P3 Hospital Deals: A Warning from Ontario – Nova Scotia Must Not Repeat the Same Mistakes

“We’ve seen the disaster unfold in Ontario. Nova Scotia must not repeat these mistakes. Our hospitals, our health, and our public dollars are too important to gamble away on risky P3 deals.” Danny Cavanagh.

The Nova Scotia Federation of Labour is sounding the alarm over the province’s $7.4 billion public-private partnership (P3) deal for the new Halifax hospital, drawing urgent lessons from Ontario’s disastrous experience with P3 hospitals. The recent $100 million lawsuit filed by Humber River Health against its P3 developer in Toronto is a stark reminder of the risks Nova Scotia is now taking with public dollars and public health.

Ontario’s P3 Hospital Disaster: A Cautionary Tale

Ontario’s Humber River Hospital, built and maintained by a private consortium under a 30-year public-private partnership (P3) contract, is now at the centre of a significant lawsuit. The hospital alleges that negligent design and construction have left the floors so uneven and deteriorated that critical rooms are unusable, posing a risk to patient and staff safety. This is just the latest in a series of legal battles over shoddy construction, leaky pipes, and water system failures, problems that have disrupted care and forced the public hospital to pick up the pieces.

Ontario’s experience is not unique. Auditors general and independent experts have found that P3 hospitals consistently cost more than public builds, with Ontario alone spending $8 billion extra over nine years on P3s. When things go wrong, it is always the public, patients, workers, and taxpayers who bear the brunt of the consequences.

Nova Scotia’s P3 Hospital Deal: Headed Down the Same Road

Despite overwhelming evidence, Nova Scotia has chosen the same risky path. The $7.4 billion Halifax Hospital P3 is the largest healthcare infrastructure project in the province’s history, with $2.9 billion earmarked for 30 years of private maintenance. The Nova Scotia government formally announced in February 2025 that it had finalized a $7.4 billion public-private partnership (P3) agreement to construct a new 14-storey acute care tower at the Halifax Infirmary site. This is the largest healthcare infrastructure project in Atlantic Canada’s history and will be delivered through a Design, Build, Finance, and Maintain (DBFM) model with the private consortium Plenary PCL Health. Like Ontario, the government has negotiated this deal in secrecy, refusing to release key financial reports and value-for-money studies, leaving Nova Scotians in the dark about the actual costs and risks.

The similarities are alarming:

Ballooning Costs: What began as a $2 billion plan has exploded to $7.4 billion, echoing Ontario’s pattern of cost overruns and hidden premiums.

Opaque Contracts: Key details are withheld from the public, making it impossible to hold private partners accountable in the event of problems.

Long-Term Liabilities: Taxpayers are locked into 30-year contracts, paying higher interest rates and guaranteed profits to private companies.

Risk Transfer Myth: The promise that private partners will absorb risk is fiction. When P3s fail, as in Ontario, it is the public sector that must step in, fix the problems, and bear the legal and financial fallout.

Who Is Accountable? Taxpayers Left Holding the Bag

When P3 hospital deals go astray, the government and private companies point fingers at each other. However, it is Nova Scotians who will ultimately bear the burden through higher taxes, reduced services, and hospitals that may not be fit for purpose. If the private partner fails to deliver, walks away, or cuts corners to maximize profit, the province will be forced to step in, just as Ontario is now doing.

Our Position: Build Public, Keep It Public

The Nova Scotia Federation of Labour calls on the provincial government to halt this P3 hospital experiment before it is too late. There is overwhelming evidence that the public procurement, ownership, and management of hospitals deliver better value, more accountability, and safer care for all Nova Scotians.

We demand complete transparency, the public release of all financial studies, and a commitment to maintaining the true public nature of our hospitals. Nova Scotians deserve hospitals built for care, not for profit.