As government health systems across the Middle East, North Africa and Turkey region look to the future after three years of pandemic-driven urgency, they are increasingly exploring public-private partnership (PPP) as a model to address some of the biggest challenges facing the sector.

Population growth and the rising incidence of lifestyle diseases mean that healthcare systems must be ready to handle more patients. But, given budget constraints and the need to allocate limited resources to other national priorities, healthcare must be delivered sustainably.

Healthcare PPP offers an approach that relieves the upfront capital burden on health ministries and fosters new operating models that can treat more patients more quickly, at a lower cost, and with improved health outcomes.

Hady El Khoury Middle East, Northeast Africa, and Turkey General Manager with GE HealthCare, explains that this is possible by “leveraging private sector expertise in new technologies, new clinical care pathways, and new systems that are flexible enough to handle rising caseloads and respond nimbly to the next unexpected health event.”

Healthcare PPPs also tend to deliver projects on time and within budget, as well as achieve a total lifecycle cost that is lower than comparable facilities developed and delivered solely by the public sector.

In both mature and emerging markets around the world – from the UK and Canada to Turkey, India and China – healthcare PPP has been enormously effective.

That’s an important lesson for the Middle East, Northeast Africa and Turkey, Hady said, given the region’s extensive experience with PPPs in other sectors such as transportation, power genera-tion, and oil and gas. PPP is still relatively new when it comes to social infrastructure such as healthcare.

“Thankfully, that is changing,” he said, “as countries begin putting in place the necessary legislation and regulations to implement healthcare PPP projects.”

Healthcare PPPs are most often structured to address one of the following scenarios:

Two popular infrastructure-focused healthcare PPP structures include, “build and finance,” where private sector partners build, finance, and (sometimes) maintain a health facility operated by the public sector. When including maintenance, the private partners take care of the facility according to service-level agreements.

The second infrastructure-focused option, and one commonly offered by GE HealthCare, is a “design-build-finance-operate-maintain” structure, where private sector partners design, build, fi-nance, operate and maintain a public facility, receiving payment on a per-patient or service-delivery basis.

Private sector players can include hospital groups, banks, technology providers, and other stake-holders that provide the equity and debt financing needed to construct and equip the buildings.

Service-focused PPP structures are popular with governments that want to upgrade delivery of a specific clinical service, such as radiology, dialysis, or laboratory services. The private sector consortium will not only design, equip, and maintain equipment, but also hire staff and manage the full patient experience. The ministry then pays on a per-patient basis.

Through PPP scenarios such as these, quality of care is built into the agreements through KPIs such as equipment uptime and availability, patient satisfaction, lab or radiology reporting turnaround times, and patient waiting times in outpatient clinics and service departments.

PPP agreements represent effective solutions to the current needs of regional health ministries. But these are complex structures that require the right regulatory and legislative frameworks to encourage participation from the private sector and ensure improved levels of service delivery, technology improvement and patient outcomes that are the goal of these agreements.

Countries like Saudi Arabia, the UAE and Turkey have put in place successful PPP legislation by consulting with local and international stakeholders that bring experience implementing healthcare PPPs in other markets.

They have taken the best elements of overseas models and modified them to their own domestic needs and market realities.

Success also requires the right partners, Hady said, noting that GE HealthCare “has experience working in markets at different stages of PPP maturity all around the world.”

He pointed to the company’s capabilities in areas crucial to building successful PPP consortiums, such as healthcare technologies, financing, consortium partner development, and project management, where GE HealthCare has extensive expertise in delivering complex projects on time and within budget.

“One of our most important priorities is bringing our experience together with our local knowledge to support governments in implementing public-private partnership as an ideal mechanism to achieve their goals in areas such as enhancing access and delivery of care, cost control, and the sustainable management of an increasing patient load.

“The results are good for all by setting the stage for healthier and more vibrant economies and societies far into the future.”

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