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Top e-government news, updated daily, and regular features from the top people in the public sector.
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| NHS building schemes rethink call |
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The NHS wastes cash on big hospital building projects while freezing spending on small schemes, say experts.
The Reform think tank said the reliance on private finance initiative (PFI) projects - more than £18bn is earmarked up to 2014 - was misguided.
The centre-right group said smaller health centres should be funded, but capital budgets were not being spent.
The government said all PFIs - built using private cash, but paid for over time by the NHS - were being reviewed.
Reform pointed out the government is hoping to shift health care away form hospitals and into the community as set out in a white paper earlier this year.
It said this was at odds with the money planned to be invested in PFI hospital projects, many of which involve the complete rebuilding of hospitals.
The biggest scheme given the go-ahead so far is the £1.2bn rebuild the Bartholomew's Hospital and its near neighbour in east London, the Royal London.
It said the NHS was building "over-large and expensive" hospitals, saying big projects could be put under pressure because of the uncertainty over future incomes as the government introduces competition into the health service.
However, Reform said public private partnerships such as PFI were good in principle as they were a "step forward in traditional public sector procurement".
The report also found many NHS trusts were not spending their capital budgets - pots of money that traditionally goes on smaller schemes such as health clinics, baby units and replacing equipment.
Last year the NHS in England under spent its capital budget by £1.2bn - double the figure the previous year.
Report author Nick Bosanquet said NHS trusts were being paralysed by the fear of the deficits, which was depriving the health service of the kind of spending it needed.
"Large hospital buildings schemes are only appropriate in certain situations.
"In effect the NHS should move to a system which could fund investment of various sizes from £5m to £30m."
He even suggested the NHS could rent property as it was "unnecessary and inefficient for the NHS to own so much capital" and added it should be left to local managers to identify more manageable schemes in the future.
Andrew Lloyd-Kendall, policy manager at the NHS Confederation, said the NHS needed to think very carefully about whether PFI builds were needed.
"PFI is a very important tool for bringing hospital facilities up to date. Although the direction of travel is increasingly towards care in community settings there is still a need for hospitals."
And Paul Miller, chairman of the British Medical Association's consultants committee, added: "We have been asking for a while if PFI is necessary, I am not convinced on the whole they are."
But a Department of Health spokesman said all PFI schemes were being reappraised to see if they offered "value for money" and were "needed" in the changing climate.
Health Minister Andy Burnham said: "We have asked all trusts taking forward a major PFI scheme to undertake a review to ensure every penny of extra investment in new NHS hospitals is spent wisely and options taken forward locally are in patients' best long-term interests."
He also pointed out money was being invested in primary care facilities through the LIFT scheme - the equivalent of PFI for community services. |
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