P3 concerns expressed about North Island hospitals
About 90 people showed up to a Comox Valley town hall meeting to listen to concerns surrounding the public-private partnership (P3) model planned for the North Island Hospitals Project (NIHP).
Citizens for Quality Health Care (CQHC) held the two-hour meeting in the Rotary Room of the Florence Filberg Centre on Thursday evening. Speakers included: Dr. Vanessa Brcic from Canadian Doctors for Medicare, Stephen Elliott-Buckley from the Canadian Union of Public Employees research department and Barb Biley from CQHC.
If the public-private partnership goes ahead as planned, a consortium of companies would be responsible for designing, building, financing and maintaining the new hospitals in the Comox Valley and Campbell River, rather than simply designing and building, as would happen if the project was simply public.
Concerns around cost, privatized services and accountability were some of the main issues discussed.
Biley said the question of P3s in healthcare comes down to an ideological question.
"You want to live in a society where healthcare is a commodity to be exploited by private corporations for profit, or where healthcare is considered a social responsibility that government delivers to the citizens to meet the healthcare needs of the citizens," Biley said during her presentation.
All three speakers expressed concerns around which services could be privatized if this model is followed.
The Vancouver Island Health Authority (VIHA) was not formally invited to this meeting and did not attend, but it has maintained that all services related to the delivery of healthcare would remain public.
According to VIHA's Request for Qualifications (RFQ), privatized services could include: general management services; plant services; environmental services; roads and ground maintenance, including structured parking; help desk services; utility management services; housekeeping and linen services (but not laundry); waste management and recycling services; and pest control services.
However, according to NIHP interim project director Grant Hollett, VIHA has not made the final decision on housekeeping services — a service many people do not want privatized.
"We put it in as a possibility into the RFQ just to see what the marketplace would respond but no final decision has been made yet as whether housekeeping will be placed with project company or kept within VIHA," Hollett told the Record on Monday. "The plan right now is for food services to stay with VIHA."
Brcic's presentation Thursday looked at the bigger picture of Canada's healthcare system and why privatization in the system is growing. Titled "When the Shift hits the Fan: Health care in crisis and transition," Brcic's talk explained the 'shift' is a move towards a two-tiered healthcare system, and the 'fan' is the federal government "walking away from responsibility on healthcare."
She also spoke about cost-cutting concerns related to P3 hospitals.
"Inevitable cutting of corners, the quality of actual physical facility," she said, adding that cutting corners happens when private profit is a motive. "In the U.K. (United Kingdom) they found that roofs were collapsing in patients' rooms because of corners that were cut during construction.
"Extra services, how many things can you define as a supplementary or excess service that the hospitals then don't have to take care of and that you then might have to pay for out of pocket?"
During the question-and-comment period, one speaker noted patients had to rent wheelchairs in one public-private hospital she'd been to, and some couldn't afford to.
Elliott-Buckley spoke specifically on P3 projects, listing disadvantages and pro-P3 touted advantages with his critiques.
He said private companies are less accountable than government, pointing out companies can declare bankruptcy and pull out of projects, leaving the government partner to pick up the pieces.
According to Elliott-Buckley, P3 projects cost more. He pointed out government interest rates are lower than private and taxpayers pay for the project in the end anyways, and he questioned Partnerships BC's assessment of the financial success of past P3 projects, among other things.
Hollett has repeatedly said the P3 model will give the "greatest value to taxpayers" and will ensure the project is finished "on time and on budget."
Elliott-Buckley also pointed out transparency could be an issue. VIHA confirmed that while the public would be able to see agreement between the government and the private partners, there would not be access to the private partners' financial records, in accordance with the law.
Elliott-Buckley noted the public would be unable to see how much profit the consortium is making.
"They deserve their privacy right, but they're going to get paid 30 years of public dollars, I want to see their books," said Elliott-Buckley. "It's my money, I want to see where it's going and I want to see if they're making nine per cent or 15 per cent."
According to CQHC organizers, the town hall meeting in Campbell River on Wednesday also drew a large crowd, and NIHP chief project officer Tom Sparrow was invited to attend but had another meeting that evening.
The Request for Proposals stage is expected to begin by the end of the year, and three of the eight interested consortiums will be asked to submit bids.
The two consortiums not chosen during this part of the process will each receive a $750,000 honorarium for applying, according to Hollett, who added the companies would likely have spent $1 million each during the bidding process.