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THE UNDERSTANDING OF PUBLIC PRIVATE PARTNERSHIP IN HEATHCARE SECTOR 1. Definition of Public Private Partnership in Heathcare Sector

Dalam dokumen STATE AND DIGITAL SOCIETY (Halaman 130-134)

The term partnership covers a multi-dimensional continuum of widely differing concepts and practices, and is used to describe a variety of types of relationship in a myriad of circumstances and locations. As Lankshear in Osborn (2010) suggest that key terms like ‚partnership‛ are words

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that cross discursive boundaries, spanning multiple world-views, interests and value systems. They all carry positive connotations and name ideals to which people who embrace different – and often incompatible – aspirations, purposes, interests and investments claim allegiance. The OECD (2008) has defined partnerships as systems of formalised co-operation, grounded in legally binding arrangements or informal understandings, co-operative working relationships, and mutually adopted plans among a number of institutions. They involve agreements on policy and programme objectives and the sharing of responsibility, resources, risks and benefits over a specified period of time. This paper defined partnership as working relationships through co-operation in legally binding arrangements which involve agreements on policy and programme objectives and the sharing of responsibility, resources, risks and benefits over a specified period of time.

Partnership become an urgent way to public administration to meet public need and one of the model is public private partnership. Public Private Partnership (PPP) are becoming more popular as models governing the distribution of public goods and services. Savas (2000) stated the term public private partnership used in three different ways. First, it is use loosely to refer any arrangements in which the public and private sectors joint together to produce and deliver goods and services. Second, it use for complex, multipartner, privatized and infrastructure projects. Third, it refers to a formal collaboration between business and civic leaders also local government officials to improve the urban condition

Forrer, Kee, et, all (2007) explained that PPP is also developed as solutions to overcome the problems and needs of governments. This is because the private sector has the ability to maximize the value of money through lower financing (Andrews & Entwistle, 2010). Partnering with the private sector means using its expertise, efficiency, innovation and risk sharing in the execution of public works for the quality of public services and facilities can be improved (Cheung, 2009). The understanding of public private partnership on this paper refers to an arrangements in which the public and private sectors joint together producing and delivering goods and services to overcome problems and needs of governments by private expertise to improve the quality of public services.

2. The Important of Public Private Partnership

There are some points regarding to the importance of Public Private Partnership (PPPs). The public demand of high quality heath service is increase. This public demand leads PPP as an urgent in healthcare sectors, because its complexity must be handled accurately and the best policy to take is PPP Heathcare. Some of literature stated that innovation, sustainability, efficiency and accountable, represent the importance and the urgency of Public Private Partnership in Heathcare Sector.

Innovation in the public sector should be understood as a radical departure from old solutions and that the new solutions have to be sufficiently radical to bring about irreversible changes in core tasks (or routines) in public sector organizations (Lember, 2014). Related to the

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organizational perspective, innovations are found to be crucial in the public sector and facilitate or determine radical change in organizations: new kinds of regulation, public infrastructure, social relationships, and governance mechanisms (including PPPs)

Public Private Partnership (PPPs) is more than an ordinary collaboration. One of key concept of PPP is innovation that the public sector and the private sector have to come up with new solutions and ‘work together or achieve a common purpose (Hodge and Greve, 2011). To create innovation, PPPs are associated with policies on how the government should interact with the private sector in order to improve public services.Innovation through PPP identifies as an inherent quality of private sector involvement to bring new ideas, knowledge, competencies and resources (Lember, 2014). (Innovation OK)

Sustainability is the long term stability of the economic and environment which is only achievable through integration and acknowledgement of economic, environmental and social concern by decision making process. The key principle of sustainable development underlying all others is the integration. Partnership is perceived as a form of intensive interaction among organizations targeted at implementation of political, economic, social programs and at solution of problems.

The relation in partnership partly oriented on sustainable development (Raišienė, 2012).

