of ten years. The short time was set because theconstruction was excluded. Theconstruction was conducted by the State, requiring investments of approximatelyUS$ 54 million while Promedica & Dalkia invested US$ 23 million to equip thehospital, being expected more US$ 9 million over the life of the concession (Brazil:Hospital do Suburbio 2013).Thepayment to the consortium is linked to key performance indicators based onquantitative and qualitative expectations, therefore creating incentives forhigh levels of performance. The agreement established that regular auditing isto be conducted by qualify companies, analysing not only performance indicators,but also financial statements. In auction at BOVESPA, Sao Paulo stock exchange,the consortium requested maximum annual payments of R$ 103.5 million(approximately US$ 52 million), wherein seventy per cent would be volume based,and the rest linked to quality indicators. As the payment mechanism is the principal means for allocating risks andproviding incentives in the PPP contract, it was settled to minimize thestates credit risk thus increasing interest by the consortium and thepossibility of obtaining financing for the project (Brazil:Hospital do Suburbio 2013). The deal closed in just 90days from when the contract was awarded until the project reached financialagreement. The results evidence not only the quality of services, but also theconstraints of the project. IssuesThe issues identified in this socialinfrastructure PPP are: lack ofpublic transport in the area; high rates of absenteeism; and overcrowding whichare associated to the low staff commitment, insufficientcommunity involvement, and inefficient assessment of political and socialrisks.As thenumber of patients is higher than expected, the public sector is under pressureimposed by both, the community that calls for more and more beds; and theconsortium, which added beds but wants to negotiate a higher payment. Besides,concerns about quality have been raised around the facilitys low capacity, bywhich the principal of equitable access to quality health services for poorpeople is directly affected. Moreover, the lack of public transport in the areaevidences a public controversy in achieving social goals.Frameworkto evaluate The Suburban Hospital PPP According to Wettenhall(cited in Hodge & Greve 2005), public-private partnerships arebased on win-win-win arrangements by which the public sector, the private sectorand the community are simultaneously benefited in a synergistic interaction. Thus,there are many concerns around the achievement of effective public-private partnerships. Trafford and Proctor (2006) suggest thatindentifying critical features that may impact these multi-sector alliances is crucialto achieve long-term sustainability. In order to consolidatebenefic and successful public-private partnerships, expectations, risks andresponsibilities need to be mutually agreed and clearly specified in advance. Additionallyit is critical that the contractual arrangements are complete and effective,preserving good relationships between partners, communication efficiency, goalsand value alignment and continuous adjustment for mutual benefits. Furthermore,Bresnen (2007) states that diversity may be an important factor to recognizedifferentiation as a tool to reach efficiency and adaptability. Moreover,affordability and value for money, project design, compliancy of rules andlimits, risk sharing, communication, transparency, legality, monitoring, andpolitical support may be key elements that may compose PPPs frameworks of goodpractices (Public-Private Partnerships: In Pursuit of Risk Sharing and Valuefor Money 2008). Formulatingarguments around PPP effectiveness or good practice, as well as determining theappropriateness of partnerships are not easy tasks, as they can varyconsiderably across