A catalogue of complaints from staff at a Wiltshire hospital has been released by the public service union, Unison.
The hospital opened in November 2002
The Great Western Hospital in Swindon is understaffed, has bed shortages and "serious" design faults, says the report.
Unison said its study was another "damning indictment" of the private finance initiative (PFI).
The hospital says it is disappointed that the union did not share its findings, and denies several of the charges made.
Chris Birdsall, communications manager at the Great Western, told BBC News Online: "This report looks damning, but is more a collection of individual gripes by a small number of staff.
"We absolutely refute that we are letting down staff and patients."
The Great Western, one of the first PFI-funded hospitals, was criticised in July by the Commission for Health Improvement for "insufficient bed space".
Unison's report said: "The Swindon PFI experience is of a hospital that was always going to be too small and in an inaccessible place.
"Services are run on the cheap by a company whose main objective is to maximise the profits it can deliver to shareholders."
Nurses complained that wards were too big and understaffed, and that the accident and emergency centre had no windows and was too small.
Mr Birdsall called the claim of inaccessibility "ludicrous" and added: "By the end of this year, we will have opened another 26 beds.
"And by March 2005, there will be a new 128-bed treatment centre."
Unison general secretary Dave Prentis said the report condemned PFI as a financing option that was not working in the best interests of taxpayers.
"Not only is PFI failing to deliver value for money, it's failing to deliver improvements in patient care and it's certainly failing staff."
The Great Western could not have been built without PFI, said Mr Birdsall, who added that the hospital was more interested in treating patients than in the political debate surrounding PFI.