Construction projects

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Scores of hospitals being built under the £7bn NHS private finance initiative are in danger of becoming white elephants unable to adjust to changing health needs, the government was warned last night. The King's Fund, an independent think tank respected by health ministers, said the PFI projects were being managed under binding 30-year contracts without the flexibility needed to keep up with changing policies and technological progress. The fund's researchers said the NHS had never been good at taking the needs of local people into account when making investment decisions. Mistakes would continue to be made at hospitals built by the public sector as well as those contracted out under the PFI. But the private contracts would be harder and more expensive to correct. Guardian 7 September 2000

Around 600 hospital workers in the West Midlands town have begun their seventh strike against transfer to the private sector, in a dispute which has become the front line in the growing resistance to the public finance initiative in the health service. Yesterday was the second full day of a two week stoppage by non-clinical staff at four Dudley hospitals, whose jobs have been earmarked for transfer to Summit Healthcare, a private consortium, in an industrial stand-off that is being claimed as the longest series of strikes in the NHS. At issue are the health trust's plans to hand hospital buildings and non-clinical services and employees - including porters, cleaners and IT staff - over to the private sector on a 40-year £80m contract. In return, the private consortium, which includes Siemens, Building & Property and Sir Robert McAlpine, will rebuild one of Dudley's four hospitals as a "super hospital", turn two others into outpatient centres and close the fourth, with a loss of 70 beds. Despite advice from the health secretary, Alan Milburn, last year that PFI contracts need not include the transfer of non-clinical staff to the private sector, Dudley trust management says it is too late to revise the contract, which is due to be signed within weeks. Guardian 23 November 2000.

Labour is having a love affair with PFI, and for some health managers it is 'the only show in town'. In the third of our series, Faisal Islam runs some tests on the long-term future of NHS funding. Observer 25 February 2001.

The government's £1bn plans to renovate or replace 3,000 GP premises by 2004 through public private partnership schemes are "unworkable", according to a "national" survey of 27 GPs and primary care managers. Several of the GPs had not even heard of the public private partnership scheme, known as local improvement finance trust, or Lift. Health Service Journal round-up Publication date: April 26 Guardian Society Friday April 27, 2001

Crisis-hit hospital finds that private finance for NHS comes at a price. Labour is committed to greater involvement of the private sector in public services. It wants to use private companies to build new schools and hospitals and to run some services. But what has been the experience so far? Has the private sector, as the government claims, brought new money and fresh ideas to demoralised and underfunded public services? Today the Guardian examines the record at North Durham, among the first of a wave of new hospitals built by private finance and one of the flagships of Labour's programme. Felicity Lawrence Guardian Unlimited Monday July 23, 2001

The controversial Private Finance Initiative (PFI) could be "dead" if protests against it grow, key corporate partners have warned ministers. Guardian Society Wednesday August 1, 2001

The GMB union stepped up its campaign against private finance initiatives in the NHS yesterday by claiming that contractors stand to make between £1bn and £3.4bn profit over the next 30 years. Guardian Society Wednesday August 1, 2001

PFI delays fatal, say builders Nick Mathiason Observer Sunday September 2, 2001

Durham hospital chief executive defends record of PFI. Steve Brown Guardian Wednesday September 5, 2001

Post-PFI trust cuts staff to balance budget Guardian Society Friday September 7, 2001 [Scotland]

Lib Dems accuse Labour of fixing PFI figures Simon Parker Guardian Society Tuesday September 25, 2001

Lib Dems urge 'seven tests' for public-private partnerships Simon Parker Guardian Society Tuesday September 25, 2001

Brown 'mortgaging future' with private deals Lucy Ward, political correspondent Guardian Unlimited Wednesday September 26, 2001

Go-ahead for new-style hospitals. Blair brokers Whitehall deal on trusts borrowing private cash. Patrick Wintour and John Carvel Thursday October 10, 2002 The Guardian

Thousands of crumbling doctors' surgeries will be revamped using private-sector money under government moves to stop GPs deserting the inner cities. Gaby Hinsliff, chief political correspondent Guardian Society Sunday November 4, 2001

The government's controversial £7.6bn privately financed hospital building programme was back on track last night after union leaders accepted a compromise deal over staffing to end six months of deadlock. Guardian Unlimited Thursday November 22, 2001

The government's scheme for modernising services through public private partnerships (PPPs) was in turmoil last night as concern mounted about the financial health of Amey, one of its key partners. Terry Macalister The Guardian Wednesday July 10, 2002

Alan Milburn, the health secretary, yesterday provoked a fresh cabinet split over NHS funding when he said public sector hospitals should be free to raise money through local bond issues outside Treasury control. John Carvel, social affairs editor Thursday February 6, 2003 The Guardian

PFI 'white elephant' hospital faces merger. Health adviser drafted in to conduct emergency review of services in Darlington and Durham county. Guardian Society Friday February 8, 2002

The government's hospital construction programme is one of its few outright errors of policy, the independent King's Fund said yesterday in an otherwise upbeat post-budget audit of Labour's health initiatives. David Walker Guardian Thursday May 9, 2002

MPs reject attack on PFI in health service. John Carvel Society Wednesday May 15, 2002

Jury still out on PFI. Society Wednesday May 15, 2002

Reality of the private finance initiative. Guardian letter Tuesday May 21, 2002

PFI critic demands retraction after 'sloppy research' accusation by MPs John Carvel, social affairs editor. Guardian Saturday June 1, 2002

Many of more than 70 hospitals being planned under the government's private finance inititiative might be obsolete long before taxpayers have footed the bill for their 30 year contracts, a report said yesterday. Guardian Saturday June 8, 2002

Outdated hospitals. A Victorian model that needs revamping. Leader Monday June 10, 2002 The Guardian

Public fraud initiative. False accounting exposes private cash for public services as a theft from the taxpayer. George Monbiot Tuesday June 18, 2002 The Guardian

Is it not a touch ironic that an NHS hospital in Scarborough is being forced to open beds for private patients (Private arrangement, July 24) while here in Calderdale the local NHS trust has, in the last year, been obliged to send over 500 patients to the neighbouring Bupa hospital for treatment because of bed shortages in the new PFI-funded Calderdale Royal hospital? Ian Wishart, Chislehurst, Kent, Readers' letters Guardian Wednesday July 31, 2002

Unions call for end to PFI deals. Guardian Wednesday September 11, 2002

Resist those PFI bullies. Letters Monday September 30, 2002 The Guardian

The PFI needs a review. Tony Blair must address party concerns. Leader Tuesday October 1, 2002 The Guardian

Privately financed revolution. The chancellor says using the PFI is a fiscal imperative. But even the Treasury doesn't think that's all there is to it. Charlotte Denny Thursday October 3, 2002 The Guardian

The hidden PFI agenda. The creeping privatisation of health will end up with more charging and inequality. Felicity Lawrence Wednesday October 16, 2002 The Guardian

PFI's unhealthy future. Letters Monday October 21, 2002 The Guardian

NHS chiefs in Enfield are working on three huge private finance initiatives (PFIs) that could make or break the local health service. John Carvel Monday October 21, 2002 The Guardian

Milburn clashes with Unison over PFI. David Gow and Larry Elliott Wednesday November 27, 2002 The Guardian

PFI: the issue explained. Matt Weaver Wednesday January 15, 2003

Interview with David Metter, Innisfree chief executive. Terry Macalister Saturday February 22, 2003 The Guardian

A new report into hospitals built under the controversial private finance initiative paints a "damning picture" of bed shortages, reduced levels of patient care and poorly designed buildings, the country's biggest union said today. Thursday April 3, 2003

A report which claims the government's private finance initiative is turning the NHS into little more than an "emergency service" was yesterday dismissed by health officials. Researchers carrying out the first academic study into the controversial policy of using public-private funding to build hospitals claim it has led to fewer beds and cuts in services. The study, published in the British Medical Journal, was based on the £184m construction of Edinburgh Royal Infirmary, which, researchers say, has failed to increase efficiency and has led to a 24% cut in beds in the Lothian area. Gerard Seenan Saturday April 26, 2003 The Guardian

The government announced yesterday that it is abandoning the use of private finance initiatives for computer projects after a string of blunders across Whitehall. Charlotte Denny Wednesday July 16, 2003 The Guardian

A computer firm once proposed a novel way of charging the NHS for a maternity IT system. It would install the computers free, but receive a fee for every baby born at the hospital. Michael Cross Thursday July 17, 2003 The Guardian

This week's review of the private finance initiative is a serious attempt to answer some of the scheme's many critics. For the unions there is a promise that value for money will not come at the expense of staff terms and conditions. Local government officials overwhelmed by the legal and technical complexities will get a streamlined procurement system. Thursday July 17, 2003

A Swedish consortium is likely to win a £900m deal to redevelop St Bartholomew's Hospital in London - despite there being insufficient bidders for the contract under government private finance initiative guidelines. Terry Macalister Tuesday November 11, 2003 The Guardian

The government is funding a £1m scheme to give NHS wards a makeover following fresh evidence that an improved environment benefits both patients and staff. Helene Mulholland Thursday November 13, 2003

Private finance deals for hospitals are under strain because they are too inflexible to incorporate changes to government health policy, NHS managers warned today. Helene Mulholland Friday November 21, 2003

The private consortium made preferred bidder for the £900m redevelopment of St Bartholomew's and the Royal London hospitals has been accused of a conflict of interest. Terry Macalister Monday December 1, 2003 The Guardian

The government yesterday chose a Swedish-led consortium to undertake Britain's first £1bn hospital redevelopment scheme after ministers dismissed allegations of a conflict of interest. Tash Shifrin and John Carvel Thursday December 11, 2003 The Guardian [St Batholomew's}

