Business Mirror, 24 September 2013
By Cai Ordinario
THEÂ Philippines has a huge potential to undertake health-related Public-Private Partnership (PPP) ProjectsÂ but the country has yet to embrace this potential having only one full-blown PPP in the health sector.
PPP Center Executive Director Cosette Canilao said that currently, the government only has one PPP project in the health sector which is the P5.7-billion Modernization of the Philippine Orthopedic project.
Canilao said the Department of Health (DOH) recently decided to undertake the P453-million Vaccine Self-Sufficiency Project through the regular procurement system rather than via PPP.
She said that while the DOH has expressed interest in proposing a PPP for digital cancer centers, this PPP may not be able to maximize the potential of a full-blown PPP project.
â€śThe [DOH] said something about digital cancer centers but again theyâ€™re thinking of the structures. They will build the structure but it seems it will not be a pure PPP, its not a high-value PPP. It seems it will just be a public-private interaction. Itâ€™s not a real PPP [because it will be done through a] service agreement and I dont think youâ€™re harnessing the real power of PPPs through that,â€ť Canilao said.
In a presentation at the Health Care for All forum on Tuesday, Philippine Institute for Development Studies Consultant Josephine Anne Lucero said PPPs is a strategy that will help attain Universal Health Coverage in the country.
She said, however, that PPPs that were reviewed in her study were not long term and most were focused on specific health services. She added that while there were a lot of efforts to address health concerns through PPPs, these efforts were scattered.
â€śA health public-private partnership should be a long-term contract between the public sector and one or more private sectors, organized as a legal entity, with a common goal to provide a public health service, while sharing substantial financial and operational risk,â€ť Lucero said in her presentation.
Lucero said what is ideal is for the government to undertake not only public-private interactions (PPIs), which is the classification of most PPPs in the country, but Public-Private Investment Partnerships (PPIPs) which are long term at least 10 years and deliver integrated services, among others.
To create PPIPs, Lucero noted that the government must develop an integrated and long-term health plan that contains detailed steps and identifies accountable institutions and agencies.
She added there is a need to â€śincentivizeâ€ť local chief executives to participate in PPIP projects. One of the ways by which this can be done is to turn the participation in PPIPs into a competition of best practices among local government units (LGUs).
â€śThe DOH should increase the capacity of all stakeholders-central office officials, LGUs, private sector, health-care workers and civilian groups. [There is also a need for] a more specialized capacity building program for PPPs in health should be fostered by the DOH PPP Center,â€ť Lucero said, among other recommendations.
25 June 2013, Business World
The Megawide Construction Corp.-World Citi Inc. consortium could soon be declared the winner of a hospital public-private partnership (PPP) deal after its technical and financial proposals were yesterday deemed “compliant” by the Health department.
Health Undersecretary Teodoro J. Herbosa, bids committee chairman, said Megawide and World Citiâ€™s offer for the modernization of the Philippine Orthopedic Center (MPOC) project would now be evaluated by the National Economic Development Authority-Investment Coordination Committee (NEDA-ICC).
A notice of award will be issued if the NEDA-ICC gives its approval, he added.
The consortium bid P5.672 billion for the project, which the government had said would cost P5.7 billion. Megawide and World Citi also asked for an annual subsidy of P600 million for five years, which Mr. Herbosa said would fund services for the poor.
He cited Republic Act (RA) 7718 or the amended build-operate-transfer law, which states that “direct negotiation shall be resorted to when there is only one complying bidder left”.
The Megawide-World Citi consortium was the sole bidder for the MPOC project, which involves the construction, operation and maintenance of a 700-bed facility that will be built inside the National Kidney Transplant Institute compound along East Ave. in Quezon City.
The POC is currently located at Maria Clara corner Banawe streets., also in Quezon City.
The Health department earlier said that nine firms were interested.
Bidding is being conducted under a “one stage, three envelope system” where qualification documents and technical and financial proposals are submitted the same time.
The Megawide-World Citi consortium earlier passed the qualification hurdle and Mr. Herbosa had said a ruling on the technical offer would follow. The financial proposal, meanwhile, was only opened yesterday.
Megawide has already bagged one PPP project, last year securing a contract for one of two phase one segments of the PPP School Infrastructure Project (PSIP). It has also qualified to bid for phase two of the PSIP.
