It was almost 20 years ago that the story of the Montreal super-hospital began. Despite its current reputation, the project began simply and without controversy. In 1993, five hospitals came together and decided that it would be more economical to merge their facilities into a 1,100-bed “super-hospital,” which would replace aging facilities in scattered locations with a central, convenient, and state of the art institution. The plan was a straightforward one, which aside from providing better health care, also aimed to save the province money, while increasing patient services. Two decades later, there is still no hospital, but only a promise that one will be built. Instead of saving money, the project grows more expensive with each year, and with each new estimate. And instead of providing the people of Quebec with better, more accessible health care, the hospital has turned into another weapon to make free health coverage a thing of the past.
It was the Parti Quebecois that was first confronted with the unfortunate predicament of the health care system. In 1993, the chairman of the Montreal Children’s Hospital estimated that by the turn of the century, health costs would account for more than half of the province’s budget. The PQ had loftier ambitions than simply healing the sick; it needed to heal the budget. In the name of “deficit-busting,” they carried out wave after wave of attacks, the likes of which have not been seen until recently. By 1997, the PQ government had closed seven hospitals, eliminated 2,438 beds, and continued by “adopting an ‘ambulatory’ approach that gets people in and out of hospitals fast.”
By the following year, the health care system was in tatters, with “congested hospital emergency departments, waiting lists for operations.” Extensive education cuts yielded a high drop-out rate and a forceful pressure towards the privatization of education. The PQ gave beneficent declarations of support for both a downtown and McGill super-hospital proposal, but stopped short of providing any funding. This was in 1999. By the time the election of 2003 came around, the people had had enough and kicked the PQ out of office.
At first, the newly elected Liberal Party of Quebec (PLQ) appeared to be truer to their word. They had promised to build the hospitals, and offered $800-million dollars to each proposed super-hospital for immediate construction. Some additional funding would be needed from other sources — either from the federal government or various charities — but the project was going to be underway immediately. At least, that’s how it looked at the time.
In 2006, following three years of delay and indecision (except in the matter of pay freezes for public employees and cuts to public education), the PLQ announced that, yes, the hospitals would be built. The date for completion was set for 2011, and the facilities would, while actually reducing the total beds and overall capacity of the city, be completely modernized. But this time there was a catch — the construction would be done as a “public-private partnership,” a system where private businesses would finance and construct the facility, and the province would “lease” it for the following 30 years.
On the surface, public-private partnerships appear to be a purely financial issue that helps to shift some of the financial burdens away from the government. In reality, these so-called “partnerships” are a way of beginning the privatization of public services, services that the working class has fought for. This is especially dangerous in the case of the Montreal super-hospitals, as private business longs to destroy public healthcare in Canada. On top of all this, “leasing” the hospitals means that the costs for the entire project are still entirely borne by the province, which now must also pay out a “reward” for the private businesses it deals with. From a cost of $1.6-billion in 2003, the price-tag doubled to $3.2-billion in 2006, even as Charest fought to award the construction contracts to Liberal-friendly business interests. By 2009, it anticipated cost had soared to $5.2-billion. Thus, with each year, private companies anticipate an increasingly lucrative business deal, while the prospects for seeing the new hospitals in place begin to look even more distant.
The idea for a “super-hospital” was first proposed by the existing hospitals themselves. It was seen as a necessary improvement on existing infrastructure. Most importantly, it was supposed to increase the medical capacity of the city, reducing waiting times and allowing for better patient care. The proposed “super-hospital” project by the Charest government would do just the opposite, reducing the number of beds and specialized care facilities. “You can’t say that 1,000 beds for specialized medicine will be made up for by 700 beds for specialized medicine,” said Gaétan Barrette, the president of the Fédération des médecins spécialistes, “That’s a drop in service.” Indeed, doctors and medical workers unilaterally came out in opposition to the plan. But the Liberals have pressed on, confident in their own superior medical knowledge.
Financially, the project has come under repeated criticism from Quebec’s auditor general. In 2009, he attacked the proposal for lacking any coherent plan of costs or timeline, neither of which have yet been released to the public. In 2010, he released a report refuting the claims of the Liberal cabinet that the latest “partnership” initiative would save money; in fact, it would cost considerably more than public funding. These findings were, however, disregarded as Treasury Board president Michelle Courchesne announced that the project was going ahead as planned. Not to worry, though; it had the support of an unnamed “panel of experts,” whose brilliant input has, also, not been released to the public.
Almost 20 years after its humble beginnings, Montreal’s new “super-hospitals” are, again, scheduled to be built. Again, they will be funded by private companies. The price-tag is likely higher than anyone in 1991 could have thought possible. Construction, however, will not begin immediately, if it does at all. The history of these buildings is a history of Quebec — a history of health care under attack, and the need to defend it. In 20 years, workers have seen their wages frozen or cut, students have seen tuition rise, and all so the government of Quebec — both PQ and Liberal — can sell away our health and our future.
It is clear that neither the PQ nor the Liberals can be trusted with the interest of the people of Quebec. After two decades, their “hospital,” for all its costs, does not even solve any of the problems it set out to. In fact, it only makes them worse. And meanwhile, the people who know what needs to be fixed — the doctors, the nurses, the technicians, indeed, workers everywhere — are pushed to the side and ignored. This needs to change. The PQ and the PLQ have shown which side they are on; they will defend the interests of capitalism over that of the people of Quebec. It is time for those very people — the workers, students, the young, and the old — to take control, for only they can fight for their needs, the needs of the people of Quebec.
