Financials and Contractual Guidelines to Support Public-Private Partnership Proposals in the Healthcare Sector

Over the past decade, the phenomenon of collaborations between public and private entities has flourished in broad fields of the public realm. Public-private partnership (PPP) has attracted increasing interest from public authorities because of the many benefits that can be derived from the implementation of this type of arrangements. Analyses conducted by the Italian Presidency of the Council of Ministers - Department for the Planning and Coordination of Economic Policy (DIPE), however, show that the PPP market in Italy does not seem to be fully developed yet, especially in comparison with other markets in major European countries. This can be traced back to a number of challenges. Yet, as reported in the study conducted by DIPE, one of the main disincentives to private investment in Italy lies in the uncertainty and excessive length of the authorization and administrative processes (DIPE, 2022). The challenges and issues set forth are clearly reversed and reflected at the regional level, where local administrative bodies and private entrepreneurs are exposed at the forefront in dealing with the complex administrative procedures involving PPPs. For these reasons the research work, by going to analyse a series of case studies submitted to the Regione Piemonte in the Healthcare field (as per Art.183 paragraph 15 of the Legislative Decree No. 50 “Codice dei contratti pubblici” April 18, 2016), aims at developing an initial set of specific guidelines that can enhance and speed up the procurement process. The guidelines address different critical aspects of the awarding procedure (PSC, Risk Matrix, financials, etc.) and aims at providing a framework which is able to support both the private and the public party in the submission of new privately-led PPP proposals. Furthermore, by means of an extensive literature review, this research aims also at expanding the general knowledge on PPPs. The resulting model can be an important step toward the future implementation of a set of more specific guidelines and tools that can streamline the procurement process, ultimately leading to a potential greater development of the PPP market in Italy.