The Gazette has a brief editorial about the long delays and controversial detours taken en route to one day building two new teaching hospitals in Montreal, one to be run by McGill University and the other by Université de Montréal. The editorial concludes that impatient Montrealers really don’t care in the end how they’re built; these hospitals should have opened their doors by now.
While the frustration over the delays is understandable, I am sceptical of the “just get the blasted things built!” argument. Having witnessed the ongoing debacle in Quebec’s infrastructure sector, about which you can read some of the latest news in Laura’s post here, and also, specifically related to seeming union intransigence and corruption in La Presse, we might well pause to consider whether getting it done right should take precedence over getting it down right now.
The Gazette correctly pinpoints “public-private partnerships” as an issue that has tripped up the government in the teaching hospitals debate. PPPs, as they’re called, (or PFI, Private Finance Initiative, if you’re following similar debates in England) emerged into prominence over the last two decades as a way for governments to ostensibly get projects off the ground more cheaply and quickly than via public financing alone. Over here, The Guardian newspaper has a great collection of resources about PFI and the mixed results in the UK.
On balance, it looks like PPPs are sometimes not as cost-effective or efficient as governments would like. One of the chief reasons being that governments start with a natural advantage when raising capital since they can borrow money at more competitive rates than the private sector. When costs seem cheaper, it is typically because a PPP involves less money up front, but if one is to factor in the cost of leasing a hospital/school/bridge back from the private consortium, factor in interest and a profit margin, long-term cost are often higher.
So yes, we might want the Quebec government to hurry up and get these new hospitals built – they’ve been sorely needed for years now – but we might rue the day we rushed this decision if the costing model is not correct.
Moreover, it’s worrisome in light of the de la Concorde overpass collapse, and other local infrastructure tragedies and incidents, to consider the possibility of buildings/schools/hospitals/bridges etc. not actually belonging to the people whose tax dollars paid for them and who will depend upon them for years to come. What would happen if a PPP infrastructure failed? Who would be to blame? In the murky territory between public and private, where do citizens seek redress?
It is not hard to imagine the families depicted in our play, Sexy béton, stuck between confronting the government and a private company in the event that an overpass like the Concorde were under the ownership of the latter, with each side likely pointing fingers at the other. A lot of finger-pointing, and not enough responsibility-taking, is what happened in this case already.
These are thorny issues. Some PPPs appear to have succeeded; it would be interesting for a larger conversation in Quebec to help guide general awareness about how we ensure, if used, they could work here.
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