Balfour Beatty has been made the preferred bidder for a £521m contract to build a new hospital in Birmingham despite what it admits are glitches with similar contracts and a catalogue of problems on the railways. Terry Macalister Thursday January 22, 2004 The Guardian

A thinktank has accused controversial private finance initiative schemes of keeping people in the dark. The public sector's failure to share basic information about projects under the initiative is proving a stumbling block to holding such deals to account, according to research published today by the Institute of Public Policy Research. A survey of projects last year found much of the information surrounding private finance initiatives (PFIs) was being kept secret, despite openness legislation. Hélène Mulholland Monday February 9, 2004

At least 10 NHS hospitals, built with private-sector funds, are facing deficits amounting to more than £40 million, says a new report from health campaigners. One hospital has had to close a ward, another has raised its car-parking charges for visitors, and several others are cutting back on agency staff to save money. The large monthly sums they have to pay to their private consortium partners, along with the rising number of emergency admissions, has put them under financial pressure. John Lister of campaign group London Health Emergency, which carried out the survey, said the hospitals built in the first wave of PFI face a unique handicap in the new competitive environment from April. Jo Revill, health editor Sunday March 14, 2004 The Observer

The Government's passion for PFI is basically a tax that it is set to bankrupt future generations. Nick Cohen Sunday March 28, 2004 The Observer

Halliburton, the American construction group, is being wooed by British government officials seeking new capacity to take on hospital schemes under the private finance initiative. The Department of Health is alarmed by the absence of domestic firms queuing up to take on new schemes which has already forced a dilution of the PFI competition rules. The latest trouble surrounds the £300m Vanguard hospital project in Plymouth, which has been falling behind schedule because of a lack of interest from the private sector. This follows the £620m redevelopment project for Barts and the Royal London hospitals, for which only two companies bid. Terry Macalister Monday April 5, 2004 The Guardian

A major public health disaster was avoided only 'by luck' after Labour's flagship hospital treated patients suffering from deadly contagious diseases in isolation facilities that did not work. The Observer has uncovered evidence that vital equipment at Norwich and Norfolk University Hospital for patients suffering from virulent strains of tuberculosis and other serious respiratory diseases, such as Sars, has never been operational. The hospital was built three years ago under the controversial private finance initiative (PFI) and was championed by New Labour as the future model for the NHS. Now, however, internal hospital correspondence has revealed that two 'containment' rooms which should have sealed in lethal infections by preventing contaminated air from escaping could have pumped the infected air into the public areas of the building. Antony Barnett, public affairs editor Sunday June 20, 2004 The Observer

The government's private finance initiative has led to huge mistakes in the £6bn hospital building programme in England, NHS chief executives told ministers yesterday. Contracts signed with big private consortia had led to poorly designed buildings with the wrong number of beds and insufficient flexibility to cope with changing health needs. John Carvel, social affairs editor Tuesday June 22, 2004 The Guardian

A select group of City banks and building firms have reaped more than £170 million in windfall profits from building four flagship hospitals under the government's controversial Public Finance Initiative policy, The Observer can reveal. The disclosures sparked outrage from unions and backbench MPs who described it as a 'public scandal'. They have demanded an independent inquiry into PFI, under which private firms are used to develop public buildings such as hospitals, schools and prisons. An Observer investigation has discovered that while new hospitals struggle with mounting debts and building faults, private contractors reap huge financial rewards using sophisticated methods to 'refinance' the original PFI deals. Antony Barnett, public affairs editor Sunday July 4, 2004 The Observer

We are left footing the PFI bill. The public pays the price when contractors pull out of projects. Jarvis, one of the country's leading PFI contractors, is on the brink of collapse. With debts of £230m and bank covenants broken, the group's banks have given Jarvis a waiver against the breaches until the end of the week, the effective deadline for the group to produce its results for the year. This is bad news for taxpayers and the Treasury's flagship PFI policy. Allyson Pollock and David Price Tuesday July 27, 2004 The Guardian

Allyson Pollock and David Price's article on PFI (Comment, July 27) repeats the usual misleading myths. The fact is that the private finance initiative means companies only get paid if they deliver. Letters Wednesday July 28, 2004 The Guardian

The health secretary gave the go-ahead yesterday for 15 new NHS hospital developments. John Reid said the health service was "in the middle of the biggest hospital building programme in its history", but was warned by NHS managers that the government would not get full value unless it changed private finance initiative rules. Gill Morgan, the chief executive of the NHS Confederation, representing health service trusts, said: "The PFI process needs to be made more flexible to ensure hospitals are suitable for patient care both today and in 30 years' time." Mr Reid said the new buildings would help in the fight against infections such as MRSA, as most would have more than 50% single rooms, allowing infected patients to be isolated. John Carvel Wednesday July 28, 2004 The Guardian

Thousands of GP surgeries in Britain can expect to be rebuilt or refurbished with £108m of new funding announced today. Health minister John Hutton announced the "improvement pot" which can be used to refurbish surgeries or create space for more staff. The money will be being allocated to primary care trusts that will work with local organisations to direct funding to the developments most needed in the community. The money has been made available in addition to the £1.19bn already invested in primary care premises over the next two years. Alice Wilby and agencies Thursday July 29, 2004

London's mayor, Ken Livingstone, is set to veto Britain's first £1bn hospital under the private finance initiative after its design was today severely criticised by the government's architecture watchdog. The project to rebuild the Royal London hospital in east London as an 18-storey block "recreates mistakes made in the 1960s", according to the Commission for Architecture and the Built Environment (Cabe). Matt Weaver Tuesday August 3, 2004 The Guardian

One of the government's biggest hospital building projects is in jeopardy after a damning review of its financial management. The Paddington Health Campus, a plan for west London which includes redeveloping St Mary's Hospital, the Royal Brompton and Harefield, which are both heart hospitals, and Imperial College, has seen costs rise from £382 million to £800m last year after a series of planning blunders. Jo Revill, health editor Sunday October 3, 2004 The Observer

A tale of two hospitals. One is a Kafkaesque monolith with endless echoing corridors. The other is a bright, airy child-friendly haven. Robert Booth on the right and wrong ways to design a hospital. Monday October 25, 2004 The Guardian

The government has paid up to 30% more in construction costs for hospitals built under the controversial private finance initiative (PFI) in order to meet deadlines and budget demands, accountants claimed today. They also claimed that 26% of the increase in NHS income between 2000-03 has gone towards paying PFI charges for new hospitals. The report, by the Association of Chartered Certified Accountants, criticised PFI as an expensive way of financing and delivering public services which could, in the long term, lead to cuts in or tax increases. The costs to trusts involved in the first 13 PFI hospitals included a "risk premium" of around 30% so that buildings went up on time and under budget, they claimed. The researchers also argued that PFI charges were higher than originally expected, which raises questions about the reliability and validity of the value for money arguments originally used when the decision was made to use private finance. Six out of the 13 PFI hospitals were in the red which, they said, suggested that this kind of private public partnership (PPP) was not affordable. Debbie Andalo Wednesday November 24, 2004

Jarvis teeters on the brink. PFI work grinds to a halt as group pins hopes on property deal. Terry Macalister Tuesday December 7, 2004 The Guardian

The government's policy of getting the private sector to build and lease back hospitals, roads and schools takes a dent today with the disclosure that a civil engineering contractor has made a £37m windfall profit from a £13m investment within three years of the opening of Britain's first privately financed hospital. The National Audit Office reveals in a report published today that Carillion - formerly Tarmac - made most of the money by selling on its shares in the new Darent Valley hospital, near Gravesham, Kent, to Barclays bank. David Hencke, Westminster correspondent Thursday February 10, 2005 The Guardian

An ambitious plan to build a £1 billion state-of-the-art hospital for London, replacing the Harefield and Royal Brompton heart hospitals, has fallen through, and developers are privately accusing civil servants of scuppering the deal because of alarm over costs and possible political fallout as the election looms. The proposal was to create the 'Paddington Health Campus', taking Harefield and the Royal Brompton and redeveloping them with St Mary's Hospital on land near Paddington station. But the consortium that owns the land, Paddington Development Corporation Ltd (PDCL), has withdrawn from all negotiations. Jo Revill, health editor Sunday April 24, 2005 The Observer

The biggest hospital building programme in the history of the NHS may be producing expensive "monuments" that are no longer needed in the new era of patient choice, a senior Department of Health official has warned. Bob Ricketts, head of a programme to accelerate patients' access to treatment, raised fears about the inflexibility of about £18bn worth of contracts given out under the private finance initiative (PFI) that will lock NHS trusts into paying for the new facilities for at least 30 years. John Carvel, social affairs editor Thursday June 9, 2005 The Guardian

Banks and property developers made windfall profits of £73m by refinancing one of the Labour government's first privately financed hospitals, the 989-bed Norfolk and Norwich hospital, the National Audit Office reveals in a report published today. The windfall is the third to be disclosed by parliament's financial watchdog after complaints from MPs and the public. The other two are Fazakerley prison in Liverpool and the Dartford and Gravesham hospital. The report says that funding for five other privately financed hospitals - South Buckinghamshire, Calderdale, North Durham, Bromley and South Manchester - could also yield windfall profits for developers. David Hencke, Westminster correspondent Friday June 10, 2005 The Guardian

It was flagged as one of the most ambitious hospital projects in Europe. But with costs spiralling out of control, the canalside Paddington Health Campus is set to be sunk. Mark Gould reports on a PFI flop. Wednesday June 15, 2005 The Guardian

