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Public Private Partnerships . Innovation or Profiteering?. History of Infrastructure Development. 1800-mid 1900s religious, philanthropic, charitable institutions 1948 – National Health Grants Program 1971 – Wind up of National Funding, Provinces and Municipalities take responsibility

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Public Private Partnerships

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Public Private Partnerships

Innovation or Profiteering?


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History of Infrastructure Development

  • 1800-mid 1900s religious, philanthropic, charitable institutions

  • 1948 – National Health Grants Program

  • 1971 – Wind up of National Funding, Provinces and Municipalities take responsibility

  • 1990s – Tax Cuts Agenda, Delayed Infrastructure Programs, Growth of P3s


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Fiscal Imbalance

Decline in federal transfers

Downloading of responsibility

for infrastructure


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P3s – What Are They?

  • Public Private Partnerships, also called PFI – Private Finance Initiative, AFMs – Alternative Finance Mechanisms, AFPs – Alternative Finance and Procurement

  • While generically described as “partnerships” the legal relationship embodied in PPP may be a partnership, joint venture, corporation, lease, management arrangement, trust or other structure

  • All definitions include judgements on the benefits or damage caused by these schemes

  • Proponents – P3s harness innovation and transfer risk

  • Ontario Health Coalition – P3s are simply another term for privatization

  • British Medical Association – PFI is “Perfidious Financial Idiocy”


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Privatization

BOO – Build Own Operate (Ontario Long Term Care facilities since 1997)

BOT – Build Operate Transfer

DBFO – Design Build Finance Operate (Brampton & Ottawa P3 hospitals and new P3 hospitals)

Concession Lease

Corporatization

BTO – Build Transfer Operate

Lease

Models of PPP


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Ontario Health P3s/Privatization

  • P3 Hospitals –DBFO P3s, DBF P3s

  • Long Term Care Facilities built under Conservative Government 1998-2003 – BOO

  • Private Homecare Contracts brought in under Conservative Government 1997

  • MRI/CT clinics

  • IT contracts, leasing and concession arrangements, etc.


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Harness new investment

Not privatization

Transfer risk

Come in under budget and within timelines

Innovate

Find efficiencies

Public control maintained

Separation of strategic control from operation

The Claims


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Higher cost

Cuts to services – shrinking scope of public medicare

Inflexible contracts

Loss of democratic control

Legal wrangling/management breakdown

Commercialization of public service

Shoddy construction/maintenance and safety problems

Inequality

Creation of new risks

Deepening privatization

The Problems


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P3s in Operation


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P3s in Operation


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P3s in Operation


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P3s in Operation


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Public Alternatives to P3s


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Can We Jump Into P3s and Get Back Out Again?

NAFTA

Cost

Duration


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Resources

  • www.policyalternatives.ca

    • “Funding Hospital Infrastructure: Why P3s Don’t Work, and What Will” by Lewis Auerbach, Arthur Donner, Douglas D. Peters, Monica Townson, and Armine Yalnizyan

  • www.ontariohealthcoalition.ca

    • Click on Public Private Partnerships

  • www.P3watch.ca


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