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Hospital Beds

Volume 610: debated on Wednesday 15 March 2000

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2.46 p.m.

How they reconcile their private finance initiative hospital building programme with the recent findings of the national beds inquiry.

My Lords, the bed modelling for the 16 major acute hospital projects currently being built under the PFI scheme considers the same major factors and drivers as identified in the national beds inquiry. To be approved, PFI schemes need to demonstrate flexibility. Experience already shows that changes can be accommodated at PEI hospitals.

My Lords, I thank the Minister for that reply. Is it not clear that the first PFI schemes being completed involve a reduction of 30 per cent of available beds and cuts in staff numbers of up to 25 per cent? The national beds inquiry made clear that we are at least 4,000 beds short. Last year 56,000 operations were cancelled due to lack of beds. Is it not time that the Government recognised, like the Institute for Public Policy Research, that the economics of PFI schemes are extremely unsound and that they will cost the NHS more money in the future while forcing a continuing and disastrous reduction in the numbers of beds available? Or is the NHS, after the Prime Minister's recent comments, planning to fill the gap with private beds?

My Lords, the noble Lord is quite wrong. Public/private partnerships enable us to combine the best of the public sector—particularly in regard to the direct delivery of clinical services—with the best of private sector skills in the management and financing of major capital projects such as the 16 new hospitals now in train. The NHS has had unhappy experience of the traditional route for capital builds going back to its foundation. Many schemes have taken years and years to bring to fruition. I am sure that many noble Lords will know of instances where there has been a phase one, a phase two, a phase three and a phase four in the building of a hospital, which can take up to 20 years. With the public/private partnership arrangement we can build whole hospitals at a very quick pace.

As to beds, there are two factors to bear in mind. First, in a comparison between outline cases using the traditional capital route and the PEI route, there does not appear to be any difference in the number of beds planned. Secondly, of course we need to take notice of the national beds inquiry and to ensure that we have the flexibility to take account of the changes we need to make. We recognise that we need to increase the number of beds in this country and to use the ones we do have more effectively.

My Lords, does the Minister agree that if an NHS trust is unable to provide an urgent operation to a patient, there is no ideological barrier to the trust placing that patient somewhere in the private sector? If he agrees that there is no such barrier, has that message been transmitted to the chief executives of NHS trusts?

My Lords, the Government have made the position clear. Where the NHS requires extra provision to be made and where it is not available within the NHS it can then look to the private sector. The policy is quite clear.

My Lords, will my noble friend the Minister note that many on this side of the House agree with his outline of the future in relation to the initiatives being undertaken by the Labour Government? However, will he explain in slightly more detail how he sees the delivery of these hospitals as regards timescale and issues of that nature?

My Lords, the national beds inquiry is currently being consulted upon. We expect the consultation period to run to 15th May. We shall then be able to make decisions in developing a national strategy for providing NHS beds in the future. I believe that the current capital programme with the PFI and conventional funding, which is enabling us to build a record number of new hospitals, will allow us to take account of the inquiry as quickly as possible.