A RETROSPECTIVE ON THE DEVELOPMENT OF MECHANISMS FOR IMPLEMENTING PUBLIC-PRIVATE PARTNERSHIPS IN THE HEALTHCARE SECTOR

Abstract

The article is devoted to the study of the process of formation and development of mechanisms for the implementation of public-private partnership in the healthcare sector of Ukraine in a retrospective perspective. The article analyses the historical stages of evolution of institutional, legal and organizational frameworks that have led to the transformation of relations between the public and private sectors in a sensitive social sphere. Particular attention was paid to the context of healthcare system reform, in particular, the introduction of the ‘money follows the patient’ principle and the participation of the National Health Service of Ukraine in creating conditions for a contractual financing model, which opened up new opportunities for attracting private healthcare institutions.The author highlights the main regulatory and legal milestones in the formation of public-private partnerships in the healthcare sector, including the adoption of the Law of Ukraine ‘On Public-Private Partnership’, as well as the consistent expansion of the regulatory framework through changes to budget, commercial, tax and municipal legislation. The importance of decentralization of power as an institutional prerequisite for strengthening initiatives at the local level is revealed, which has provided greater autonomy for self-government bodies in launching partnership projects.The key challenges that accompanied the process of private sector integration in the healthcare sector were investigated, including legal uncertainty about risk allocation, weak contractual culture, lack of specialists in partnership project management, and insufficient regulatory detail of typical models of interaction. Particular attention was paid to the change in focus from the economic logic of partnership to the security logic, which led to increased requirements for transparency, capital origin, digital data protection tools, and operational management of medical risks in wartime. Practical cases of cooperation in the areas of telemedicine, mobile hospitals, logistics and outsourcing of ancillary services are systematized.It is determined that public-private partnerships in the medical sector have gradually transformed from a tool for targeted infrastructure modernization into an integral element of national sustainability, capable of providing a prompt response to crisis challenges, reducing the burden on the budget and introducing innovative technologies in the field of healthcare.