John Lister (London Health Emergency) M INISTERS are closing their ears to criticism and ignoring all of the •warning signs as they rush headlong to rubberstamp more hospital building projects financed by the Private Finance Initiative. Another list of six major. new hospital developments (totalling £650m) which have been given the green light to finalise deals unveiled early in July, covering schemes in Leeds, Oxford, Havering (East London), Portsmouth, Blackburn and Derby, Two more years of costly negotations will follow before building begins on these schemes in 2001.
37 new hospital projects have now been agreed in principle, with 17 of them currently under construction - all but four of these funded by PFI.
Tony Blair has joined Alan Milburn and other ministers in claiming that the combined package of PFI schemes, costing a massive £3.1 billion, represent the "biggest hospital building programme in the history of the NHS" - ignoring the fact that previous NHS hospital building was financed by government cash, and created new assets for the health service rather than longterm debts.
But even as the bulldozers and cranes swing into action, the storm of scepticism and opposition is increasing.
• doctors' leaders in the BMA are warning that ministers are unleashing the "largest acute hospital closure programme" ever to hit the health service:
• the all-party Commons Health select committee has called for a halt to new PFI projects while the true costs are evaluated;
• the NHS Confederation, герresenting Health Authorities and Trusts, has expressed its reservations at the cost and complexity of PFI deals;
• Community Health Counciis, the patients' watchdog bodies, have also voted overwhelmingly at their 1999 national conference to oppose PFI;
• the National Audit Office has warned that the first PFI hospital to be completed, Dartford & Gravesham, will fall short of the promised savings;
• academics are warning that PFI deals can only claim to represent value for money by fiddling the figures and leaning on government subsidies;
• building firms and others in PFI consortia are boasting of the fat profits they expect to coin in from these projects over the next 30-60 years;
• and campaigners across the country are protesting that PFI deals will result in hospitals moving to remote greenfield sites, and leave local services desperately short of front-lite beds.
To embarrassing are the facts government review of the PFI process, set up by Health Minister Alan Milburn before he departed to the Treasury, has been shelved by his successor John Denham, while many Trusts embroiled in PFI schemes are hiding vital information behind a curtain of "commercial confidentiality". I work for the NHS and care -and. for the patients-(cooktheir books!
Health authorities commonly respond to detailed criticism of the viability of their plans by simply refusing to answer questions - and omitting questions they cannot answer from their summary of the consultation proOne classic example of this is Worcestershire, where a new PFI hospital, in Worcester means a massive 35 percent cutback in acute beds throughout the county. The viability of the Full Business Case rests on the injection of an extra £7m to the revenue of the Worcester Royal Infirmary, at the expense of axing in-patient care at Kidderminster General Hospital and A&E services in Redditch: but the. Health Authority has stubbornly refused to answer any detailed questions from campaigners on how the reduced hospital services would cope with demand. A detailed study commissioned by UNISON of one Full Business Case, for the North Durham Acute Hospitals Trust, revealed the extent to which PFI deals rig the figures to make the case for private funding. The new hospital will be able to use only 350 beds, compared with an original plan for 900 in 1991. The Trust will have to cut back on clinical staff, mainly cutting nurses, in order to afford the new building. This reduced number of beds will treat fewer patients, but still cost the health authority more money each year, and require an additional €750,000 a year subsidy from the government. The public sector option would have cost much less over 30 years.
London Health Emergency, health unions and other comnpaigners have warned from the outset that the huge reductions in front-line beds being driven on by the PFI ook the process will leave hospitals and health services struggling to cope with a rising tide of medical admissions. Ancillary and non-clinical staff will be handed over wholesale to profit-seeking private firms, and health authority budgets will be skewed by the long-term obligation to fund Trusts locked in long-term, legally-binding lease agreements with PFI consortia.
Far from a dream solution to the cash problems of the NHS, PFI - dreamed up by Tory ministers as a means of privatising sections of the NHS - is a nightmare in which dwindling NHS resources are siphoned into the coffers of banks, building firms, cheapskate contractors and their shareholders.
The longer it is allowed to go on, the worse will be the longterm damage to the NHS.
Susan Moore AS WE go to press, the death toll from the horrendous earthquake in North-western Turkey on August 17 continues to mount. Tens of thousands lie buried under collapsed buildings, and many are at risk in the weeks to come as the damage to sewage and clean water supplies leads to the spread of disease. Further it remains likely that there will be a series of afterchocks or Turner tremor that could last for months or even years.
ФСАШОТ Cost-cutting concrete buildings without reinforcement have taken a brutal toll of lives What is clear is that the fall out from the calamity has been made Also emergency goods and clothing will be very valuworse by the relentless search for profit. Many buildings on the long known about fault line have been whether to go ahead with the building of a nuclear power station at Akkuyu on the country's Mediterranean coast. Energy minister Cumhur Ersumer made it clear that the government was likely to go ahead with the project that they hope to complete in 2006 - despite concerns that the projected site is in an earthquake zone. It is also clear, as many affected by the tragedy are increasingly pointing out, that there has been a differential response to different groups affected by the quake. Not only did the Turkish government act speedily to rescue those trapped at the naval base at Golcuk, but Israel speedily lent a hand to rescue a small group of Israeli