Labour's PFI review could save the NHS billions of pounds
Dr Kailash Chand
John McDonnell’s pledge to review private finance initiative (PFI) contracts is a sensible idea that could save the NHS billions of pounds and is worthy of a proper review.
The pledge is a step in the right direction to reform a deeply flawed, unpopular programme. PFI was introduced as a complex new form of contracting designed to get around public accounting rules. In the process, the private sector under Conservative and Labour governments has generated £831m in profits in the health sector over the past six years alone.
Alarm bells been sounded by the CBI and other vested interests about the cost to taxpayers of implementing Mr McDonnell's policy. John Appleby, chief economist at the Nuffield Trust, estimates that the total cost of buying out all the PFI contracts in the NHS alone could be well over £50 billion. Certain institutions put the figure at £200 billion.
The truth is very different. If you examine the press release sent out to accompany his speech, it did not say that Labour would wind up every PFI deal. Rather, it said: ‘Labour will review all PFI contracts and, if necessary, take over outstanding contracts and bring them back in-house, while ensuring NHS trusts, local councils and others do not lose out, and there is no detriment to services or staff.’
The master plan is that parliament will assess the appropriate level of compensation at the point at which contracts are brought back in-house, and shareholders will be compensated in the form of Government bonds, which will be exchanged for shares.
Private Finance Initiative (PFI) deals have meant paying for hospitals and other NHS facilities many times over – justly compared to the exorbitant repayment rates on ‘pay day loans’. Since the Major government, 717 PFI projects have had a value of £54 billion, but have cost the taxpayer £301 billion!
In many NHS trusts, for instance in South London, this has resulted in huge, unpayable debts which ‘necessitate’ dramatic cuts and closures – sometimes even of neighbouring, financially solvent hospital trusts, such as Lewisham.
Many hospital trusts in England spend nearly 15% of their budget a year repaying their PFI debt – nearly half of which is on interest payments. New research from the Centre for Health and the Public Interest (CHPI) shows just how much these debts are hurting our NHS. Over the next five years, almost £1bn of taxpayer funds will go to PFI companies in the form of pre-tax profits.
PFI has proved a rotten deal for taxpayers because the accumulated annual payments have dwarfed the initial building costs.
It’s universally accepted that PFI is an unfair, unaccountable rip-off, destroying our NHS. Continuing PFI costs the taxpayer much more over the long term. It allows private financiers and construction firms to make a killing out of public infrastructure, privately owned via offshore tax havens.
As our NHS struggles under the pressure of PFI, Labour’s pledge on PFI contracts is not only a ray of hope, it also provide answers for the future too.
Already, we have excellent precedents – Northumbria Council took out a loan to buy out Hexham hospital’s PFI, and in doing so saved £3.5m every year over the remaining 19-year term.
PFI was an expensive folly. There are cheaper, transparent and fairer ways of providing health care.
Dr Kailash Chand is a retired GP from Tameside and is honorary vice-president of the BMA