It’s like some sort of dangerous game show where contestants must phrase their answer in the form of a question. In the case of new hospital construction in Ontario and BC, the answer to community pleas for new hospital facilities has been ’would you like a private, for-profit hospital – or no hospital at all?’. Talk about putting our public health care system into jeopardy.
The private sector is pulling out all the stops in its efforts to convince Canadians it doesn’t matter who finances, owns and operates our hospitals. Michael Wilson’s ’prescription’ in these pages yesterday is the latest incarnation of the hard sell.
The fact is “ownership matters” and sweeping claims that the public will benefit from private, for-profit hospitals ring hollow in the face of evidence that they are likely to cost more and threaten levels of care.
The private sector has always built hospitals, and done it well. Opponents of for-profit hospitals aren’t arguing to don hardhats and take over that work. The foundation of our concern is the added cost and risk – and the reduced accountability and access – that come when the private sector’s role expands into ownership, operation and financing of so-called public private partnership (P3) hospitals.
Private financing won’t solve the problem of declining investment in new hospital construction. Nor will it change the reality that private sector borrowing inevitably costs more than public financing, adding to the price tag of a new hospital even before the groundbreaking ceremony.
A recent study, conducted by a former director with the federal auditor general, found that the two planned for-profit hospitals in Ontario will likely cost taxpayers millions of dollars more than public hospitals.
The public pays this higher cost for private hospitals through escalating lease payments that cut into hospital operating budgets, guaranteeing the private sector an assured revenue stream, while levering public money into private profits and away from care.
This has been the experience in the UK where studies published in the British Medical Journal show private financing, ownership and operation of hospitals have meant a 30 per cent cut in the number of beds, and a 25 per cent staff cut – a clear and direct impact on access to and quality of care.
The record also shows that delivering for-profit hospitals “on time and on budget” has often meant drastic – and dangerous – cuts to the building design and construction – inevitably leading to higher operating costs.
For-profit hospitals are risky business for other reasons. Independent medical research demonstrates that for-profit ownership results in a greater number of deaths. A McMaster University study published this past spring in the Journal of the Canadian Medical Association showed that mortality rates are higher in American for-profit hospitals. Equally risky, involving the private sector opens the door to serious trade consequences that could threaten every aspect of public health care under NAFTA and other trade deals.
The schemes being proposed in BC and Ontario – and looming in Alberta and New Brunswick – have another fatal flaw. In an era where Canadians are demanding increased accountability in the public health care system, these deals are shrouded in secrecy. Assurances about high standards are meaningless, since those standards are being negotiated behind closed doors and under a cloak of commercial confidentiality.
If money can be found to commit to long-term lease payments, those same funds could be applied to pay down public debt incurred through public investment in public facilities – at less cost to the taxpayer. Moreover, public financing of capital investments would protect operating budgets for the care and maintenance that makes hospitals places of healing.
Let’s ensure our health care spending goes to publicly funded, owned and delivered health care and hospitals. P3 hospitals should be shelved once and for all. Every cent of our public health care dollar should go into care, not profits.
Judy Darcy is the National President of the Canadian Union of Public Employees, Canada’s largest union. CUPE has 180,000 health care workers among its half-million members.