Three PPP projects have so far been awarded:
â€˘ the P1.96-billion Daang Hari-South Luzon Expressway Link, bagged by Ayala Corp. in December 2011;
â€˘ the P16.42-billion PSIP Phase One granted last year to Citicore Holdings Investment, Inc.-Megawide and BF Corp.-Riverbanks Development Corp. consortiums; and
â€˘ the P15.86-billion Ninoy Aquino International Airport Expressway Phase II project awarded last month to San Miguel Corp. unit Optimal Infrastructure Development, Inc.
09 June 2013, Business World
The Health Department is set to announce today if sole participant Megawide Construction Corp.-World Citi, Inc. consortium is eligible to bid for the Philippine Orthopedic Center (MPOC) modernization project, an official said yesterday.
“Iâ€™ll know tomorrow [Monday] p.m. [afternoon]. TWG (technical working group] reports to PBAC (Pre-qualification, Bids, and Awards Committee),” Health Undersecretary Teodoro J. Herbosa, MPOC PBAC chairman said by text message when asked if the qualification documents submitted by the Megawide-World Citi consortium is complete and accurate.
The consortium was the lone bidder that showed up last week to submit qualification documents, technical and financial proposals for the Public-Private Partnership (PPP) project.
With an estimated cost of â‚±5.70 billion, the project involves the construction, operation and maintenance of a 700-bed facility that will be built inside the National Kidney Transplant Institute compound along East Ave. in Quezon City. The PoC is currently located at Maria Clara st. corner Banawe st., also in Quezon City.
Megawide has bagged one PPP project last year securing a contract for one of two Phase One segments of the PPP School Infrastructure Project (PSIP). It has also qualified to bid for phase two of the PSIP.
Mr. Herbosa last week said PBAC will issue a resolution declaring Megawide-World Citi as eligible to bid once the qualification documents are determined as complete.
The technical proposal will then be reviewed, to be followed by the financial offer. The Health department will then recommend approval of an award by National Economic Development Authority-Investment Coordination Committee if the financial offer “is below or within our ceiling,” Mr. Herbosa said last week.
He said the Health departments expects “20 days to do all of that.”
The bidding is being conducted under a “one stage, three envelope system” where a prospective investor submits its qualification documents and its technical and financial proposals at the same time.
The PPP program was launched in late 2010 by the Aquino administration as a means of addressing the countryâ€™s lack of critical infrastructure.
Three PPP projects have so far been awarded: the â‚±1.96-billion Daang Hari-South Luzon Expressway Link, bagged by Ayala Corp. in December 2011; the â‚±16.42-billion PSIP Phase One granted last year to the Citicore Holdings Investment, Inc., Megawide and BF Corp.-Riverbanks Development Corp. consortiums; and the â‚±15.86-billion Ninoy Aquino International Airport Expressway Phase II project given earlier this month to San Miguel Corp. unit Optimal Infrastructure Development, Inc. — KMPT
25 November 20012, Business World Online
Another public-private partnership (PPP) project has been rolled out by the government, with the Health department calling for bids to build and operate a new Philippine Orthopedic Center.
The P5.6 billion-project — approved by President Benigno S. C. Aquino III on Sept. 8 — involves a 25-year contract for the construction as well as operations and maintenance of a 700-bed hospital inside the National Kidney and Transplant Institute compound in Quezon City.
Bid documents for the project will be available for P250,000 starting today until Feb. 25 next year, the Health department said. A pre-bid conference will be held on Jan. 25, 2013 and qualified bidders have until March 26 to submit their offers.
Health Undersecretary Teodoro J. Herbosa, officer-in-charge of the departmentâ€™s PPP projects, had said they were looking to award the contract by May next year.
Prospective bidders are expected to procure, install and manage “modern diagnostics and clinical equipment” as well as “teaching and training facilities for basic and advanced clinical care.” They also need to provide “appropriately qualified staff,” including medical, paramedical, nursing and support personnel.
The Orthopedic Center project joins two other PPP projects — the P60-billion Light Rail Transit-1 extension and the P15.86-billion NAIA Expressway 2 — that are now in the advanced stages of being bid out.
