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Has PFI changed healthcare?

Supporters of PFI note that more hospitals have been built in the UK in the last 10 years than in the previous 50. Detractors think the capital inflows are being spent on the wrong assets in the wrong places, leaving the future as uncertain as ever.


IW, PwC In the UK the last 10 years has seen an unprecedented increase in investment in healthcare, both in terms of the overall healthcare revenue spend and investment in healthcare infrastructure. There are many different programmes – private finance initiatives (PFI), NHS Local Improvement Finance Trust (LIFT), Independent Sector Treatment Centres (ISTCs) and the National Programme for IT (NPfIT). In all we have seen over £5 billion of funds raised under PFI since 1997, and there is an expectation that this will more than double over the next three years, as many more schemes are financed. NHS LIFT promises to raise £1 billion, and the ISTC programme is expected to let contracts of over £1 billion per year. In itself, the NPfIT programme is believed to be the largest global investment of IT, with investment of over £5 billion and implementation costs expected to take that figure much higher. But there are many challenges: first have we really learnt lessons from the PFI process to date? second, the development of the ISTC market, the introduction of payment by results, and the creation of Foundation Trusts is creating new challenges for investment; third, will the contracting and investment model change? and finally what future plans do our colleagues from foundation trusts have for future investments?

JS, PwC Let's start by addressing how successful do we think are the PFI, LIFT and ISTC schemes at introducing new investment?

RN, UCL Hospitals  We are only getting our new hospital because of PFI, but I think the jury is still out as to whether this has been a valuable investment for the trust or for the NHS in the longer term.

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