PPPs: inter-actor relationships two cases of home-based care services in China.

Yu, Jianxing ; Qu, Zhiyuan

INTRODUCTION

Over the past 30 years, initiatives have been taken throughout the world to seek alternatives to traditional methods for the provision of public services. PPPs, an important tool for government reform, have been increasingly implemented since the 1980s (Gibelman and Demone 1983) and have become popular institutional arrangements for supplementing or replacing traditional supply models of public services.

At present, the definition of PPPs remains ambiguous. Some define PPPs in a narrow sense as private investment in public infrastructure, and this has become the focus of most existing research. Others consider PPPs to be a middle way between state and privatization (Leitch and Motion 2003). Savas broadly defined PPPs as any relationship between the public and private sectors, or any arrangement under which the private sector takes up actions traditionally performed by the public sector (Savas 2002: 105). His definition covers almost everything with public and private features, including such arrangements as contract system and joint operation. This paper utilizes a broad definition: PPPs are agreements between the public and non-public sectors, in which the non-public sector participates in public service decision-making, directly or indirectly provides services, and shares risks with the public sector. (1)

The division of public service delivery subjects into providers and producers can be traced back to the late 1950s (Musgrave 1959). Later, the multiple service provision model was put forward (Savas 2002: 69). The service provision under administrative orders model was gradually replaced by the provision through market allocation based on competitive contracts model. As a result, the relationship between the public and private sectors was reconstructed. The multiple service provision model required cross-sector partnerships and collaboration and targeted integration between the public and non-public sectors. PPPs then emerged as institutional arrangements to address these issues (Jamali 2004).

The strengths of PPPs include reduced input cost, improved operational efficiency, better service quality, risk sharing, and maximum use of existing resources and competition. As an innovative path for public service provision, PPPs can bring about more new resources and competition (Domberger and Jensen 1997, Pongsiri 2002, Bovaird 2004). In PPPs, government is increasingly dependent on the external environment to fulfill its mission of providing public services. Most of this work must be completed by coordinating complex inter-actor relationships. The majority of government employees are not in direct contact with personnel responsible for public service provision. The traditional approach of acting alone features limited impact, but the expertise of the public and non-public sectors can complement and balance each other (Linder 1999). Besides, increased efficiency of individual organizations is not equal to the improved overall service of PPPs (Provan and Milward 1995). This may be due to the other organizations' reduced efficiency, or to the poor coordination of different organizations. Government no longer relies solely on traditional hierarchical authority or itself to provide public services (Rhodes 1996), but more on a variety of collaborations and partnerships to establish a network to achieve the goal of public service provision. It's the establishment of reasonable partnerships that can guarantee the strengths and successes of PPPs.

Although Savas included various forms of PPPs in the multiple institutional arrangements for public service provision (Savas 2002: 69-91), he failed to analyze in depth how PPPs should be established. Cooper managed to deepen his research into the quality level in contract management (Cooper 2007: 5), but he ignored that excessive reliance on regulatory management and control, such as special inspection and regulations, might cause confrontations between subjects in the collaborative network, for in this case the principal aimed to find errors, but not to improve partnerships (Goldsmith and Eggers 2004: 106). Most infrastructure PPPs focused much on financing methods and cooperative relationships, such as JV, BOO, BOT, BOOT, DBF, DBFO, DBFOT (Grimsey and Lewis 2008: 54), but the formation mechanisms of partnerships between the public and private sectors were not discussed. Nor was any comparative study of social organizations and the private sector conducted. Research into the efficiency of individual organizations and the efficiency of public service provision started early and much has been accomplished. Few scholars, however, have studied inter-actor relationships in PPPs, which, in fact, exert great influence on the success of PPPs projects and the quality and efficiency of public service provision.

Therefore, this paper examines the features of the ideal type of inter-actor relationships in PPPs. By examining and comparing two PPPs projects on elder care services in China, this paper aims to acquire more information on non-infrastructure PPPs projects, compare the differences between social organizations and the private sector, enrich PPPs theory with Chinese practices, and provide new proof to the construction of inter-actor relationships in PPPs.

IDEAL TYPE OF INTER-ACTOR RELATIONSHIPS IN PPPS

Bartlett and Grand maintained that a competitive market, a perfect information system, low transaction costs, effective incentives, and supervision mechanisms were indispensable to the success of collaborative networks among public service providers (Bartlett and Grand 1993: 13--34). Huxham even concluded that only when all the participants in PPPs were clear about how to obtain "collaborative advantages" with their partners could the partnership as a whole have competitive advantages over other partnerships (Huxham 1993). Government is no longer confined to its conventional role. It needs to handle its relationship with other subjects, and coordinate the relationships among other subjects in the network (McGee 2001). The above elaboration indicates that good inter-actor relationships in PPPs consist of, at least, two parts. First, a good institutional environment is essential. Government must not only make good rules, but also follow the rules, as good rules help to regulate partners' behavior, ensure contract performance, avoid monopoly, and reasonably share risks. Meanwhile, good rules also regulate the public sector's behavior. Second, the subjects of PPPs collaborate, build a platform for trusted partnerships to increase the confidence among partners, bring into play the strengths of each sector, and ensure the effective operation of PPPs. Therefore, we believe that the ideal type of inter-actor relationships in PPPs should, at least, include the following principles.

Power Sharing, from Control to Consultation

By examining the European experience in PPPs infrastructure projects, Broadbent and Laughlin proposed political will as a core element in PPPs projects (Broadbent and Laughlin 2004). This is true, not just in Europe or of PPPs infrastructure projects, but it is a universal issue faced by any PPPs project in any country. In PPPs, "partnership" inevitably requires sharing power, achieving common goals through the integration of resources and professional skills, and sharing accountability.

In other words, in the decision-making process for public services or goods provision, the public sector and the non-public sector first need to jointly identify the type, quantity, and quality of the public services or goods, plan the provision approach and process of delivery, set common targets, and consult on indicators and methods for performance appraisal. This is because standards unilaterally set by the public sector, to a large extent, are no more than the requirements for its partners, but are not the common goals.

Transparency, Information Sharing

Market-based competition may undermine information flow in the collaboration system in PPPs, and the information is often incomplete and asymmetric. Competition enables subjects to be aware of keeping their own information confidential, which substantially reduces the possibility of open collaboration. Even worse, the government's understanding of partners' defects increases as time goes by, and the financial performance of an individual subject remains unknown until it is time for the subject to declare bankruptcy. Such a consequence will adversely impact the subject selection, efficiency, and quality of public service provision. Ensuring efficiency through competition instead of government's internal control, is problematic, because structural risks caused by the absence of government's internal information, control, and free outsourcing make it more likely for government to ignore political accountability. Meanwhile, the collaborative network also requires the government to be more capable of information communication. This is because, on the one hand, network communication and power sharing will encounter various barriers (Bardach 1998: 131-134), and, on the other, the information systems of the subjects in the collaborative network need to be compatible for information communication.

Accountability Sharing

According to the World Development Report 2004: Making Services Work for Poor People, "accountability," a core concept of public service delivery, refers to the relationships among different participatory subjects. It consists of short and long routes of accountability. Short route accountability means to pass decisions and powers directly to citizens or clients. It generally is based on transactions through which citizens directly voice their service requirements to hold service providers accountable and supervise the service delivery and performance of service providers. The long route accountability, in contrast, refers to the control mechanism, which includes the voice used by citizens to hold the state accountable, and the compact between the state and service providers (World Bank 2004: 46-52). This indicates that, although government passes part of their accountability to its partners in PPPs, it is still held accountable for public service delivery. Thus, the public sector, together with its partners, is required to ensure the effect, quality and quantity of public services or goods delivery, and to safeguard public access to the services or goods.

Desire to Cooperate: Trust, Fairness, and Mutual Respect

Non-public and public sectors enter into the PPPs for different reasons (Posner 2002: 523-551) and with substantially different aims. For example, the public sector aims to employ private sector's capital and technology and introduce the third sector to prevent "government failure" and "market failure," share risks with the non-public sector in order to guarantee better delivery of public services or goods. The private sector, on the other hand, mainly aims to win support from the public sector and make profits. The aim of the third sector is similar to that of the public sector, but the third sector still aims to ensure its survival and independence. The multiple aims of the public sector and the non-public sector need to be integrated though consultations (Pongsiri 2002). It is very important in public service provision to coordinate the subjects' values (Warner and Hefetz 2008), relations, and behaviors.

Therefore, the successful operation of PPPs projects requires the subjects to integrate and fully respect subjects' aims. Meanwhile, the subjects require fair treatment, and the trust among the subjects should be cultivated (Spackman 2002).

Partnership-Based Performance Appraisal

Performance appraisal of PPPs helps to build mutual trust among personnel with different purposes and backgrounds, to involve administrators on both sides in the appraisal, continuously to improve organizational outcomes and enhance partners' accountability (Forrer, Kee, Newcomer and Boyer 2010). Nevertheless, outputs and appraisal results will vary dramatically due to the complex and multidimensional nature of PPPs along with different appraisal criteria. For instance, some people may applaud PPPs and acknowledge their success, because of the reduced cost of infrastructure and timely delivery, while others may criticize PPPs due to low wages and inefficient operating performance. The current performance appraisal of infrastructure projects focuses on two criteria: reduced government expenditure and timely delivery. Neither involves appraisal or satisfaction of the general public. Therefore, the PPPs often are considered successful due to explicit appraisal criteria. It seems inadequate to appraise PPPs performance in education, health care and other areas according to the above-mentioned two aspects, however, because the services in these areas are multi-dimensional. Besides, public satisfaction with services may be more influential for the success of these PPPs projects. Bovaird (2004) pointed out that, from the perspective of public governance, the performance of PPPs should be appraised at the level of partnership, rather than simply at the agent level. He also said that it was rather risky to assess whether the contribution of a single partner was in line with the principle of cost saving. He added that a more appropriate approach was to examine whether agents made the partnership work well, and whether agents could do better (Bovaird 2004).

In brief, the ideal type of inter-actor relationships in PPPs requires not only the institutions that regulate subjects' behaviors, but the elements that facilitate the formation of the collaborative relationship, including these five principles: power sharing, information sharing, accountability sharing, desire to cooperate, and partnership-based performance appraisal. The cases in China are examined and compared to validate the application of the above principles in practice. Meanwhile, social organizations and the private sector are compared to figure out the possible differences in the approaches, depth and scope of applying the above principles in the cases.

CHINESE PRACTICES: EXAMINATION AND COMPARISON OF TWO CASES OF HOME-BASED CARE SERVICES

As society has aged, different approaches to social care service delivery have emerged. Many elder care institutions cannot meet the growing demand due to financial pressures. In the estimate of civil affairs departments, an elder care institution with basic functions involves an early-stage investment of RMB 50,000/bed, plus daily operations costs of RMB 250-350/month for each bed. Over recent years, home-based care has become an important supplement to institutional and family care and has become a focus of attention.

This paper examines and compares the home-based care services provided by the PPPs of Ningbo Haishu District Government and Starlight Elderly Care Association, and the PPPs of Hangzhou Municipal Government and YTONE, in particular the partnerships of two different natures. PPPs in developing countries, such as China, have potential space for existence. Social organizations, other than the private sector, also can become government's partners. The partners' nature is not, however, the necessary condition for the success of PPPs projects. More importantly, success lies in how government coordinates its relationships with partners.

Home-Based Care Services Provision in Haishu District, Ningbo (2)

Background and details. Haishu District is located in Ningbo City and had a registered population of 302,384 at the end of 2010. By March 2011, senior citizens over the age of 60 in Haishu District totaled 54,000, including 26,000 empty-nest solitary elders, accounting for 46.4% of the elderly population. As the population aging accelerates, the family's function in elder care is weakening. Institutional care services feature limited coverage and high costs, exerting great pressure on government finances. At present, it takes at least four years for the elders in Ningbo to have their applications for access to elder care centers approved. By contrast, the cost is much lower if the government provides basic care services to solitary senior citizens in collaboration with the non-public sector.

In March 2004, seventeen communities in Haishu District were selected to carry out pilot work on social home-based care services. The work was welcomed by all sectors of society. Then, in May, the Haishu District proposed establishment of a new social home-based care service system in accordance with the idea of "government supports, nonprofit organizations operate, and society participates." After March 2005, the PPPs model for home-based care services were promoted in sixty-five communities in Haishu District. Haishu District Government bought home-based care services from a nonprofit organization--Starlight Elderly Care Association. The communities selected the home care attendants who would provide home services one hour per day for the solitary elderly and those with difficulties. Most attendants were unemployed people in the communities. The services included life care, medical rehabilitation, and mental comfort. All senior citizens in the area with difficulties or who were living alone could receive these services. Currently, about 600 senior citizens receive the services. The average annual cost of these services amounts to RMB 3,285 per person. A reserve fund of 5% of the financial allocation was established. Haishu District Government also built elder day care centers in communities, helped the elders to move about and go out of their homes during the daytime, and provided day-care services, including meals, rehabilitation, recreational activities, and educational activities.

Inter-actor relationships. Haishu District Government set up a leadership group for the implementation of home-based care services. Its major task was to improve the care service systems at district, neighborhood, and community levels. The Vice District Director in charge of elder care work served as the group director, and the Director of District Civil Affairs Bureau and President of a nonprofit organization--"Haishu District Starlight Elderly Care Association"--served as the deputy group leaders. The district government included the cost in its financial budget, annually allocating RMB 1.5 million (RMB 1.2 million for the daily one-hour service of 600 senior citizens, and RMB 300,000 for the operation of the association). As the minimum wage and consumption costs increased, the Haishu District Government increased the service budget to RMB 2,400 per person per year beginning in 2007. In 2008, coverage was extended to those with difficulties or living alone (empty nest) aged 75 and above, instead of beginning at age 80. In the light of actual circumstances, more people, including the poor elders in the grip of illnesses and those unable to take care of themselves or totally unable to take care of themselves, were included in the list service targets.

The Starlight Elderly Care Association in Haishu District, through which the Haishu District Government hoped to promote the purchase of home-based care services, was established in 2003. It mainly undertakes tasks in the area of social home-based care services. The association reviews service targets, "senior citizens with difficulties or living alone," as defined by Haishu District Government, to avoid the waste of financial resources caused by incomplete information. Meanwhile, the association determines service items, such as life care, medical rehabilitation, and mental comfort, and the care attendants and the elders jointly decide the service items. The association also supervises and checks the quality of the elder care services. The association set up the Haishu District Home-Based Care Service Center, with four young employees in charge of the supervision and management of home-based care services in the whole district. Every day two of them visit the communities to check the care attendants' work and collect information on service needs and feedback from the elders. Moreover, apart from meeting the government's requirements, the association also trains home-based care attendants and home service volunteers. The care attendants are selected by the communities, mainly from laid-off workers. Most volunteers are the elders who are relatively young and healthy. The association provides these people with specialized trainings for five days. In addition to the basic knowledge of home care and health care, they need to understand the emotions of the elderly and the establishment of a concept of family service is emphasized. The association appropriates funds for the attendants' salaries two months in advance to the communities. The care attendants receive salaries from the communities on a monthly basis for their services. To encourage the public to participate and make up for the lack of services, the association established the first county/city/district-level "Volunteer Service Centre" in China in 2007. Currently, there are 3,186 registered volunteers. In spite of their partnership, the Starlight Elderly Care Association and the government faces some "tension." For instance, the relationship between the civil affairs department and the association has been strained for some time regarding the supervision of the home-based care services.

The communities carry out their work at service stations in the name of the Starlight Elderly Care Association. As a hub of social participation, it mobilizes the resources of the elderly to establish a model for home-based volunteer services. That is, the association mobilizes the relatively young and healthy elders in the communities to get registered and receive training before providing for solitary senior citizens without access to the government home-based care services. More than 1,000 people have applied, with 429 qualified to get the "home-based care volunteer service license" after training and serving more than 800 senior citizens. This has basically solved the problem of caring for all the senior citizens in the region. The association provides support to the elderly "day care" centers and the integration of public health resources, and addresses the issues in the model of home-based care services, such as physical and psychological health problems of the elderly.

The YTONE Smart Management Service System in Hangzhou

Background and details. Zhejiang YTONE Hi-Tech Development Co., Ltd., developed the YTONE Smart Community Smart Management Service System (YTONE system) in 2005. The system is committed to solving the problem of information asymmetry between government and citizens, government and public services providers, and citizens and public services providers in the delivery of public services. First experimented with in the Tianshui neighborhood of Hangzhou in July 2005, the YTONE system has been applied in nearly 300 regions nationwide. The number of users has reached over 120,000, with the total calls of more than 400,000 person-times. The system has solved users' problems for more than 250,000 person-times, sending out rescue personnel over 2,200 person-times. The entire system has integrated more than 16,500 social service providers and public service organizations. In the YTONE system, there are currently about 30,000 government-hired attendants in Hangzhou, accounting for 95% of the participants in the YTONE home-based care service system. The government also has assigned 1,100 attendants for 10,000 senior citizens with low-income, who are living alone, who live in poverty, or are unable to look after themselves. The average monthly value of the coupons used by each senior citizen ranges between RMB 100 and RMB 200.

While using the YTONE system, the elderly do not have to remember any phone number for help. Nor do they have to provide family names, given names, or addresses. The elders simply press the red button (for emergency) and green button (for help). The staff at the YTONE Community Information Service Centre immediately will call back to provide services. The Community Information Service Centre provides a 24-hour waiting and has its own emergency response teams in case of busy calls. Emergency calls, text messages and the Internet are linked to service calls, such as 110, 120, 119, and to relatives, neighbors and communities. The community and the neighborhood can immediately read the call information as well as the operation process.

The YTONE system keeps a quantitative record and management of identities, number of visits, service time, service items and customer satisfaction of all the attendants and working staff from service providers.

Inter-actor relationships. In this case, the primary function of the government is to provide financial support for the home-based care services. It purchases service coupons and settles with providers through the settlement system. With the settlement platform open, relevant government departments can log into the platform and view the report forms on the use of service coupons. Compared with the case in Haishu District, the case of YTONE involves more thorough transfer of government functions. The government transfers the whole service package to YTONE, which is also responsible for the evaluation of care attendants and service providers. YTONE provides the attendance reports, according to which the government administrative departments pay the attendants. The service provider evaluation system also is part of the settlement. YTONE pays sample weekly return visits to the elderly who have been served. If the elderly complain or give negative feedback, the service providers will be given a warning. If given three warnings, they will be excluded from the list of service providers. If the elderly press the pager for complaints, the service provider should make compensation on-site, and then YTONE will rearrange service providers. In addition, in order to support YTONE's survival and development, science and technology authorities at the national, city and district levels have provided YTONE with six subsidies totaling RMB 1.5 million.

The main function of the YTONE system is to construct a home-based care service platform. As an information carrier, the platform also includes home-care service providers, service criteria, and an industry chain for all the goods catering to the elderly. YTONE is the hub in the entire service platform. It supports information flow, service funds settlement, and management of care attendants, all of which are digitized and sent out through various channels. The system starts as a tool for the elderly to voice their requirements, transforms the requirements into information, and links the requirements up to a huge care service team. Home-care services also are delivered in accordance with standard service items, and evaluation is conducted in accordance with standard service requirements. For example, service coupons distributed by the government for the home-based care services can be effectively managed through the YTONE system on the basis of virtual currency. It opens a funds account for each senior citizen and recharges the cost of the service coupons into the account. All the service providers for the elderly and on-site service staff are registered in the platform. Through the YTONE platform, the needs of the elderly are allocated to service providers and service staff. Each time home-based care services are provided, the service staff will press the pager to report the services provided and the fees. According to this report, the system deducts the fees from the user's account, and a text message is sent to the user's children about the services provided and the fees. At the end of each quarter, YTONE or the government will settle with service providers based on the system's clearing statements.

The community, as the most accessible service agency for the elderly, also should be incorporated into the service provider system, wherein the community is mainly responsible for the establishing community information service centers. In today's China, the community more often becomes a window for various government departments to serve citizens. The services provided by the community are what the elderly cannot buy in the society, such as the mediation of neighborhood disputes and of family relations.

DISCUSSION AND LESSONS OF THE CASES

So far, the results of existing empirical research on PPPs performance are rather different. Successful cases mainly are found in infrastructure construction, which cannot prove the universal effectiveness of PPPs in public service provision. The above two Chinese cases at least show that PPPs with good inter-actor relationships in non-infrastructure sectors are likely to function. When it realizes its weaknesses in resource and information, government cooperates with social organizations or enterprises, fully utilizes the capacity of social organizations and communities to integrate resources, brings into full play enterprises' advantages in information technology and professional skills, mobilizes all community members and other citizens to collaboratively and effectively meet the requirements for care services for solitary senior citizens.

Judging from the coverage and fiscal expenditures of the elder care services, the two cases are basically successful. The Haishu District Government, in cooperation with the Starlight Elderly Care Association, successfully has provided home-based care services to more than senior citizens and solitary elderly people. The association, in cooperation with the government, has improved its capabilities and provided home-based elder care services, with enterprises' donations and volunteers' help, to over 800 elderly persons not eligible for the services funded by the government. In the case of YTONE, the government also has successfully provided home-based elder care services at low cost by paying YTONE 8% of the service purchase fees as the management fees. Besides, the coverage of the YTONE system is greater than that of Starlight Elderly Care Association. The home-based care attendant and information staff positions of these two systems provide more job opportunities for the unemployed, resulting in one disadvantaged group providing services to another disadvantaged group. To some extent, this approach has solved the welfare problem of two groups.

In today's China, partners' participation in public decision-making is limited. More often, their function is to implement government policies. Through careful examination, however, we can still identify the independent operating space of social organizations and the private sector as government's partners. In the case of the Haishu District, the Starlight Elderly Care Association originated from the local government's advocacy. The government is both advocate and sponsor of the policy, but it doesn't operate the project alone. Instead, it delegates service delivery to a social organization to make the most of the organization's advantages and compensate for "government failure." Although established and run by the government, the Starlight Elderly Care Association is quite independent in its operation. It does not operate entirely under government orders, but enjoys some independence in improving home-based care services and the service network. Its resource integration, service supervision, and care attendant training are independent from the government and rely on the association's initiative. Volunteer recruitment, for example, is beyond government requirements.

The inter-actor relationships in the case of YTONE are significantly different from those in the Haishu District case. The local government in Hangzhou outsources to the enterprise not only the provision of public services, but also clients' evaluation of the service and the home-based care attendants. It monitors the ongoing operation through the information platform provided by the enterprise. The YTONE system is more committed to running the information platform, while the community is responsible for policy implementation and service provision. The two cases are similar in that government is the direct service sponsor. They differ from how public sectors obtain external funds to make up for their own limited financial capacity through PPPs. Despite its strong dependence on partners, government is still likely to choose from other alternative partners. Of course this paper can only point out such a possibility, and further studies will be conducted with more case studies in the future. The third sector and private enterprises have not maturely developed. There exist some risks for failure in the above cases, as the governments have no alternative service providers. This is true in the case of YTONE. The case of Haishu District indicates that, in view of the lack of alternative partners, government may establish non-governmental organizations with which to cooperate.

Target integration between the public sector and its partners exerts far-reaching effects on the success of PPPs. The civil affairs department and Starlight Elderly Care Association, in the case of the Haishu District, used to have disputes over the right to supervise home-based care services. In the case of YTONE, however, the government monitors such information as the service hours, the nature of services, service requirements of the elderly, and service fees. Such an open information platform enables the public sector and the private sector to integrate their targets well. Of course, considerable risks also exist there, because the public sector has little or no experience in the use of these new technologies (Langford and Harrison 2001). The platform constructed by these new technologies makes it possible to improve services and the communication between stakeholders, thus it is difficult to curb their vigorous momentum. Another risk in the model of YTONE is that, as the partner in PPPs, the company plays an increasingly important role and overshadows the government's role as a protective umbrella over voluntary organizations, particularly in developing countries where the third sector is not sufficiently developed.

In the above two cases, it is noteworthy that, although there is no breakthrough in the approaches to performance appraisal, the increasing public participation guarantees, to some extent, the performance of public service providers. Scholars and practitioners have emphasized the importance of public participation in PPPs, but most of them concentrate on public participation in decision-making, supervision, and control of government behavior. Little PPPs literature has been concerned with public participation in appraising partners' performance in providing public services. In PPPs, once government has selected partners (i.e. agents) for providing public services, it has to construct the corresponding incentive and penalty systems to guide the agents to act in accordance with the government's requirements (Kettl 2009: 22-23). But, it remains unknown how effective the government will be in getting its partners to undertake tasks in a manner conducive to improving service quality. Therefore, public participation in performance appraisal may increase costs, it helps to supervise and maintain long-term stable partnership.

The YTONE case shows that citizens can voice their requirements on service type, quantity, and delivery. For example, after home-based care attendants and service providers have provided their services, telephone liaison staff will immediately ask the elders about service fees, service hours, and service quality and record that information in the system. Using the system, the government and YTONE can obtain updates on progress, evaluate the service quality in terms of frequency, time, and quality, pay the attendants based on the information obtained, and supervise providers' service quality. Public participation is essential for performance appraisal and requirement expression. Without effective public participation, PPPs may overlook public interests and eventually fail.

In both cases, the local governments are willing to share part of their power with partners. Target integration, public involvement, and appraisal all rely on government's knowledge of the home-based care services provision obtained directly from the YTONE system or indirectly through association feedback. The two cases differ greatly in their approach, however. The Starlight Elderly Care Association sends four full-time staff members to investigate the elderly's requirements and appraise service quality, while YTONE enjoys more technological advantages in information communication. YTONE appraises the services via telephone inquiries immediately after the service provision and helps the attendants to log into the system to record service information. Real-time access to such information via the system is available to the local government and to YTONE. The comparison of the two cases shows that, at present, smooth communication can be accomplished in both cases, but, in the case of the Haishu District, once the scope increases, information congestion is likely to take place. The YTONE system, on the other hand, is highly expandable. The application of information technology almost overcomes any potential difficulty in information communication.

CONCLUSION

PPPs should not count merely on the improved efficiency of a single organization to provide better quality public services or goods, because the so-called "short-board effect" exists in network-based public services provision. The efficiency, profits, and public nature are adversely impacted by poor coordination among the organizations. In the ideal type of inter-actor relationships in PPPs, the public sector needs to properly address two issues: regulation and collaboration. Regulation functions when the public and non-public sectors fail to act effectively in accordance with contracts or agreements due to defective rules or laws. Good collaboration, an essential requirement of PPPs, ensures its effective operation in line with principles, such as power sharing from administrative control to consultation, transparency, information sharing, accountability sharing, subjects' desire to cooperate, mutual trust, fairness and respect, and partnership-based performance appraisal.

The cases in China regarding the provision of home-based care services show that, when the market economy and social organizations are not fully developed, and even when there is a lack of many alternative partners, the public sector still can achieve the goal of improving the provision of public services and goods by adjusting inter-actor relationships in PPPs. In this process, enterprises can seek growth via market mechanisms, and social organizations also can achieve their development through partnerships with government. These cases offer fresh examples for other developing countries to follow when tackling problems in government's provision of public services and goods, such as shortage in funds, inefficiency, inadequate staff, lack of professional skills, and difficulty in resource integration. The partners in PPPs should not be limited to the private sector, but should include social organizations. Though both subjects participate in PPPs projects with different purposes, either of the two cases includes the five principles of the ideal type of inter-actor relationships in PPPs. Social organizations and the private sector differ in their means, weight, depth, and scope of applying these principles, however. It is noteworthy that the case of YTONE also indicates that information technology provides more convenience for citizen involvement and makes it possible to innovate in the supervision of public services provision.

Of course, this paper has some defects, mainly in the nature of case studies. The two typical Chinese cases manage to prove the possibility of establishing such ideal collaborative relationships in PPPs and of achieving success in terms of coverage and costs. However, case studies based on logic induction require support from more projects or cases. For instance, the weight placed on each principle for the ideal type of inter-actor relationships in PPPs may vary in the light of national circumstances, historical stages, and situations in specific cases. This is our future research direction and also the issue we will further study.

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JIANXING YU

Zhejiang University, P.R. China

ZHIYUAN QU

Zhejiang University, P.R. China

(1) Savas also asserted that in institutional arrangements of public service provision, public sector could hand over the producer's role not only to the private sector or the third sector, but even to other public sector through inter-government agreement.

(2) This case is borrowed from the joint investigation made by the authors of this paper and Prof. Wang Shizong, with reference to Wang Shizong's Governance Theories and Their Applicability in China, Zhejiang University Press, 2009, 163-169.

(3) The authors of this paper have made similar discussions. See Yu Jianxing, Jiang Hua, Zhou Jun, China's Civil Society Growing through Participation: A Research on Wenzhou Chamber of Commerce in Zhejiang, Hangzhou, Zhejiang University Press, 2008, 210-211.