Public Private Partnerships and Collaboration in the Health Sector in the Kingdom of Saudi Arabia: A Qualitative Study

Abstract

A public-private partnership (PPP) is defined as a collaboration between the public and private sectors in the financing, delivery and development of public goods and services. This phenomenon has been adopted globally by many as a new economic paradigm. This study identifies challenges and other hindrances in promoting PPPs, identifies the concrete contribution of PPP initiatives in improving healthcare service delivery and determines the level of participation of the private sector in healthcare delivery systems under PPP initiatives in the Kingdom of Saudi Arabia. Semi-structured interviews were conducted with 13 participants, including 4 government hospital directors, 5 private hospital directors and 4 health personnel. Participants were interviewed face to face, and the interviews were audio-recorded. The participants were purposefully selected based on their knowledge and familiarity with the implementation of PPP schemes. The evidence showed that the most important benefits of adopting a PPP are the quality of service, the speed at which low-cost healthcare service delivery is made accessible and the diversification of risks between the two sectors so that neither the private sector nor the public sector bears the entire risk alone. The results also revealed that PPPs will lead to increased efficiency and accuracy with respect to the design and implementation of infrastructural projects as well as the financing, execution, maintenance and development of the healthcare sector-the implementation of which makes high-quality services available to end users. Risk sharing is of great importance for the healthcare sector in that it helps hospitals to avoid closure and failure, distributes financial flows in an ideal way, and reduces the pressure on hospitals to work in a safe investment environment. This aim can be achieved through increasing the partnerships between public and private sectors.

Healthcare human resource development in Saudi Arabia: emerging challenges and opportunities—a critical review

“…Moreover, there is a scope for ensuring that future healthcare sector investment matches the need for local HRD requirements vis-à-vis job opportunities, especially for nurses, doctors and allied professionals and equally disengaging from costly consultant-level specialisation for hospitals to specialist-level primary healthcare. A launching of public-private partnership models in selection of upcoming institutions for resource sharing including human resources is therefore essential [26]. There is a need to significantly increase the hospital utilisation rate from the current 53%, especially in the rural areas, with a focus on the growth in the local HRD initiative in the family medicine area employing local doctors, nurses and allied staff specialised in family medicine.…”

The impact of economic and political imperatives on the successful use of public-private partnership (PPP) in projects

“…The same applies to Saudi Arabia, (Biygautane et al 2016) especially healthcare (Al-Hanawi et al 2018, 2020Almalki and Al-Hanawi 2018) and transportation sectors (Al-Muawi et al 2021). Putting this into perspective, according to the World Bank (2021a), the total amount of investment in PPP projects in developing countries stood at around US$ 1,958,777 billion in 2017.…”

“…2020;Hathroubi and Aloui 2022). It has also placed considerable pressure on the national economy in infrastructure development (Almalki and Al-Hanawi 2018;Al-Hanawi et al 2020). The Saudi government has responded by strongly pursuing new fiscal management policies focused on expanding the role of private sector in providing services traditionally deemed reserved for the public sector (Abid and Alotaibi 2020;Rahman 2020).…”

“…Both types of factor are commonly implicated in influencing (i) the nature of the competition, (ii) the services provided, and (iii) the financial resources available to PPP projects (Winch 2009;Turner et al 2010;Dewulf and Garvin 2020). In Saudi specific literature, there are as yet no emergent generalisations on CSF rankings by criticality for success of PPP projects (see Al-Hanawi et al 2018, 2020Al-Hanawi and Qattan 2019;Almalki and Al-Hanawi 2018;Al-Muawi et al 2021;Biygautane et al 2016;Biygautane 2017). However, a very recent study by Al-Hanawi et al (2020) does at least suggest that barriers often tend to be (i) legal, (ii) environmental, or (iii) technological in nature.…”

Hospital services under public-private partnerships, outcomes and, challenges: A literature review

“… 10 A qualitative study in Saudi Arabia showed that the PPP in hospitals has improved service quality, increased efficiency and accuracy in services, and reduced potential hospital losses due to risk sharing. 17 Although PPP gave good results, studies in Spain showed that it was not always better than hospitals with traditional management. 18 Still from the same country, another study found that PPP, in general, has not outperformed hospitals with traditional management although the progress has been remarkable in some areas of services.…”