Amongst civil society attendees was Fiji Nursing Association’s National Council Executive member Mr Isimeli Radrodro Tatukivei. Speaking at a meeting on Public Private Partnerships Mr Tatukivei raised questions about the effectiveness of PPPs in healthcare concerned that Fiji’s Government is proposing to privatise two public hospitals.
“As nurses we have a responsibility to know what the impact of PPPs might be for our communities and the workers” said Mr Tatukivei. His inquiry comes at an important time as Fiji enters into National elections in mid November.
PPPs have received bad press in recent times with several reports showing that PPPs in healthcare are failing. Taking Back Control a report from an inquiry in Australia outlined failures in over nine examples of healthcare PPPs and whole sale privatisations. And a report by Eurodad, HistoryRepppeated provides a case study of hospital PPP failure in Sweden and Lesotho.
According to Eurodad Lesotho’s experience supports international evidence that health related PPPs can be extremely risky and costly. The report suggest that healthcare PPPs should be avoided, especially in low-income, low-capacity contexts where they can constitute a threat to the entire health system. The Taking Back Control report demonstrates that when healthcare privatisations fail it comes at great costs to the community, in both health outcomes and financially as the state is left to pick up the pieces.
It’s not just the usual suspects denouncing PPPs. The International Monetary Fund’s own analysis demonstrates that the benefit of privatisation is usually only an “illusion” and highlight that privatisation has left the UK in a poor fiscal position (see reports in the Independent and the Guardian for further comment). The IMF has repeatedly come out and said there is not a good business case for PPPs as they create hidden liabilities for governments.
And yet the World Bank continue to push privatisation and PPPs, making it a condition of loans and key reform targets.
“We don’t know why our government has been recommended to privatise Lautoka and Ba hospitals through PPPs” said Mr Tatukivei. “We are often told the PPPs are not a form of privatisation, however the information I have gathered from attending these meetings make it clear that PPPs are a version of privatisation. The community and healthcare workers in Fiji don’t know enough about what PPPs will do to healthcare. I will take this information back to Fiji to discuss with the unions, communities and relevant government ministers.
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