public private partnerships innovation or profiteering?
TRANSCRIPT
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
1990s – Tax Cuts Agenda, Delayed Infrastructure Programs, Growth of P3s
Fiscal Imbalance
Decline in federal transfers Downloading of responsibility
for infrastructure
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”
Models of PPP
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
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.
The Claims
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 Problems
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
P3s in Operation
P3s in Operation
P3s in Operation
P3s in Operation
Public Alternatives to P3s
Can We Jump Into P3s and Get Back Out Again?
NAFTA Cost Duration
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