The NHS will axe its biggest ever hospital investment today, scrapping plans for a private finance initiative to build a £1.1bn healthcare and research campus in west London. Patricia Hewitt, the health secretary, will approve an independent inquiry into how the scheme for a super-hospital in Paddington wasted eight years of effort and almost £14m in project costs before being cancelled without a brick being laid. Mark Gould and John Carvel Tuesday June 21, 2005 The Guardian

A legal challenge from local residents that threatened to stall the biggest ever private finance initiative (PFI) hospital building project in the UK has been abandoned, after protesters were warned that they could be liable for the legal costs of the local council and the hospital trust. The crumbling Royal London hospital in the East End dates back to 1752 and has a Grade II-listed 19th-century facade. It is being rebuilt as part of a £1.2bn PFI project that also includes St Bartholomew's Hospital in the City. Mark Gould Wednesday August 10, 2005 The Guardian

A flagship NHS hospital which opened four years ago under the government's private finance initiative admitted last night that it has become technically insolvent. Senior managers of Queen Elizabeth hospital NHS trust in Woolwich, south-east London, spoke to the Guardian after a warning from auditors that the annual deficit will climb to £100m by 2008-09 unless the government restructures a crippling PFI debt. The problems cast doubt on assurances from Patricia Hewitt, the health secretary, that the NHS's financial difficulties can be resolved by "turnaround teams" of management consultants which she sent out this month to correct a £623m forecast deficit across England. John Carvel, social affairs editor Friday December 16, 2005 The Guardian

Cash crisis puts new medical centre in jeopardy. Plans to build a multi-million pound one-stop medical centre at Bridgnorth Hospital are in doubt as an agreement between Shropshire health chiefs and developers Matrix Holdings Ltd has been put on hold until the new year. Summary by Keep our NHS Public of Shropshire Star 23 December 2005

Hospitals feel pain of funding problems. The FT says the Department of Health's decision to review the St Bartholemew's and Royal London PFI project "is a symptom of a deeper malaise affecting large-scale PFI hospital projects". Patricia Hewitt has hinted that in future there will be more reliance on "LIFT" (local infrastructure trusts) and fewer big PFI hospitals. An NHS executive said: "My guess is that Birmingham, and Barts and the London, will go ahead. But they will be the last of the mega-deals". Other PFI projects that could be in doubt include the £700m rebuild of University of Birmingham Hospitals. Minutes from a board meeting of financial regulator Monitor show that the DoH asked Monitor to approve the scheme's affordability - a request that was refused on the grounds that the guarantor, not the regulator, should carry the commercial risk. Treasury officials are known to be sceptical about four big projects in Liverpool worth £1bn. Schemes in Bristol, Plymouth, Hertfordshire and Leicester could also be in question. Summary by Keep our NHS Public of Financial Times 27 December 2005 (subscription needed to access FT articles)

The health secretary, Patricia Hewitt, has imposed a review of the biggest hospital rebuilding project in Britain, casting into doubt Labour's multibillion pound private finance initiative in modernising the NHS. Ms Hewitt has not only questioned the affordability of the £1bn plan to rebuild the Royal London hospital in Whitechapel and partly rebuild St Bartholomew's in Smithfield - founded in 1123 and England's oldest hospital, but is also asking whether projects on this scale will best serve patients' needs in an age of rapidly-changing healthcare. Ms Hewitt's decision to question the scheme reflects growing concern about the ability of hospital trusts to bear the huge annual costs of servicing 25-40 year PFI deals at a time when hospitals' guaranteed incomes have been plunged into uncertainty by the new payment-by-results policy. Michael White, political editor Wednesday December 28, 2005 The Guardian

Rethinking inconsistent hospital policies. Leader Wednesday December 28, 2005 The Guardian

New PFI health centres poised to open soon Three non-hospital health centres built under the PFI by the Prime PLC consortium will finally open after more than a decade of delays. A £1.5 million building in Packmoor in Stoke-on-Trent will be handed over to the already indebted North Stoke PCT in mid-January, followed by the £3 million Fenton health centre in April and another centre at Alton. In early 2007 a further project at Audley will be completed and schemes at Cobridge, Blythe Bridge, Bucknall, Shelton and Sneyd Green are being planned. Summary by Keep our NHS Public of Stoke Sentinel 30 December 2005

Walsall Manor Hospital PFI deal delayed amid concern over affordability. Walsall Hospitals NHS Trust chief executive Sue James said: "Commitment to a much needed capital development is essential, but we must be clear how we are going to save money we need for the annual repayments we will have to make for the lifetime of the contract." The PFI project is worth £160m and will cost the trust £13m a year in repayments. The trust still intends to go ahead and contract with either Carillion Health or Skanska Innisfree. Summary by Keep our NHS Public of West Midlands Express and Star 4 January 2006

Don't let cash crisis cost us new hospital. The outgoing chairman of the University Hospital of North Staffordshire, who resigned in December after it was revealed that debts were twice as high as had been reported, has said that a planned PFI 'super-hospital' development must not be sacrificed to tackle its financial crisis. He said the deal with private consortium Equion, which now appears to be under threat, is vital to provide modern facilities. Summary by Keep our NHS Public of Stoke Sentinel 6 January 2006

PFI hospital will go ahead. The University Hospitals of Leicester NHS Trust says its £761m Pathway PFI hospital project will commence despite doubts over the future of large PFI deals being unviable under payment by results. The deal with private contractor Triskelion will see Glenfield Hospital double in size, the existing General Hospital virtually demolished and the Leicester Royal Infirmary site converted to a new children's hospital. Summary by Keep our NHS Public of Leicester Mercury 9 January 2006

PFI moratorium delays hospital projects. A Department of Health moratorium on the criteria used to approve PFI hospital projects is expected to delay schemes awaiting the go ahead by 6 months. All trusts procuring major PFI projects have been asked not to progress until the review is completed. Summary by Keep our NHS Public of "PFI.net" 12 January 2006

A thousand doctors from St Bartholomew's and the Royal London hospitals have protested at the health secretary's refusal to approve a £1.15bn rebuilding scheme, weeks before contracts were due to be signed. Patricia Hewitt ordered a review of the project amid growing concerns that hospitals rebuilt under the private finance initiative will not be able to service their debts. The review will consider whether cancer and cardiac services at Bart's, in Smithfield, could be relocated elsewhere. But the trust believes that changes at this late stage would threaten a scheme that has taken years to develop. Tania Branigan, political correspondent Monday January 16, 2006 The Guardian

Billion-pound hospitals plan faces collapse. Ministers are considering scaling back or cancelling about ten PFI hospital building schemes, including projects in Bristol, Liverpool and Newcastle, due to concerns over cost. Under payment by results, hospitals do not have a guaranteed income and due to patient choice they could potentially close, leaving the Department of Health worried about the viability of the PFI. 24 PFI schemes with a total capital spend of £2.1bn have been completed. 14 more schemes, worth £3bn, have been approved. A further £12.1bn worth of projects are awaiting approval. A DoH source told the Times "Ministers are considering how to make it clearer that PFI schemes have to make financial sense. They are looking at how we got into this position and how to avoid it happening again." Patricia Hewitt ordered a last minute review of the St Barts and Royal London PFI project in December. If a decision is not made by the end of January the contract with private partner Skanska will lapse and the consortium will be entitled to walk away with costs of £100m paid, or to continue and be paid more. Summary by Keep our NHS Public of Times 16 January 2006

Doctors' concern for cancer care. 1,000 doctors at St Bartholomew's and the Royal London hospitals, including 450 consultants, have signed a letter to The Times protesting at government plans to renege on a £1.15 billion deal to rebuild the two hospitals. They say: "These hospitals have some of the best clinical outcomes for the treatment of cancer and heart disease. They serve Europe's most ethnically diverse population. The loss of any of these services would be damaging to the health of this vulnerable population and irretrievably damage our medical school…It would be a cruel injustice to the population of East London if 13 years of planning for the new hospitals were ended by the collapse of the scheme." Summary by Keep our NHS Public of Times 16 January 2006

Healthy questions. A Times leader backs the PFI, claiming that "public investment and private money remain the key to better hospitals." "Does anyone believe the Government could have undertaken the biggest hospital building programme in the history of the NHS with public money ? Nearly 40 hospitals have benefited, with another 60 next in line. It is precisely this kind of creative investment, with private sponsors responding to local needs, that is required across Britain's public services." Summary by Keep our NHS Public of Times 16 January 2006

Aborting PFI project could cost £100m. The cost of aborting the St Barts and Royal London PFI project - currently being reviewed by the Department of Health - could be £100m. If it is not approved by 31 January, construction company Skanska will be entitled to leave the project and charge £100m to cover its costs. Alternatively, the firm could continue on the basis that it will be paid more. Summary by Keep our NHS Public of Hospital Doctor 19 January 2006

PFI doubts lead Hewitt to turn down hospital's trust application. An application by the University Hospitals of Leicester trust has been put on hold while its £761m PFI scheme is reviewed. There are rumours in the PFI market that there is a 6 month moratorium on new PFI hospitals, something the Department of Health denies. Summary by Keep our NHS Public of Financial Times 19 January 2006

East End hospitals have a crucial role. Members of the Patient and Public Involvement Forum for Bart's and The Royal London Trust have written to the Guardian to call for the £1,15bn PFI project, currently being reviewed by the Department of Health, to be put back on track. Summary by Keep our NHS Public of Guardian 23 January 2006

