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NHS building plans will 'fail to deliver modern service'

New investment approach urgently needed to make improvements, says independent think tank

The NHS is wasting billions of pounds on over-expensive hospital building projects at the expense of investment on improving services, according to a report by the public policy think tank, Reform.

The centre-right group said that the money ploughed into the NHS will not provide the service with the modern generation of buildings needed to improve standards of care, reduce waiting times and increase productivity.

The report, titled Investment in the NHS - Facing Up to the Reform Agenda, argues that the NHS reform agenda, including payment by results, patient choice and practice based commissioning, means that large hospital building schemes - so-called `white elephants' - will only be appropriate in certain situations. It calls for the use of smaller and simpler units, which could be leased to NHS providers rather than owned by the NHS.

The study recommends that the Department of Health (DoH) should look to local managers to `identify a new wave of manageable schemes which will be affordable and justified by local demand'.

ìLarge hospital building schemes are only appropriate in certain situations,î said report author, Professor Nick Bosanquet of Imperial College. ìIn effect the NHS should move to a system which could fund investment of various sizes from ?5m to ?30m.î

He added that NHS trusts were being paralysed by fear of large deficits, inadequate financial information and pressure on costs from the DoH.

The report also found that some areas of the country plan for considerably more investment in public private partnerships schemes, such as the Private Finance Initiative, than others, citing the fact that the West Midlands and London Strategic Health Authorities plan to spend four times as much per head of population than the South East Coast SHA.

However, despite the failings of the `white elephant' schemes, the report said it would be `unfair and wrong' for the blame to be laid at the door of partnerships such as PFI, which it said had been `a major step forward on traditional public sector procurement'.

30th September 2008

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