30 November 2007
A senior official in the Department of Health's private finance unit has acknowledged that deficiencies in procurement practices have left the NHS with facilities it does not need.
Paul Webster, legal consultant in the DoH unit, told a Public Finance/Deloitte round table debate on the future of the Private Finance Initiative that not enough had been done to establish clear requirements before projects got under way.
'We are guilty, particularly in the health sector, of poor procurement and of not knowing what we want. Some of the buildings we have may not fit our vision,' Webster said.
'Originally we were told to build hospitals bigger but now they're being mothballed, because the political pressure at the turn of the century was that everything had to be bigger… We're trying to get to the stage where actually what we're doing is building the right facilities.'
But Webster told participants that a more rigorous approach was now being adopted towards the PFI and other forms of procurement. He said that last year's moratorium on hospital PFI schemes while a review was carried out, which resulted in every scheme being reduced in size, had yielded useful lessons.
Webster said that, as well as drawing up clearer specifications, hospital trusts were also having to consider the affordability of PFI schemes in greater detail. 'We are saying to them… where is your income stream to service the repayments, where are the patients going to come from?'
But Margie Jaffe, Unison's national policy officer for the PFI, told the round table that the value for money of projects remained a key concern, exacerbated by the difficulty of properly scrutinising them.
'From the point of view of users, communities and workforce, projects are… far less accessible, and what goes on is far less open to scrutiny. I'm very worried about that.'
Jaffe also argued that, because public sector procurement skills are now sharper, many benefits attributed to the PFI could be achieved by other methods.
Full coverage of the Public Finance/Deloitte round table debate will appear in next week's issue
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