Can PFI climb up off its sickbed? After the Bart's brouhaha, what's next for the axe? High costs and the uncertainty of hospital income under payment by results have put large-scale PFI projects in doubt. Industry insiders are now looking to the smaller LIFT scheme for the future of health building projects. Summary by Keep our NHS Public of Independent on Sunday 22 January 2006

The exorbitant cost of PFI is now being cruelly exposed. The huge deficits run up by NHS trusts are part of a wider market-induced healthcare crisis: we must have a full-scale review. Allyson Pollock Thursday January 26, 2006 The Guardian

Trusts ordered to review PFIs. The Department of Health will instruct all trusts planning PFI schemes to review them over the next six months. The Business Arrangements for 2006-07 rulebook asks trusts to take into account the impact of current policies as well as "lessons learned from earlier PFIs". Summary by Keep our NHS Public of Health Service Journal 26 January 2006

PFI a thorn in the side of foundation trusts. There is concern over how foundation trusts will cope with PFI. Foundation Trust Network director Sue Slipman said: "The real catch is whether or not you will be able to enter into PFIs in the future or make a lot of investment in the other assets you hold. Under [Monitor's] prudential borrowing code, foundation trusts will be able to do small-scale projects with short-term turnaround, but it is not a formula for solving the issue of investment in healthcare assets. You might be able to use it to open up a ward or department but it seems unlikely you could use it to replace the bigger PFI investments." Summary by Keep our NHS Public of Health Service Journal 26 January 2006

Hospital building plans face 40% cuts. Documents leaked from the Department of Health say that while the PFI will remain the chief means of building acute hospitals, the £12bn of projects currently planned is likely to be cut back to around £7bn to £9bn, a reduction of almost 40%. The department calls this a "reappraisal" of PFI, after denying a review or moratorium. The viability of the PFI has been brought into question due to the introduction of payment by results, patient choice and the move away from big hospitals. 40 big schemes are now in doubt, although it is more likely that they will be reduced in size rather than abandoned. Summary by Keep our NHS Public of Financial Times 28 January 2006

Hewitt insists QEII Hospital will be built. Patricia Hewitt has insisted the £550m Birmingham hospital will be built despite uncertainty over the future of PFI. Managers at the Queen Elizabeth Hospital in Edgbaston had expressed concerns about delays in signing the contract for a new 1,249-bed superhospital. Hewitt said: "The particular proposal in Birmingham is at a very advanced stage indeed. The final discussions are taking place between ourselves and the hospital now." Summary by Keep our NHS Public of PFI.net 30 January 2006

Smaller is better, says minister in hospitals shake-up. Chris Ham, former head of strategy at the Department of Health, has said that the measures in the white paper are likely to prompt the closure or severe scaling-back of larger hospitals. He added that those hospitals with PFI deals could face serious problems. Summary by Keep our NHS Public of Times 31 January 2005

Ministers balk at Barts' £1.15bn development project. John Carvel, social affairs editor Wednesday February 1, 2006 The Guardian

PFI fears could scupper hospital. The chief executive of University Hospital Birmingham NHS Foundation Trust has said that the £550m PFI superhospital project will be scuppered if the Treasury asks for the plans to be scaled down. Mark Britnell said scaling down the scheme could add a six-month delay and up to £49 million to its costs - putting it "on the cusp of affordability". He also said the delay, while the government reconsiders PFI projects in the light of other health reforms, was costly: "Balfour Beatty are asking for another £6 million for February, and if we do not reach agreement by mid-February we could be facing further capital costs of £40 million." Summary by Keep our NHS Public of Birmingham Post 1 February 2006

'Gerrymandering': Hewitt accused. A health scrutiny committee has invited Patricia Hewitt to explain a decision to overrule NHS managers on the location of a new hospital. Hewitt rejected plans to build a new critical care hospital in Sutton, opting instead to situate it in St Helier in Carshalton on the grounds that it could do more to reduce health inequalities in this more deprived area. Epsom and Ewell Conservative MP Chris Grayling said her decision was "party political" and a "blatant act of gerrymandering", because it came after representations by a Labour council and a Labour MP. He said the decision had caused a "stand-up row" between Hewitt and Sir Nigel Crisp. Summary by Keep our NHS Public of Health Service Journal 2 February 2006

Union criticises inflexibility of public-private LIFT contracts. Unison has said that the Lift scheme, a public-private arrangement similar to PFI generally used to deliver primary care facilities, risks locking the NHS into inflexible long-term contracts. Lift has so far been used to provide buildings, such as surgeries, clinics and community hospitals, but soon the private sector will also be allowed to provide clinical services. Lift was expected to become a £1bn programme but will now be larger as PFI projects are scaled back and the emphasis of policy shifts away from hospitals. Unison says Lift creates "inflexibility for the NHS, which is locked into long-term contracts in order to guarantee the private sector's cash flow". Any alterations to Lift buildings must be carried out by the contractor, creating a risk that they will overcharge. A National Audit Office report that concluded that Lift was good value for money has been criticised by the Commons public accounts committee, who asked the NAO to look at the issue again. Summary by Keep our NHS Public of Financial Times 3 February 2006

Review for Leicester hospital project. The government has asked the University Hospitals of Leicester NHS Trust to undergo a "revalidation exercise" of its £761m PFI Pathway hospital building scheme. The project, undertaken by consortium Triskelion Healthcare and the second biggest PFI scheme in the UK, would see Glenfield Hospital double in size, Leicester General virtually rebuilt and a new children's hospital open at Leicester Royal Infirmary. The decision is part of the Department of Health's moratorium on PFI projects as it seeks to cut the total cost of England's hospital building project by up to 40%. Summary by Keep our NHS Public of Leicester Mercury 3 February 2006

Blow for Frenchay as hospital get the OK. Avon, Gloucestershire and Wiltshire Strategic Health Authority have approved the business plan for a new superhospital at Southmeade in Bristol, further reducing the chances of a reprieve from closure for Frenchay hospital. Summary by Keep our NHS Public of Bristol Evening Post 3 February 2006

The PFI industry has got us over a barrel. In a comment piece Liam Halligan writes: "big PFI providers - and their shareholders - have little to fear…the industry has got the Government - and by implication taxpayers - over a barrel…As the next election starts looming ministers will be desperate to be seen opening new hospitals, despite the cash crunch…In the NHS and elsewhere, PFI will press ahead in the face of compelling evidence, from the National Audit Office and others, that it offers "poor value for money". One senior civil servant recently told me "more than 80% of PFI deals are not on Government books". Another said "the NAO has spotted many health and education deals neither on the public sector deficit nor even included in the sum total of PFIs"…So don't be fooled - PFI is here to stay. That's good news for shareholders, if not for current or future taxpayers. Summary by Keep our NHS Public of Telegraph 5 February 2006

Deadline for Bart's as Hewitt rethinks £1bn hospital plans. The Independent on Sunday reports signs that Patricia Hewitt has caved in to pressure from the Treasury over the £1.1bn PFI project for rebuilding St Barts and the Royal London hospitals. The Treasury fears the scheme is unaffordable, and now Hewitt is thought to be preparing to postpone half the work, most likely the St Barts side of the project. A Department of Health source said: "Patricia Hewitt needs to convince herself totally that the business case for this project stacks up if she's going to take on the Treasury." Summary by Keep our NHS Public of Independent 5 February 2006

Stealth plan to redevelop Barts may herald its break-up. The Government may decide to give the green light to half the £1.1bn PFI rebuilding programme for St Barts and Royal London hospitals, and defer funding on the second half. The second phase of the project involves 50% of the redevelopment of Bart's, including all cardiac services, as well as refurbishment of the dental hospital and outpatient buildings at the Royal London Hospital. Meanwhile the delays are currently costing an estimated £500,000 a day and Skanska Innisfree, the PFI consortium, has threatened a £100 million claim against the trust if the deal does not go through. Summary by Keep our NHS Public of Times 6 February 2006

The head of Barts hospital in London last night warned the health secretary, Patricia Hewitt, against an "unlawful" proposal to withhold approval for part of its £1.1bn redevelopment scheme. John Carvel, social affairs editor Monday February 6, 2006 The Guardian

Unison says LIFT is bad for the NHS. Unison general secretary Dave Prentis has called on the government to halt the expansion of LIFT, the primary care variant of PFI, in the light of the troubles over the latter. He said the union has produced reams of evidence exposing the enormous cost, bureaucracy and profiteering associated with PFI and highlighting its inflexibility. He said: "The white paper on community health and care services published just last week commits the government to an enormous investment programme in new GP surgeries. The government needs to step back and properly evaluate LIFT, rather than recklessly handing over hundreds of millions of pounds of NHS money to monopoly providers for expensive and inflexible schemes." Summary by Keep our NHS Public of PFI.net 7 February 2006

Uncertain destination: will private finance for public projects soon run out of road? There is a sense among some PFI providers that the UK market has stalled, or is in decline. But the Treasury rejects the suggestion. Richard Abadie, head of PFI policy at the Treasury, said: "Different companies focus on different sectors" - in area such as health there has been "a slight reduction in the scale of what is planned". Where shifts in policy or changes in technology and population may have a significant impact over 30 years, PFI may lack the necessary flexibility. With schools and hospitals there are worries that the use of buildings will change considerably or that they may not be needed at all. The cost of varying a PFI contract once it is signed can be substantial. The FT says the cancellation of the Barts PFI scheme would "shock the entire PFI industry as well as shaking to its foundations one of the UK's most venerable institutions." Summary by Keep our NHS Public of Financial Times 8 February 2006

