This dissertation focuses on the findings of a multi-case study centered around two public-private partnership (P3s) projects in Ontario: the Royal Ottawa Hospital and the Brampton Civic Hospital. Partnerships have become particularly important as a part of infrastructure procurement for all levels of government in Canada. While infrastructure public-private partnerships have grown in popularity, they remain a controversial means of procuring public assets. Considerable questions remain as to whether the mechanisms related to partnerships with the private sector represent a sufficient response to the challenges facing health care systems. As such, major avenues exist for contributions in the form of evidence-based examinations to the field of knowledge pertaining to hospital procurement.
A body of research literature and review of public-private partnerships, including those with a particular focus on health-sector projects in Canada, has grown over the past two decades. This study contributes an analysis of the relationship between public and private partners to that literature, utilizing a conceptual lens developed out of complex evolutionary systems theory. The study is intended to examine the capacity of public managers entering into a public-private partnership arrangement to successfully activate agents and utilize the skill and knowledge of these agents, conduct joint fact finding and consensus building, and better understand how they have arranged and organized joint interactions between the public and private sector.
The two case studies demonstrate the key inputs into the decision-making processes for what were formative health infrastructure partnership projects in Ontario, providing an assessment of the degree to which the government of Ontario was successful in managing a cooperative decision-making process that stressed inclusion and horizontal steering. Results find that public managers struggled in some ways to leverage an effective horizontal management style and engage in smart interventions to utilize expert knowledge to address knowledge gaps, contributing to stagnating negotiations and driving up transaction costs for the projects. Some noteworthy successes were experienced in the case of the Royal Ottawa Hospital in leveraging private-sector knowledge to develop performance metrics, and the approach to stakeholder engagement in this case presents positive lessons-learned for future P3 infrastructure projects.
| Identifer | oai:union.ndltd.org:uottawa.ca/oai:ruor.uottawa.ca:10393/35319 |
| Date | January 2016 |
| Creators | Parsons, Blair |
| Contributors | Rouillard, Christian |
| Publisher | Université d'Ottawa / University of Ottawa |
| Source Sets | Université d’Ottawa |
| Language | English |
| Detected Language | English |
| Type | Thesis |
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