The new hospitals must be built


What else can go wrong with Montreal's two superhospital projects? Like a mirage in the desert, the projects for years have always been just out of reach, with politicians promising that there's only one more obstacle to overcome, that we're a single study/partnership/fund-raising away from building.
The latest bad news is that the global economic crisis has hit Quebec's would-be private partners hard. Both hospital projects - the McGill University Hospital Centre and the Centre hospitalier de l'Université de Montréal - are currently planned as public-private partnerships.
The Charest government adopted the PPP model in the hope of avoiding cost overruns, at the same time as keeping billions of dollars of debt off its books.
As planning progressed, consortiums of private enterprises were lined up and ready to finance, design, build, and operate the two new teaching hospitals. The province would then rent the facilities from the private owners, by agreement over a period of 30 years.
In adopting the PPP model, Finance Minister Monique Jérôme-Forget argued as recently as last week that its principal advantages held - that the government would not be forced to take out loans and that any financial risk was the private partners' problem.
Now, however, the private partners have run headlong into very skittish money-lenders and insurers. Insurers don't want to take on 30-year loans. The credit markets have all but dried up around the world.
If the private consortiums manage to get their hands on the loans they need, it is going to cost them a great deal more than it would have a year or two ago. They now want the Quebec government to help them. One option is a government-backed financial guarantee for their loans. Rent spread out over 30 years is now too slow an option.
Critics of the new teaching hospitals might be tempted to use the economic crisis as a reason to call for the projects to be abandoned. It's too late for that. Montreal needs these hospitals. We have studied, analyzed, and rethought them nearly to death, but killing them off at this point will hurt us, patients and taxpayers alike.
It has been 17 years since the MUHC was first proposed. New machinery, techniques, teaching methods have come on line in those years. Few renovations have been carried out in the city's existing hospitals. We are in a situation where going forward is the only realistic option.

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