Mechanisms for implementing public-private partnerships in the healthcare sector: EU experience

doi:10.26565/1992-2337-2025-1-34

Tikhon Yarovoi Institution «University of Transformation of the Future», 28 Remisnycha Street, Chernihiv, 14000, Ukraine https://orcid.org/0000-0002-7266-3829
Oleksiy Sidelkovskyi Zhytomyr Polytechnic State University, 103 Chudnivska Street, Zhytomyr, 10005, Ukraine https://orcid.org/0000-0002-4139-4478
Yulia Kononenko National University of Civil Protection of Ukraine, 94 Chernyshevskaya Street, Kharkiv, 61023, Ukraine https://orcid.org/0009-0000-3721-5978

DOI: https://doi.org/10.26565/1992-2337-2025-1-34

Keywords: public-private partnership, healthcare, implementation mechanisms, public administration, medical infrastructure, public-private cooperation, management efficiency, strategic partnership, public policy, healthcare services, foreign experience, EU experience

Abstract

The article is devoted to the study of the mechanisms for implementing public-private partnerships in the healthcare sector, taking into account the experience of the European Union countries. The article analyses the theoretical and legal foundations of PPP as a form of public-private interaction, defines its basic principles, legal nature and structural features. Attention is drawn to the difference between PPP models and classical forms of public order, and the long-term and mutually beneficial nature of such relations is emphasized. It is substantiated that PPPs ensure the integration of resources, expertise and management potential of the private sector into the implementation of socially significant projects in the healthcare sector.

The comparative analysis of national models of PPP implementation in the healthcare sector in France, Germany, Italy, Spain, and the United Kingdom is noteworthy. The article identifies the specific features of approaches to management, financing, contract forms and distribution of responsibilities in different countries. It is summarized that most models are based on the principle of separation of clinical and administrative functions, transfer of operational management to a private partner, while maintaining strategic control by the state. The author demonstrates how the introduction of a system of contractual obligations, performance audit and public monitoring has contributed to the achievement of high quality standards and economic sustainability.

The key legal acts of the European Union and international regulatory sources that form the legal framework for PPPs are highlighted. The provisions of Directive 2014/23/EU on concession contracts, UNCITRAL recommendations and other universal acts that define the principles of transparency, accountability, managerial efficiency and prevention of conflicts of interest are analyzed. The author emphasizes the role of institutional stability of legal regulation in ensuring investor confidence and creating a predictable regulatory environment. The author substantiates the expediency of implementing the European experience into the Ukrainian legal space, taking into account national realities. The author proposes directions for improving Ukrainian PPP legislation, in particular, in the healthcare sector, which should contribute to increasing investment attractiveness, management efficiency and quality of medical services. The author points out the prospects of using complex contractual models with integration of the functions of design, construction, financing and operation of medical institutions.

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Author Biographies

Tikhon Yarovoi, Institution «University of Transformation of the Future», 28 Remisnycha Street, Chernihiv, 14000, Ukraine

Doctor of Science in Public Administration, Associate Professor, Professor of the Department of Public Management and Administration, Higher Education Institution «University of Transformation of the Future»

Oleksiy Sidelkovskyi, Zhytomyr Polytechnic State University, 103 Chudnivska Street, Zhytomyr, 10005, Ukraine

Doctor of Juridical Sciences, Associate Professor, Professor of the Department of Law and Enforcement Activity, Zhytomyr Polytechnic State University

Yulia Kononenko, National University of Civil Protection of Ukraine, 94 Chernyshevskaya Street, Kharkiv, 61023, Ukraine

PhD candidate, National University of Civil Protection of Ukraine

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