Management Cycle Phase 1: Project Initiation, Screening, & Selection Phase 2: Feasibility Analyses & Proposed Risk-Allocation Structure Phase 3: Tendering & Procurement Phase 4: Final Contract Signing & Financial Closure Phase 5: Post- Award Performance Monitoring 11

12 Phase 1 Phase 1: Project Initiation, Screening, & Selection Phase 2: Feasibility Analyses & Proposed Risk-Allocation Structure Phase 3: Tendering & Procurement Phase 4: Final Contract Signing & Financial Closure Phase 5: Post- Award Performance Monitoring 12

13 Selecting candidate projects Which projects should get selected for s? Who should be responsible for identifying and selecting candidate projects? What are the risks if the private sector identifies and selects them? Should more resources (human & financial) be spent on a detailed analysis and a proposed risk-structure for this project? 13

14 Good practices & discussion Generally good to break-up the public monopoly on identifying all new projects, including non-s. Involve users However, Govt. should be able to quickly analyze & screen projects identified & selected by private developers. This is especially true for s that would require public sector supports (such as availability payments, capacity payments, minimum traffic/ridership guarantees, etc. 14

15 Phase 2 Phase 1: Project Initiation, Screening, & Selection Phase 2: Feasibility Analyses & Proposed Risk-Allocation Structure Phase 3: Tendering & Procurement Phase 4: Final Contract Signing & Financial Closure Phase 5: Post- Award Performance Monitoring 15

16 Purpose of feasibility study Project proposal and FS Purpose of feasibility study is to analyse the feasibility of project, risk identification, project structure and output requirements.. Key challenges: Preparation of FS is normally costly as it requires hiring experienced advisors. 16

17 Feasibility Analyses: 1. Project Demand & Capacity Projections 2. Technical Feasibility Analysis 3. Financial & Commercial Feasibility as a 4. Economic Feasibility Analysis 5. Legal Regulatory & Institutional Feasibility 6. Environmental Impact Assessment & Social Impact Assessment 7. Output Specifications 17

18 Phase 3 Phase 1: Project Initiation, Screening, & Selection Phase 2: Feasibility Analyses & Proposed Risk-Allocation Structure Phase 3: Tendering & Procurement Phase 4: Final Contract Signing & Financial Closure Phase 5: Post- Award Performance Monitoring 18

19 Purpose of Phase 3 Purpose of Phase 3 is to select the private partner that is best able to deliver the project s outputs through a competitive, fair, and transparent process in compliance with the standards of Procurement Laws Key Challenge: Public Authorities are expected to have experienced advisors to be able to conduct nearly all of these Phase 3 s tendering & procurement procedures. 19

20 Tendering process to select investor Project structure and Project information Issuance of RFQ RFQ evaluation and shortlist of bidders Market test with shortlisted bidders Preparation of RFP Bidding instructions and procedure contract sample Guarantee letter sample Issuance of RFP Evaluation of RFP application (Technical and financial) and award contract 20

21 Prequalification of investors Experience/Technical Financial Others 21

22 Output specifications Output specifications? Requirements set for facilities and services by public sector Guidance for bidders in their bidding preparation Specific information about DEMAND needs to be met, Not a METHOD to meet the demand 22

23 Evaluation criteria Meet output specifications? Lowest VGF? Lowest service fees? Highest payment to government? Shortest transfer time to government? Lowest leasing fees? Other criteria Combination of technical and financial evaluation 23

24 Phase 4 Phase 1: Project Initiation, Screening, & Selection Phase 2: Feasibility Analyses & Proposed Risk-Allocation Structure Phase 3: Tendering & Procurement Phase 4: Final Contract Signing & Financial Closure Phase 5: Post- Award Performance Monitoring 24

25 Purpose of contract signing and financial closure Purpose of this phase is a contract signing between public and private partner to form project contract. Selected investor is to negotiate with ASA on the terms of the contract. 25

26 Key content of contract Contract definitions, terms, interpretation Project description Design, construction, quality and technical requirements Key milestones in project cycle Safety, environment issues Capital funding and government support (if any) Obligations of each parties Price/fee adjustment and payment mechanism Land clearance and settlement (if any) Contract performance management and monitoring Force majeure Dispute procedure 26

27 Phase 5 Phase 1: Project Initiation, Screening, & Selection Phase 2: Feasibility Analyses & Proposed Risk-Allocation Structure Phase 3: Tendering & Procurement Phase 4: Final Contract Signing & Financial Closure Phase 5: Post- Award Performance Monitoring 27

28 contract management Purpose of Phase 5 is to ensure that the project performs as it is supposed to, according to the required output standards of the contract & delivers the benefits (VfM) intended. Key Challenge: Very few ASAs have experience with monitoring the delivering of public services by other, private partners. ASAs will likely need experienced outside advisors to be able to design and to set up contract monitoring bodies (PMUs) and may likely need their help to operate and manage these PMUs. 28

29 Contract Management & Performance Monitoring: ASA s Monitoring of the Project Company s Progress in Reaching Financial Closure (How Government can facilitate/support the project company & their lenders reaching successful & timely financial closure; and how to handle instances of failure to reach financial closure - cancellation or extension, etc.) ASA s Monitoring Performance during Construction and the Operational/Service Delivery Stage (Appointment of Independent Advisor/supervising engineer during construction, Performance standards, verification procedures, project monitoring checklists) Managing Requests & Instances of Price Adjustments (within the context of the existing Contract) Managing Requests to Revise or Renegotiate Contracts (changing the contract itself. Managing clarification changes vs. risk-transfer changes) Managing Contract Disputes (Dispute Resolution Committees, Alternative Dispute Resolution techniques, & Contract Termination procedures) Contract Management at the End-of- Contract Stage (inspections, residual asset valuation & asset transfer techniques, contract close-out procedures, termination of performance/surety bonds, re-tendering options, etc.) 29

30 Thank you for your attention!!! Questions and queries, please contact: Mr. Tran Duy Hung CEO of Monitor Consulting, Senior and Finance Expert Tel: Website: 30