Premier Clark announced on April 26 this year that the government has approved the North Island Hospitals Project to build two new hospitals on the North Island. The current plan is that they will be P3s, Public-Private Partnerships.
The plan is that through Partnerships BC, the government will award a contract to design, finance, build, and maintain the hospitals until about 2047. Regardless of changes of government, changes in medical practice, unforeseen health care needs, etc., virtually everything but nursing care will be delivered by private contractors for the next 30 years.
P3 backers argue that the beauty of handing over the financing to a private partner is that the private finance company “takes the risk”. Not true. Whether the government borrows or some global multinational borrows, it is the people of B.C., through our taxes, who pay. Governments get better loan rates from banks to cover the capital cost of building and purchasing equipment for hospitals so if the government borrows we pay less.
Since 2008, banks and financiers are pulling out of P3 financing. The new Fort St. John Hospital, which started out with great fanfare as 90 per cent private and 10 per cent public, ended up, very quietly, being about 10 per cent private and 90 per cent public. So much for the financing advantage.
The argument for handing over control of the physical operation and other aspects of running a hospital for 30 years is that the private companies involved are “on the hook” for problems that arise and the contracts provide “penalties” for poor performance. In practice, once the contracts are signed (think about those 30 years), health authorities and governments have had a very hard time renegotiating to meet new needs or to enforce penalties.
VIHA (Vancouver Island Health Authority), at the end of a five-year food service contract with Compass in 2011, thought it had solved the problem of widespread complaints of poor quality food by awarding the new five-year contract to a new company, Marquise. But within a month Compass had bought Marquise and there was apparently nothing VIHA could do about it.
The 30-year contract, not the capital financing, is what makes these P3s lucrative for the monopolies, and their lawyers. In 2009 forensic accountants Ron Parks and Rosanne Terhart reported that in all cases, P3s cost substantially more over the life of the contract than public projects. Their in-depth study of the Diamond Centre showed that “…the Diamond Centre (at Vancouver General Hospital) will cost $203 million over the life of the contract as compared to a cost of $89 million had the project been publicly delivered – a difference of nearly 130 per cent”.
That’s $114 million that could have gone to patient care if the hospital was publicly run.
Health care is a right that must be provided for all based on need, not ability to pay. Public funds must be used for health care, not to enrich the owners and shareholders of the consortia that would run the P3 hospitals. Health care and profits don’t mix. If the success of your business is based on increasing profits for the shareholders, anything that hurts profits results in cuts — cuts to services, cuts to staff, cuts to health care.
There is no reason the North Island Hospitals should be P3s and a million reasons that they should not!
Lois Jarvis, Campbell River
Barbara Biley, Comox
Citizens for Quality Health Care