Multilateral Investment Fund (MIF) Inter-American Development Bank (IDB) 2015 PPP Americas Conference - PowerPoint PPT Presentation

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Multilateral Investment Fund (MIF) Inter-American Development Bank (IDB) 2015 PPP Americas Conference

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Multilateral Investment Fund ... the practical side Build health infrastructure and ... organization management and ICT systems into the health sector ... – PowerPoint PPT presentation

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Title: Multilateral Investment Fund (MIF) Inter-American Development Bank (IDB) 2015 PPP Americas Conference


1
Multilateral Investment Fund (MIF) Inter-American
Development Bank (IDB) 2015 PPP Americas
Conference
  • Session 2B
  • How PPPs Can Satisfy Demand in the Health Sector
    -
  • The Trinidad and Tobago Health Perspective
  • Stewart Smith, Senior Health Systems Adviser
  • Ministry of Health
  • April 14, 2015

2
Health PPP Initiatives in TNT
  • National Dialysis Centres On-going
  • Design-Build-Finance-Operate-Maintain (BDFOM)
  • National Diagnostic Centres Business Case being
    developed
  • Design-Build-Finance-Operate-Maintain (BDFOM)
  • Hospital Contract Management Hospital
    construction being completed
  • Operations and Maintenance

3
Benefits of PPP to the TNT Health Sector the
practical side
  • Build health infrastructure and replace ageing
    and obsolete hospital plant and biomedical
    equipment
  • Address the challenges of government capital
    funding by incentivising the private sector
  • Satisfy the increased demand for improved
    healthcare services by the citizenry and the need
    for new and improved health care services
  • Strengthen the management and operations of
    hospitals to improve efficiency and care and
    service quality
  • Attract, build and retain a skilled, experienced
    and competent health workforce
  • Infuse modern governance, organization management
    and ICT systems into the health sector
  • Resulting in a strengthened health system

4
Challenges of PPP in the Caribbean
  • The concept is newNo developed cadre of
    government subject-experts with the know-how to
    lead and manage the process
  • The constant need for support from international
    organizations
  • International foreign subject-expertise is very
    costly
  • The PPP development process itself is very costly
  • Local private sector market is risk averse and
    still wants Government guarantees - no clear
    understanding of the concept of the transfer of
    risk to the private sector
  • PPP procurement strategy is in competition with
    traditional procurement approach a comfort
    issue
  • High developmental PPP costs with high recurrent
    PPP costs in LMIC with high imports and resource
    constrained economies
  • Significant and heavy long-term commitment on
    foreign exchange outflows - with possible limited
    inflows

5
Lessons Learnt and Way Forward
  • Need for a long term government commitment to the
    PPP procurement model and modification to
    existing procurement legislation
  • Need to strengthen the local talent pool for PPP
    support
  • Establish a dedicated unit of subject experts and
    train-up that group to the level of advisers
    all professionals
  • Need for more private sector sensitization as
    well as more private sector financial institution
    sensitization
  • As there is till limited, partial or completely
    wrong understanding of the PPP concept
  • The thinking and expectation are still too
    government-centric
  • Need for more thought-leadership and idea
    generation by the private sector (particularly in
    health delivery)
  • One hopeful outcome
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