Two PPP projects been awarded since the government unveiled its flagship infrastructure program in 2010. The P1.96-billion Daang Hari-Southern Luzon Expressway link was given to Ayala Corp. last December. The second, a P16.42-billion project to build 9,300 classrooms in Luzon, was won in September by the BF Corp.-Riverbanks Development Corp. and Citicore Investments holdings, Inc.-Megawide Construction Corp., Inc. consortiums.
22 November 2012,Â United Nations Economic Commission for Europe (UNECE)
On 22 November 2012, Sven Alkalaj, United Nations Under-Secretary-General and UNECE Executive Secretary, and Dr. Enrique T. Ona, Secretary of Health of the Republic of the Philippines, signed a Memorandum of Understanding (MoU) establishing the Specialist Public-Private PartnershipsÂ (PPPs) Centre on Health in the Philippines. An official signing ceremony took place in Manila at the National Kidney and Transplant Institute (NKTI), where the office of the Specialist Centre is located.
On this occasion, Sven Alkalaj declared: â€śThe Centre of Excellence in Health in the Philippines will be operating under the auspices of the global Centre of Excellence whose Secretariat is based within UNECE in Geneva. With this project, we wish to target specifically the socially and economically disadvantaged. We want to ensure that by disseminating best practices from one country to others, the weaker and more vulnerable members of our societies will benefit.â€ť
Dr. Enrique T. Ona said: â€śThe signature of this MoU symbolizes the institutionalization of our long-term relationship with UNECE. It is very timely in view of the current thrust of our government recognizing the essential role of the private sector in pursuing national growth and development objectives. The Centre demonstrates that PPP can be a viable instrument to bring about infrastructure development in pursuit of our ambition to achieve universal health care for all Filipinos, especially the poor.â€ť
The NKTI has already introduced successful public-private partnerships that emerged as a solution to the scarcity of funds to furnish the hospital with state-of-the-art machines for patients suffering from end-stage renal disease. The project was undertaken through a long team lease arrangement (build-operate-transfer) with a private partner so that new and modern equipment can be acquired and housed under a new centre.
The Specialist Centre on Health is charged with the major task to identify best practice in PPP in health. By realising this mission, the Centre will become the global and focal centre on PPP in health sector internationally. The Philippines will benefit from this as well when shaping its own PPP programme for the health sector. The Centre will also help to train government officials in the new skills required to do PPP in the health sector, such as project management and private financing, which most governments lack.
The Centre will be operating under the auspices of the UNECE International Centre of Excellence whose Secretariat is based at UNECE. The UNECE International Centre will consist of a small hub in Geneva and Specialist Centres in different countries in the world responsible for specific sectors (roads, water, waste disposal, renewable energy etc.).
The overall goals of the UNECE PPP International Centre of Excellence are to:
UNECE welcomes the initiative taken by the Government of Philippines and anticipates more countries joining the UNECE International PPP Centre of Excellence and taking a lead in developing Specialist Centres in specific sectors, which are the priority for their own countries.
Through its International PPP Centre of Excellence and the Specialist Centre on Health, UNECE will continue to work closely with the Asian Development Bank and the World Health Organisation, One example of this successful cooperation was the recent joint conferenceÂ on Public-Private Partnership in Health â€śDeveloping Models, Ensuring Sustainability: Perspectives from Asia and Europeâ€ť, held in Manila, from 23-25 October 2012.
22 November 2012, Philippine Information Agency (PIA)
Health Secretary Enrique Ona, on behalf of the Philippine Government, and United Nations Economic Commission for Europe (UNECE) Executive Secretary Sven Alkalaj today signed a five-year Memorandum of Understanding (MOU) to further modernize the countryâ€™s health sector.
The MOU formalizes the partnership between the country and the UN agency to maximize the Public-Private Partnerships (PPP) strategy, recognized worldwide as an answer to a cash-strapped governmentâ€™s plan for reforms being done in the countryâ€™s health services, a statement from the Department of Health said.
The meeting between Ona and Alkalaj aims to strengthen cooperation in the area of PPPs.
The meeting also endorses the establishment of the Specialist Centre on Health in the Philippines as an integrated part of the government and will operate under the MOU between UNECE and Philippines.
During the meeting, discussions focused on cooperation in the area of public-private partnerships, particularly in the health sector, agenda of the newly-established Specialist Centre on Health in Manila within the overall framework of the UNECE International PPP Centre of Excellence.
