Public-private partnerships and efficiency in public procurement of primary healthcare infrastructure: a qualitative research in the NHS UK

Aim There is growing interest in the contribution of public-private partnerships (PPPs) bridging the shortage of financial resources and management expertise in developing public healthcare infrastructure. However, few studies have evidenced PPPs’ ability in increasing efficiency in public procurement of primary healthcare infrastructure. The aim of this study was to assess to what extent PPPs would increase efficiency in public procurement of primary healthcare facilities. Subject and Methods A qualitative analysis, adopting a realistic research evaluation method, used data collected from a purposive sample of public (n=23) and private sector staff (n=2) directly involved in the UK National Health Service Local Improvement Finance Trust (LIFT). Results We find a positive association of LIFT helping to bridge public sector capital shortages for developing primary care surgeries. LIFT is negatively associated with inefficient procurement because it borrows finance from private banks, leaving public agencies paying high interest rates. The study shows that some contextual factors and mechanisms in LIFT play a major part in obstructing public staff from increasing procurement efficiency. Conclusion PPP’s ability to increase efficiency may be determined by contextual factors and mechanisms that restrict discretion over critical decisions by frontline public sector staff. Developing their capacity in monitoring PPP activities may make partnerships more efficient.

Development and Progress as Historical Phenomena in Tanzania: “Maendeleo? We Had That in the Past”

Academic discussions of development continue to grow, yet critical engagements with communities affected by development interventions remain limited. Drawing from life history interviews conducted in southern Tanzania, this article details the varied experiences of development interventions among older people and how these affect broader understandings of progress. Many juxtapose their negative views of ujamaa villagization with more positive recollections of previous interventions (especially the Groundnut Scheme), which are infused with what is described here as “development nostalgia.” Perceptions of the past clearly inform the social, political, and economic aspirations forwarded today, with the richness of the constructed narratives adding further nuance to existing depictions of Tanzanian historiography.