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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 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”
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
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.
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
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
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