Safdie, famous for his design of Habitat 67 and the National Gallery of Canada, resigned as designer of the McGill University Health Centre hospital in the first week of December, saying P3s are “highly problematic” and will lead to “cutting corners”. Safdie and his Boston-based firm were hired before the Quebec government decided to build the hospital as a P3.
He told the <a href=”http://www.canada.com/montrealgazette/news/story.html?id=abebdaa0-17dd-497a-bc0f-16881ee7c398&k=67759”“>Montreal Gazette “the objective of the private developer…is to produce the cheapest possible solution,” adding he was “deeply concerned that there would be compromise.” Safdie’s concerns were reinforced several days later by architect Michael Fieldman, who withdrew from a bid to design a P3 hospital in Abbotsford, BC.
Fieldman told the media some private operators cut corners on materials, leaving the public sector to pick up the repair tab when the P3 lease ends. “When you turn things over to the private sector, they’re bottom-line oriented,” he told the Gazette. “They’re there to make money.”
Designed to fail
Safdie and Fieldman’s concerns are well-founded, given the experience with privatized schools and hospitals in other provinces, and overseas. The squeeze begins with something as basic as the number of hospital beds. A new P3 hospital in Brampton, Ontario has drawn fire recently. The deaths of two patients have sparked massive community unrest, prompting the provincial government to appoint a supervisor for the six-week-old facility.
While the government denies any connection to privatization, the Ontario Health Coalition points out that while construction costs almost doubled from $350 to $650 million, the hospital has just three-quarters of the promised beds – a drop from 608 to 479.
There have also been a host of problems at the P3 Royal Ottawa mental health facility, which is a year old. According to a recent report, the hospital was originally designed to hold 284 beds at a cost of $95 million. Instead, it opened as a 188 bed hospital costing $146 million – $51 million over the original target budget and significantly smaller than originally planned.
Many are predicting a similar shortage of beds for P3 hospitals in Victoria and Abbotsford, BC. While construction costs for the Abbotsford hospital have soared, the number of beds hasn’t budged, despite a fast-growing population. At least one doctor is so fed up, he gave up his hospital privileges earlier this year.
Privatization has meant fewer hospital beds and poorly-designed schools and hospitals in Britian. Here, architects have long criticized the impact of privatization on the country’s schools and hospitals. In 2006 the government-funded Commission for Architecture and the Built Environment (Cabe) found that half of all new schools being built were badly designed. Of those, nine of the 10 worst-designed schools were PFI schools. (Private Finance Initiative, or PFI, is the British equivalent of a P3.)
Cabe has described Britain’s first wave of PFI hospitals as “urban disasters”, and in 2004 said plans for the Royal London hospital fell “a long way short of what ought to be expected of one of the largest public sector building projects in the country.”
The government design watchdog has also warned that some schools and hospitals built under the first wave of PFI contracts might be obsolete before the end of their lifespan.
A 2005 Cabe report found that while PFI procurement can – in theory – deliver good design, it isn’t the reality. The report found that “the vast majority of PFI buildings commissioned to date have not been designed and built to a high enough standard and public service delivery suffers as a result.”
Scottish architects and doctors protest PFI
Privatization’s impact on design – and public services – drove award-winning Scottish architect Malcolm Fraser to resign earlier this year as deputy chair of Architecture and Design Scotland (A+DS) over concerns about PFI schools and hospitals.
Fraser’s resignation letter had a scathing assessment of Scottish PFI schools. “The best of them are not good-enough, and the worst fill me with despair for the generations of young lives that will be blighted by their dark classrooms, poor facilities and crabbit playgrounds.”
Fraser’s resignation sparked more architects to speak up, and earlier this month, the organization he quit criticized PFI schemes. A+DS chairperson Richard Young launched the organization’s annual report saying it was “frankly unacceptable that we are still seeing developments which meet only the very lowest standards of design quality and where short-term profit is pursued at the expense of long-term community gain.”
Scottish doctors have been calling for a moratorium on PFI hospitals since 1999, after learning the financial bottom line led to bed cuts at Edinburgh’s Royal Infirmary. They renewed their criticism last week, pointing to the “bed shortages, financial problems, poor design, poor quality and reduced levels of care as a result of PFI.” The association also criticized “ the diversion of public funds into private sector profits.”
The push-back is spreading. In Northern Ireland, a new government advisory group similar to Cabe is also calling for an end to PFI, saying it is a process that “puts money before design quality.”