Editing Public–private partnership (section)

===Health services===
[[File:Anbumani Ramadoss addressing at the inauguration of the Associate Chamber of Commerce & Industry (ASSOCHAM) MeetNational Summit on Public Health Initiatives Public Private Partnership (PPP) Model, in New Delhi.jpg|thumb|Indian Minister of Health and Family Welfare [[Anbumani Ramadoss]] addressing the inauguration of the Associate Chamber of Commerce & Industry National Summit on Public Health Initiatives and the PPP model, in New Delhi. (2006)]]
For more than two decades, public–private partnerships have been used to finance health infrastructure. In [[Healthcare in Canada|Canada]], they comprise 1/3 of all P3 projects nationwide.<ref name=":0" /> Governments have looked to the PPP model in an attempt to solve larger problems in health care delivery. However, some health-care-related PPPs have been shown to cost significantly more money to develop and maintain than those developed through traditional public procurement.<ref name="Policy Note 2017">{{cite news |last1=Reynolds |first1=Keith |title=The enormous cost of public-private partnerships |url=https://www.policynote.ca/the-enormous-cost-of-public-private-partnerships/ |access-date=28 June 2019 |work=Policy Note |date=3 August 2017 |language=en-CA}}</ref>

A [[health service]]s PPP can be described as a long-term contract (typically 15–30 years) between a public-sector authority and one or more private-sector companies operating as a legal entity. In theory, the agreements entails that the government provides purchasing power and outlines goals for an optimal health system. It then contracts a private enterprise to design, build, maintain, and/or manage the delivery of agreed-upon services over the term of the contract. Finally, the private sector receives payment for its services and assumes additional risk while benefitting from returns on its investments during the operational phase.<ref name=":3">{{Cite journal|last=Whiteside|first=Heather|date=September 1, 2011|title=Unhealthy policy: The political economy of Canadian public-private partnership hospitals|journal=Health Sociology Review|volume=20|issue=3|pages=258–268|doi=10.5172/hesr.2011.20.3.258|s2cid=143156657|issn=1446-1242}}</ref>

A criticism of P3s for Hospitals in Canada is that they result in an "internal bifurcation of authority". This occurs when the facility is operated and maintained by the private sector while the care services are delivered by the public sector. In those cases, the nursing staff cannot request their colleagues from the maintenance staff to clean something (urine, blood, etc.) or to hang workplace safety signs, even if they are standing next to each other, without the approval of the private managers.<ref name=":0" />{{rp|chapter 4}}

In the UK, P3s were used to build hospitals for the [[National Health Service]]. In 2017 there were 127 [[Private finance initiative#National Health Service (NHS)|PFI schemes in the English NHS]]. The contracts vary greatly in size. Most include the cost of running services such as facilities management, hospital portering and patient food, and these amount to around 40% of the cost. Total repayments will cost around £2.1 billion in 2017 and will reach a peak in 2029.  This is around 2% of the NHS budget.<ref name="nuffieldtrust1">{{cite news|last1=Appleby|first1=John|title=Making sense of PFI|url=https://www.nuffieldtrust.org.uk/resource/making-sense-of-pfi#so-whos-involved-with-these-deals-on-the-private-side-of-pfi|access-date=6 October 2017|publisher=Nuffield Trust|date=6 October 2017}}</ref><ref name="Barlow, J. Roehrich 2010">{{cite journal|last1=Barlow|first1=J. Roehrich|last2=Wright|first2=S.|year=2010|title=De facto privatisation or a renewed role for the EU? Paying for Europe's healthcare infrastructure in a recession|journal=Journal of the Royal Society of Medicine|volume=103|issue=2|pages=51–55|doi=10.1258/jrsm.2009.090296|pmc=2813788|pmid=20118334}}</ref>