On lessons from abroad

As so often seems to be the case, the Tyee has the best coverage of the problems with P3s...this time pointing out that Gordon Campbell's European models for health care have done nothing but raise costs while harming care:

Dr. Pollock is deeply skeptical of claims made for PFIs as instruments for building and operating hospitals. Her 2002 paper in the British Medical Journal titled "Private Finance and 'value for money' in NHS hospitals: a policy in search of a rationale?" suggests that PFIs have been a financial and service delivery disaster for the public, creating large amounts of long-term debt, while sharply reducing service delivery.

The toll: a 30 percent loss in bed capacity and 20 percent reductions in staff in the hospitals and their areas served studied after PFIs were implemented.

Those cuts, Pollock says, failed to deliver any of the cost reductions and efficiency improvements promised by proponents. Further, she and her co-author argue that the fiscal case for the public-private-partnership structures depends upon deceptive accounting procedures that fail to stand up to critical review...

Some prominent British doctors have spoken out, warning Canadians not to let similar damage be done to our system. In 2005, the Association of Surgeons of Great Britain and Ireland came out strongly against private sector involvement in the National Health Service. Dr. Jacky Davis, a senior British radiologist writing in The Guardian, said "We see hospitals closing wards and operating theatres. We see huge profits already going to PFI companies. We are not deceived by the rhetoric about patient choice and predict that patients may lose the one choice that is important- a good comprehensive local hospital."

The article speculates that Campbell's trip to Europe may have been largely an attempt to divert attention from the likelihood that any privatization would follow a model closer to that applied in the U.S. And it's not hard to see why Campbell would desperately want to avoid any link between his desired reforms and the U.S.' expensive, ineffective system.

But even using Campbell's preferred comparators, the P3 model has led at best to false economies and worse patient care. And with so many readily-available examples from abroad, there's no reason for Canadian patients (and citizens) to suffer in order to prove that point yet again.