Healthcare public-private partnerships in Italy: Assessing risk sharing and governance issues with PESTLE and SWOT analysis

Healthcare infrastructural investments are a key strategic issue in countries such as Italy, whose aging population faces severe public budget constraints, exacerbated by the unprecedented recession. The choice between traditional procurement (TP) and Public Private Partnerships/Project Finance (PPP/PF) is by now a cornerstone of public strategies concerning complex infrastructural investments. PESTLE and SWOT strategic analysis provides a systematic and comprehensive reflection of the external and internal operational environment but has infrequently been applied to infrastructural procurement. Risk sharing between public and private actors and consequent corporate governance and ownership issues are still under-investigated in the literature, especially if associated with innovative PESTLE and SWOT instruments. Evidence shows that PESTLE and SWOT analysis improves procurement choices and public-private partnering, softening governance concerns. Since empirical considerations about Italy may be globally extended, even beyond the healthcare industry, the audience of this study may conveniently widen well beyond its apparently narrow focus.