NHS trusts are closing accident and emergency departments to help pay for hospitals built under the Private Finance Initiative, an investigation by The Daily Telegraph has found.
27 Jan 2011
Since 2007, more than a fifth of England’s hospital trusts with active PFI hospitals have closed casualty departments, or published proposals to do so. In the same period, only four per cent of trusts without PFI hospitals have closed, or proposed to close, A&E units.
Fewer than a quarter of England’s 168 NHS hospital trusts have significant PFI hospitals in operation. But these trusts account for almost two-thirds of A&E closures or proposed closures.
Health campaigners said there was a “clear connection” between the “inflated” costs of the PFI and the cuts in A&E.
Most trusts insisted there was no connection — not all A&E closures are necessarily done on financial grounds and some are supported by local clinicians.
In recent days, The Daily Telegraph has disclosed how some PFI hospitals – built and operated by the private sector, and effectively rented back to the taxpayer – will end up costing the public purse more than 10 times their capital value.
The new Princess Royal University Hospital in Bromley, south London, cost £118million to build. It will end up costing taxpayers £1.2billion, including facilities management. South London Healthcare, the NHS trust responsible for the Princess Royal, has a second PFI hospital, the Queen Elizabeth in Woolwich.
The trust’s annual deficit was raised to £100million by the two deals. It has closed the A&E unit at one of its non-PFI hospitals, Queen Mary’s in Sidcup.
In internal documents seen by The Daily Telegraph, the trust stated that the “occupation costs” of the PFI hospitals were roughly double those of its non-PFI hospital. A spokesman admitted that its PFI contracts placed “some undeniable restrictions on our flexibility”. But she insisted that the decision to close A&E at Sidcup was “entirely unrelated” to PFI.
Other trusts closing A&E units include Coventry and Warwickshire NHS Trust, which recently opened a new PFI hospital and plans to shut the full A&E unit at its non-PFI hospital in Rugby.
Barking, Havering and Redbridge Trust, which opened a new PFI hospital in Romford, wants to close the A&E unit King George’s Hospital in Ilford.
East Lancashire Trust has closed A&E at its Burnley hospital to help pay for a new PFI hospital at Blackburn. In Nottinghamshire, Sherwood Forest NHS Trust has downgraded A&E services at Newark after opening a new PFI hospital in Mansfield. At least four other trusts with PFI hospitals have similar plans.
Pests mean prizes
Under its PFI contract, Queen Elizabeth Hospital, Woolwich, must have 64 visits a year from pest controllers, even when there are no pests to control. When there are pests, the hospital must pay for further visits, which it did 10 times last year.
Meals on wheels
Food served at the Queen Alexandra PFI hospital in Portsmouth is cooked in south Wales, then driven 100 miles to Hampshire.
Early PFI hospitals had on average 20 per cent fewer beds than the hospitals they replaced, according to research. Because of high service charges, several PFI hospitals cannot afford to keep even these reduced numbers of beds fully open.
In an effort to disguise their private ownership, a number of PFI hospitals have changed their names to include a royal connection. Greenwich District Hospital became Queen Elizabeth Hospital. Salford Hope Hospital is now Salford Royal. Oldchurch Hospital, Romford, became Queen’s Hospital. Farnborough Hospital, in Bromley, was renamed after Princess Anne.