The health sector reform under the current administration, named Universal Health Care or Kalusugan Pangkalahatan, is envisioned to expand and improve PhilHealth coverage and benefits, increase access to quality health care facilities, and implement program interventions with intended target clientele in mind.
The government of the Philippines plans to make the most of what public-private partnerships have to offer to modernize the countryâ€™s health sector. In this regard, close cooperation has been developed over the last years with the UNECE PPP program to build up capacity and share best practices.
As an example, the modernization of the Philippine Orthopedic Center is the first PPP project for health approved by the National Economic Development Authority (NEDA) earlier this year. NEDA is chaired by President Benigno Aquino.
â€śWith the MOU, we expect more investors to help us in fast-tracking the reforms that we intend to do so that our people can expect better and quality services from government health facilities,â€ť Secretary Ona said. (DOH)
02 November 2012, Philippine Daily Inquirer
by Rafael Castillo M.D.
Last week, the country hosted a gathering of experts on public-private partnerships (PPPs) in Manila which aimed to develop a sustainable model for healthcare delivery in countries like the Philippines.
The Asian Development Bank (ADB) and the United Nations Economic Commission for Europe (UNECE) have been at the forefront of healthcare PPPs worldwide and they organized this regional event in collaboration with the World Health Organization, Department of Health, PhilHealth and the Development Bank of the Philippines to offer fresh perspectives on PPP from Europe and the other Asia-Pacific countries. After all, one does not have to reinvent the wheel. Building on the success of other countries which have successfully carried out PPPs would make an ideal starting point.
Forging strategic partnerships with the private sector would definitely make a practical alternative to fill in the various public service â€śgapsâ€ť the government cannot possibly fill in adequately by itself.
â€śPPPs in the health sector can help meet infrastructure needs and improve service delivery,â€ť said Stephen Groff, ADB vice president for East Asia, Southeast Asia and the Pacific.
Last weekâ€™s summit on PPPs brought together policymakers, local and international health advocates, private health investors and local chief executives and the participants discussed the benefits, challenges and opportunities of PPP, especially in similarly situated countries like the Philippines.
The ADB is providing technical assistance to assist the Philippine government in developing and promoting PPP programs in the health sector, with funds donated by the Japanese government. Strategies to strengthen the PhilHealth to enhance its capacity to effectively deliver health services are also being developed.
Based on other countriesâ€™ experiences, PPPs have provided innovative, long-term contractual arrangements for developing infrastructure and providing public services through infusion of private sector funds and expertise in areas that are normally the responsibility of the government.
Foreign and local resource persons during the PPP summit shared their experiences and insights on how to effectively execute a successful healthcare PPP. We hope our health policymakers and decision-makers learned from the wealth of information and insights on PPP â€śbest practicesâ€ť during the regional event.
There is no question that PPPs would play a vital role in improving the quality of healthcare in the country and hopefully, improving access to it by the marginalized sectors of society. Whatever progress in healthcare delivery which the PPP could achieve would be meaningless unless it trickles down to those who need them most.
It can always be argued that it is the governmentâ€™s responsibility to ensure quality healthcare and make them accessible to the poor. But we have to be humble enough to accept the reality that this is not feasible despite the governmentâ€™s best intentions and efforts. Even Health Secretary Enrique Ona admits that the governmentâ€™s health budget allocation would never be enough to achieve universal healthcare.
Provided that PPP arrangements are planned and executed appropriately based on international â€śbest practices,â€ť there is no question that it can deliver what it promises to deliverâ€”quality healthcare for everyone including the poor. It will ensure that the poor do not only have an empty sense of assurance that they are PhilHealth members and carry its card, but that this membership will really entitle them to the healthcare benefits they need and assure them that there are enough facilities in the country to provide these services.
Objective assessment system
The PPP program indeed looks excellent as it is, but any plan is just as good as the manner it is executed and its effectivity in achieving the desired results. During the summit, Geoffrey Hamilton from the UNECE hit the nail on the head when he highlighted the importance of an objective assessment system to evaluate the success of any PPP. Such system for evaluating the performance of any PPP must be in place before making any long-term contractual arrangements, so there would be leveling of expectations and a mechanism to gauge whether itâ€™s doing as well as it was expected so the necessary adjustments could be made to improve it.
During the summit, an international PPP specialist center on health was launched. The center will be under the auspices of the DOH and will serve as the focal point in identifying, collecting, analyzing and disseminating best PPP healthcare practices worldwide. The center is a joint effort of the Philippine government and UNECE.
