Improving Health Service Delivery through PPP: Experience at LGU Level by Brillo Reynes, Sr. Vice President, Development Bank of the Philippines

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IMPROVING HEALTH SERVICE DELIVERYIMPROVING HEALTH SERVICE DELIVERYTHROUGH PPPTHROUGH PPP ATAT LGU LEVELLGU LEVEL

By Brillo Reynes, , Sr. Vice President, Development Bank of the Philippines

15 March 2011

Disclaimer: The views expressed in this paper/presentation are the views of the author and do notnecessarily reflect the views or policies of the Asian Development Bank (ADB), or its Board of

, .included in this paper and accepts no responsibility for any consequence of their use. Terminologyused may not necessarily be consistent with ADB official terms.


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PPP at a sub-national level governanceand implementation challenges

Presentors: Nigeria, France, India, Mexico

and the Netherlands

State level & large local government units

General observations only, specific PPP


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For PPP to prosper at a sub-national level:

Need to harmonize guidelines and make resultspredictable among sub-national units

Government

Advanta es of Sub-national PPPs Faster dissemination of the PPP modus operandi

Greater room for SME participation

Insurance of leaders political life

Constraints of Sub-national PPPs

Difficult exercise need for a central unit

Varied levels of knowledge need for TA


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devolved among public services

Least understood among LGU

officials and their constituentsMost needed by local communities,

.


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Bridges financing gap makes public

services available now, not later Frees u the IRA for basic infrastructure

needs complementary services

,resource matching with beneficiaries

Value for Money

pens up oppor un es or app ng oca

private investors & investment funds


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PPP is a complex exercise a path less

traveled, esp. at LGU levelMarket limitations countr side markets

are small coupled with low buying power

assurance of consistency of policies

private sector hesitant to engage

ene s are no o v ous some are non-

financial & hard to quantify


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experience, templates and supports

advisory servicesearn ng rom pa n er pro ec s

document and disseminate knowledge

Development of PPPH investment folios& conduct of PPPH conference for LGUs


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Revisit devolution where LGU PPPH

investments have strategic fit Adherence by LGU to high standards of

governance and transparency

Comprehensive approach include PPPHin strategies & address all dimensions

Formation of local PPPH Team to ensure

capabilities and learnings Communication plan Social Marketing to

defuse anxiety and facilitate buy-in


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Two athfinder ro ects N. Samar &

Sarangani); possibly 2 more (Cavite & Bohol) Networking with NEDA PPP Center and with

DOH PPP

Working out w/ COA to address LGU concerns

s a s ng a por a as we sys ema zeknowledge materials

communication materials

Reviewin available time of Consultin Team todetermine needed adjustments


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Improving Health Service Delivery through PPP: Experience at LGU Level by Brillo Reynes, Sr. Vice President, Development Bank of the Philippines