Education and debate

What happens when the private sector plans hospital services for the NHS: three case studies under the private finance initiative

NHS Consultants' Association, c/o Hill House, Great Bourton, Banbury OX17 1QH, Radical Statistics Health Group, c/o 10 Ruskin Avenue, Bradford BD9 6EB, NHS Support Federation, 37-39 Great Guildford Street, London SE1 0ES

Correspondence to: Dr Allyson Pollock, Department of Public Health Sciences, St George's Hospital Medical School, London SW17 0RE. a.pollock@sghms.ac.uk

	Introduction

We aim to promote efficiency, to improve services and to stimulate fresh flows of investment. We want to harness the private sector's management expertise and resources, bringing a new approach to investment in a whole range of activities and services traditionally regarded as the exclusive domain of the public sector. Kenneth Clarke, chancellor of the exchequer, November 1993

The private finance initiative (PFI) for public sector projects was launched by the government in 1992 to transform "public sector organisations from being owners of assets and direct providers of services into purchasers of services from the private sector."¹ The types of projects funded under the scheme range from the building and operation of trunk roads, computer systems, and vehicle fleets to the construction of hospitals and delivery of . . . [Full text of this article]

Summary points

	How PFI contracts are negotiated

Consultation

	What determines bed numbers under the PFI?

	Interpreting trends in bed availability

	The three schemes

Lothian
Calderdale
Bromley

	Discussion

	Acknowledgements

	References

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