PFI: the infection at the heart of Scotland’s gravest NHS crisis

by Colin Fox, SSP national co-spokesperson

· Scotland’s NHS is in the grip of its worst crisis in 75 years. Waiting times and waiting lists are at record levels. Staff morale is at its lowest ever with vacancies at their highest. It survived the pandemic but in doing so exposed lethal shortcomings in this country’s social care provision.

Unable to keep the promises made about the length of time patients would spend suffering outside A&E departments, or waiting for clinically diagnosed and much needed operations, NHS Scotland is also haemorrhaging huge sums of money in payments to the private companies who now own and control much of this key public service.

Billions of pounds that should be spent on improving patient care is pouring out of the NHS and into the accounts of commercially motivated consortia who duped our political representatives into signing lucrative [for them at least] Private Finance Initiative contracts.

Shady companies
You don’t believe me? Well here’s a question for you. What do Consort Healthcare Ltd, H DGH Ltd, Summit Healthcare Ltd., Forth Health Holdings Ltd., Stobhill Healthcare Facilities Ltd., Macquarie Capital Solutions and Dumfries Facilities Holdings Ltd. all have in common?

Answer, they are the anonymous, shady companies who own Scotland’s seven PFI hospitals. That’s right, Edinburgh’s Royal Infirmary, Hairmyres, Wishaw General, Forth Valley Royal, Stobhill, Edinburgh’s Sick Kids and Dumfries and Galloway Royal Infirmary are not owned by the NHS.

The first five were privatised by Labour, the last two by the SNP. Both parties having vehemently condemned PFI ‘in opposition’ they then employed it in government. There is a word for such betrayal of the NHS, but I’m too polite to use it in the pages of a family newspaper like this!

Had NHS Scotland built these hospitals itself the billions of pounds saved could have been spent on essential operations. Instead the exorbitant payments to these privately owned hospitals eat away at our NHS every single day.

The cost of the seven facilities mentioned above would have been £2billion if they had been constructed by the NHS via the public purse in the usual way. The actual charge over the lifetime of these contracts will be nearer £10billion! ‘Err in haste, repent at leisure’ as the saying goes.

Seventy-seven such ‘initiatives’ were signed off by governments across Britain over the past 20 years [Source; UK Department of Health and Social Care].

In the case of Wishaw General, Scottish Government figures show that the £100million facility which opened in 2002 will cost NHS Lanarkshire £813million over the 25 year life of the contract. Eight times as much!

Similarly, Edinburgh’s Royal Infirmary, which would have cost £350million to build publicly in 2002, will see NHS Lothian charged £1.2billion by the end of 2028.

And, as if their record wasn’t bad enough, Labour intends to push further privatisation onto our NHS. Whilst a recent YouGov poll found 84 per cent of voters want to see healthcare publicly provided, Sir Keir Starmer, his Health spokesman Wes Streeting and Scotland’s only Labour MP Ian Murray [in whose constituency Edinburgh’s two PFI hospitals sit], aim to increase the role the private sector plays in delivering NHS services.

‘We believe we have a responsibility to utilise the private sector’ they say adding ‘those who can afford to, should pay to go private’. [Ian Murray’s open letter on NHS privatisation, May ‘23]. In other words the wealthy will get treatment, the rest of us will not. So much for protecting the central principle of ‘universality’ designed by Aneurin Bevan in 1948 when the NHS was founded!

The Scottish Socialist Party has campaigned steadfastly against privatisation for 25 years now. And we can be found on Princes Street every week for example petitioning people to support returning Edinburgh’s two PFI hospitals to the NHS. This is something we seek for all Scotland’s privatised health facilities. All these PFI contracts should be renegotiated, in our view, to ensure that our hospitals are returned to NHS ownership and the public gets far better value for its money than hitherto.

Why wait…?
Why should we wait until 2027 for example to return Edinburgh Royal Infirmary to the NHS when the service is losing money at the rate it is? It is entirely reasonable to insist that the terms of these commercial contracts should be revisited given what we now know.

Such negotiations take place every day of the week in the corporate world. Our elected politicians need to show some leadership in this regard. Curing Scotland’s worst public health crisis must therefore involve escaping from punitive PFI contracts and redeploying the money saved into much needed frontline care. Public opinion in Scotland will accept nothing less.

We, the people of Scotland, have made it abundantly clear time and again, we want our NHS to be owned by, and accountable to, the people of Scotland, not to profiteering private companies of which we are allowed to know little.