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  1. Planning the “new” NHS...
  2. Planning the “new” NHS: downsizing for the 21st century
Education And Debate The private finance initiative

Planning the “new” NHS: downsizing for the 21st century

BMJ 1999; 319 doi: https://doi.org/10.1136/bmj.319.7203.179 (Published 17 July 1999) Cite this as: BMJ 1999;319:179

Data supplement

  • Sources of data in tables

    Table 1:

    NHS Trusts data are from Department of Health. Bed availability and occupancy, 1995-96 and 1996-97.

    Projected bed numbers are from House of Lords written answers (Hansard) 1999 February 2:columns WA202-6; corrected in light of full business cases where necessary.

    Case 2:

    1995-6 data are from Department of Health. Bed availability and occupancy, England, financial year 1997-98.

    PFI data are from the appendix in the full business case of Calderdale Healthcare NHS Trust.

    Case study 2 - House of Lords written answers (Hansard) 1999 February 2:columns WA202-6

    Table 2:

    Actual admissions from Department of Health. Ordinary and day case admissions, England, financial year 1997-98.

    PFI caseload from full business cases.

    Table 3:

    Full business cases for South Buckinghamshire, Carlisle Hospitals, Norfolk and Norwich Hospitals, and Calderdale Healthcare NHS Trusts.

    Table 4:

    Full business cases for new Edinburgh Royal Infirmary and North Durham Acute Hospitals.

    Table 5:

    Full business cases for Edinburgh Royal Infirmary and North Durham Acute Hospitals NHS Trusts.

  • PFI availability payments

    Private finance initiative availability payments fund both the cost of capital (debt service, returns to shareholders) and the lifecycle capital costs of the new facility. In general, private finance initiative business cases do not distinguish between these two elements, making it difficult to estimate the cost of capital. However, in a letter to Mr T Waterson of UNISON of 17 September 1998, Mr J Owens, then chief executive of the Royal Infirmary of Edinburgh NHS trust, gave the following breakdown of the availability payment for the trust’s private finance initiative scheme:

    Debt and interest payments 21 882

    Less: benefit from sale of existing sites - 1 881

    Net debt and interest 20 001

    Building, maintenance, and lifecycle costs 3 811

    Availability payment 25 693

    We have used the figure of £20m as the private finance initiative cost of capital. To this need to be added NHS capital charges payable on equipment and other NHS assets retained by the trust.

    In the case of North Durham, in order to arrive at a comparable figure for the cost of capital we have subtracted the trust’s estimate of the lifecycle maintenance capital costs for its public sector comparator (£1.21m) from the private finance initiative availability payment (£7.1m). It is, we feel, safe to assume that the private finance initiative lifecycle costs have not been estimated to be higher than the public sector comparator estimate. Again, we have included the NHS capital charges for which the trust is liable under the development.

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