TORONTO – The privatization of hospitals will lead to a reduced quality of patient care, fewer beds and higher costs, says a British doctor and public health policy expert who is in Canada this week to address the Romanow Commission on Health. Dr. Allyson Pollock, who will present the British experience with privatized healthcare institutions to the Commission in Saskatoon on Thursday, is Head of the Health Services and Health Policy Research Unit at the School of Public Policy, University College London, and Director of Research and Development at University College Hospitals Trust in London, U. K.
“This would be catastrophic for Canada,” Dr. Pollock says. “Canada has something that’s very precious. You have nothing like the health care problems we have in the U. K. If you go down this route the consequences for healthcare are very serious. The poor will get poorer and the sick will get sicker. It will lead to enormous inequities in provision and supply, and it will hit older people.”
The Ontario government recently announced that private firms will build and own hospitals in Toronto, Brampton and Ottawa which will then be leased back to public-health authorities. New federal Health Minister Anne McLellan has said she has no problem with private hospitals as long as the provinces respect the principles of the Canada Health Act. Her predecessor Allan
Rock had frequent battles with Alberta Premier Ralph Klein over the Alberta government’s Bill 11, which allows for the expansion of private hospitals in the public system, but Rock also talked about involving the private sector to help manage costs.
Dr. Pollock says the U. K. implemented its Private Finance Initiatives, or PFI, for healthcare in 1992. She said this is essentially a “design-build-operate” scheme that involves the private sector in all facets of hospitals.
“Contracts are drawn up which guarantee the private sector and its shareholders an annual revenue stream from the public purse for 30 years,” she says. “Using private finance leads to much greater costs because of the high cost of borrowing in the private sector. But it goes beyond that. Private finance distorts the whole planning process. Before, the UK National Health Services was planned on the basis of population needs, but now it’s based on what the private sector wants and what the public sector can afford to pay. The consequences are a massive downsizing in order to pay the profits of the private sector.”
Dr. Pollock says there is no country in the world that delivers universal health care to all its population on the back of for-profit providers. In the U. K., she said, the results of using private finance in the National Health Services have been:
- a 30% reduction in the number of hospital beds
- a 25% reduction in clinical staff budgets
- massive closure of public services
- loss of accountability
- creation of a two tier system
Dr. Pollock says the Private Finance Initiative has resulted in new hospitals in the U. K., but they aren’t working. She says the U. K. is now exporting the private finance model to Greece, Italy, Spain, Portugal, Canada, Latin America and other European countries.
Dr. Pollock has written many papers on public health policy in leading medical journals. Before specializing in public health, she trained in medicine in Scotland and worked in hospitals in Edinburgh and Leeds.
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