Published 7 May 2009, doi:10.1136/bmj.b1863
Cite this as: BMJ 2009;338:b1863

Editor's Choice

The problem with ISTCs

The first 150 words of the full text of this article appear below.

"Perfidious financial idiocy" was how a previous editor of this journal described the private finance initiative (PFI), a way of securing private funding for public projects, notably hospital building (BMJ 1999;319:2-3, www.bmj.com/cgi/content/full/319/7201/2). Richard Smith based his assessment largely on the work of Allyson Pollock, who, Cassandra-like, found her message ridiculed when it wasn’t ignored. But that was then. The current unravelling of PFI, with the government bailing out projects in trouble, makes her analysis look prescient. So we should at least take notice of what Professor Pollock has since turned her attention to.

Her latest target is independent sector treatment centres (ISTCs), the beneficiaries of the British government’s policy of contracting out clinical services to commercial companies. Last year, she castigated the Department of Health for failing to collect and provide data to allow evaluation of this policy, quoting a member of the Commons Health Committee who said . . . [Full text of this article]

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