Are Italian healthcare organisations paying too much for their public private partnerships?

Italy's Servizio Sanitario Nazionale (SSN) has developed Europe's second largest market for healthcare public private partnerships. In this paper, we describe the origins of private finance for SSN infrastructure, examine the programme’s scale and key characteristics, and provide a capital budgeting analysis of rates of return on 14 privately financed schemes. We demonstrate that excess returns are being made by investors on these projects, suggesting that there is potential for SSN procurers to achieve significantly better value for money than has been the case to date.