Summary Private health care in low-income and middle-income countries is very extensive and very heterogeneous, ranging from itinerant medicine sellers, through millions of independent ...practitioners—both unlicensed and licensed—to corporate hospital chains and large private insurers. Policies for universal health coverage (UHC) must address this complex private sector. However, no agreed measures exist to assess the scale and scope of the private health sector in these countries, and policy makers tasked with managing and regulating mixed health systems struggle to identify the key features of their private sectors. In this report, we propose a set of metrics, drawn from existing data that can form a starting point for policy makers to identify the structure and dynamics of private provision in their particular mixed health systems; that is, to identify the consequences of specific structures, the drivers of change, and levers available to improve efficiency and outcomes. The central message is that private sectors cannot be understood except within their context of mixed health systems since private and public sectors interact. We develop an illustrative and partial country typology, using the metrics and other country information, to illustrate how the scale and operation of the public sector can shape the private sector's structure and behaviour, and vice versa.
Prompted in part by constrained national budgets, European governments are increasingly partnering with the private sector to underwrite the costs of constructing and operating public hospitals and ...other health care facilities and delivering services. Through such public-private partnerships, governments hope to avoid up-front capital expenditure and to harness private-sector efficiencies, while private-sector partners aim for a return on investment. Our research indicates that to date, experience with these partnerships has been mixed. Early models of these partnerships-for example, in which a private firm builds a hospital and carries out building maintenance, which we term an "accommodation-only" model-arguably have not met expectations for achieving greater efficiencies at lower costs. Newer models described in this article offer greater opportunities for efficiency gains but are administratively harder to set up and manage. Given the shortages in public capital for new infrastructure, it seems likely that the attractiveness of these partnerships to European governments will grow.
The Innovative Medicines Initiative (IMI) was launched in 2008 as a large‐scale public–private partnership between the European Commission and the European Federation of Pharmaceutical Industries and ...Associations (EFPIA). With a total budget of €2 billion, the IMI aims to boost the development of new medicines across Europe by implementing new collaborative endeavors between large pharmaceutical companies and other key actors in the health‐care ecosystem, i.e., academic institutions, small and medium enterprises, patients, and regulatory authorities. Projects conducted by IMI consortia have already delivered meaningful results, providing proof‐of‐concept evidence for the efficiency of this new model of collaboration. In this article we review recent achievements of the IMI consortia and discuss the growing interest in the IMI as a best‐practice model to reinvigorate drug development.
Clinical Pharmacology & Therapeutics (2012); 91 3, 418–425. doi:10.1038/clpt.2011.321
The New Public Governance? Osborne, Stephen P
2010, 20100121, 2009, 2010-01-21, 2009-12-22, 20100101
eBook
Despite predictions that 'new public management' would establish itself as the new paradigm of Public Administration and Management, recent academic research has highlighted concerns about the ...intra-organizational focus and limitations of this approach. This book represents a comprehensive analysis of the state of the art of public management, examining and framing the debate in this important area.
The New Public Governance? sets out to explore this emergent field of research and to present a framework with which to understand it. Divided into five parts, the book examines:
Theoretical underpinnings of the concept of governance, especially competing perspectives from Europe and the US
Governance of inter-organizational partnerships and contractual relationships
Governance of policy networks
Lessons learned and future directions
Under the steely editorship of Stephen Osborne and with contributions from leading academics including Owen Hughes, John M. Bryson, Don Kettl, Guy Peters and Carsten Greve, this book will be of particular interest to researchers and students of public administration, public management, public policy and public services management.
Stephen P. Osborne is Professor of International Public Management and Director of the Centre for Public Services Research at the University of Edinburgh, UK. He is President of the International Research Society for Public Management (IRSPM) and Editor of Public Management Review (PMR).
‘Stephen Osborne is to be congratulated for assembling an impressive array of contributors and producing a text which makes a major contribution to the debates about this emerging paradigm.’ - Robert Pyper, Glasgow Caledonian University, UK
'This book showcases the best writing on ‘public governance’, bringing together new research in institutional analysis, policy dynamics, and government-society relationships. It provides a good balance of conceptual insights and empirical analysis grounded in the large changes evident in advanced countries in recent decades.' - Brian Head, University of Queensland, Australia
'This text, edited by Stephen Osborne, may do as much for critical insight to Europe’s public service delivery as the David Osborne and Ted Gaebler text on Reinventing Government did for the United States in the 1990s in refocusing the public sector for improvement.' - Dean F. Eitel, DePaul University, USA
1. Introduction: The (New) Public Governance: A Suitable Case for Treatment? (Stephen P. Osborne) Part I: Theoretical Perspectives on Public Governance 2. Global Perspectives on Governance (Patricia Kennett) 3. Meta-Governance and Public Management (B. Guy Peters) 4. Innovations in Governance (Mark Moore and Jean Hartley) 5. Governance and Governability (Jan Kooiman) 6. Does Governance Exist? (Owen Hughes) 7. What Endures? Public Governance and the Cycle of Reform (Laurence E. Lynn, Jr.) Part II: Governance and Inter-Organizational Partnerships to Deliver Public Services 8. Theory of Organizational Partnerships: Partnership Advantages, Disadvantages and Success Factors (Ronald W. McQuaid) 9. Public-Private Partnerships and Public Governance Challenges (Carsten Greve and Graeme Hodge) 10. Introducing the Theory of Collaborative Advantage (Siv Vangen and Chris Huxham) 11. Relationship Marketing, Relational Capital and the Governance of Public Services Delivery (Stephen P. Osborne, Kate McLaughlin and Celine Chew) 12. Leading Across Frontiers: How Visionary Leaders Integrate People, Processes, Structures and Resources (Barbara C. Crosby, John M. Bryson and Melissa M. Stone) 13. Public Governance and the Third Sector: Opportunities for Co-Production and Innovation? (Victor Pestoff and Taco Brandsen) Part III: Governance of Contractual Relationships 14. Governance, Contract Management and Public Management (Donald F. Kettl) 15. Governance of Outsourcing and Contractual Relationships (Federica Farneti, Emanuele Padovani and David W. Young) 16. The Governance of Contracting Relationships: "Killing the Golden Goose": A Third-Sector Perspective (Steven Rathgeb Smith and Judith Smyth) Part IV: Governance of Inter-Organizational Networks 17. Trust in Governance Networks: Looking for Conditions for Innovative Solutions and Outcomes (Erik-Hans Klijn) 18. Implementation and Managerial Networking in the New Public Governance (Laurence J. O’Toole Jr, and Kenneth J. Meier) 19. From New Public Management to Networked Community Governance? Strategic Local Public Service Networks in England (Steve Martin) Part V: Governance of Policy Networks 20. Policy Networks: Theory and Practice (Tobias Jung) 21. Policy Networks in Practice: The Debate on the Future of Amsterdam Airport Schiphol (Menno Huys and Joop Koppenjan) 22. Governance, Networks and Policy Change: The Case of Cannabis in the United Kingdom (Beatriz Acevedo and Richard Common) 23. Conclusions: Public Governance and Public Services Delivery: A Research Agenda for the Future (Stephen P. Osborne)
Background: India contributes approximately 25% of the missing cases of tuberculosis (TB) globally. Even though ~50% of patients with TB are diagnosed and treated within India’s private sector, few ...are notified to the public healthcare system. India’s TB notification policy mandates that all patients with TB are notified through Nikshay (TB notification portal). We undertook this study to assess how mandatory notification has influenced the number of TB cases reported in the Nikshay portal from the private sector from Solapur district between 2015 and 2022. Objective: To evaluate the contribution of mandatory notification in enhancing TB notification in Solapur district between 2015 and 2022. Methodology: This study employed a quantitative observational approach, using record-based data extracted from the laboratory register and the Nikshay portal. The analysis period spanned from 2015 to 2022, allowing for an in- depth evaluation of TB notification trends before and after the implementation of the mandatory notification policy in 2018. Data was compiled and analysed using MS-Excel. Frequencies, means, and proportions used to effectively describe tuberculosis (TB) case notifications in both the private and public sectors were used. Results: Between 2015 and 2022, Solapur district experienced a variable but overall increasing trend in TB notification rates. In 2015, the TB notification rate was 58.15 per 100,000 population, which increased to 90.69 by 2022. The annual presumptive TB examination rates showed significant growth over the years. In 2015, the rate was 628 per 100,000 population, which escalated to 1965 by 2022. Conclusion: This rise is indicative of enhanced TB case detection, especially after the implementation of the mandatory notification policy and increase in presumptive TB examination rates is attributed to the rising use of advanced diagnostic methods such as CBNAAT and TrueNAT.
