PFI is ineffective

The private finance initiative (PFI) implemented in Lothian, Scotland, led to capacity constraints across all acute specialties and downsizing of hospital and community provision. Dunnigan and Pollock (p 905) analysed projected and actual trends in bed capacity and inpatient and day case admissions for the Lothian healthcare plan, and compared the results with those from the rest of Scotland. Rates for inpatient admission in all specialties and for day case admissions in acute specialties were significantly lower in Lothian hospitals than in the rest of Scotland, while the proportion of delayed discharges in staffed beds was higher. The authors conclude that PFI did not reach its targets, and further downsizing may be required due to its high costs.