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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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

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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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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

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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

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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 Dont
  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