When they are funded through the costly Private Finance Initiative even the newest nospitals lack any spare capacity to treat patients from outside their existing catchment area, and plans for many proposed "critical care centres" are already being downsized or abandoned as Trusts and the commissioning Primary Care Trusts attempt to cut back on spending and address deficits.
Epsom and St Helier hospitals in SW London, for example both seem certain to close the bulk or all of their district general hospital services - while plans for the promised E250m PFl-funded replacement hospital and the promised additional network of local care hospitals have been scrapped.
In NE London, where the brand new £238m Queens Hospital is opening up in Romford, the Barking Havering & Redbridge hospitals Trust is facing a cumulative £43m delicit coupled with the need to pay out £36m a year for the next 30 years or more to the PFI consortium.
It is urgently seeking economies by downsizing the neighbouring King George's Hospital in Ilford - only completed in 1993 - to an "ambulatory care unit". This way even a state of the art new hospital can result in a worsening of access and patient care in the surrounding area.
Similar "reviews" and plans are being hatched up all over the country - threatening popular local services in pursuit of balanced budgets while hundreds of millions are
The extra cost (equivalent to paying a massive 18% interest) is the premium that the NHS is set to pay for PFI as a one-sided, extravagant "partnership" with the private sector without taking any account of further windfall profits from refinancing their loans on the money markets once the construction phase is complete.
It seems the secrecy surrounding these deals is because there is plenty that ministers are understandably eager to hide.
But while every million extracted from the NHS in profit is a million less in resources for patient care, the real cost of private sector involvement is far higher than its profits and bureauстасу.
The NHS is being transformed from a comprehensive, equitable provider of healthcare into a tax-funded insurance fund, commissioning services from a range of being siphoned from NHS spending to purchase overpriced operations from a new, parasitic private sector delivering the simplest riskfree procedures in profitseeking "Independent Sector Treatment Centres".
A new ISTC is due to open in NE London in February, delivering up to 11,000 operations a year which would otherwise have been commissioned from NHS Trusts - leaving the NHS hospitals high and dry. AVt TIAL Even a child can work out that Blair and Hewitt's reforms don't add up... providers in a new healthcare "market" which continues to destabilise many local NHS services - to make space for the new private providers.
Even though NHS spending has doubled since 1997, government policies have still triggered a constant sense of crisis and uncertainty among health staff, record deficits, job-losses and closures - and lost the confidence of the electorate, especially those who believed Blair's claim New Labour was the party to "save the NHS".
The "purchaser/provider split" which Labour in opposition correctly castigated as "costly and wasteful" has been widened - with tension between the purchasers (now primly termed "commissioners") - the Primary Care Trusts (PCTs) -and the providers (NHS Trusts and foundation trusts) exacerbated everywhere as each side seeks to resolve its financial problems at the expense of the