IMPROVING HEALTH SERVICE DELIVERY THROUGH PPP AT LGU LEVEL

By Brillo Reynes, , Sr. Vice President, Development Bank of the Philippines

15 March 2011 Asian Development Bank

Disclaimer: The views expressed in this paper/presentation are the views of the author and do not necessarily reflect the views or policies of the Asian Development Bank (ADB), or its Board of Governors, Governors or the governments they represent ADB does not guarantee the accuracy of the data represent. included in this paper and accepts no responsibility for any consequence of their use. Terminology used may not necessarily be consistent with ADB official terms.

PPP DAYS 2012: DAY2 PLENARY 2

PPP at a sub-national level governance and implementation challenges Presentors: Nigeria, France, India, Mexico and the Netherlands State level & large local government units not very comparable to our LGU levels General observations only, specific PPP projects not discussed

PPP DAYS 2012: DAY2 PLENARY 2

For PPP to prosper at a sub-national level: Need to harmonize guidelines and make results
predictable among sub-national units Sub-nationals to adopt the tools from the Federal Government

Advantages of Sub-national PPPs g Faster dissemination of the PPP modus operandi Greater room for SME participation Insurance of leaders political life Constraints of Sub-national PPPs Difficult exercise need for a central unit Varied levels of knowledge need for TA

PH HEALTH CARE SERVICE Health Care one of the most devolved among public services Least understood among LGU officials and their constituents Most needed by local communities, esp. esp the poor segments of society

BENEFITS FROM PPP IN LGUs

Bridges financing gap makes public services available now, not later Frees up the IRA for basic infrastructure p needs complementary services Unlike loans does not tie up future loans, resource matching with beneficiaries Creates greater sense of accountability Value for Money Opens up opportunities for tapping local O t iti f t i l l private investors & investment funds

MAJOR CONSTRAINTS
PPP is a complex exercise a path less traveled, esp. at LGU level Market limitations countryside markets y are small coupled with low buying power Short time horizon of LGU officials no assurance of consistency of policies Halo Effect of corruption in govt Halo gov t private sector hesitant to engage Benefits are not obvious some are nonB fit t b i financial & hard to quantify

TO BREAK THROUGH
Networking with national govt agencies gov t experience, templates and supports Provision of technical assistance and advisory services Learning f L i from thfi d projects pathfinder j t document and disseminate knowledge Development of PPPH investment folios & conduct of PPPH conference for LGUs

TO BREAK THROUGH
Revisit devolution where LGU PPPH investments have strategic fit Adherence by LGU to high standards of governance and transparency Comprehensive approach include PPPH in strategies & address all dimensions Formation of local PPPH Team to ensure capabilities and learnings Communication plan Social Marketing to defuse anxiety and facilitate buy-in

STATUS OF PPPH @ LGU LEVEL

Two pathfinder p j p projects ( Samar & (N. Sarangani); possibly 2 more (Cavite & Bohol) Networking with NEDA PPP Center and with DOH PPP Working out w/ COA to address LGU concerns Establishing E t bli hi a PPP portal as we systematize t l t ti knowledge materials Developing a Social Marketing framework and communication materials Reviewing available time of Consulting Team to g g determine needed adjustments