April 21, 2003
Muzzles firmly in place over hospital plans
The sleeper issue in the coming provincial election
campaign could be the Conservative government's effort to get new hospitals
built by the private sector.
Two such projects are already in the works — the
William Osler Health Centre in Brampton and the Royal Ottawa Hospital (a
psychiatric institution) in the nation's capital.
A third — the Markham-Stouffville hospital — is in an earlier stage of development.
Contracts could be signed on the Brampton and Ottawa projects in the next few weeks.
They are called "public-private partnerships," or P3s
for short. A private sector consortium designs and builds the hospital
according to agreed-upon specifications and then leases it back to the public hospital board.
The argument for P3s is that they will both save money
and free up hospital administrators to focus on patient care, not bricks
"Canada's most respected luxury hotels don't own the
buildings in which they operate," argues former federal finance minister
Mike Wilson, chair of the Canadian Council for P3s. "Banks, too, have sold much of their downtown real estate to property
companies and now lease back the space ... This lets them focus on banking."
Unfortunately, for proponents of P3s, this is an argument that no one in government is making these days.
Last year, the Brampton and Ottawa projects were
announced by the government with much fanfare. Since then, however, the
government has bunkered on P3 hospitals; according to my sources, the Tories have decided that a backlash on the issue could
cost them votes. Media questions are deflected to the hospital boards.
The William Osler board, in turn, has imposed a media blackout.
Last week, Rosalie Penny, vice-president of public
affairs for William Osler, issued a press release that stated: "In view of the
fact this is still an open and competitive process, William Osler Health Centre will not be conducting media interviews re this
To its credit, the Royal Ottawa has been more open with
the media. But last month representatives of the hospital cancelled a
scheduled meeting with the editorial board of the Toronto Star. They cited the war in Iraq as the reason.
Into this vacuum have flooded local activists and unionists who are fighting the P3 hospitals.
A group called the Brampton Health Coalition held a
press conference at Queen's Park last week to accuse the government
and the William Osler board of a cover-up. The non-response from the government and the hospital only served to reinforce
According to the activists, P3 hospitals are the "thin
edge of the wedge" of privatized health care. In their minds, the
government's real aim is not privately built hospitals but "private hospitals," a term that has a whole different connotation
In this fight, they have been joined by opposition
parties. Both the New Democrats and the Liberals have flatly rejected P3
hospitals in their election platforms.
Their thinking has apparently evolved.
When in power in the early 1990s, the New Democrats
first introduced the P3 concept to Ontario in the original plans for
Highway 407, which was to be designed, built, maintained and operated by the private sector.
Today, however, as the New Democrats busily erase the
memory banks from those days, they refuse to acknowledge paternity
for the idea. When asked about it at press conference last week, NDP Leader Howard Hampton flatly denied the NDP had
ever countenanced a P3 highway.
As for Liberal Leader Dalton McGuinty, as recently as
last fall he said that he had an "open mind" on the idea of private sector
delivery of some aspects of health care.
But when the Liberals' health platform was released
last month, it declared: "We will end the Harris-Eves agenda of creeping
In an interview last week, McGuinty explained that the
party's thinking changed after the Romanow commission reported late
The commission devoted just half a page to P3s in its
356-page report and concluded that they would cost governments more
"in the longer term."
Of course, the Brampton and Ottawa hospitals have been planned as pilot projects to test that very theory.
Should McGuinty become premier later this year — an
increasing likelihood — he could be faced with a dilemma if the
Brampton and Ottawa contracts have already been signed. The situation would be similar to the one faced by Prime Minister
Jean Chrétien vis-á-vis the Pearson airport contract in the early 1990s.
Would McGuinty, like Chrétien, tear up the contracts?
"I'm not going to commit to tearing up a contract that I haven't seen
without knowing what kind of penalty Ontario taxpayers would have to pay," he said.
But in the same breath he added that the Liberals would
move "as quickly as we can" to phase out private ownership of these
hospitals and bring them back into public hands.
This could get messy.