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Medicopolitical Digest

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BMJ 2000; 320 doi: (Published 27 May 2000) Cite this as: BMJ 2000;320:1479

PFI poses threat to health care

The private finance initiative (PFI) “poses a major threat to the ability of the NHS to provide the sort of comprehensive care that the people of the United Kingdom expect and deserve.”

This is the conclusion of Private Finance in Health Care: Why Not by the National Health Service Consultants' Association (NHSCA). The NHSCA has opposed the initiative since it was originally proposed because it believes that a tax funded service should not irrevocably tie up its finances in the private sector.

The report points out that PFI hospitals are far smaller than the old ones, creating additional demands for primary care services, and they are more expensive, leaving the trusts with less to pay for nurses and doctors. Although it is possible that increases in throughput may not have serious effects on patients, the NHSCA says that many patients may feel forced into the private sector; funds will be found to allow trusts to use spare capacity in the private sector; or patients with potentially curable diseases will be forced to wait longer or find their treatment has been rationed.

Although the Labour government has prioritised …

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