)A client of mine works at the hospital and he was telling me that the number of beds is no longer a true indication of the capacity and usefulness of the hospital (because I asked him why there wasn't a significant increase in the number of beds at the new hospital). He was saying that with technology changes a lot of procedures that used to require an overnight or longer stay can now be performed in a few hours with patients being sent home the same day or mobile nurses now have the ability to perform procedures at a patient's own home without the need for them to actually attend the hospital and require a bed. So he said as technology continues to change the way care is administered continues to change ultimately reducing the required number of beds for any given population size.Stubbo wrote:From memory, the original issue was that a significant percentage of the 'new beds' were for day procedures and therefore not a technical increase in capacity for ongoing patients or overnight / multiple day stays.
Not sure if that has been changed or not.
The proposed mining tax is not troubling investors into Australia at all (that's just a FUD campaign from those opposed), the EU problem isn't really bothering them much either. Sure it's affecting investment decisions into the EU, but the current dip in the Australian market has more to do with people losing their investment confidence in China. Believe it or not, foreign investors don't buy Aussie dollars because they are investing in Australia, they buy them as a de facto investment in China. Since China doesn't participate in the open market the only "safe" way is to buy into Australia, as we are so closely tied with China's prosperity (through our supply of raw material like steel).skyliner wrote:Just read the AFR today. ASX not too good at present - 'Aegean contagion' rattling many European governments as well as Wall St. Fear also a significant contributor as well as the mining tax as far as we are concerned. Will be interesting to see how all this pans out with the RAH.
Just recently been a $1trill bailout for Greece and still in trouble. (smacks of the GFC).
ADELAIDE - TOWARDS A GREATER CITY SKYLINE
The Greek bailout is just over 100 billion.skyliner wrote:Just read the AFR today. ASX not too good at present - 'Aegean contagion' rattling many European governments as well as Wall St. Fear also a significant contributor as well as the mining tax as far as we are concerned. Will be interesting to see how all this pans out with the RAH.
Just recently been a $1trill bailout for Greece and still in trouble. (smacks of the GFC).
ADELAIDE - TOWARDS A GREATER CITY SKYLINE
That's my point - thanks mate!Pikey wrote:The relevance is that both companies tendering for the job are from Europe, and are being financed from Europe. Foley has already come out and said that.
Just build it wrote:Bye Union Hall. I'll see you in another life, when we are both cats.
stumpjumper wrote:Following Foley's statements this morning. it's clear that the debate over the new (railyards location) hospital has descended to a typically South Australian condition - that is, argument by presentation of poorly substantiated guesses.
In other words, my guess of cost is better than your guess.
While no-one is presenting documents to back their claims, there is not much that's realistic about such an argument. It's purpose is to take headlines.
There's much more to it than that. Extraordinary claims require extraordinary proof. So far the government's based its policy decisions on the extraordinary claim that it's cheaper to build a completely new RAH than to replace the parts of the existing one that are inadequate. Yet they have not supplied any proof at all.stumpjumper wrote:Following Foley's statements this morning. it's clear that the debate over the new (railyards location) hospital has descended to a typically South Australian condition - that is, argument by presentation of poorly substantiated guesses.
In other words, my guess of cost is better than your guess.
One of the worst things to happen to footy in recent years is that if anyone tries a spectacular mark and fails, the umpire usually accuses him of being "not realistic" and awards a free against him. So I hope you understand why I'm rather suspicious of anyone who resorts to that criticism.While no-one is presenting documents to back their claims, there is not much that's realistic about such an argument. It's purpose is to take headlines.
Just build it wrote:Bye Union Hall. I'll see you in another life, when we are both cats.
Do it on another thread. Maybe on the pub. Maybe a speculation thread.Aidan wrote:stumpjumper wrote:And now that the argument for it is starting to fall apart, we should go for the jugular with all guns blazing!
Henry Ergas, Senior Economics Adviser, Delloitte’s, in The Australian Oct 30, 2009:
EARLY this year (2009), Victorian Transport Minister Lynne Kosky locked away until 2058 all the documents surrounding the troubled construction of Melbourne's $700 million Southern Cross Station. Were transparency and accountability thereby eliminated? No, merely deferred, though if you want to see those contracts, you'll need to keep pretty fit.
Kosky's decision is, unfortunately, hardly unusual. It has become standard practice for Australian governments - and this holds true for the commonwealth's Infrastructure Australia - to hide from the public the detailed information that would allow any assessment to be made of large infrastructure contracts.
Nowhere is the trend more pronounced than with respect to so-called public-private partnerships, projects in which private parties takeresponsibility for financing, constructing and operating public-use infrastructure, in exchange forthe right to receive user fees andcharges.