Sector as opaque as ever on value for money. It is difficult to fully assess whether the PFI offers value for money, because data is hard to come by and limited by commercial confidentiality. Colin Talbot, professor of public policy and management at Manchester Business School, said: "Given the scale of this programme and the key role it now plays in providing public infrastructure and services, it is frightening how difficult it is to make an independent public policy assessment of its real value for money." Summary by Keep our NHS Public of Financial Times 8 February 2006

Investor equity brings uneven outcomes. Some companies have made huge earnings from the PFI. Carillion has seen its stakes almost triple in value over the past two years. Its original investment of £29m (in 19 projects) has a present value of £84m. Balfour Beatty holds PFI investments worth more than £600m from an initial investment of £188m. Its profits doubled in 2004. Amec has said its stakes in hospital and rail schemes have doubled in value. Summary by Keep our NHS Public of Financial Times 8 February 2006

New LIFT health centre to open in Hull. The £1.9m Newington Health Care Centre will house two GP practices and opens at the end of the month. Repayments will be made to the private consortium that built it over 25 years. Summary by Keep our NHS Public of Hull Daily Mail 9 February 2006

£40m PFI deal for Durham. County Durham and Darlington Priority Services Trust and Derwentside PCT are commissioning a £40m project under the Private Finance Initiative to build a mental health hospital on the outskirts of Durham and a new medical centre in Stanley. The mental health centre will cost £23m to build, while Stanley's centre for primary care and services for children and young people will cost £17m. PFI schemes are controversial in the area after the PFI built University Hospital of North Durham came under concerted attack for its design after opening five years ago. The £97m hospital was criticised for having too few beds to cater for projected demand. Summary by Keep our NHS Public of Newcastle Journal 14 February 2006

The cost of ministers' indecision: £600,000 a day. · Hewitt accused of stalling over signoff deadline · Workers paid on retainer racking up daily costs. Sandra Laville Thursday February 16, 2006 The Guardian

Group out to protect the NHS. Greenwich Keep Our NHS Public has been formed to campaign against the marketisation of the NHS. Of particular local concern is the Queen Elizabeth Hospital in Woolwich, where the new PFI hospital costs £9m a year more than a traditionally financed hospital of the same size, causing huge financial problems. Summary by Keep our NHS Public of News Shopper 16 February 2006

Poor prognosis for the PFI. Public Finance sets out the reasons for the government's change of heart over the PFI: "Under payment by results, a flexible cost base is vital. A large PFI scheme, with its fixed costs, will inevitably focus all attempts to achieve savings on to the remainder of the trust's cost base and, increasingly, its clinical staff." Affordability is the second great problem. In the case of the Queen Elizabeth Hospital in Woolwich, the auditors said "the trust achieved its breakeven duty only through significant amounts of financial support". However, "central financial support provided to the trust in earlier years of the scheme…is currently being phased out, thereby exacerbating the trust's financial difficulties." The Woolwich PFI scheme was only ever affordable with a subsidy, and that subsidy is now steadily shrinking: from £3.1m in 2002/ 03 to £1.1m in 2005/ 06. Public Finance says: "The PFI has never been a free lunch for the NHS. The internal rate of return on a scheme - that is, the level of return to equity investors - has typically been around 12%-15%. At Norfolk & Norwich, the actual rate has been estimated at 60%. Yet the rate of return on capital implied within the NHS's financial model is a mere 3.5%." It has also become less and less feasible to justify the off-balance sheet accounting treatment that made the PFI so attractive to government, as accounting rules have gradually changed. Summary by Keep our NHS Public of Public Finance 17 February 2006

Community services squeezed despite funding rise. Capital funding in the NHS will increase by 19% in 2006-7, the Department of Health has announced. The overall capital allocation for the DoH will be £5.2bn - £83m higher than originally planned. PCTs will receive a minimum of a 10% increase in their operational capital. But they will not be given any dispensation to strategically overspend next year, and balance their books in the next. While payment by results is expected to cause instability and closures in the acute sector, critics say PCTs have not been given the flexibility to start up new community-based services in their stead. Summary by Keep our NHS Public of Public Finance 17 February 2006

Plea for ministers to back super-hospital. Labour councillors have written to the Health Secretary urging the Government to back Birmingham's £559 million new super-hospital. The work is in danger of coming to a halt if the Treasury fails to make a decision soon over whether the trust - which runs the existing hospitals - can go ahead with its plans. Summary by Keep our NHS Public of Birmingham Post 20 February 2006

LIFT medical centre opens in Leicester. The £2.4 million Merridale medical centre in Braunstone, Leicester, is the first of a £50m project that will comprise eight more facilities in the city. Also planned are £2.4 million primary care practices in Humberstone, De Montfort University, Belgrave, Bede Island and Groby Road, and an £11.2 million Charnwood health and social care centre. Summary by Keep our NHS Public of Leicester Mercury 20 February 2006

Right to review Barts. A letter to the Guardian from health minister Jane Kennedy says: "The cost of a rash judgment on the redevelopment of Barts would have had far more serious implications than our decision to carry out a review. Given the scale of the proposals, the large sums of taxpayers' cash involved and the significant reductions in waiting lists in recent years, it would have been reckless to go ahead without proper scrutiny…The NHS is not contractually bound to pay any increase in building costs and the final figure is open to negotiation. Our policy has successfully delivered new hospitals in the past and there is every reason to believe it will continue to do so." Summary by Keep our NHS Public of Guardian 21 February 2006

Superhospital plan may be scaled down. Negotiations are under way to reduce the size of North Staffordshire's planned £420m PFI superhospital, raising fresh fears over job cuts. Already 1,200 posts are to be lost because of the financial state of the University Hospital of North Staffordshire. Hospital executives are in talks with PFI consortium Equion to see if the 30 annual instalments of £53m the NHS is set to pay under the PFI can be reduced by keeping some of the support services - including cleaning, catering and portering - in the public sector after all. They are also looking at a scaled down scheme with fewer beds. Unison branch secretary Pat Powell said: "We warned this would happen years ago but were ignored. It would seem the only alternative now is for the Government to ditch the whole PFI policy and start funding hospitals from the Treasury as they always used to…If the trust is now talking about cutting costs by keeping the staff within the NHS instead, that can only mean job numbers falling. We have always fought to keep jobs and services in-house at this hospital but in light of recent events you now wonder if they would be less at risk if they were working under a private contractor." Summary by Keep our NHS Public of Stoke Sentinel 21 February 2006

Foundation trust hospitals are likely to be given the lowest investment-grade credit rating - just above high yield or "junk" status - on money they borrow in the City, a leading credit agency warned yesterday. This means that the hospitals will face higher rates of interest, putting even more stress on their stretched resources. Terry Macalister Wednesday February 22, 2006 The Guardian

Is the PFI empire crumbling? As well as large PFI projects at St Barts, Plymouth and Birmingham being put on hold, regional health bosses are due to carry out reviews in the coming months into the value for money, affordability and need for about a half a dozen other schemes. Summary by Keep our NHS Public of BBC Online 23 February 2006

Setback for NHS revamp. The future of health services in the Midlands has been "put in limbo" with a second major multi-million-pound development under threat due to the Government's review of the PFI. Plans to revamp healthcare across west Birmingham and the Black Country with new hospitals and changes to Sandwell and City Hospitals have been put on hold. The postponed consultation exercise would have looked at proposals to either refurbish existing hospitals or build five new community hospitals and a new hospital in Smethwick. Birmingham's £550m superhospital is also on hold because of the problems of PFI. Summary by Keep our NHS Public of Birmingham Mail 24 February 2006

Plans for mini-hospital casualty of NHS crisis. A £5 million pound PFI mini-hospital to treat people falling ill at nights and weekends has been scrapped, because of the financial crisis gripping North Staffordshire healthcare. It was set to become Britain's first fully comprehensive out-of-hours medical centre, containing GPs, nurses, dentists and pharmacists. But the four North Staffordshire PCTs - with a combined deficit of £15m - say they can no longer afford the PFI scheme it due to the "present financial climate". In the autumn the service will be transferred from its current location to the University Hospital of North Staffordshire's central outpatients department. Doctors have voiced concerns over how a service incorporating 80 doctors, 48 nurses, teams of drivers and a range of full-time staff can be "grafted on to" an already busy hospital department. Summary by Keep our NHS Public of Stoke Sentinel 01 March 2006

Doctors had own plan for treatment. A doctors' co-op in North Staffordshire's was prepared to run out-of-hours medical cover and was poised to build a state-of-the-art centre before the service was incorporated into the mainstream NHS two years ago. Now PCTs cannot afford the mini-hospital. Summary by Keep our NHS Public of Stoke Sentinel 01 March 2006

Hospitals decision. The Treasury has reportedly balked at the cost of the Barts and Royal London PFI scheme, and agreed to proceed only after substantial cuts have been made. Summary by Keep our NHS Public of Times 01 March 2006

Hospital to mothball 250 beds. Managers at Barts and the London NHS Trust revealed that they have struck a deal with the Government that will allow the PFI hospital to be built, but leave it with fewer beds than they have now. Wards will be left empty to save £20m from the original scheme. Two floors at the Royal London Hospital and one at Barts will be mothballed once building work is complete. According to figures from the trust and the developers, Skanska Innisfree, the delay caused by the government's decision at Christmas to review the project has added an extra £35 million to the bill. Summary by Keep our NHS Public of Telegraph 5 March 2006

Doctors yesterday welcomed the long-awaited approval of the scheme to rebuild two teaching hospitals in London in the biggest private finance initiative within the National Health Service. Patricia Hewitt, the health secretary, approved the redevelopment of St Bartholomew's hospital and the Royal London after delays which patient groups and the hospital trust claimed had added £35m to the £1.1bn cost. The decision to go ahead with the redevelopment of Barts will saddle the local healthcare trust with a 30-year financial commitment. Across the NHS, PFI schemes, which form the backbone of new hospital projects, are being re-examined over growing fears about the ability of trusts to repay the private companies over 25 to 40 years. Sandra Laville and Terry Macalister Thursday March 9, 2006 The Guardian

