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.

Renaturing cities using a regionally-focused biodiversity-led multifunctional benefits approach to urban green infrastructure

If a ‘Renaturing of Cities’ strategy is to maximise the ecosystem service provision of urban green infrastructure (UGI), then detailed consideration of a habitat services, biodiversity-led approach and multifunctionality are necessary rather than relying on the assumed benefits of UGI per se. The paper presents preliminary data from three case studies, two in England and one in Germany, that explore how multifunctionality can be achieved, the stakeholders required, the usefulness of an experimental approach for demonstrating transformation, and how this can be fed back into policy. We argue that incorporating locally contextualised biodiversity-led UGI design into the planning and policy spheres contributes to the functioning and resilience of the city and provides the adaptability to respond to locally contextualised challenges, such as overheating, flooding, air pollution, health and wellbeing as well as biodiversity loss. Framing our research to encompass both the science of biodiversity-led UGI and co-developing methods for incorporating a strategic approach to implementation of biodiversity-led UGI by planners and developers addresses a gap in current knowledge and begins to address barriers to UGI implementation. By combining scientific with policy learning and defined urban environmental targets with community needs, our research to date has begun to demonstrate how nature-based solutions to building resilience and adaptive governance can be strategically incorporated within cities through UGI.

Preparing for disaster: a comparative analysis of education for critical infrastructure collapse

This article explores policy approaches to educating populations for potential critical infrastructure collapse in five different countries: the UK, the US, Germany, Japan and New Zealand. ‘Critical infrastructure’ is not always easy to define, and indeed is defined slightly differently across countries – it includes entities vital to life, such as utilities (water, energy), transportation systems and communications, and may also include social and cultural infrastructure. The article is a mapping exercise of different approaches to critical infrastructure protection and preparedness education by the five countries. The exercise facilitates a comparison of the countries and enables us to identify distinctive characteristics of each country’s approach. We argue that contrary to what most scholars of security have argued, these national approaches diverge greatly, suggesting that they are shaped more by internal politics and culture than by global approaches.