Rethinking Private Authorityexamines the role of non-state actors in global environmental politics, arguing that a fuller understanding of their role requires a new way of conceptualizing private ...authority. Jessica Green identifies two distinct forms of private authority--one in which states delegate authority to private actors, and another in which entrepreneurial actors generate their own rules, persuading others to adopt them.
Drawing on a wealth of empirical evidence spanning a century of environmental rule making, Green shows how the delegation of authority to private actors has played a small but consistent role in multilateral environmental agreements over the past fifty years, largely in the area of treaty implementation. This contrasts with entrepreneurial authority, where most private environmental rules have been created in the past two decades. Green traces how this dynamic and fast-growing form of private authority is becoming increasingly common in areas ranging from organic food to green building practices to sustainable tourism. She persuasively argues that the configuration of state preferences and the existing institutional landscape are paramount to explaining why private authority emerges and assumes the form that it does. In-depth cases on climate change provide evidence for her arguments.
Groundbreaking in scope,Rethinking Private Authoritydemonstrates that authority in world politics is diffused across multiple levels and diverse actors, and it offers a more complete picture of how private actors are helping to shape our response to today's most pressing environmental problems
Western liberal governments increasingly seek to improve the performance of the public sector by spurring innovation. New Public Management reforms from the 1980s onward viewed strategic ...entrepreneurial leadership and public–private competition as key drivers of public innovation. By contrast, the current wave of New Public Governance reforms perceives collaboration between relevant and affected actors from the public and private sector as the primary vehicle of public innovation, and tends to see governance networks as potential arenas for collaborative innovation. The new focus on collaborative innovation in networks poses a fundamental challenge for public managers, elected politicians, and others aiming to metagovern governance networks. Hence, we claim that a specific metagovernance strategy is needed when the purpose of governance networks is to stimulate efficiency, effectiveness, and democratic legitimacy through innovation rather than incremental improvements. The article aims to sketch out the contours of such a strategy by comparing it with more traditional metagovernance strategies. The argument is illustrated by an empirical analysis of an example of collaborative innovation in Danish elderly care.
Eager to learn from private sector trends, practitioners in (semi)public organizations across the world have recently turned their eyes to the concept of work engagement to improve employee ...performance. Studies in the private sector show that work engagement is a more robust predictor of performance than, for example, satisfaction. The goal of this study is to find out whether the effects of work engagement on attitudinal, behavioral, and performance outcomes within the semipublic and public sector are also as high as expected and whether these relationships differ between the public, semipublic, and private sector. The results of the cross-sectoral meta-analysis of 130 studies showed that the most noticeable significant sectoral differences can be found in the mean work engagement and the effects of work engagement on the level of attitudinal outcomes (job satisfaction and commitment) and behavioral outcomes (workaholism and turnover intention).
Summary Background Understanding the amount of tuberculosis managed by the private sector in India is crucial to understanding the true burden of the disease in the country, and thus globally. In the ...absence of quality surveillance data on privately treated patients, commercial drug sales data offer an empirical foundation for disease burden estimation. Methods We used a large, nationally representative commercial dataset on sales of 189 anti-tuberculosis products available in India to calculate the amount of anti-tuberculosis treatment in the private sector in 2013–14. We corrected estimates using validation studies that audited prescriptions against tuberculosis diagnosis, and estimated uncertainty using Monte Carlo simulation. To address implications for numbers of patients with tuberculosis, we explored varying assumptions for average duration of tuberculosis treatment and accuracy of private diagnosis. Findings There were 17·793 million patient-months (95% credible interval 16·709 million to 19·841 million) of anti-tuberculosis treatment in the private sector in 2014, twice as many as the public sector. If 40–60% of private-sector tuberculosis diagnoses are correct, and if private-sector tuberculosis treatment lasts on average 2–6 months, this implies that 1·19–5·34 million tuberculosis cases were treated in the private sector in 2014 alone. The midpoint of these ranges yields an estimate of 2·2 million cases, two to three times higher than currently assumed. Interpretation India's private sector is treating an enormous number of patients for tuberculosis, appreciably higher than has been previously recognised. Accordingly, there is a re-doubled need to address this burden and to strengthen surveillance. Tuberculosis burden estimates in India and worldwide require revision. Funding Bill & Melinda Gates Foundation.
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