Intended for healthcare professionals


PFI: perfidious financial idiocy

BMJ 1999; 319 doi: (Published 03 July 1999) Cite this as: BMJ 1999;319:2

A “free lunch” that could destroy the NHS

  1. Richard Smith, Editor
  1. BMJ

    Education and debate p 48

    “I see the private finance initiative in very simple and personal terms. At the moment i own a beautiful but outdated home in a prime position in Edinburgh, one of the world's loveliest cities. Now i'm going to ‘give it away’ at below market value in exchange for a smaller, unglamorous modern house on the edge of the city that doesn't have enough bedrooms and is hard to reach by public transport. Worse, i'll have to pay for it for 30 years—without any option of moving elsewhere. Worse still, we will have to reduce how much we do around the home in order to pay for the new building. Worst of all, my children will find themselves years from now in an outdated building in an awful position. They won't be able to afford either a new home or the services of the home. They'll have to buy them privately.”

    This is the view of one doctor in the Royal infirmary of Edinburgh of what the private finance initiative (PFi) means to him, his colleagues, and his successors. His view may simplify some of the complexities of the initiative, but it's more true than untrue. The private finance initiative is a “smoke and mirrors” policy that may destroy the NHS.18 The complexity of it all has left many electors …

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