Sustainability makes improvements to the total quality of life, both now and in the future, in a way that maintains the ecological processes on which life depends while satisfying the needs of all stakeholders (Gray and Stites, 2013)

The private sector is widely regarded as enjoying a number of resources that may benefit public service delivery. Andrews & Entwistle (2010) stated that the benefits of public-private partnership will be most apparent in the efficiency dimension of performance. This statement contain two reasons, first, private sector organizations operate in an economic environment of contestable resource markets. Second, the efficiency argument maintains that private sector organizations typically benefit from less ‘‘red tape‛. So the private sector costs remained significantly lower than costs in all other sectors. (efficiency teori- ok!)

Accountability has become a prominent political catchword to serves a rallying cry for civil society organizations aiming to control the actions of governments, international organizations and corporations and is used by those who want to create a positive image for their organization (Steets, 2010). Adopted from Merriam-Webster by Steets (2010) accountability is the quality or state of being accountable; especially: an obligation or willingness to accept responsibility or to account for one’s actions. Accountability in the partnership consists of accountability for finances, accountability for compliance with rules and processes; and accountability for results.

3. Barriers in Public Private Partnership

Partnerships may not achieve the potential for synergy because of some barriers in achieving effective and efficient partnerships (Osborne, 2010). Some barriers are:

a. Conflict over goals and objectives. Many partnerships have agreed broad aims, but their detailed goals may be unclear or have differing understandings of what the goals mean. This

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can be lead to misunderstanding, lack of coordination, and possible conflict between the partners.

b. Resources costs. There are considerable resources costs in partnership, for instance in terms of staff time in meetings, discussions, consultation with partners.and making agreements. If all partners do not agree, it might be difficult to close an inefficient or unsuccessful partnership, or even one whose objective has been achieved.

c. Power Relation. The handling of differences in the relative power of different bodies in a partnership is important to its success. In most partnership there is a degree of unequal power but it should not imply that all partners should necessarily have equal power.

d. Organizational difficulties. It inhibiting successful coordination of programs and approaches, and overcoming the specialist concerns of disparate organizations, is a key implementation problem faced by agencies working together. Within this context, barriers to effective partnership working include: organizational, political, legal and technical of organization

Farazman (2004) identify the potential obstacles for every partnership which are appearing in a variety of forms bellow:

a. Distrust, it is even much more problematic in governance because it involves a variety of political issues.

b. The widening gap between the North and South nations, and the disparities that also exist within each category of nations.

c. The tendency of certain power structures by making the dominated partners mere subservient members of the partnerships.

d. The higher expectations trough partnerships, making dependency problems worse when responsibilities are transferred to weaker parties or to stronger parties should carry this burden.

e. Potential environmental conditions, ranging from political and ideological to economic and social spectrums.

f. Cultural and religious obstacles can cause major impediments to effective partnerships at all levels of governance.

g. Ethnic and racial differences that can pose serious obstacles are factors that should not and must not be underestimated.

4. The Strategies of Public Private Partnership

Strategies needed to gain the aim of public private partnership. Several strategies can assist in building and sustaining effective partnerships, include PPP by Farazman (2004), and the strategies explain below:

a. Adaptive strategies inform governance actors to accurately read their changing environmental dynamics and consider strategic choices in partnership building, maximize chances of successful governance and avoid being behind the state-of-the-art in governance and in the

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ecology of governing systems. This strategy requires modification and compromise in approaches to partnership building without compromising principles.

b. Proactive strategies are very effective if they are genuinely pursued for mutual interests and based on mutual respect and cooperation. The strategies need (a) genuinely involve actors of civil society and share power and responsibility to enhance governance process, or (b) build alliances for dominance, aggression, and control of governance domains at all levels.

c. Reactive strategiesare the opposite of partnership building. They are a reaction to chains of events or the effects of actions, causing the necessity for partnership building. Reactive strategies may or may not become necessary as a reaction to adversarial or competitive actions.

d. Accommodative strategies are approaches to partnership building that aim to manage and reconcile conflicting interests and that would prevent tensions or escalation of contradictions.

e. Neutralizing strategies are deliberate attempts by governments to neutralize oppositions and potential threats. It is not a strategy of appeasement, but rather a strategy of disarming the adversaries and opportunists.

Dalam dokumen STATE AND DIGITAL SOCIETY (Halaman 130-134)