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P3 is not the way to go for hospital says Jarvis

November 23, 2012

Campbell River Courier-Islander

Sian Thomson

Campbell River's Lois Jarvis, Citizens for Quality Health Care representative, says the Public Private Partnership or "P3" entered into by the Vancouver Island Health Authority (VIHA) is not in the best interests of future patients and staff of the new hospital.

Jarvis said that current staff may be hired at a lesser rate or replaced with lower paid workers who are inexperienced.

Jarvis, who has spent many hours inside hospitals due to illnesses of family members, says examples abound of what can go wrong.

"Royal Jubilee (hospital in Victoria) for instance had a great cafeteria where even the neighbourhood people would visit and purchase good nutritious meals," she said. "It was replaced by a private company and the hours were vastly reduced. They were not open on weekends, the food was awful and the patients were subjected to inedible food. I witnessed carts of uneaten meals being returned to the kitchen.

"While we are very happy to have a new hospital we think the taxpayers health dollars should be re-invested in our public health care system rather than go to large profits to private companies. There will be many current jobs on the line. The North Island Hospitals Plan is confidential and the planned P3 contracts are also secret so we have no way of knowing if the assurances from VIHA are true 'that it is a super deal compared to the public health care hospital model.'"

In 2002 the B.C. government established Partnerships British Columbia, a company owned by the Province whose mandate is to implement "Public Private Partnership" Projects or P3's. Government and business enter into a contract for the provision of assets and the delivery of services such as transit, airports, corrections, schools, roads and hospitals. In the case of the new Campbell River Hospital scheduled for completion in 2017, it will be designed, built, owned and operated by one of three finalists in the bidding process; Arbutus Health Care Partners, Plenary Health, or Tandem Health Partners, all private for-profit corporations, a consortium of banks, architects, property management, and private health care services. These corporations build their profit margins into the project including privatization of hospital management and hospital services.

The government then leases back the hospital from the consortium over the period of the agreement, which is 30 years, and the costs are paid out of the operating budget of the hospital.

"Who benefits from P3 hospitals?" asked Jarvis. "The government because the costs are not on their books, and the private companies who are profiting from the deal. Who doesn't benefit? The patients, the staff ,the community. The extra money spent to facilitate P3's could be spent on public health care, reducing wait lists, investing in new technology, building care homes for seniors."

VIHA says that by entering into a Public Private Partnership (P3) to build the new Campbell River Hospital, the benefits include value for money and the best option for ensuring completion of the hospital on time and on budget.

But Stephen Elliott-Buckley, a health researcher and writer for CUPE and the Hospital Employees Union, said there is significant evidence to the contrary.

"While VIHA admits that it will cost the taxpayers more, they say there is good value for the money," he said. "The private company takes the risk and is the best option to make sure the project is completed on time and on budget. But studies show that they end up costing the taxpayer more than if the government built these facilities themselves."

P3's were pioneered in Britain in the 1990's. Since then, the British Medical Association has warned the Canadian government to stop pursuing P3 hospitals because they have reduced health care access and quality in the UK.

The BC Health Coalition calls P3's "Privatization the Poison Pill."

The British Medical Journal has gone further and have now have renamed P3's "Perfidious Financial Idiocy".

The Ontario Health Coalition said there is a growing body of evidence to suggest that the Private Public Partnerships or P3's are putting corporate profits over public needs and result in cost over runs, delays, reduction of size and services.

And some projects do not come in on time or budget.

"Not by a long shot" says the Canadian Union of Public Employees, who published what they call, "The Horrid Hundred" to demonstrate that in Canada, there have been many serious problems, flaws, even cancellations of P3 Hospital projects.

The list includes Abbotsford Regional Hospital where costs soared from $210 million to $355 million and the annual operating lease has doubled from $20 million to $41 million. Legal and consultant costs were budgeted at $25 million and paid for by the taxpayer.

Calgary Southeast Hospital was abandoned when the head of the Calgary Health Region said the hospital is much more complex than an office building and that no one has more expertise than the health region to build a hospital.

PEI Hospital P3 was abandoned when public outcry followed a report that the hospital would cost much more as a P3 to build.

Royal Ottawa Hospital P3 ended up with $20 million dollars over budget and fewer beds than the hospital it replaced.

William Osler Health Centre in Brampton went from $350 million to over $550 million, the hospital size was reduced and it opened in stages.

CUPE includes P3 schools, recreation centres, social services buildings, courthouses, highway and bridge projects and sports arenas all over Canada among the "Horrid Hundred."

"Here in Canada and worldwide, P3's have proven not to be an efficient use of public funds," according to Dr.

Vanessa Brcic, Executive Board member of Canadian Doctors for Medicare. "They cost more and provide fewer services over the long term."

Brcic said that the international experience is so bad that in Britain, where P3'S originated, and failed, the British Medical Journal reported that the hospital constructions cost 18 to 60 per cent more than had they been government funded.

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