Public–Private Partnerships in Health Services Delivery

Abstract

In this article, we conceptualize public–private partnerships (PPPs) from a network organizations perspective, and apply interorganizational relations (IOR) to study fifteen PPPs in a district health system in the state of Rajasthan in India. We find that the Government occupies a dominant position in the network because of the centrality of its functions, authority and control over resources and information. There is greater reliance on formal mechanisms of co-ordination. For effective network governance, it is imperative to reduce the power asymmetry, develop horizontal co-ordination, trust and social capital, and enhance public managers’ capacity for effectively managing interorganizational relationships.     

When Public–Private Partnerships Fail

Abstract

This article explores the dynamic and the results of efforts by citizens to resist the costs passed onto them by public–private partnerships for infrastructure, through examining citizen engagement in two problematic projects in Taiwan and China. In both cases, the design and procurement phase focused on the government–investor relation, with no obvious opportunity for citizen voice and costs were displaced onto users. In the operational phase, citizen protest (voice) was more effective in resisting costs in Taiwan where the institutional environment was more open and responsive; in the China case, availability of alternative roads (choice) was crucial in resisting costs.     

Public–Private Partnerships in the Health Care Sector: A systematic review of the literature

Public–private partnerships (PPPs) have become popular worldwide as a way of improving health care service delivery. In order to enhance our knowledge of PPPs in the health care sector, we conduct a systematic review of forty-six articles published in peer-reviewed journals for the period of 1990–2011. Six lines of research in the PPP domain are identified: effectiveness, benefits, public interest, country overview, efficiency and partners. The main findings suggest that although PPPs are used to address internationally emerging public health issues, questions as to their actual effectiveness, efficiency and convenience, still remain unanswered. We propose viable recommendations and ideas for future research.     

Multiple Institutional Logics in Health Care: ‘Productive Ward: Releasing Time to Care’

Health care organizations are often confronted with multiple institutional logics. In this study, a longitudinal case study method was used to gain insights into the adoption decision-making and implementation process of an apparently hybrid innovative practice when multiple logics are present. The case study focuses on the adoption and implementation of ‘Productive Ward: Releasing Time to Care’ in a Dutch hospital. This is a quality improvement programme developed by the National Health Service (NHS) in the United Kingdom. The results show that institutional logics complicate the adoption and implementation process.     

Public–Private Partnership’s Procurement Criteria: The case of managing stakeholders’ value creation in Kazakhstan

Abstract

The article presents the study of the criteria that Kazakhstan’s government used for granting a public–private partnership (PPP) contract to a private investor for construction and operation of eleven kindergartens in the city of Karaganda during 14 years. From the perspective of value creation for critical stakeholders, there was often misalignment between bidders’ views of these criteria and the perceived value for citizens and the government. The latter may significantly enhance the creation of shared values in a PPP by actively engaging stakeholders in the design of the bids’ assessment criteria.     

Public–private partnership in Public Administration discipline: a literature review

Public–private partnerships (PPPs) have become popular tools to deliver infrastructure and public services around the world. As an innovative public procurement approach, PPPs have drawn considerable attention from academic circles. In order to enhance our knowledge of PPPs, the authors conducted a systematic literature review of articles published in international journals of the Public Administration (PA) discipline. Four main topics in this discipline are identified by means of social network analysis, including PPP concept, risk sharing amongst PPP participants, the drivers of PPP adoption, and PPP performance. Seven propositions about the four topics are summarized. Directions for future research are also considered.     

Public–Private Sector Comparisons of Nurses’ Work Harassment Using Set: Italy and Australia

Using Social Exchange Theory, this study compared the impact of nurses’ workplace relationships with management and colleagues upon nurses’ work harassment, psychological well-being, and engagement within the public and private sectors in both Australia and Italy. Using survey data from 1,587 nurses, SEM findings indicated that public sector nurses in Australia had the lowest satisfaction with supervision, higher work harassment, and lower engagement and psychological well-being, than the other groups. The implications include that poor workplace relationships enable work harassment and therefore management upskilling is required along with changes in performance measures to ensure greater nurse well-being and engagement.     

