Summary
With objectives like a means of renewing national health service (NHS) and adequate maintenance of health facilities in the long-term, the private finance initiative (PFI), a public-private partnership (PPP) model has been highly controversial. With research literature focusing on PFI’s long-term financial characteristics, especially on health service operators, the article establishes the relationship between healthcare infrastructure design and PFI towards enabling it in PFI’s future adaptability in NHI.
Analysis
The PFI was not responsible in the delivery of stakeholder benefits by stimulating innovation. From the study, the special purpose vehicle (SPV) resulted in an increased focus on project risk analysis and focus on the same. Moreover, through PFI, the levels of distrust in the stakeholders were undoubtedly increased based on longer demands for risks, which manifested among the clients. Additionally, despite the intention by the government to impact changes in future service demands in NHS, the level of innovativeness with the model was little (James & Martina, 2009). The lack of stimulating innovation among stakeholders was coupled with the desire to incorporate a degree of scheme’s adaptability relative to new design solutions.
Due to the lack of support in the ability to innovate, SPV became more of an actor in the promotion of more collaborative working ways and an integrator. Moreover, from the findings, the study shows the roles and responsibilities of the SPV appeared to be fragmented between clinical operational and project delivery sides of the schemes. The responsibilities of hospital stakeholders were to maintain trust to the facilities and to the users. That was the case despite being employed by SPV’s contractors. The need of the stakeholders was to feed the process in a way that was performance-oriented and methodical, which was never realized by the integration of the PFI in service delivery. The other concern informing the need and expectation of the stakeholders was to become fully involved in clinical process (James & Martina, 2009). However, the expectation was never achieved based on trust deficit in PFI’s incorporation in the facilities.
Meeting the needs and expectations of the stakeholders would require integrating the scheme in the clinical process through fully involving the stakeholders in every area. Thus, the government should start by building trust among the stakeholders to facilitate willingness and ability to engage in the planning process (James & Martina, 2009). Through such, the PFI would not only meet the needs and expectations of the stakeholders but also enable the facilities to take advantage of the scheme.
Recommendations
Based on the challenge to effectively earn the trust of the stakeholders in the planning process, it is recommended that the government should allow its representatives to form trust with private sector members. Effective public-private partnerships rely on trust, an essential aspect that must be considered (Mitchell, 2019). Not only does trust allow partners to think outside the box but also facilitates in the committee an ability to design an effective planning process (Cunningham & Cuba, 2020). Moreover, the government should employ the appropriate procedures in the design process. Such a realization will counter the challenge associated with a less systematic briefing process. The emergence of an integrated procurement context should also create a supportive climate for collaboration (James & Martina, 2009). The PFI has its challenges, but the human factor in such activities should bring the necessary benefits.
Implications
With trust between public and private sectors, PFI’s effect in health care facilities will not only facilitate full integration of the supply chain but will also allow for risk assessment in the planning process in the short term. Other short-term examples are additional costs for innovation and procurement processes. Moreover, the integration will counter the challenge associated with a fixed early bidding process in the long term (Mitchell, 2019). Other longstanding expectations include a commitment to the project and the improvement of SPV members’ reputations (James & Martina, 2009). The outcome will enable facilities to experience collaboration and new ideas discussed in the bidding process.
References
Cunningham, L. A., & Cuba, S. (2020). Margin of trust: The Berkshire business model. Columbia University Press.
James, B., & Martina, K. G. (2009). Delivering innovation in hospital construction: Contracts and collaboration in the UK’s private finance initiative hospitals program. California Management Review, 51, 2, 126-143.
Mitchell, M. T. (2019). Supporting innovators: Trust, purpose, partnership. Center for Creative Leadership.