MORE FINANCIAL INSANITY IN THE NHS

They can't fund the hospitals they have so what do they do? Build new ones! Unbelievable

Six new Private Finance Initiative hospitals will be approved by the Government today, signalling its commitment to continue what it claims to be the largest hospital building programme in the history of the NHS. But the optimistic message will meet with fury from public health specialists and training hospitals, which have been told to cut their budgets to hold down NHS deficits. Under the plans, Guy’s and St Thomas’ will lose 4.7 million pounds , Bart’s and the London 3.7 million, the Royal Free 2.1 million and St George’s 2.2 million, for example.

The money will come from budgets set aside for education and training for this year, which is already half over. “Lord knows how we are going to make these kinds of cuts when the money is already committed,” one hospital manager said yesterday. “What a way to run a business!” said another in an exchange of e-mails across the network of London teaching hospitals. The impression being given was that the hospitals would not take the cuts lying down.

Public health spending has also been targeted, according to Health Service Journal, which reported that the department’s plan is to set aside a 350 million “contingency fund” to help to bring the NHS back into financial balance. This will come from money devolved to strategic health authorities (SHAs) this year from central funds that were devoted to public health, medical education and training, clinical excellence awards, performance-related pay for GPs and services such as walk-in centres, out-of-hours services, and NHS Direct.

Public health specialists are furious. Professor Rod Griffiths, the president of the Faculty of Public Health, told Health Service Journal: “I’m very disappointed that something as important as this has been so clumsily managed. “The overspends have not been caused by community medicine. It is poor commissioning and poor management of acute services.” The department is projecting a gross deficit for the NHS in this financial year of 883 million, against 1.2 billion last year. It plans to offset this against a 135 million surplus from primary care and acute trusts, 415 million from savings by SHAs, and the 350 million contingency fund. That should achieve a net surplus of 17 million.

But these problems will be brushed aside by ministers as they announce another 1.5 billion for six new PFI hospitals to be built for University Hospitals North Staffordshire, Tameside and Glossop NHS Trust, Salford Royal Hospitals, Walsall Hospitals, South Devon Healthcare, and University Hospitals Leicester. Andy Burnham, the Health Minister, said: “We are delighted to be able to give the go-ahead for these new hospitals. This is great news for the hundreds of thousands of patients who will benefit from the modern, bright new buildings. “The new facilities will not only be the best in terms of design and quality, but they will be affordable well into the future.”

The six hospitals will have far more single rooms than traditional NHS hospitals, with up to half the beds in single rooms. The standard of accommodation and facilities will be a big leap forward, the department said. The first of the new hospitals will open in 2010. The announcement means that since 1997, more than 10 billion will have been committed to hospital building. A total of 76 schemes are open — 58 PFI and 18 built using public capital — and another 30 are under construction. Andrew Lansley, the Shadow Health Secretary, said: “The reality is that the NHS financial crisis has resulted in over 20,000 job losses in NHS hospitals, and has raised the spectre of some of these hospitals closing.”

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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