PPPs for PHC: the case of Ireland

EIB funding PHC strengthening through PPP: environment clauses

It starts to look as though your Decide Hub is undertaking a tour of the Celtic lands to check their health policy towards PPPs.

Decide informed you extensively about the progress of the Mutual Interest Models or MIMs in Wales (click here to read the news). Insight was also shared about the behemoth investment in a health PPP in Scotland (click here to read more).

Brittany and Galice can wait as now is the turn of Ireland to draw attention onto its PPP agenda. Thanks to the European Investment Bank, a network of Primary Health Care centres was built to improve access to quality health and social services across Ireland. The PPP model preferred by the Irish health authorities and the EIB comprised:

the design, build, finance, maintenance and facilities management of 14 Primary Care Centres (PCCs) on greenfield and brownfield locations owned by the Government of Ireland in the four main Health Service Executive (HSE) regions of Ireland.

A particular attention was paid at the outset of the project in 2015 to the environmental and social clauses, which gave way to a monitoring mechanism worth mentioning. In 2021, the EIB published a Environmental and Social Completion Sheet (ESCS) taking stock of the impact of its project as regards these two considerations (click here to access the monitoring sheet)

At a time where PPPs are increasingly under scrutiny to demonstrate their added value in terms of contribution to environmental, social, employment, local development and even gender-balance policies, this monitoring system implemented early on may prove inspiring.

As an after-note which has its importance, it is worth remembering that the use of PPPs to strengthen networks of PHC facilities is not necessarily new: German development bank KfW used it in India in the early 2000’s.

It is also the same dynamic prevailing behind the Local Improvement Finance Trust (LIFT), a UK programme aiming at refurbishing PHC facilities in view of the staggering conclusion 15 years ago that nearly 80% of all NHS PHC facilities were not fit for purpose.