Super hospital delays prove costly. Government delay in approving Birmingham's £559m super hospital is to cost taxpayers an extra £1 million a week. Bosses at University Hospital Trust have revealed the NHS will pay out an extra £1m per week to building company, Consort, from next week for the cost of more delays. Summary by Keep our NHS Public of Birmingham Mail 10 March 2006

PFI can be too inflexible for growing range of projects, study finds. Deloitte, leading adviser on the PFI, has said the scheme is proving unsuitable for a growing range of projects. Where uncertainty is greater, as over the use to which hospitals will be put, PFI does not work well, and that is being compounded by the introduction of market mechanisms such as patient choice, which create uncertainty about the demand for a particular facility. Summary by Keep our NHS Public of Financial Times 10 March 2006

Two big hospital PFIs at risk. The University of North Staffordshire NHS Trust has admitted it will not be able to afford it's £350m PFI hospital without scaling back the project. The scheme, which also includes the construction of a community hospital, would tie the trust in to paying the private consortium Equion between £52m and £53m a year over 30 years, a total of around £1.5bn. The government is also reviewing the PFI project at the University Hospitals of Leicester NHS Trust. Summary by Keep our NHS Public of Independent 12 March 2006

Why taxpayers may get huge PFI hospital bill. Taxpayers could end up picking up the bill for costs incurred by contractors if the Treasury refuse to approve plans for Birmingham's £559 million 'super hospital'. A leaked letter from the Department of Health states it, and not the University Hospital Birmingham foundation trust, will compensate the private sector partner for any costs if the project does not get the go-ahead. From this month the project faces mounting building costs of £1.5 million a week. Summary by Keep our NHS Public of Birmingham Post 18 March 2006

Public finance initiative. In a letter to the Guardian, Harry Keen, president of the NHS Support Federation, and Peter Fisher, president of the NHS Consultants' Association, write: "We have long argued the case for government or local authority bonds - i.e. a public finance initiative - as a cost-effective and socially progressive alternative to the private finance initiative for the NHS. Up to now it has fallen on deaf ears as far as government is concerned. But Professor Peregrine (Letters, March 16) again raises the idea and gives it added value at a very appropriate moment… Transfer of some patient care into the community points to the need for more, not less, flexibility in the use of hospital buildings in the future. Will the Treasury at least respond to Professor Peregrine's proposal and enter into a debate ?" Summary by Keep our NHS Public of Guardian 21 March 2006

The chancellor Gordon Brown will try to bury the Conservative charge that he is Labour's roadblock to reform when he uses his budget today to justify plans for a controversial £26bn expansion of the private finance initiative across 200 public sector projects. Patrick Wintour, political Editor Wednesday March 22, 2006 The Guardian

The government yesterday signalled a possible end to long-running contracts of up to 30 years in private finance initiatives and suggested a shake-up of the scheme that is being used to modernise hospitals and schools. A Treasury document, published with the budget, said there may be "positive benefits" from separating the building contracts from service ones providing cleaning and maintenance. Terry Macalister Thursday March 23, 2006 The Guardian

Services cut fear on new hospital. The chief executive of Birmingham's planned super-hospital has said that some of the planned clinical services may have to be cut if the £559 million project is to get government approval. Summary by Keep our NHS Public of Birmingham Post 29 March 2006

Treasury begins drive to improve PFI. A drive to improve procurement of complex projects across the public sector is being launched by the Treasury. The Department of Health is to pilot an integrator team or "project delivery organisation" to buy hospital and health buildings. They will develop projects before they go to market then run the competition to provide the service. Summary by Keep our NHS Public of Financial Times 29 March 2006

Ipswich PFI financial close. The Ipswich Hospitals Garret Anderson Centre project has reached financial close. The £26m, 30 year PFI project will see Prospect Healthcare - a consortium of Kier and HSBC - building the new centre, which will include a new emergency department, a critical care centre, and a day surgery suite. Summary by Keep our NHS Public of PFI.net 31 March 2006

Hospitals plan. Capital Hospital is to raise £1.025bn in index-linked bonds secured against future NHS funding to finance the redevelopment of three London hospitals - At Barts, the Royal London and the London Chest Hospital. Summary by Keep our NHS Public of Financial Times 4 April 2006

Funding switch could spark NHS cash crisis. Four north west Labour MPs - Rosie Cooper, Helen Jones, Angela Eagle and Andrew Miller - have joined forces to protest that payment by results will penalise newly built hospitals that currently receive bigger grants because they face higher depreciation costs. Rosie Cooper said: "Hospitals should not be penalised by a mathematical formula simply because they are new facilities. Unless changes are made, debts will continue to rise and draconian measures will result which could have dire consequences." Southport and Ormskirk and North Cheshire trusts are heading for combined debts of £43m next year, partly because of payment by results, according to Cheshire and Merseyside SHA. Already, plans have been drawn up to end emergency admissions at Halton Hospital, in Runcorn, and transfer them to Warrington. The SHA's study also warned that Ormskirk Hospital - currently running a £6.5m loss - would not be able to cover its overhead costs under the new system. Cooper suggested that Royal Liverpool & Broadgreen University Hospitals, the Walton Centre for Neurology and the Countess of Chester Hospital would also lose out, and called on Patricia Hewitt to alter the system. Summary by Keep our NHS Public of Liverpool Daily Post 5 April 2006

Dozens of new doctor's surgeries and health centres this year. The Department of Health plans to open 125 more health centres by the end of this year. £812 million in private sector and £210 million public sector funding has already been injected through Local Improvement Finance Trust (LIFT). There are 42 NHS LIFT schemes established with another eight in procurement. This has, to date, delivered 68 new buildings with another building a week opening during 2006. Summary by Keep our NHS Public of Department of Health 6 April 2006

Fixation on deficits could 'derail' foundation project. The foundation trust programme could be 'derailed' by the government's fixation on NHS deficits, the Foundation Trust Network has warned. A report by the Network highlights several factors contributing to the threat to the foundation trust programme, including the low uplift in this year's tariff for payment by results and 'problems with commitments to private finance initiative projects'. It says the government could fail to reach the minimum target of 65 foundation trusts by next April, and it is unclear where the next phase of applicants will come from. Summary by Keep our NHS Public of Health Service Journal 6 April 2006

MP steps into rebuild delay row. Leicester East MP Keith Vaz has demanded a meeting with Patricia Hewitt about delays to the University Hospitals of Leicester PFI rebuilding programme in her constituency, which is adjacent to his. Vaz said: "The bill [for consultant and architect advice] stands at around £60m without a brick being put in place." The DoH said in January it wanted to re-examine the plans. This week it said it hoped to make a decision within the next three months. Summary by Keep our NHS Public of Health Service Journal 6 April 2006

Plan for new hospital site to be reviewed. Patricia Hewitt revealed that a DoH team is in Staffordshire reviewing plans for the £420m PFI superhospital, which has already been delayed two years and may now be downsized. Summary by Keep our NHS Public of Stoke Sentinel 6 April 2006

£6m ward closed before it opens. A new £6 million PFI hospital ward at Weston General Hospital, Weston-super-Mare, is to be mothballed because the NHS cannot afford the staff to run it. The ward, intended for vulnerable old people with mental health problems, is part of a £78m PFI intended to revamp mental health facilities across the Avon area. Avon and Wiltshire Mental Health Partnership NHS Trust and North Somerset PCT will pay the PFI firm £200,000 a year for 30 years, a total of £6 million, for the building and maintenance of the ten bed facility. The trusts had originally budgeted to build one 25-bed ward, a plan that was scrapped in favour of two wards, one with ten beds and one with 15. But the extra cost of staffing two separate wards had not been taken into account, leaving a shortfall of £560,000. The two trusts found their PFI contract did not allow them to pull out of the ongoing building, so they were left with no choice but to build both wards and leave one empty. Summary by Keep our NHS Public of Times 6 April 2006

Cost and consultants in the NHS. In a letter to the Times, Dr Chris Laing writes: "There is justifiable concern about where the large increases in NHS funding has been going. This has been met with rather cynical briefing that it "has all gone on pay rises". This is preferable to the wastage being pinned on government initiatives, such as £5 billion for "choose and book". It is frequently stated that spending has gone awry because of a lack of reform. This "reform" has transformed the world's most efficient health service to one of the most inefficient. It has transferred huge amounts of public money into the coffers of management consultants, contract lawyers, IT firms, private healthcare companies and PFI builders and left a mounting bureaucratic burden. Perhaps a little less reform would be in order ?" Summary by Keep our NHS Public of Times 6 April 2006

Town with £6m to spare says: let's build a hospital. A district council has become the first local authority in Britain to build its own hospital, in an experiment which is turning the Private Finance Initiative on its head. Wychavon District Council, in east Worcestershire, is spending £6.7m to build a 26-bed hospital in Pershore. The council is due to finish the project in September, then lease it to South Worcestershire PCT, which is in financial difficulties and making cuts elsewhere in the region. The trust plans to close the 19-bed cottage hospital. Initially it will be unlikely to run the new hospital at full capacity, as it has the staff to run only 19 beds. The council will receive a higher rate of return - 7% - than the bonds in which it had previously invested its surplus money. Summary by Keep our NHS Public of Times 10 April 2006

