The first trust to engage with a PFI scheme, Cumberland Infirmary in Carlisle, has encountered major problems with fire safety owing to construction flaws. These are now being put right – at public expense. Which raises a grave question: who pays for PFI failures? It looks to be the public.
The PFI scheme was hailed as the way forward when it was first introduced: a synergy between public service and private enterprise. However, critics (including DFNHS, then the NHSCA) pointed out that much of the long-term risk attached to these schemes – soaring repayment costs and the saddling of a public hospital with a debt it would have to meet for decades to come whatever the health economy – would be left not with the private contractor, but with the trust. The private sector gets all the profit, the public are left to pay for any emerging problems. Added to that was the evidence indicating PFI did not save any money, and the paucity of evidence supporting the scheme’s economic soundness.
The problems at Cumberland Infirmary relate to fire safety, chiefly worries over a failure to contain fire and stop it spreading, and were http://premier-pharmacy.com/product/revia/ highlighted in an independent report commissioned by the trust itself. This is now being put right – but it seems that the trust is having to foot the bill, not the original PFI contractors, Health Management Carlisle Ltd. This was made public by the Fire Brigades Union (FBU) who in a statement referred to the hospital as “one of Carlisle’s biggest fire risks”.
The trust cannot be faulted for acting responsibly in commissioning the report, and moving as quickly as it can to minimise the risks. What is at fault, plainly, is the central argument of the PFI scheme itself. Which leaves many important questions unanswered. Not least, who should foot the bill for any mistakes in the years to come? If it’s the taxpayer, then that is something that should be placed at the centre of any decisions over PFI schemes in future. DFNHS have grave doubts about the PFI scheme, on the basis that there is no evidence that it is cheaper. It seems the public may be paying for government not heeding that view for some time to come.