(De)Politicization Dynamics in Public–Private Partnerships (PPPs): Lessons from a comparison between UK and Flemish PPP policy

This article analyses the (de)politicization dynamics in complex and technical matters like public–private partnerships, which is necessary given its social impact and budgetary consequences for the years and generations to come. The global financial crisis provides an excellent window of opportunity to present this argument, because PPP policy needs to reinvent itself. We argue that PPP policy needs to be (re)politicized at the broader societal and discursive levels, which means that their public nature is recognized and that policy alternatives are debated in the public forums. The ‘Private Finance Initiative’ reassessment process in the UK may serve as an example.     

Public infrastructure provision and skilled–unskilled wage inequality in developing countries

In this paper, we develop several static three-sector general equilibrium models with diverse labor market structures to investigate the effects of government provision of public infrastructure on the skilled–unskilled wage inequality in developing countries. The basic full employment model shows that the production sectors' relative dependence on the public infrastructure provision plays a crucial role in determining the skilled–unskilled wage inequality. Different relative dependences on public infrastructure may even result in opposite changes in the skilled–unskilled wage inequality. The above results are robust even when we extend the basic full employment model to three fundamentally different cases.     

Managing partner opportunism in public–private partnerships: the dynamics of governance adaptation

ABSTRACT

Controlling partner opportunism in public–private partnership (PPP) is still controversial despite its extensive adoption. We demonstrate that partner opportunism gets controlled by the extent to which deployed governance mechanisms are aligned with the governance needs of the transaction. As unique constraint, the institutional voids limit this alignment. If not aligned with governance needs, governance adaptation cycle continues, resulting in extensive or minimally acceptable partner opportunism. The organizations tolerate opportunism as long as they derive some economic value. In the context of institutional voids, the risk of exploitation of incomplete contracts is high but if governed effectively PPPs could still deliver value.     

When Does Public Service Motivation Fuel the Job Satisfaction Fire? The Joint Moderation of Person–Organization Fit and Needs–Supplies Fit

Abstract

This study takes a comparative approach to study the ‘outcome’ performance of a work-integration social enterprise (WISE) and a ‘for-profit’ work-integration organization that both provided employment enhancement programmes to NEETs. Participants at both organizations completed general self-efficacy questionnaires before and after engagement on the programmes. Additionally, semi-structured interviews and focus groups were held with the owners and staff at both organizations. The results revealed no significant difference between the ‘outcome’ performance of the WISE and for-profit organization. However, an analysis of the organizational aims, values and structures suggests that the ‘added value’ offered by the WISE came from the different induction policy that it operated.     

Person–Organization Fit and Public Service Motivation in the Context of Change

This study examines public sector change, motivation and person–organization (P–O) fit in a stress context. The results provide empirical evidence that change initiatives produce change-induced stressors. However, change processes, including participation in change decision-making and the provision of change information, increase public service motivation, reduce change-induced stressors and ultimately improve P–O fit and job satisfaction. The results also depict that, in the context of change, public service motivation positively influences job satisfaction, with this relationship partially mediated by P–O fit. Implications for New Public Management and the importance of change processes for reducing workplace stress are discussed.     

Leader–Member Exchange and Relational Quality in a Singapore Public Sector Organization

An objective of Singapore’s ongoing public sector reform (PS21) requires agencies to focus on getting the best out of its employees. One way of doing this is by creating a positive leader–member exchange (LMX) relationship, enabling supervisors to motivate their subordinates towards the development of organizational citizenship behaviours (OCBs). This article reports the extent of LMX and relational quality in a public sector agency experiencing PS21 reform and high staff turnover. In addition, we examined the effects of organizational justice perceptions and job satisfaction towards a subordinates’ OCB. A path model was developed to examine the relationships between LMX, organizational justice, job satisfaction, and OCB and tested by applying LMX theory. The path analysis results showed that LMX mediates the relationship between organizational justice perceptions and OCB. The results also showed that one’s job satisfaction led to higher level of OCB. The study findings have implications for theory and practice which have been presented in the discussion section.     

