Select Committee on Health Minutes of Evidence

Examination of Witnesses (Questions 960 - 963)



Julia Drown

  960. That is why I said you can put it in writing.
  (Mr Campbell Davis) You saved the best one until last.

  961. It is because you have put those interesting things in here and we do not want to miss out on them. Do feel free to answer in writing.
  (Mr Campbell Davis) Would it be helpful in that case if I give you just a few headlines and then write to you about the substance?

  962. Yes please.
  (Mr Campbell Davis) First of all, on the issue of flexibility, although the health service has always tried to do so, it is perhaps fair to say that we have not always over the years got it right in our planning of hospital development. So with PFI, as one mechanism, we are now trying to do that with the private sector. It is also true that the private sector is learning some of those skills for the first time. The difference this time is that they are being written into typically 30 year contracts, whereas in the past, building hospitals ourselves, the consequence of getting it wrong was not given the same degree of consideration and was downstream and usually somebody else's problem. It will now be the problem of the parties to the contract, the private sector, so much more focus goes into that. A lot of work has developed over the lifetime of PFI and, indeed, since you mentioned the Future Hospital Network and the Confederation, we are now doing what I think is really some seminal work, looking ten or 20 years ahead, to do with the way that the NHS—with the emphasis on the word service—will change, and trying to work backwards to what the physical design of hospitals should be. People like Professor Ara Darzi at St Marys of London—who I think Dr Taylor may know from the Kidderminster review—have been doing interesting work on whether hospitals will exist, for example, with medicine and surgery continuing alongside one another, or emergency and elective work, in the future in the way they have done in the past. The answers are complex and cannot be stated simply, but I do think as that work develops over the next couple of years we should have something that we can tell and sell to the public about what their local health service will look like. Hopefully it will take some of the difficulties out of the debate about local access to high quality services, if we get 4 right. You asked about risk transfer, and perhaps that is something we might write to you on and give examples where we think it has worked or not. Finally, you asked for a single side of A4, and I was pleased to hear my colleague, Mr Catton, mention that at least PFI might be simple, but then compare it with something less complex. Of course, it is very difficult for any of us to describe in a paragraph or two how it works! We have got to do so, because until we are able to tell people that PFI is just another financing mechanism, with these qualities and these benefits, and these risks, I think there will continue to be scepticism and fear. I think we are closer to doing that now and, although I will not attempt to do it in front of you, I think I can probably have a stab at it now in a way that I could not have done a year ago, Chairman.


  963. We are grateful. I am concerned to finish soon because there is a health statement in the Commons which colleagues want to get to.
  (Mr Catton) One point which is particularly of concern to us at the moment is the pressure on clinical budgets in some PFI sites. We have written to you on Hexham, Edinburgh is another one as well which is causing us some concern at the moment.

  Chairman: Do any of my colleagues have any further questions? If not, can I thank you for your co-operation. Mr Campbell Davis, you will send us some follow up information. I am not sure if I can wish you a Happy New Year, Mr Roy, or not, we do not know where you will be. We wish you well and we are grateful for your co-operation.

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