PFI: Value for money or not?

THE '˜buy now, pay later' PFI contracts, signed by five NHS trusts in Yorkshire at a cost of £3.8bn to taxpayers and now regarded as '˜scandalous' because of the scale of the repayment charges, need to be seen in the context of New Labour's landslide win in 1997. Twenty years ago, Britain's hospitals '“ and schools for that matter '“ were in a shameful state of neglect. They were literally falling down after decades of chronic under-investment.

It also made sense for Tony Blair and Gordon Brown to embrace the Private Finance Initiative – it had been pioneered by John Major’s government and it enabled them to honour promises made to voters in key marginal constituencies across the country. In this regard, both men maintain – to this day – that this was, and is, money well spent because of the parlous state of the public services that they inherited. Yet, in value-for-money terms, these deals – and the eyewatering costs incurred – were too good to be true and are now compromising the care of patients across the region because so much cash has to be diverted from the front line just to service these debts.

Though hindsight is everything in politics, those Labour MPs and campaigners who cheered their then-Prime Minister and Chancellor might not have been so acquiescent if they had actually taken the time to read the small-print, never mind the fact that some buildings have become almost obsolete over the years because of changes in the way NHS care is delivered.

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What matters now, however, is that past misjudgments are not repeated – the warning issued today by former Wakefield MP David Hinchliffe who chaired Parliament’s health select committee from 1997 to 2005. A politician who commanded respect because of his expertise, and independence, he is despairing that more has not been done to re-negotiate these deals, especially as interest rates are at a record low, and that such arrangements have not been subjected to greater scrutiny. It’s an important point. Just think how many doctors and nurses could be recruited now if the region’s trusts weren’t paying out £112m a year to honour PFI obligations before they treat a single patient?