Friday, November 8, 2002
Canada to see first
private hospital: Would combine public
and private treatments: Full-service facility touted as wave of future, but
damned by others as end of medicare
Fri 08 Nov 2002
Byline: Tom Arnold
Plans for Canada's first privately owned full-service acute care hospital were revealed yesterday, prompting some praise but also predictions the facility could lead to the destruction of medicare.
The $350-million hospital is to be financed, built, owned and maintained by a private-sector company, which will then lease most of the space back to the William Osler Health Centre group in Brampton, Ont.
While most treatments offered by the hospital will be publicly funded, some of the equipment could be used for private clients in off hours.
"It's in-patient and acute care, and has all the bells and whistles of a large hospital for a large and growing community. A private hospital like this is a first in Canada," Tony Clement, Ontario's Health Minister, said yesterday.
"It's the same accessibility, same universality, but in a facility built much sooner than it normally would have."
He said it will be the largest community hospital in Ontario and probably in the country.
There is no proof these joint ventures are successful, said Richard Plain, a senior health economist at the University of Alberta. "In terms of cost savings, where are they? Let's see the numbers. Quit telling me about the private-public song and dance. Where's the beef? And the beef isn't there. They dodge it every time," he said.
"It is ideology rather than economics and it means less money for health care."
The one-million-square-foot hospital is to have 18 operating rooms and 608 beds, and is to accomodate 90,000 emergency patient visits and 110,000 outpatient visits a year.
Four consortium groups have been selected to submit bids by year's end. These groups include banks, architects, construction companies and building management companies. The team chosen will be expected to provide all non-medical services, including food, housekeeping, maintenance and security staff, which are not likely to be unionized.
Government officials expect the bid will include retail outlets, potentially from clothing stores and fast-food outlets, to specialty coffee houses. It is also expected to include offices of doctors and specialists.
The Osler health group, which has three sites, will choose the favoured option, which will then be voted on by Ontario's Cabinet. Before a final vote, officials will consider whether a public bid could come in cheaper than a private one.
Construction is to start in the spring. Doors are to open in fall, 2004 or spring, 2005, to serve Brampton's 340,000 residents, a community just outside Toronto.
It is one of two pilot projects in Ontario originally approved in December, 2001. The other site is a new $100-million mental facility at the Royal Ottawa Hospital, where some of the biggest firms in private and public-private hospital management in the United States and Britain are expected to compete for the project.
Mr. Clement said without private funding this hospital would not be built for years because the government does not the money.
"We believe that it will mean we are able to build this hospital probably 10 years sooner than if we had done it the old way, waiting for the provincial government to come up with the funding.
"Will you look at my desk, I've got about $7.5-billion worth of requests for capital renovations and reconstruction of hospitals. My budget this year for meeting those requests is about $342-million."
Mr. Clement said public-private partnerships are innovative and likely the option of choice in the future across Canada as governments grapple with soaring health costs. "This way we can deliver higher quality of care sooner."
He called the concept, "the best of both worlds," allowing the public sector to focus on health while the private sector deals with all non-medical issues.
"My number one question is I want the proof that this is going to be an efficient, better run hospital that is doing what's right for the patients," said Sandra Pupatello, deputy leader of the Ontario Liberals and the party's health critic. "We have no proof and from our research that proof doesn't exist, that it will in fact save money.
"We have big concerns that we're going to be in a situation where the thing fails and the public is left holding the bag," she added. "I'm afraid that the ideologues in the government are getting their hands on this and saying, 'We're doing this because we believe in the private sector,' as opposed to, 'We believe in this because it's actually better for health care, better for government dollars.' "
Michael McBane, national co-ordinator for the Canadian Health Coalition, a group representing unions and various social groups, said the move is unethical, will cost taxpayers more in the long term and offer poorer service to patients.
"The government accepts all the risk. You socialize the risk and privatize the profits. They're privatizing everything that can make money. That's actually not a partnership. That's a one-way street. It is an outrageous proposal, and it's designed to sabotage the public system."
Canada's first private hospital will not contravene federal or provincial legislation, added Mr. Clement. "This is perfectly within the public Hospitals Act and it is within the bounds of the Canada Health Act because the medically necessary clinical services are still universally accessible and part of our health insurance plan system. None of that has changed."
Dr. David Gratzer, editor of the recently released book Better Medicine: Reforming Canadian Health Care, said public-private partnerships are "tried, tested and true." Such moves by government are "significant in that it's finally a step in the right direction, unlike so many of reforms in Canada that are discussed today. Internationally, the overwhelming trend is toward public-private partnerships. Why? Because they save money, they are very effective and patients internationally tend to be more satisfied."