중남미

Public private partnerships (PPPs) are a public policy instrument that seeks to employ the availability of private capital and the private sector’s ability to efficiently manage projects for the creation of public infrastructure and the provision of public services. The Government of Chile initiated a program of hospital concessions in 2007, leading to the tendering for two hospitals (Maipu and La Florida) in 2008. A private entity designs facilities based on the public authority’s specified requirements, builds the facility, operates the facilities and finally reverts the ownership of the hospital back to the public authority after a certain time period. The objective of the concession program was and is to close hospital infrastructure gaps with greater speed, to improve the maintenance of hospitals, to ensure higher quality auxiliary services (hospital laundry, building security, cleaning etc.) by creating a competitive market among private companies for the construction as well as the provision of maintenance and auxiliary services. The extended use of the model for hospital concessions has however been slower than anticipated. The main objective of the reimbursable advisory services (RAS) was to provide evidence-based advice to the Chilean Government on the advantages and disadvantages of the current hospital concessions framework in view of best practices identified in international experiences with hospital concessions. To achieve this objective, the task team working on the RAS identified and analyzed key elements of the Chilean framework for hospital concessions and compared the framework based on these key elements to cases of best practice for hospital concession models from a selected group of countries (for example, Spain, Australia, England, and Canada) in which the vast majority of relevant international experiences with hospital concessions have been made.