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Last Updated: Tuesday, 12 June 2007, 08:00 GMT 09:00 UK
PFI hospitals 'hit patient care'
University Hospital
Dr Fielden said wards have been closed at University Hospital Coventry
Debts racked up by hospitals under the Private Finance Initiative (BFI) hit patient care, says a leading member of the British Medical Association (BMA).

Dr Jonathan Fielden, chair of the BMA's consultants' committee, told BBC Radio 4's File On 4 that the debts are distorting "clinical priorities."

And even supporters of PFI say it could lead to the "wrong services in the wrong places" for local patients.

But The Department of Health said PFI did offer genuine value for money.

Dr Fielden is concerned that with hospital trusts owing millions of pounds to contractors under PFI they struggle to finance these long term deals.

He cited the example of University Hospital Coventry where the NHS Trust had to borrow money to pay the first payment of 54m it owed the private contractor involved in the PFI deal.

The trust was struggling to afford the money before the hospital had opened its doors.

"We know there that they do have a fabulous new facility there but they payments they are tied into - the long term 30plus year deal - means that because the amount of money coming in under the 'Payment by Results' scheme is now less than predicted and they are mothballing services, closing wards and not running all their theatres that they could do.

"They are potentially reducing jobs."

He said the trust's debt also meant that neighbouring hospitals were being deprived of funds.

Dr Fielden claimed that in general PFI deals could be poor value for NHS Trusts.

He said some trust managers did not see the long term consequences of the PFI deals and signed deals that were not good.

"We cannot have these long term debts - these long term debts are distorting clinical priorities now, they are distorting our ability to treat patients" Dr Fielden added.

His views were echoed by Prof Nick Bosanquet of Imperial College, London said a lot of projects were started before anybody knew if they could afford them creating a number of hospitals which are too expensive and too large.

"There are already one or two PFI hospitals where wards and wings are standing empty because nobody wants to buy their services.

"There will be a temptation to say 'right we are stuck with these contracts we will close down older hospitals', which may in fact be loweer cost," said Prof Bosanquet who is an advocate of PFI.

"Just closing down non PFI hospitals in order to up activity in the PFI ones is not going to be the answer because we may have the wrong kind of services in the wrong places."

Prof Jean Shaoul, of the Manchester Business School, said construction companies were making a 58% return on some of the NHS PFI schemes - a better return than on their main business.

'Patient needs'

She said this was a bad deal for the NHS.

The Department of Health said: "PFI is only ever used if it is affordable to the NHS, meets patient needs, and offers value for money."

It added that the National Audit Office had twice confirmed that PFI offers genuine value for money savings and provides "greater price certainty than conventional procurement".

Nobody from University Hospital Coventry was available for comment.

BBC Radio 4's File On 4 is broadcast on Tuesday 12 June 2007 at 2000 BST and repeated on Sunday 17 June at 1700 BST. You can listen to the programme for seven days after broadcast by clicking here.

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