Public–private wage gap in Latin America (1992–2007): A matching approach

Using matching methods, we estimate the public–private wage gap for urban workers in eleven Latin American countries for the 1992–2007 period. These methods do not require any estimation of earnings equations and hence no validity-out-of-the-support assumptions; furthermore, this approach allows us to estimate not only the average wage gap but also its distribution. Our main findings indicate that the average public sector worker earns more than his/her private counterpart, and that this differential increased over the 1992–2007 period. Important differences along the wage distribution are also shown in the results; in fact, public servants in the highest percentiles of the wage distribution generally earn less than their private sector equivalents. Nonetheless, the percentile at which a positive wage gap becomes a wage penalty shifted over the period as the average wage gap experienced by most countries widened. Still, the most qualified public sector workers do face a wage penalty. Furthermore, indicators of government effectiveness show no relationship with the country ranking according to the public–private wage gap.     

Institutional change in the Schumpeterian–Baumolian construct: power,contestability and evolving entrepreneurial interests

Baumol's hypothesis, i.e. that the allocation of entrepreneurial talent in productive, unproductive and destructive activities is determined by the rules of the game, is supported by a growing body of empirical research and underpins new avenues of research in entrepreneurial studies. However, Baumol's paper offers precious few insights, beyond policy action, regarding how change to the rules of the game can be effected, because it views institutions as endogenous. This paper sets out to address this gap through an extension of Schumpeterian–Baumolian construct. The paper argues that changing institutions is a contestable process: its outcome determined by the complex nexus of interests and power endowments of actors. Changing the outcome of this contestation is dependent on the emergence of new entrepreneurial groupings and/or the evolution of the power endowments or interests of existing ones. Two historical illustrations are used to support the hypothesis and of this study.     

Public–private collaborations in drug development: boosting innovation or alleviating risk?

Consistent with popular belief among certain academics, practitioners, and policy makers, we hypothesize that collaboration between private and public organizations promotes success. We test this hypothesis for data on clinical trial success. Contrary to this popular belief, our results do not support the beneficial effect of within- and cross-sector collaborations. In contrast, we find that trials from single private companies are four times more likely to be successful than are trials in which public and private organizations collaborate. Hence, our results indicate that companies engage with public partners to mitigate development risks, not to exchange knowledge or technologies with them.     

Public–private innovation: barriers in the case of mobility as a service in West Sweden

Departing from open innovation (OI), this case study explores the development of Mobility as a Service (MaaS) in West Sweden. An analysis of 19 interviews reveals how representatives from involved actors perceive internal and external barriers as hampering the regional public transport authority’s attempts to collaborate with private actors, and that the perception of barriers is incongruent across public and private actors. Transferability to other cases of public–private OI is discussed, and implications for public actors are proposed. The paper expands the knowledge of preconditions for MaaS’ development and of the unique conditions for OI in public–private settings.     

Managing organizational entry in China: the roles of newcomer–supervisor exchange,incumbent support,and perceived insider status

The socialization literature has long recognized the important role of perceived insider status in facilitating newcomer adjustment, but knowledge on how to cultivate this desirable psychological state is limited. This study examines newcomer–supervisor exchange as an antecedent of perceived insider status of newcomers, which in turn facilitates their social adjustment and task mastery during organizational entry. We also explore incumbent support as a boundary condition for these effects. We conducted a survey study on 320 new employees and 92 supervisors in China. This study revealed that newcomer–supervisor exchange was related positively to newcomers’ perceived insider status, and perceived insider status mediated the positive relationships of newcomer–supervisor exchange with social adjustment and task mastery. In addition, incumbent support moderated the positive relationship between newcomer–supervisor exchange and perceived insider status, as well as the positive mediated relationships of newcomer–supervisor exchange with social adjustment and task mastery through perceived insider status. Specifically, these relationships were weaker when incumbent support was higher. Theoretical and practical implications were discussed.