This book considers the use of Public-Private Partnerships (PPPs) in the delivery of physical assets, infrastructure and technologies and related clinical services, in the health sector. The PPP model represents the most complex form of contracting transaction yet to have emerged in the health...

<title>Abstract</title> The return on capital is a major contributor to the cost of design, build, finance and operate (DBFO) contracts, under which public infrastructure is financed and delivered by private companies. The article presents a method for evaluating the rates of return targeted by bidders and...

<title/> The public expenditure implications of PFI projects in Scotland's NHS are substantial. This article compares PFI capital expenditure with projected unitary charges, examines the annual cost of existing PFI schemes and looks at future costs arising from the planned expansion of PFI. Unless the...

Italy's health service—the Servizio Sanitario Nazionale (SSN)—has developed Europe's second largest market for healthcare public--private partnerships. This article describes the origins of private finance for SSN infrastructure, examines the programme's scale and key characteristics, and...

Leasing allows organizations to procure fixed assets without the need for upfront investment, and can be an attractive option for public authorities. This article describes the pattern of public sector demand for leases in Italy. While leasing is widely regarded as a model with the potential to...

There is a growing need for investments in hospital facilities to improve the efficiency and quality of health services. In recent years, publicly financed hospital organisations in many countries have utilised private finance arrangements, variously called private finance initiatives (PFIs),...

In this timely Handbook, leading scholars from around the world explore the challenges presented by infrastructure PPPs, and contemplate what lies ahead as governments balance the need to provide innovative new infrastructure against the requirement for good public governance. This Handbook...

This paper is concerned with the cost-efficiency of Private Finance Initiatives (PFIs) in the delivery of hospital facilities in the UK. We outline a methodology for identifying the “fair” return on equity, based on the Weighted Average Cost of Capital (WACC) of each investor. We apply this...

The global financial crisis had a major impact on the cost and availability of finance for infrastructure-based public-private partnerships (PPPs). In response, policy-makers have introduced models of 'credit-enhancement' that aim to reduce the risk faced by private investors and attract...