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Public–Private Partnerships in the health sector: the Danish experience

Published online by Cambridge University Press:  01 April 2008

KARSTEN VRANGBÆK*
KARSTEN VRANGBÆK**
Affiliation:
Institute of Political Science, University of Copenhagen, Denmark
*
*Correspondence to: Institute of Political Science, University of Copenhagen, Øster Farimagsgade 5, 1353 Copenhagen, Denmark. Email: kv@ifs.ku.dk
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Abstract

This article investigates the current use of Public–Private Partnerships (PPP) in the Danish health sector based on an initial discussion of theoretical approaches that analyze PPP. The empirical analysis concludes that PPP has been used very sparsely in the Danish health sector. There are few examples of large-scale partnership projects with joint investment and risk taking, but a number of smaller partnerships such as jointly owned companies at the regional level. When defining PPP more broadly, we can identify a long tradition for various types of collaboration between public and private actors in health care in Denmark. An analysis of the regulatory environment is offered as an explanation for the limited use of PPPs in Denmark. Major political and institutional actors at the central level differ in their enthusiasm for the PPP concept, and the regulatory framework is somewhat uncertain. A number of general issues and concerns related to PPPs are also discussed. It is suggested that a risk-based framework can be useful for mapping the potential and challenges for both private and public partners. Such a framework can be used to feed into game theoretical models of pros and cons for PPP projects. In general terms, it is concluded that more empirical research is needed for the assessment of the various risk factors involved in using PPPs in health care. Most PPPs are still very young, and the evidence on performance and broader governance issues is only just emerging. Ideally, such assessments should include comparisons with a purely public alternative.

Type
Articles
Information
Health Economics, Policy and Law , Volume 3 , Issue 2 , April 2008 , pp. 141 - 163
Copyright
Copyright © Cambridge University Press 2008

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References

Barnekov, T., Boyle, R. and Rich, D. (1989), Privatization and Urban Policy in Britain and the United States, Oxford: Oxford University Press.Google Scholar
Boyer, M.C. (1983), Dreaming the Rational City, Cambridge, MA:MIT Press.Google Scholar
Ghobadian, Abby et al. (eds) (2004), Public–Private Partnerships: Policy and Experience, Palgrave Macmillan.Google Scholar
Greve, Carsten(0000), ‘Why do some countries experiment with PFI-type Public–Private Partnerships while others don’t?', International Center for Business and Politics, Copenhagen Business School.Google Scholar
Hardcastle, C., and Boothroyd, K. (2003), ‘Risk overview in public–private partnership’, inAkintoye, A.Beck, M. and Hardcastle, C., (eds), Public–Private Partnerships, Oxford:Blackwell, pp.31–57.Google Scholar
Hodge, G. and Greve, C. (eds) (2005), The Challenge of Public–Private Partnerships: Learning from International Experience, Edward Elgar.CrossRefGoogle Scholar
Hood, Christopher (1991), ‘A public management for all seasons?’, Public Administration, 69:3–19.CrossRefGoogle Scholar
Joumard, I., Kongsrud, P.M., Nam, Y.S. and Price, R. (2005), ‘Enhancing the effectiveness of public spending: experience in OECD countries’, OECD Economics Department Working Paper No. 380, available at: www.oecd.org/ecoGoogle Scholar
Jørgensen, T.B. and Vrangbæk, K. (2004), Det offentlige styringsunivers: Fra government til governance? 99 s, Århus, Magtudredningen.Google Scholar
Kettl, Donald (1993), Sharing Power: Public Governance and Private Markets, Washington, DC: Brookings Institution.Google Scholar
Kjær, M. (2004), ‘Offentlig-private partnerskaber’, MA-thesis, Department of Political Science, University of Copenhagen.Google Scholar
Klijn, Erik-Hans, and Geert R., Theisman (2000), ‘Governing Public–Private Partnerships’, in Osborne, S.P. (ed.) Public–Private Partnerships: Theory and Practice in an International Perspective, Routledge Advances in Management and Business Studies.Google Scholar
Klijn, Erik-Hans, and Geert R., Theisman (2004), ‘Public–Private Partnerships: the right form at the wrong moment? An analysis of institutional and strategic obstacles’, in Abby, Ghobadian et al. (eds), Public–Private Partnerships: Policy and Experience, Palgrave Macmillan.Google Scholar
Klijn, Erik-Hans, and Geert R., Theisman (2005), ‘Public–Private Partnerships as the managing of co-production: strategic and institutional obstacles in a difficult marriage’, in Hodge, G., and Greve, C. (eds), The Challenge of Public–Private Partnerships: Learning from International Experience, Edward Elgar.Google Scholar
KPMG (Denmark) (2005), OPP-markedet i Danmark 2005–2010 [The Market for Public–Private Private Partnerships 2005–2010], Copenhagen: KPMG.Google Scholar
Larsen, J.B., Vrangbæk, K., Mount, J.K., and Kruse, P. (2004), ‘Dynamics of pharmacy regulation in Denmark, 1932–1994: a study of profession-state relations’, Pharmacy in History, 46(2):ss.43–61.Google ScholarPubMed
McKee, Martin, Nige, Edwards, and Rifat, Atun (2006), ‘Public-Private Partnerships for hospitals’, Bulletin of the Workd Health Organization, 84(11): 890–896.Google ScholarPubMed
Irina A., Nikolic, and Harald, Maikisch (2006), ‘Public–Private Partnerships and collaboration in the health sector: an overview with case studies from recent European experience’, HNP discussion paper, World Bank.Google Scholar
OECD (2005),OECD Economic Surveys: Denmark, Volume 2005/1, March.Google Scholar
Osborne, S.P. (ed.) (2000), Public–Private Partnerships: Theory and Practice in an International Perspective, Routledge Advances in Management and Business Studies.CrossRefGoogle Scholar
Pollitt, Chritopher (2005), ‘Decentralization’, in Ferlie, E., Lynn, L.E., and Pollitt, C. (eds), Handbook of Public Management, Oxford University Press.Google Scholar
Rhodes, R.A.W. (1996), ‘The new governance: governing without government’, Political Studies, 44(3):653–667.CrossRefGoogle Scholar
Rosenau, Pauline (ed.) (2000), Public-Private Partnerships, Cambridge, MA: MIT Press.Google Scholar
Walter A., Rosenbaum (2000), ‘Good lessons of bad experience: rethinking the future of commercial nuclear power’, in Pauline, Rosenau (ed.), Public-Private Partnerships, Cambridge, MA: MIT Press.Google Scholar
Røvik, Kjell Arne (1998), Moderne organisasjoner: Trender i organisationstenkningen ved tusendårsskiftet, Bergen-Sandviken: Fagbokforlaget Vigmostad og Bjørke A/S.Google Scholar
Savas, E.S. (2000), Privatization and Public–Private Partnersips, New Jersey, Chatham House.Google Scholar
Stiglitz Joseph, E., and Scott J., Wallsten (2000), ‘Public-private technology partnerships: promises and pitfalls’, in Pauline, Rosenau (ed.), Public–Private Partnerships, Cambridge, MA: MIT Press.Google Scholar
Weihe, Guri (2006), ‘Public–Private Partnerships: addressing a nebulous concept’, CBS, International Center for Business and Politics, Working Paper No. 16.Google Scholar