STop ing them to contemplate Patricia Hewitt's decision to slash back £1.9 billion plan to rebuild Barts and the London hospitals through the Private Finance Initiative (PFI) marks a sharp change in attitude to big hospital schemes as ministers look to purchase increasing volumes of services from the private sector.
At Barts & The London 250 beds - 20 percent of the planned capacity - are to be axed, with three floors of the new buildings be left empty to wrestle down the capital cost of the scheme by £160 million, leaving the new mega-hospitals with fewer beds than they have now.
The empty floors will stand as a vivid monument to the folly of PFI, while the bed cuts come despite the insistence by consultants that the full plan was absolutely essential deliver the planned mix of services to the people of the City and East End.
Other PFI schemes have also ground to a halt and face "downsizing" - with a massive cutback in plans for a new hospital in Wakefield, a reduction or even cancellation of a planned new hospital in Stoke on Trent, and a
of long-delayed schemes in Birmingham, Bristol, and even a £760m scheme in Hewitt's own local patch in Leicester.
Many of the first wave PFI schemes are causing financial chaos elsewhere in the NHS WITN major redundancies already announced in struggling Trusts in Worcester, in Norwich and at the Queen Elizabeth Hospital, Woolwich, now technically bankrupt: doubts remain over the numbers of jobs and services to be axed in England's largest PFI hospital London's f420m University College Hospital which is facing a projected a f40m deficit.
Virtually every PFI hospital is now in financial difficulty, or about to be plunged into problems from April when the new system of "payment by results" comes in, paying Trusts only a fixed price for each item of treatment they deliver, regardless of the inflated overhead costs faced by PFI hospitals.
PFI has been the fig leaf
PFI POUNDS FOR SALE ONLY €1.50 EACH! behind which the government has hidden its refusal to invest in the long term future of the NHS, with just 4% of the capital for new hospital projects coming from the Treasury. Our last issue flagged up the pressures on NHS Chief Executive Sir Nigel Crisp, but barely had our newspaper hit the streets before Crispy him. self was out on the cobbles -or more accurately spending more time with his bruised ego on the cross-benches of the House of Lords, with just a £3m pension pot and a parttime job flogging Blairite reforms of African health care systems.
We can't claim credit for Crisp's sharp exit: but it is clear that the two career bureaucrats who have stepped temporarily to fill his vacated post will struggle to solve the complex range of problems arising from the government's "reforms" and contradictory policies and targets.
It appears that the process of mergers of Primary Care Trusts and Strategic Health Authorities which Crisp initiated will be carried through, triggering an estimated £300m bill for redundancies at management level, and raising fresh concerns over the future of many of the services currently provided by Primary Care Trusts - employing around 250,000 staff - which could face privatisation or closure.