Effective contract structures and value for money in PFI social housing projects

In the last 20 years the UK has witnessed a continuous evolution in the use of private finance for the procurement of public infrastructure and services. social housing is the new frontier in utilising PFI in the provision of public service. Private involvement in social housing is complicated by the highly social nature of the sector. Given the often conflicting objectives between the public and the private sectors, the challenge is to structure PFI projects in such a way that they are viable to both parties. Due to the private sector need for confidentiality research to date has been severely constrained by having access to only one of the stakeholders resulting in only a partial understanding of the risk allocation and risk sharing procedures in PFI. This PhD research had the unique and unprecedented opportunity to access confidential .' , data including contracts, financial models on one of the first social housing PFI projects. The Grove Village PFI pathfinder has transformed the run-down housing estate from a crime-ridden place to a vibrant community. Empirical data accessed was utilised to build a detailed and exhaustive case study of the internal processes of the project to extract the key differences between the risk perceptions of different project parties and explain how competing objectives of the project parties were reconciled. The research revealed several facts in the development of social housing PFI projects that reduce value for money and developed mechanisms by which parties can reconcile the differences that exist between them. The research provides evidence on how PFI projects can maximise value for money for the various stakeholders involved.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

USE OF PROVISIONAL SUMS IN THE UAE CONSTRUCTION INDUSTRY: AN EMPIRICAL STUDY

Provisional sums are widely used in the FIDIC (Red Book) forms of contract in the UAE construction industry. The practices on dealing with provisional sums have exposed the contracting parties to a number of risks. Therefore, this research aimed at identifying such risks and mitigation measures to limit such risks in using provisional sums in the UAE. The research started with a comprehensive literature review followed by a questionnaire survey among the UAE construction industry professionals. Based on the survey findings, six semi-structured interviews were conducted with expertise in the construction industry to verify the survey findings and close any gaps in the data. The study found that provisional sums are mainly used in the FIDIC (Red Book) forms of contract in the UAE for special works, contingencies, the works which can be only defined in the site, facilitating the appointment of nominated subcontractors and overlapping design and construction. The most common risks of using provisional sums are related to claims, variations and conflicts among the contracting parties. Defining the scope of provisional sums before tendering, incorporating the provisional sums into the project programme and limit the value of provisional sums in the contract are suggested as the key measures to minimize the risk of provisional measures

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially