Lesotho New Referral Hospital

This case study describes a Build-Operate-Transfer public-private partnership (PPP) established in 2009 to create a 425-bed referral hospital and three satellite clinics in Lesotho. The project, costing approximately US$100 million, involved a consortium led by Netcare SA Healthcare Group and the Lesotho government, facing significant challenges regarding national policy, public perception of private healthcare, and government capacity to manage PPPs.

• The Lesotho New Referral Hospital project is a Build-Operate-Transfer PPP brokered in 2009 between the Lesotho government and the Tsepong Consortium. The consortium holds a 67% stake and includes Netcare SA Healthcare Group, Excel Health, Afri’nnai, Women Investment company, and D10 Investments, while the government holds 33% in partnership with the Development Bank of South Africa, the International Finance Corporation, and the World Bank.
• The project infrastructure consists of a 425-bed referral hospital, divided into 390 public beds and 35 private beds, along with three satellite clinics. The satellite clinics began operating in May 2010, followed by the hospital in late 2011. The total cost was approximately US$100 million, funded by private equity, a government contribution, and the Development Bank of Southern Africa, with additional technical assistance from Sweden, the Netherlands, and the Global Partnership for Output Based Aid.
• The project faced several institutional and social barriers, including a lack of national PPP policy in Lesotho at the time of the deal and limited government capacity to plan or manage such agreements. There was also public skepticism regarding the profit motives of private healthcare operators in a public domain, as well as negative perceptions regarding the inclusion of a private 35-bed facility within a public operation.
• To mitigate financial risks and ensure profitability for private partners, the agreement utilizes a unitary payment system linked to specific outpatient visits and referrals. Additionally, a 35-bed private hospital facility was built with a state subsidy, allowing the private partner to retain all profits from that specific facility exclusively.

APA

South African Institute of International Affairs (2012). Lesotho New Referral Hospital. https://saiia.org.za/saiia-toolkit/lesotho-new-referral-hospital/

Chicago

South African Institute of International Affairs. Lesotho New Referral Hospital. 2012. https://saiia.org.za/saiia-toolkit/lesotho-new-referral-hospital/.

Wikipedia

{{cite report |author=South African Institute of International Affairs |title=Lesotho New Referral Hospital |date=24 July 2012 |url=https://saiia.org.za/saiia-toolkit/lesotho-new-referral-hospital/ |access-date=17 August 2026 |via=Climate Insights Directory}}

BibTeX

@techreport{southafricaninstituteofinternationalaffairs2012lesotho, author = {{South African Institute of International Affairs}}, title = {{Lesotho New Referral Hospital}}, institution = {South African Institute of International Affairs}, year = {2012}, month = jul, url = {https://saiia.org.za/saiia-toolkit/lesotho-new-referral-hospital/}, urldate = {2026-08-17}, note = {Indexed by Climate Insights Directory} }