Go-ahead for £1bn hospital schemes. Ministers have given the green light to two redevelopments of hospitals in Birmingham and St Helens costing £1bn. A new acute hospital and mental health facilities will open to patients under the £690m Birmingham scheme, which will provide 1,231 beds, as well as accident and emergency, specialist burns and transplant wards, a decontamination suite and operating theatres. The £338m St Helens scheme would see the development of St Helens and Whiston hospitals in Merseyside, including a new diagnostic treatment centre and a 963-bed hospital. Summary by Keep our NHS Public of Financial Times 13 April 2006

Medical Property raises £110m for GP centres. Planned changes in the NHS have prompted the Medical Property Investment Fund to roll out a new brand of healthcare centres. It has raised £110m through a share placing to fund its new brand of GP surgeries. Richard Burrell, the architect of the group's strategy, said: "The White Paper confirms the overall direction. We are one of few companies uniquely poised to benefit." He said the group's approach of owning and running healthcare assets in partnership with doctors was unique and there was a big shift to private and corporate ownership for the 10,000 doctors' surgeries in England and Wales. The group plans to have more than 100 healthcare centres by the end of the year. Their size will range from five GPs and 10,000 patients to 44 GPs and 68,000 patients. Summary by Keep our NHS Public of Independent 14 April 2006

Our £300m hospital's a tonic. A new 823-bed general hospital is to be built using the PFI in Whiston. A diagnostic treatment centre in St Helens is also to be developed. NewHospitals, the consortium which will build the new hospitals, is made up of companies including Taylor Woodrow Construction, Medirest, GE Medical Systems, and Health Care Projects. Summary by Keep our NHS Public of Liverpool Echo 14 April 2006

The Government has been accused of wasting millions of pounds on hospital projects which could be used instead on frontline services. The CBI blamed "sloppy" procurement such as failing to put a price on project delays, as well as poor planning. The full potential of the Private Finance Initiative was being held back, with an average of £2.4 million being added to major hospital projects, the business group said. The "extra burden" could top £120 million because of delays to current projects, it was claimed. Friday April 21, 2006 7:28 AM

Hospital delay costs NHS £50m. The NHS trust that is responsible for Bart's and the Royal London hospitals says that the delays to the project caused when Patricia Hewitt ordered a last minute review have added an extra £1.5m to the annual fee that it will pay the project developers. The trust calculates that the delay will cost around £50m over the life of the project. It expects to pay up to 20% of its annual projected income to meet the PFI fee. Summary by Keep our NHS Public of Telegraph 21 April 2006

Premises carrot for private providers. A wave of private provision of primary care by companies involved in LIFT schemes could be about to break, according to GP leaders. Fourth-wave tenders for LIFT schemes include a provision for clinical services through which LIFT companies could engage private medical companies to provide GP or district nursing services. In guidance to GPs about LIFT, which began in 2001 with the aim of developing state-of-the-art primary care premises in England, the GPC warns it will erode the public sector role in primary care even further. Ministers have said they expect 125 new health centres to open between now and the end of the year. The latest LIFT developments give private companies, which form part of LIFT consortiums, the chance to use alternative provider medical services contracts as a route into the healthcare market. GPC member Dr Grant Ingrams said practices should look to expand and take on patients from retiring doctors rather than close their lists, in order to prevent private companies winning the contract and potentially taking over their own practices later on. He advised merging before neighbouring practices went out to tender. 'We have nominal competition between GPs, but doctors tend to be nice to each other. Don't expect private providers to be nice to you,' he said. Summary by Keep our NHS Public of Doctor Update 21 April 2006

Time to look at N&N deal again. A National Audit Office report on the controversial refinancing of the Norfolk and Norwich University Hospital has made the case for a fairer funding deal "unanswerable", according to North Norfolk MP Norman Lamb, who wants the hospital to be treated as a special case. Commons Public Accounts Committee chairman Edward Leigh said that recent deals, including the refinancing of the N& N, showed that private-sector companies were still making "astronomical" profits while passing on added risk to public authorities. Summary by Keep our NHS Public of Eastern Daily Press 21 April 2006

CBI rails at cost of delays on health projects. The CBI has said that £2.4m on average is being added to the cost of hospital projects being built under the private finance initiative because of sloppy procurement by the NHS. The NHS recommends that the procurement process for PFI hospital scheme should take 18 months. But on average it took 21 months longer than this, said the CBI. It estimated the average cost of procurement delays was equivalent to 1 per cent of the capital value of each PFI scheme. The CBI proposes that NHS trusts should pay for the cost of delays up-front. It also wants better systems for mediation, improved training for procurement staff and a simplified bidding process. Summary by Keep our NHS Public of Financial Times 21 April 2006

Exclusivity clause prevents all non-LIFT developments. Practices are being denied premises funding because NHS LIFT contracts specifically prevent PCTs from funding other developments. A standard exclusivity clause gives the LIFT company first option to develop premises in an area, preventing PCTs funding non-LIFT cost-rent improvements. Dr Russell Walshaw, a member of the GPC practice finance subcommittee, said it was scandalous that all premises development may be tied to LIFT's potentially high service charges. Summary by Keep our NHS Public of Pulse 21 April 2006

Superhospital plan to be scaled down. The blueprint for the £420m PFI superhospital for North Staffordshire has been torn up, as the area's NHS faces financial meltdown. Instead, planners are looking at a scaled-down scheme, with contractors moving on site at least three years later than the previous proposals. Equion has "stood down" its teams working on the contract. Delays in the superhospital had already sent the cost of the scheme soaring by £21m a year, and preparation work was already underway.
Cuts are a prescription for concern. Most medical specialities will see their beds cut under the scaled-down proposals for the revised superhospital. There will only be 86 intermediate care beds, as opposed to 202 in the original plans, despite the fact that intermediate care beds are seen as essential to reduce the lengths of hospital stays. Overall, bed numbers inside the hospital will fall from the current 1,300 to 1,169 - including drops in maternity from 72 to 55, paediatric intensive care from 29 to 26, heart and lung critical care from 23 to seven, and general child health from 80 to 42.
Summary by Keep our NHS Public of Stoke Sentinel 21 April 2006

Doctors' protest. GPs from Limehouse assembled on the steps of the Royal London Hospital at midday on Wednesday to protest against NHS reforms in an event organised by Keep Our NHS Public. Maggie Falshaw, manager of the Limehouse Practice, said: "We are pleased that the rebuild of the London hospital is going ahead. However, because it's going through on a PFI scheme it will be very expensive. Once the London Hospital is rebuilt there will be two empty floors in the London Hospital, and one empty floor at Barts Hospital, because they won't be able to afford to fit those floors out. Experience of PFI schemes in other parts of the country shows that it's an expensive way of rebuilding. The NHS leases the hospital from the private company, then has the opportunity to buy the hospital at a later date - so it's basically paying for the hospital twice." Summary by Keep our NHS Public of The Wharf 21 April 2006

The air of crisis surrounding the government's NHS reforms grew yesterday when health workers and nurses warned of industrial action in protest at threatened job cuts to tackle NHS deficits. Health secretary Patricia Hewitt's strong defence of the NHS reform programme, including the use of the private sector, drew scorn from the health conference of the public sector union Unison in Gateshead. The anger was directed at both job cuts and the spread of the private sector into the NHS through the private finance initiative and independent treatment centres. Patrick Wintour and Martin Wainwright Tuesday April 25, 2006 The Guardian

The impact of the Private Finance Initiative (PFI) in the National Health Service will be questioned today in a highly critical report from parliament's spending watchdog. The public accounts committee details how some of the top business names in the country, including an arm of Barclays bank, took money out of a hospital project and left it with huge debts. The Norfolk and Norwich hospital is facing hundreds of job cuts as it seeks to balance its books, and there are concerns about the way the refinancing of other PFI hospitals may add to wider problems. Terry Macalister and John Carvel Wednesday May 3, 2006 The Guardian

The Private Finance Initiative is being used to help the government rebuild the country's public sector infrastructure. Supporters claim it brings private sector cash, skills and responsibility into the construction and onward management of schools, prisons and hospitals. But there has been endless - and heated - debate about whether PFI and its sister scheme, public-private partnerships, involve higher or lower costs. The short-term price seems lower but there are worries that in the longer term, PFI saddles hospitals and other institutions with high levels of ongoing debt. The report by the House of Commons public accounts committee highlights one area of concern that has received relatively little publicity so far and threatens to give new ammunition to the critics. This is the increasingly common practice of letting private sector firms refinance these projects. Refinancing allows companies to take money out of a scheme and replace it with borrowed cash. This brings the PFI players some quick profits but leaves the public body with potentially heavier penalty payments and a longer period of debt repayment. Terry Macalister Wednesday May 3, 2006 The Guardian

