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Fraser Health Authority Said No to Private Approach

Chair, since resigned, was overruled in decision to reject P3 model for facility.

By Tom Sandborn 1 Feb 2007 | TheTyee.ca

Tom Sandborn is a regular contributor to The Tyee with a focus on health policy issues.

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Premier Campbell: Scuttled recommendation

Top officials at the Fraser Health Authority opposed the provincial government's preferred P3 form of privatization in health care this summer, only to have Premier Campbell overrule their recommendations, recently released documents show.

The chair of the Fraser Health Authority at the time, Keith Purchase, made headlines last week by resigning his post, a move said to be caused by his frustration at being "out of the loop" in the budget process.

The revelation that the Fraser Health Authority also was at odds with the premier's office over how to finance facilities may shed further light on Purchase's frustration.

Excerpts from minutes of the health authority's facilities committee meetings in February and June of 2006, obtained through a freedom of information request by the B.C. Health Coalition and released to the public Jan. 31, 2007, show that Purchase was directed to meet with deputy health minister Penny Ballem and deputy finance minister Tamara Vrooman to convey the view of the Authority's top officials that "P3s are not the first choice of the committee."

The opposition to P3 structure was expressed in the context of a discussion of the planned new Surrey Ambulatory Care Facility.

Premier Campbell told delegates at a Union of B.C. Municipalities convention last October that all provincially funded capital projects over $20 million must be considered as P3 projects.

"We know P3s save money, transfer risk and add great value through design innovations and private sector ingenuity," the premier told the convention.

P3s highly controversial

The controversial P3 "public-private partnership" model involves private for-profit firms taking a role in building and sometimes operating what would otherwise be government funded and controlled services ranging from highways to hospitals.

Fans of P3s argue that the "partnership" structure reduces cost to the taxpayer and imposes the discipline of the private sector into otherwise bloated public works projects. Critics say, in contrast, that the drive to maximize profit can corrupt safety and efficiency in public service delivery and drive up costs beyond those generated by government projects. The government's recently launched Conversation on Health Care is widely expected to hear many calls for more use of private sector money on public projects like the Surrey Ambulatory Care Facility.

Both Ballem and Purchase have since resigned from their positions, Ballem in June and Purchase last week. Ballem cited her disagreement with the direction B.C. was taking in health care as reason for her resignation, and Purchase's unexpected resignation last Friday was widely reported to be in response to the government's decision to fire Vancouver Coastal Health Care Authority chair Trevor Johnstone, a longtime friend and business colleague.

In another excerpt from committee minutes dated Feb. 13, 2006, the point is made that "...if we undertake the traditional partnerships strategy (P3) there is a lesser ability to control design, longer lead times and additional risk."

"We're pleased that the FHA is following the evidence and their own experience with the new Abbotsford P3 hospital and concluding that P3s are not a good option for health care," said Joyce Jones, co-chair of the B.C. Health Coalition.

Health Minister's response

B.C. Health Minister George Abbott told The Tyee the June meeting notes are out of date. "This information was taken from minutes of meetings early in the planning process. There have been many meetings and discussions since then." Abbott said the government is finishing a "full and detailed analysis of various models for the project" and will have an announcement soon about how the ambulatory care facility will be financed and constructed.

Colleen Fuller, an independent researcher and published author on issues of health care and pharmaceutical policy matters, told The Tyee in a telephone interview: "This government is creating chaos in the health system, with firings, resignations and its refusal to learn from the body of research, here in B.C. and internationally, that shows that P3s are the wrong way to go on health care."

Today's revelations come at a time when some observers say the administrative structures controlling B.C. health delivery are in serious disarray. Vaughn Palmer reported in a column in the Vancouver Sun Jan. 31, for example, that Purchase had explained his sudden resignation from the Fraser Health Authority in an e-mail to senior colleagues that said he was leaving in part because of Johnstone's firing, but also because of government demands that he follow "a budget process which compelled me to keep my board colleagues out of the loop."

Purchase went on to say "I feel that decisions beyond our control are about to take Fraser Health rapidly backwards and this has become an affront to my personal integrity."

Related Tyee stories:

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