Public private partnerships for hospitals

Abstract

Despite the growing prevalence of Public–Private Partnerships in healthcare, scholars have paid little attention to their consequences for the workforce. Public–Private Partnerships may have important consequences in labour-intensive services such as healthcare, since staff reductions and higher working loads may lead to a decrease in service quality and patient safety. In this paper, we analyse the extent to which Public–Private Partnership schemes have influenced employment in Madrid, one of the most enthusiastic adopters of Public–Private Partnership models in Spain. To do so, we compare clinical staff employment levels across three types of hospital management models, including two types of Public–Private Partnerships. Our findings illustrate that clinical staff employment levels seem to be substantially lower in Public–Private Partnership hospitals than in directly managed public hospitals, particularly as regards nursing staff, and in those types of hospitals where the private sector manages both clinical and non-clinical staff.