The politics column - Allyson Pollock. In the New Statesman's main political column, Allyson Pollock writes: "According to Patricia Hewitt the NHS has had its best year ever. So why is the Royal College of Nursing threatening industrial action over cuts and closures, and why did the annual conference of Unison, traditional Labour supporters, greet the secretary of state with heckling? In her words, "the NHS must modernise or die". So why, from Surrey to Manchester and from Gateshead to Shropshire, are local people banding into hospital action groups and "Keep our NHS public" campaigns in an effort to defend the health service ? The chief targets for cuts are mental health services, palliative care, older people's care and emergency hospital care, yet Hewitt maintains, to general derision, that quality will not be affected… Pay accounts for 60-70 per cent of NHS hospital budgets, but pay awards accounted for less than 30 per cent of the new money and should have been absorbed easily. Nor was greed involved; the increases returned NHS pay to previous levels after years of pay freezes. The hourly rate of the lowest-paid rose initially from £5.16 to £5.67 an hour; medical consultants got increases of 4-5 per cent a year, taking them to averages of between £75,000 and £95,000, while managers - their numbers swollen by the complications of marketisation - got 7.5 per cent more last year. The real reason for the decision to axe in excess of 13,000 clinical staff and 1,000 NHS beds, plus associated services, is market-oriented reforms such as "choose and book", "payment by results" and foundation hospitals. Hospitals and services are required to behave like stand-alone companies, competing with each other and private corporations for income and patients… The government plans to hand over most of the NHS budget to the private sector through "practice-based commissioning". Under this policy, local PCTs will eventually contract with for-profit companies such as the US-owned UnitedHealth Europe to provide GP services… The Prime Minister asserts that the reforms are bearing fruit, and so they are - for "investors" such as the lucky shareholders of Norfolk and Norwich and Bromley PFI hospitals, who received a windfall of more than £500m within months of the new hospitals opening. But the PFI has been less "fruitful" for local people, who have seen a quarter of beds closed and clinical staff and community provision cut. A large part of hospital trust deficits is due to PFI debts, running at £1.5bn a year… And then there are the costs associated with establishing and operating a market - costs the NHS was explicitly designed to avoid: these are for invoicing, marketing, advertising, drawing up hundreds of thousands of contracts, legal disputes with contractors and rival hospitals, and using management consultants… And though NHS hospitals remain responsible for balancing their books, the government has ensured that the only way they can do so is by cuts, closures, the sale of land and buildings - and more privatisation. Some foundation trusts are entering joint ventures with companies such as the Hospital Corporation of America, providing care to private patients in what were previously NHS beds. Others are charging NHS patients for "extra" care: Queen Charlotte's and Chelsea NHS hospital has introduced a fee of £4,000 for one-to-one midwife care - once the NHS standard - and the government is allowing it. The less fortunate hospitals - if that is the right word - are closing services and sacking staff. Is this what the English patient needs or wants ?" Summary by Keep our NHS Public of New Statesman 2 May 2006

NHS to pay out for non-existent centre. Staffordshire's cash-strapped NHS will have to pay up to £750,000 for an out-of-hours medical centre that was never built. The "abortive costs" include fees paid to architects, planners and consultants. Local health officials are arguing with Prima 200 Ltd, the private firm that was to construct the building, to decide how the cost will be shared between them. Summary by Keep our NHS Public of Stoke Sentinel 2 May 2006

PFI Deal Extension is a 'leap in the dark'. Commenting on the Norfolk and Norwich PFI refinancing deal, Richard Bacon, public accounts committee member and MP for South Norfolk, said: "We should not be surprised that private sector companies seek to maximise their profits. What is shocking and unacceptable is that the Department of Health allowed a contract like this to be signed, which put the public sector in such a weak position. PFI has produced spectacular returns for investors but nurses and others hospital workers facing the sack will rightly feel very angry and will not understand how it has been allowed to happen." The committees report said Octagon's investors "took the benefits of refinancing immediately, whereas the N& N trust is receiving its share over 35 years". Summary by Keep our NHS Public of Eastern Daily Press 3 May 2006

Watchdog brands profits on PFI scheme 'unacceptable'. The Commons Public Accounts Committee has condemned some of Britain's biggest investors in the private finance initiative as "the unacceptable face of capitalism". John Laing, Innisfree, 3i, Barclays Infrastructure and Serco were accused of taking gains "unacceptable even for an early PFI deal" from a refinancing of the £158m Norfolk and Norwich Hospital. The five, who make up the Octagon consortium that built and runs the hospital, made gains of £95m but left the hospital with extra potential liabilities of up to £257m should it need to terminate the contract early. The gains came from borrowing more at lower rates of interest over a much longer period than the original deal and allowed Octagon to more than triple its original expected internal rate of return from 19% to 60%. As a consequence, the Norfolk and Norwich NHS Trust is committed to the contract for 39 years rather than 34 even though the committee noted that it was "impossible to predict that far in advance the nature and extent of services that may be needed." If the contract were terminated early, the hospital might have to pay up to £257m more. The refinancing produced gains of £129m. The NHS Trust, which had no contractual right to a share, received £34m under a voluntary agreement on refinancings negotiated by the Treasury. However, to receive even that, the trust accepted liability for all the £106m in extra borrowing that the consortium undertook. Edward Leigh, chairman of the committee, said: "This is taxpayers' money and the risk of this large liability was incurred essentially so that investors could have fatter returns". Summary by Keep our NHS Public of Financial Times 3 May 2006

No cash for key heart surgery. Hundreds of patients across Norfolk look set to miss out on life-saving heart surgery closer to home because the cash-strapped NHS cannot afford the £1m bill for a new cardiac suite at the Norfolk and Norwich University Hospital. The sum would allow the hospital to run its new angioplasty treatment service to its full potential. While 250 patients a year will benefit from the treatment without the new suite, another 750 will have to wait for an angioplasty at Cambridge and travel up to 75 miles. The most serious will remain on a ward in the N& N, effectively blocking beds, an issue which costs the hospital £2.4m a year. The news comes after it emerged that the Octagon consortium made a £116m profit from refinancing the N& N PFI deal. North Norfolk Norman Lamb MP has suggested that Octagon should stump up the £1m needed. He said: "I think this graphically illustrates the extent and impact of private profiteering with a hospital not being given the chance to invest in facilities that would provide enormous benefit to Norfolk patients." Summary by Keep our NHS Public of Eastern Daily Press 4 May 2006

The high price of the PFI learning curve. In the light of the report on the Norfolk and Norwich Hospital PFI refinancing deal, an FT leader claims that "the PFI learning curve has been costly, but the gains are tangible". However it calls for "greater transparency in the secondary market" and better negotiators in the public sector. Summary by Keep our NHS Public of Financial Times 4 May 2006

Public services but private motives. A Guardian leader says: "Norwich may at least have a good new local hospital, but the cost of getting it makes the blood boil. As with the city academy programme, the taxpayer has lost out. The question is whether the public sector might not have been better off borrowing the money and building the new schools and hospitals itself - perhaps by issuing bonds. Evidence for this is mounting… Not only have payments been pushed off the books and onto future governments but health trusts have been left with inflexible contracts - the Norwich deal runs for 39 years and terminating it early would cost up to £257m. Is the scheme a response to spending shortfalls of the past, rather than new challenges of patient choice and changing demand ? Health needs vary, as the recent white paper shows. But the latest worries surround the growing market in second-hand PFI contracts, sold on to buyers who may have little interest in public service and are unknown to the government. They just want to make money. That is to be expected. But the government is not getting the best of the bargain." Summary by Keep our NHS Public of Guardian 4 May 2006

DoH ditches PFI criteria plans. Plans to publish universal criteria for trusts to justify private finance initiative projects to the Treasury have been abandoned by the Department of Health. In the 2006-07 operating framework, trust boards were promised a set of indicators to help decide whether projects were financially robust, affordable and sustainable. But the decisions will now be taken on a case-by-case basis rather than on trusts' ability to meet practical guidance, and the key factor will be whether each individual trust can afford a PFI project. Summary by Keep our NHS Public of Health Service Journal 4 May 2006

Review questions PFI risk transfer. Investors in Private Finance Initiative projects face only a 'relatively benign' risk of expensive construction overruns or payment penalties, credit rating agency Standard & Poor's has stated. The analysis by S& P, whose ratings are used by investors as a guide in assessing risk, raises questions about whether the public sector has driven a sufficiently hard bargain when negotiating PFI deals and transferring risks. Summary by Keep our NHS Public of Public Finance 5 May 2006

Whitehall oversees huge increase in private financing of public projects. The size of the Government's controversial Private Finance Initiative scheme is expected to spiral from £53 billion to almost £80 billion in the next four years. Despite criticism from Labour backbenchers and trade unions, ministers have given the green light to hospitals and other health projects worth £4.8 billion for this financial year alone. Summary by Keep our NHS Public of Telegraph 7 May 2006

Carillion win Barts FM. Carillion's Sovereign Hospital Services has secured a £330m FM contract as part of the redevelopment of St. Bartholomew's Hospital and the Royal London Hospital. The contract, which will begin in July 2006 and includes the provision of patient and non-patient catering, cleaning, housekeeping, laundry, portering, receipt and distribution of goods, reception, security, telecommunications and transport, is valued at £30m per year for an initial term of 11 years of the 42-year concession period. Summary by Keep our NHS Public of PFI.net 9 May 2006

Companies stand to reap profits of £3.3bn from the government's controversial private finance initiative (PFI), a healthcare pressure group said today. The claim by London Health Emergency comes after the Commons public accounts committee criticised private firms involved in one of the first NHS PFI deals for awarding themselves an early windfall of £115m. The pressure group said private consortium Octagon's refinancing of the PFI deal for Norfolk and Norwich hospital to boost its profits was a "scandal". It estimates that recently approved PFI schemes in London, Birmingham and St Helens will produce windfall profits of £440m for the companies involved. And, it reckons, the private sector stands to make £2bn worth of bonus payouts from £10bn worth of PFI schemes in the pipeline. David Batty and agencies Wednesday May 10, 2006

Health reforms 'wasted millions'. Some key government health reforms have been criticised for costing millions of pounds but bringing few benefits. Schemes to build NHS hospitals with the private sector will leave companies with windfall profits of £3.3bn, pressure group Health Emergency claims. firms involved with NHS PFI projects are "bleeding" millions of pounds in profits. According to a Health Emergency report three recently approved PFI schemes in London,