Public-private partnership in healthcare: a feasibility study

La Sede dell'Ospedale Regionale di Bellinzona e Valli (Foto Urskalberer Wikipedia)
La Sede dell'Ospedale Regionale di Bellinzona e Valli (Foto Urskalberer Wikipedia)

Institutional Communication Service

8 September 2015

In Switzerland and in Ticino the concept of public-private partnerships are increasingly relevant, as shown by the Federal “Health2020” report, the Cantonal hospital planning, the REHA Ticino experience and the growing political and media debate on the topic. In this context, the Ente Ospedaliero Cantonale (EOC), in agreement with the Clinica Santa Chiara in Locarno (CSC) and in close coordination with the Department of healthcare and social services of the Canton Ticino (DSS), has decided to evaluate the institutional, organsiational and economic-financial feasibility of a public-private partnership between the Ospedale Regionale di Locarno La Carità (ODL) and the CSC. For this purpose, EOC, ODL and CSC have commissioned a research project to the USI Public Management and Health team at the Institute of Economics (IdEP, Faculty of Economics), in collaboration with the PPP Association Switzerland.

The results of the survey and a summary of the study were presented today at a press conference held on the Lugano campus (room A11, 11 a.m.), followed by a discussion with Piero Martinoli (President, USI), Giorgio Pellanda (Managing Director, EOC), Philipe Meyer (President of the Board, CSC), Paolo Bianchi (Director, Public Health Division DSS), Prof. Marco Meneguzzo (coordinator of the USI Public Management and Health team), and Diego Medici (tiresia).


A partnership in Ticino, the first Switzerland

The USI study focused on identifying the most appropriate form of partnership, on the main concerns of the staff of the two structures, and on the perception of the population in the Locarno region towards the public-private partnership project. With concerns to the form of partnership, the comparative analysis in Switzerland showed that the synergy between ODL and CSC in several areas could be a first in the whole country. At present, all experiences in healthcare public-private partnerships in Switzerland were related to specific medical sectors. The most interesting cases – the Outpatient Surgery Center in Lausanne, the Institute of Radiology of the Bernese Jura, the Bubenholz Nursing Home in Opfikon, the Center of Radiology Luzern Land, and the Center of Radiology at the Männedorf hospital – are nonetheless useful to identify the ideal collaboration model for the Locarno region that considers all the  institutional, political, economic and social-healthcare elements. The study presented the possible strategic guidelines, including the defining contents, timelines and the pilot trial results controlling mode for the public-private partnership in the Locarno region (gynecology obstetrics, neonatology and pediatrics – mother-child health). DSS Director Paolo Bianchi said, “The Public Health Division is very keen on this detailed study, as it represents a concrete further development of the proposal issued by the Council of State, in the context of relevant Government dispatch on hospital planning, for the creation of a combined healthcare unit in the Locarno region. We find interesting also the results of the survey that was conducted among the population, showing how the partnership would be well received and supported by the people in the Locarno region.”


The point of view of the population

The project involved the medical staff of the two entities, with meetings and discussion groups, and the population of the Locarno region, with a survey conducted from April to June 2015 by the tiresia Institute in which 930 people participated. With concerns to the hospital staff members, the purpose was to understand their main concerns in terms of logistics, organisation of work, protocols and IT systems related to clinical procedures and patient management, and to the staff training and development. As for the local population, the survey showed a considerably high bias (68% of respondents) towards an increased level of collaboration between the two hospitals. The possible future collaboration model will need to take into account and find appropriate solutions for issues related to logistics; the organisation of work; the conformity of documentation, applications and guidelines; and staff training and development.

Giorgio Pellanda, Director of the Ente Ospedaliero Cantonale, said: “EOC and CSC are aware of the legal and political difficulties that such public-private projects entail. They shall commit to find pragmatic and balanced solutions, respectful of the goals and mutual interests, and shared with the Council of State." Philippe Meyer, on his part, said: “The CSC is well aware of the need to optimise, rather than cutting back, on healthcare in the Locarno region, which is why we took part in the project, in which we are certain of its success. I now look forward with confidence to the outcome of the political process in order to evaluate the next steps.”