Commons is worried about private finance for NHSNew group will strengthen patient involvement in NHS researchSpecial conference will consider future of general practiceTransition to new grade must be completed in a yearBMJ 1996; 312 doi: https://doi.org/10.1136/bmj.312.7038.1104 (Published 27 April 1996) Cite this as: BMJ 1996;312:1104
- Linda Beecham
Commons is worried about private finance for NHS
The all-party House of Commons Treasury select committee has questioned the suitability of the government's private finance initiative (PFI) for health projects. Under the initiative, private finance is raised for large public capital projects, including new hospitals. The select committee report predates the plan for Britain's first £170m PFI hospital to be built from scratch at Norwich (13 April, p 929).
The treasury committee is concerned that those aspects of PFI projects which have a lucrative return will attract investment and would have to be linked to substantial management contracts. The ability of NHS trusts to plan the provision of services could be lost.
While the official policy is that clinical services should not be provided by private finance, the committee heard that the PFI was forcing a false split between clinical and non-clinical services—for example, in the position of the domestic housekeeper hitherto a key member of the clinical team. The committee is concerned that the PFI should not introduce arbitrary demarcations in hospital management.
In written evidence to the committee the BMA warns that while the PFI will not result in the employment of clinicians by private companies, some of them will be supplying clinical services for profit. They may be tempted to cut costs by reducing and putting financial pressure on clinical decisions, leading to ethical problems for doctors.
The BMA states that the greatest instinctive objection to private finance in the NHS is that …