Public-Private Partnership in health section: collaborative framework for Ministry of Public Health’s hospitals and private sector (in Thai language)

A number of collaborative works between MoPH hospitals and the private sector were observed. Health services collaboration is the most obvious and popular model adopted by many MoPH hospitals. Until now, these has been no clear policy regarding such collaborations and this has led to drawbacks. Authors proposed a collaborative framework should be considered a public private partnership policy. For example, the collaborations should not create selective actions between patients from different health insurance schemes, and should be operated with transparent, efficient and participatory processes.

It was revealed that public and private collaborations were found in most hospitals and that they can be divided into two groups, namely collaborations on services and on construction. Health care and non-health care related services were the most popular and obvious form of collaborations adopted by several MoPH hospitals. At a micro level, for example, a private company offered a laboratory test machine for a hospital with the condition that the hospital has to purchase laboratory substances from that company. At a macro level, we can observe private partners investing in CT scanners and hemodialysis treatment centres in public hospitals. Collaborations on construction, namely public hospital building construction or renovation by the private sector, were performed on a not-for-profit basis; for example, a local bank or temple makes a donation to construct a patient hospital ward building. This kind of contribution is largely dependent on interpersonal relationships between donors and hospital administrators. In these cases, collaborations between hospitals and for-profit private companies are likely to be more efficient and relevant to the needs of hospitals.

Currently, there is no clear policy or guidance to support such a collaboration which subsequently creates a number of drawbacks, namely

(1) lost opportunities to benefit from services that should be available,

(2) variations in and unclear practices,

(3) no transparent administration and monitoring system, and

(4) an absence of bargaining power from the public side in determining a reasonable contract. As a result of these drawbacks, a proposed set of principles for future policy development needs to be considered. They are:

(1) Public hospitals face limitations regarding construction or services that cannot be solved by available resources

(2) Selected collaborative works must be very important, needed, and urgent for the population or patients

(3) There is demand from the private sector for the collaborative works

(4) There is support and willingness from administrators and practitioners in the hospital

(5) Selected collaborative works should be conducted with transparency and in an efficient manner with participation from all stakeholders

(6) Collaborations help strengthen capacity or efficiency of the hospital and are sustainable in the long run

(7) Selected collaborative works should not create selective actions between patients from different health insurance schemes

(8) Collaborative contracts must be made available for inspection from the public