Jdidi Jihen, Mejdoub Yosra, Yaich Sourour, Ben Ayed Houda, Kassis Mondher, Fki Habib, Ayadi Ines, Damak Jamel
Tunis Med. 2017 Mar;95(3):160-167.
In a context of economic difficulties, the Tunisian government is required to find solutions to meet the expectations of the population. Health sector is one of the critical areas requiring radical reform. The objective of this paper is to find the place of public private partnership project in the harmonious development of both public and private sectors in Tunisia. Indeed, the Tunisian health system consists of two main sectors: the public sector, and the private sector, booming since the 90s. Tunisian infrastructure and staff resources distribution is characterised by a very significant regional disparity, to the detriment of the interior regions, which is more pronounced in the private sector. This area, considered innovative and responsive, captures the local wealthy clientele, and the foreign highly specialized care seekers. It wins over the best healthcare providers, inspite of some reported claims against pricing abuses leading to user's lack of confidence. As for the public sector under funded, handicapped by red tape and some forms of lack of transparency and lobbying, it can not cope with the influx of customers of poor and middle classes. The relationship between the two sectors misses often. The current challenge in the Tunisian health sector is how can public and private sectors combine and harmonize their efforts to achieve common interest objectives. The public-private partnership, is a process helping the state to involve private investors in the realization of public interest projects and develop long term contracts. So, the two sectors will share resources and technical expertise and will access to further advantages. However, it is essential to establish clear and effective legal and institutional frameworks governing private participation in the public sector.
在经济困难的背景下，突尼斯政府需要找到解决方案以满足民众的期望。卫生部门是需要进行彻底改革的关键领域之一。本文的目的是探寻公私合营项目在突尼斯公共部门和私营部门和谐发展中的地位。事实上，突尼斯卫生系统由两个主要部门组成：公共部门和自20世纪90年代以来蓬勃发展的私营部门。突尼斯的基础设施和人员资源分配存在非常显著的地区差异，这对内陆地区不利，在私营部门更为明显。这个被认为具有创新性和响应性的领域吸引了当地的富裕客户以及寻求高度专业化护理的外国患者。尽管有一些关于价格滥用导致用户缺乏信心的报道，但它还是赢得了最好的医疗服务提供者。至于资金不足、受繁文缛节以及某些形式的缺乏透明度和游说行为阻碍的公共部门，它无法应对贫困和中产阶级客户的涌入。这两个部门之间的关系常常出现问题。突尼斯卫生部门当前面临的挑战是公共部门和私营部门如何能够联合起来并协调努力以实现共同的利益目标。公私合营是一个帮助国家让私人投资者参与公共利益项目的实施并制定长期合同的过程。这样，两个部门将共享资源和技术专长，并能获得更多优势。然而，建立明确且有效的法律和制度框架以规范私人参与公共部门事务至关重要。