Itâ€™s quite unfortunate that just a few days after the successful PPP summit, close to a thousand government health workers staged a walkout to register their protest for PPPs, which are perceived and feared as a mere ploy to â€śprivatizeâ€ť government hospitals.
Itâ€™s really unfortunate that despite the governmentâ€™s earnest intentions and efforts, its own health workers seem not to understand and appreciate the beneficial role that PPPs could offer the country, especially the marginalized sectors. This highlights the importance of communicating this message clearly to all stakeholders including the government health workers and the public.
These stakeholders must be assured that the PPPs do not mean that the government is abdicating in its responsibility to its people including the poor. Itâ€™s just that the government is just being realistic and exploring alternative options to be able to deliver quality healthcare for all. We just have to trust the government that it will deliver this promise to everyone, especially the poor.
30 October 2012, Business Mirror
by Dr. Eduard P. Banzon of PhilHealth
FROM October 23 to 25, the Asian Development Bank organized and hosted â€śPPP in Health Manila 2012â€ťâ€”a regional conference on public-private partnerships for health. It is wonderful to see the health sector is more consciously beginning to seize the power of PPP to deliver better health for all. I say â€śconsciouslyâ€ť because health PPP isnâ€™t really new in the country for PhilHealth is essentially a PPP.
As the implementer of the National Health Insurance Program, PhilHealth is meant to collect and channel public funds to â€śpurchaseâ€ť care from health- care providers, including those from the private sector. In addition, we recognize that given the enormity of the task of covering all Filipinos and ensuring their true financial-risk protection toward universal health coverage (UHC), we look at them as our allies.
Whatâ€™s unique about the Philippine setting is that probably more than 60 percent of health care is delivered privately. While there are providers that are purely private, most of the time the delineation gets hazy as the two systems intertwineâ€”we have government doctors who also maintain a private practice, and private rooms and private pharmacies within government hospitals. Given that access to facilities, essential medicines and health professionals is at the heart of UHC, it is necessary for our private partners to be onboard.
And there are many strategies for private sector to step in. Beyond infrastructure and equipment, they can provide actual services and support programs. A good model is Planet Drugstore, a private pharmacy operating inside Ospital ng Makati. Planet not only ensures drug supply for admitted patients, but provides pharmacy-management services, which is admittedly a weakness of not just the Philippines but many governments around the world. Upon providing medicines to patients, Planet gets reimbursements through PhilHealth and allotted funds from the city government of Makati.
At PhilHealth, PPP has provided support for our benefits and programs. To name a few, our partners from the pharmaceutical industry have agreed to provide significant discounts to our members. The private sector has supported many of our events and programs, including the 2.17.13 PhilHealth Nationwide Run and information-dissemination campaigns.
Going back to the conference, I liked the analogy used that PPP is like a marriage. Just as a couple works toward a common goal of making the marriage work or building/sustaining a family, PPP works in the same way. Both the public and private sectors invest in the relationship and share their resources toward a common goalâ€”meeting the health needs of the Filipino people and attaining better health for all.
Both parties must recognize and respect each otherâ€™s uniqueness. Indeed, the private sector must be able to earn enough to cover their costs for an initiative to be sustainable. It is important to understand that financial viability is always a consideration. At the same time, the government pursues goals of equity and fairness, and is often called to extend preferential treatment to the poor who have many unmet needs. Iâ€™ve always believed that it is possible to find a sweet spot that balances these two goals, and it is in this spot that PPP actually thrives.
PPP means growing and learning from each other. Government can learn a lot from the innovative soul and entrepreneurial spirit of the private sector. At PhilHealth, Iâ€™m proud to say that our reforms revolve around imagination and innovation, which are keys to transcend the problems and bottlenecks that we encounter. We are also unafraid to step in where the market fails to provide the best outcome for our members. Contrary to popular thinking, government can be more efficient. This is why weâ€™re now designing PhilHealth Plus, a supplementary health-insurance scheme that would allow our members to gain more from their membership at a more affordable price. Indeed, this is where private sector can learn from us.
I cannot emphasize enough that PPP is integral for UHC to happen. I hope the private sector would heed this call, as this golden opportunity to do something great for the nation is not without bounds. Letâ€™s sit down and talk.