stumpjumper wrote:I have been trying to find any sort of document called something like "Comparison of Hospital Options".
As usual, there isn't one as far as I can tell. So how did the government reach the decision to build a new hospital on some free land that happened to pop up?
The answer seems to be that Durrow Health Services Management told them it was a good idea.
Why did Durrow tell them that? To understand it fully, I think you have to know a bit about British politics in the 1990s:
John Major was PM, but had never led his party to an election victory, and it looked like he was about to lead them to an election defeat. But he pulled a masterstroke: the Labour opposition had (or at least had a reputation for having) tax and spend type policies, so just before the election, he gave a speech about how lower taxes were good for the economy, and his party would be good for the economy because they'd cut taxes. It worked - people liked lower taxes, and safe in the knowledge that it was good for the economy, they reelected him.
But there was a problem: lower taxes weren't actually that good for the economy, and soon the government were running huge deficits, and people soon became concerned about the national debt. So the government introduced the Private Finance Initiative, so that the debt and the risk were transferred to the private sector. More often than not this was poor value for money. And while Gordon Brown was in opposition, he opposed them.
But then, to help shed their tax and spend image Labour made the election promise that they'd stick to the Major government's spending targets. It got them voted in, but if they were to keep the promise they couldn't fund much infrastructure in the normal way. Suddenly PFIs seemed very attractive, and the government enthusiastically signed as many PFI and PPP contracts as they could. But the private sector weren't very interested in upgrading hospitals - building new ones was more lucrative, so that's what was planned. And though such schemes were always subjected to a value for money test, this was usually fudged. Knowing that nothing at all would get done if the public sector option was found to be more efficient, authorities knew it was in their interest to make sure it wasn't, and nobody properly investigated what the best option really was.
Durrow Health Services Management was one of the companies involved in putting together some of those PFI deals. For legal reasons let me make it clear I'm not accusing them of deliberately fudging their value for money calculations on the RAH. However, considering their lack of experience trying to get the best value results with direct government funding, I have no faith at all in their ability to select the option that is genuinely most efficient here.
I really object to projects, instead of being a rational response to a need and properly compared to alternatives, being either porkbarrelling or the outcomes most desired by interested parties, whether they're politicians or developers.
I'd like to see all proposals costing over say $10 million of public money subject to scrutiny by a neutral panel of some sort.
So would I. Better still, they should have to answer, on the public record, every public objection to their plans.