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Exporting public-private partnerships in healthcare: export strategy and policy transfer

机译：出口医疗保健中的公私伙伴关系：出口战略和政策转移

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The literature on policy transfer has paid insufficient attention to the role of commercial interests in the transfer of policy. The British government has developed a healthcare industrial strategy that includcs an attempt to export Public Private Partnership (PPP) serviccs. This article analyses the application of the strategy to export PPP services in healthcare to developing and eastern European countries through a review of 'scoping reports'. The analysis reveals that the strategy involves an attempt to utilize the UK Department for International Development, international financial institutions such as the World Bank, and private sector consultancies to influence developing country governments towards adopting the British Private Finance Initiative (PFI) model, in order to lay the basis for the winning of consultancy, construction and other contracts by British firms. The debate concerning the suitability of PPP/PFI arrangements for the financing of healthcare facilities in Britain is considered in terms of its implications for the adoption of such arrangements by developing and eastern European countries. The purported efficiency gains of PPP/PFI in the UK are unproven, yet the drawbacks of the model may be even more problematic for public health service organizations in developing and eastern European countries, where the expertise to negotiate, monitor and enforce robust contracts with the private sector may be more limited. The article concludes that the attempt to export PPP services entails a strategy of trying to 'export' the policy itself, despite the fact that the public sector technical capacity needed to make the policy effective may be lacking in the target countries.
机译：关于政策转移的文献没有充分注意商业利益在政策转移中的作用。英国政府制定了一项医疗保健产业战略，其中包括试图出口公私合营（PPP）服务的企图。本文通过回顾“范围界定报告”，分析了该策略在医疗保健中向发展中国家和东欧国家出口PPP服务的应用。分析表明，该战略涉及试图利用英国国际发展部，世界银行等国际金融机构以及私营部门咨询机构，以影响发展中国家政府采用英国私人融资计划（PFI）模式的尝试。为英国公司赢得咨询，建筑和其他合同奠定基础。关于PPP / PFI安排是否适合英国医疗设施融资的辩论，从其对发展中国家和东欧国家采用这种安排的意义来考虑。在英国，据称PPP / PFI的效率提高尚未得到证实，但是该模型的缺点对于发展中国家和东欧国家的公共卫生服务组织而言可能甚至会成问题，因为在这些国家，专家们与该组织进行谈判，监督和执行强有力的合同私营部门可能更为有限。文章的结论是，尽管目标国家可能缺乏使政策生效所需的公共部门技术能力，但出口PPP服务的战略必然是试图“出口”政策本身。

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