An assessment of public-private partnerships as a strategy for effective delivery of primary health care in the Eastern Cape - the case of Frere Hospital

The development of public-private partnerships (PPPs) around the world has urged governments to look at alternative service delivery methods because of increased pressures on government budgets. Public-private partnerships present governments with means of generating private funds for health service delivery whilst government manages the relationship via a negotiated PPP agreement to monitor the quality of services rendered. Different PPP models are applied all over the world depending on the specific needs of countries. Different factors impact on the success of these partnerships and it is essential that government shares knowledge and best practices. This study has showed that in order for basic primary healthcare to be effective in terms of service delivery, PPPs should be considered. The legislative framework is a critical factor in the advancement of PPP procurement and the allocation of risk as an important consideration when pursuing this type of procurement. In the health sector of the Eastern Cape Province in South Africa, there are PPPs that exist; they were the first of their kind. The study examined a tertiary hospital in East London which does not necessarily provide basic healthcare but needs to improve service delivery, although there has been some improvement from 2013 to date. The hospital in question was the Frere Hospital and the study assessed a public-private partnership as a strategy for effective delivery of basic primary healthcare in this hospital in the Eastern Cape. Interviews with the sample participants comprising mainly of managers at Frere Hospital, revealed that Frere had been ‘in tatters’ with a bad reputation before 2013, and even though there were improvements afterwards, some targets were still not met. The study came up with the following recommendations: there should be training of managers and other officials on the importance of PPPs in improving service delivery at Frere; there should be some kind of a PPP at Frere to improve productivity; officials and not only managers must understand the importance of PPPs; certain methods/processes and mechanisms need to be developed to overcome challenges in terms of service delivery that the Department of Health and Frere are still facing; officials must understand that through a PPP service delivery can improve significantly; and a need exists for sound annual plans with targets that show how the annual targets will be achieved