While concession arrangements for toll roads and other infrastructure assets have existed since time immemorial, they were renamed PPPs in the late 1980s and have since become a primary means of financing mega-projects, with applications ranging from tunnels and desalination plants to hospitals and prisons.
The change in branding from concessions to PPPs is hardly innocent. A concession by a government to a private party of the right to undertake and charge for a monopoly asset has a clear negative connotation: taxpayers are giving up something that would otherwise rightly be theirs. Who, on the other hand, could object to a partnership, with all the sense of shared obligation that word implies? As with nation building, here words are being used not to assist understanding but to mislead.
For whether the contracts are indeed a partnership, and one that delivers net benefits to the community, is a question of fact, not ofform.
The crucial issues are whether the projects are worth doing and whether the concession contract provides the project outcomes at least cost to the community.
That PPPs could, in theory, help achieve these goals is clear. Two factors are involved.
First, because the parties financing the project need to recoup the costs they incur, projects need to be commercially viable. As a result, reliance on PPPs should reduce the scope for governments to pursue projects that are electorally popular but ultimately do little to improve community welfare. There should, in other words, be fewer boondoggles, lemons and white elephants littering the landscape.
That is why Adam Smith was a supporter of private roads. "When high roads are in this manner made and supported by the commerce which is carried on by means of them," he wrote in The Wealth of Nations, "they can be made only where that commerce requires them." As a result, "a magnificent high road cannot be made merely because it happens to lead to the country villa of the intendant of the province, or to that of some great lord to whom the intendant finds it convenient to make his court."
Second, as well as narrowing the range of projects selected, profit-maximisation should lead to projects being delivered more quickly and at lower overall cost, including through better management of project risks.
If PPPs delivered these outcomes, the boosterism of the PPP cheer squad could be readily tolerated. But the reality is far more mixed and, in many respects, frankly negative. To begin with, not even Smith was infallible, and on this point he was simply wrong. Smith's error lay in not envisaging the lengths to which governments will go to make projects that impose social losses yield private profits.
In the case of Sydney's Cross City Tunnel, for example, measures euphemistically referred to as traffic shaping were used so as to restrict the alternatives open to motorists, thus increasing expected patronage. The government, in other words, actually spent money degrading existing infrastructure so as to eliminate the competition the PPP would otherwise have faced.
Because there are myriad ways in which governments can create or entrench monopoly rights, increasing the profits that project sponsors can gain even from projects that would fail a proper cost-benefit test, the mere requirement of commercial viability cannot protect the community from poor project selection.
This is even more clearly the case when the government directly or indirectly bears the risk associated with project failure. In theory, those risks should largely be allocated to the project's financiers, if the benefits Smith pointed to are to be realised. In practice, governments are increasingly shifting those risks to users or taxpayers, including by financial arrangements that refinance large parts of the private financing before many of the project risks mature.
The result can be structures that allow socially undesirable projects to go ahead, provide few incentives for efficient operation, lock in inefficient user charges and all the other inflexibilities inherent in highly prescriptive long-term contracts, and leave taxpayers exposed to project risk, all the while shifting substantial profits to project promoters.
This, in turn, creates a political economy that is diabolical. Because PPPs concentrate the gains from major infrastructure projects (as part of those gains is now captured by the private "partner"), they increase the returns from rent-seeking. The rents are then shaded from public view by the claimed need for commercial confidentiality, with that confidentiality reducing the transaction costs of what amounts to cronyism, if not corruption. At the same time, the fact that the financing goes off the government's balance sheet relaxes (or, more properly, is widely but incorrectly claimed to relax) the public sector's budget constraint, thus allowing even more poor projects to be undertaken.
In short, everyone's a winner. The firms undertaking the projects get the rents. Governments get more ribbon-cutting opportunities, vocal support from PPP firms, lucrative jobs for their mates and welcome donations to campaign coffers. Only taxpayers and users suffer, but then again, ignorance is bliss. Little wonder that PPPs have proved increasingly popular with incompetent state governments and are now being vigorously promoted by the Rudd government. Full disclosure of all PPP contracts, and of the cost-benefit analyses underpinning PPP projects, is indispensable if these costs are to be averted.
There is no evidence that countries in which this information is disclosed suffer any penalties as a consequence: in fact, the opposite is true. Australian taxpayers and users have every right to know the terms on which governments contract and spend money on their behalf, and the fact that Australian governments - and now Infrastructure Australia - do not make such full disclosure is a disgrace.
Transparency is all the more important given the real infrastructure needs Australia faces, needs that are well documented in the report recently prepared for the Business Council of Australia by Port Jackson Partners. There is, as that report shows, a compelling case for infrastructure spending, but that spending needs to be efficient.
Deals made behind closed doors and contracts that are hidden from public scrutiny for decades to come will never achieve that efficiency goal. Rather, we need the full glare ofsunlight, and the sooner we get it the better.
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