Private Finance Initiative (PFI)
PFI in the NHS
Introduction to PFI in the NHS
The Private Finance Initiative (PFI) is one of a range of initiatives introduced by the last Conservative Government, aimed at increasing private sector involvement in the provision of public services. The Labour Government has sought to 'reinvigorate' PFI by streamlining the process and concentrating on 'viable' projects.
The Private Finance Initiative (PFI) involves the private sector in the finance and operation of public services. It affects mainly hospitals and schools. Under PFI the Government awards a long-term contract to the private sector to finance the building of a new facility and run the non-clinical services in it such as maintenance, cleaning, portering and security.
The clinical, medical and nursing services continue to be provided by the NHS. Thus the Government spreads the cost of new construction and the responsibility for support services can be transferred to private companies.
Why is UNISON opposed to PFI?
There are three main reasons why UNISON opposes PFI.
Borrowing
The Government can borrow money at preferential rates of interest. Over the long term the cost of providing new facilities through private investment is thus higher.Profits
The banks and operating companies will also want profits, as opposed to the Government's not-for-profit ethos. Profit levels are also kept confidential.Accountability
Private sector provision of services leads to a loss of accountability and control. In PFI hospitals, for example, the needs of the PFI consortium will be the key factor, not the needs of the NHS.How could PFI affect staff?
Clinical staff
Although medical and nursing staff will remain NHS employees, they will have to deal with the consequences. If the PFI scheme increases costs, cutbacks in clinical budgets are inevitable and quality levels will fall.Non-clinical staff
Ancilliary, Clerical, Maintenance and estates staff can become private sector employees.How does it affect the public?
Although the public may get a badly needed new facility it will have cost implications. In several areas escalating PFI costs have diverted funds from other health services. UNISON fears future PFI projects could influence health policy and eat up new money for the NHS.
UNISON believes that PFI is a more costly way of providing public services than direct borrowing by the public sector. UNISON is also concerned that transfer of staff to facilities-management companies will lead to a deterioration in terms and conditions and that the public sector will lose control over assets and service provision. The real danger is that under PFI the future provision of public services will be determined by what the private consortium wants rather than what the public need.
UNISON's Approach to PFI
UNISON campaigns to persuade the Government to abandon PFI and instead concentrate on public funding for new developments. UNISON provides advice and training for branches affected by PFI. A range of materials are also available including circulars and briefings from the Health Group and other campaigning materials from the Communications department.
UNISON has developed a twin track approach to tackling the threat of PFI:
- Campaigning against PFI nationally and locally
- Getting the best deal for members where PFI projects go ahead.
The UNISON strategy is to campaign against the high financial, employment and democratic costs of PFI, while recognising that we also need to negotiate to get the best deal for our members where PFI projects are going ahead. By following the links on this page you can download information about PFI as well as the latest UNISON Branch circulars on PFI developments.
• The UNISON contact for PFI in the Health Service is Phil Green.
Health Service Group
1 Mabledon Place
London WC1H 9AJ
Email: p.g.green@unison.co.uk
Wakefield health authority's legacy to primary care trusts. This UNISON report raises serious questions about hidden costs and lack of planning questions that the branch want answered as they continue to campaign against the PFI proposals.
Download Debts, deficits and service reductions
What's good about the NHS and why it matters who provides the service
Politicians say it doesn't matter who provides the services so long as they are publicly funded. But redistribution is built into the design of the funding and delivery system through risk pooling and integration. The two tier system, where some people can gain access to private care outside the NHS, is being accompanied by the break up of the NHS by competition, contracting out, trust status, and user charges
Download What's good about the NHS..
Equality and Inclusion
24 page booklet setting out the issues in the delivery of public services to lesbians and gay men. Covers housing, health and social care, education, administration of justice and leisure services. Part of UNISON's Positively Public campaign
Download Equality and Inclusion
The Only Game in Town?
An analysis of the failings of PFI as operated in the Cumberland Infirmary Carlisle PFI Scheme.
Download The Only Game in Town?
Downsizing for the 21st Century
An update version of an A4 report commissioned by Norther Region on the North Durham Acute Hospital PFI Scheme.
Download Downsizing for the 21st Century
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