Cumbria Infirmary, an attractive, quite new building, has massive debts to PFI and is unsafe from fire.The PFI will cost £1,018million for an £87m hospital

Liverpool Women’s Hospital was built in 1995. The Cumbrian Infirmary in 2001

What can we in Liverpool learn from this ?

Staff at Liverpool Women’s Hospital and the public have been told they will have a brand new building. What’s not to like? Why are campaigners so very wary?

Liverpool Women’s hospital was built 22 years ago and has no building debt. This is like being mortgage free.

Let us look at a hospital, a north of us, in Carlisle. Carlisle’s hospital, The Cumberland Infirmary looks beautiful, it really does. The entrance is impressive. It serves a huge area of the north of England. The staff are excellent NHS workers. You might have been there if you have hurt yourself on holiday in the Lake District. Care is not affected by PFI, except for the cost to the hospital budget and the separate problems in the build.

(Cumbria too has to fight for maternity services. We will cover in a different post )

So what happened with Carlisle Hospital?

The Cumbria Infirmary was built in 2001, a few years after the Liverpool Women’s Hospital. The hospital cost £87 million pounds to build. The PFI will cost £1,018million.In a PFI, the company builds the hospital and continues to own it for the period of the contract, 30 years normally. In that time, the first call on the budget of the hospital is the PFI payments.

How much has the NHS paid for the hospital so far on the PFI?

In year 14 of the contract, it had paid £260m, more than the cost of three hospitals. This money should have gone to staffing and to patient care.

The PFI contract though was sold on by the original contractors Interserve to Delamore for £90 million. To help give Delmore a better return the contract (like the mortgage term) was extended for 5 years. For more details see here

If at the end of 35 years, if inflation runs at 3% on average, the NHS will have paid £1018 million pounds

It costs a stupid amount, not to build, but to finance. The major expense was borrowing the money.

There is another major financial problem. “Developers will be handed huge swathes of land worth hundreds of millions of pounds, if the NHS fails to maintain a string of controversial Private Finance Initiative contracts, it can be revealed.”

Just one of our reasons to oppose the new build proposal is the way new hospitals are now usually funded. This is “PFI”. There are other reasons we oppose plans but this post concentrates on PFI

“The private finance initiative (PFI) is a way of creating “public–private partnerships” (PPPs) by funding public infrastructure projects with private capital.”

In this post we want to give just some of the background to PFI.For more detailed report read this https://www.theguardian.com/society/2017/aug/30/private-companies-huge-profits-building-nhs-hospitals

Why should people worry about how a hospital is paid for?

Before PFI, big projects were funded through the public works loan board. It was cheaper and the hospital owned the building and had more say in its construction. There was no profit to pay out to big private corporations

Many hospitals struggle to pay their PFI. In 2015 the Independent reported that “crippling PFI deals leave Britain in £222Billion in debt. Norfolk and Norwich hospital was reported as serious problems. The local paper said “How shareholders of PFI firm are making millions from cash-strapped Norfolk and Norwich University Hospital”

For an excellent summary of PFI issues in the NHS please read this

The massively expensive Cumberland Infirmary, Carlisle’s hospital, is Unsafe from Fire

Wikipedia says

“In 2015 a report commissioned by North Cumbria University Hospitals NHS Trust found that the fire proofing materials installed did not meet the required protection standard to allow for safe evacuation and prevent a fire from spreading across the building. It was described by the secretary of Cumbria’s Fire Brigades Union as “one of Carlisle’s biggest fire risks”. The Trust said that this was not the first time they had uncovered major flaws in the PFI scheme.[4]”

(We quote Wikipedia so we cannot be sued for saying this or dismissed as mad campaigners!)

Carlisle hospital’s fire safety sprinklers will not be fully installed until 2020. The faults were discovered in 2014. Meanwhile staff have rightly had to take extra precautions, taking time and money from patient care.

It was not just that the fire precautions ”were not as robust as those specified in the original plans” there was not enough staff from the fire service, nor from the NHS, to check on them

The Fire Brigades Union says

“Les Skarratts, a senior official with the Fire Brigades Union in the north west and Cumbria, said: “This demonstrates the consequences of cuts in the fire and rescue service in the area of fire safety inspectors. They’re skilled in inspecting places such as schools and hospitals. They bring enormous experience to the job and can resolve issues through taking enforcement action. Patients and staff in hospitals such as the infirmary deserve the best protection possible .In a public area, the effect of a sprinkler system is immediate .In this case, there should be some form of public inquiry.”

Despite this huge expenditure, the building has been found to be not safe from fire. Fire chiefs say safeguards “were not as robust as those specified in the original plans”.

Carlisle is not the only PFI built without fire precautions

“An independent report commissioned by the NHS trust that manages the hospital found that fire proofing materials installed by the private company did not meet the required protection standard to allow for save evacuation and prevent a fire from spreading across the building”

The Mirror reported other hospitals being unsafe from fire. Peterborough City Hospital, Coventry Hospital and Hereford County all have fire problems caused by PFI buildings. And chiefs at Hereford County Hospital fought to keep details of fire safety flaws secret after an enforcement notice was served on their PFI partner, Mercia Healthcare. (all from the Mirror)

The cost of making the hospital safe from fire will not go to the owners of the building but incredibly to the NHS.

“The private finance initiative (PFI) is a way of creating “public–private partnerships” (PPPs) by funding public infrastructure projects with private capital.”

Why should people worry about how a hospital is paid for?

Before PFI, big projects were funded through the public works loan board. It was cheaper and the hospital owned the building and had more say in its construction. There was no profit to pay out to big private corporations

The law of the land says buildings must be fire safe. These laws have not been observed.

Blessings be on the dead of Grenfell tower, and we give all respect their suffering, but that tragedy shows the scale of this further neglect of fire safety. And in hospitals too?

In Scotland when schools built with PFI began to fall down the Scottish government stopped paying the PFI. Carlisle is still paying, such is their contract

Carlisle hospital though is living lesson to those of to us in Liverpool, working in the NHS or fighting to save Liverpool Women’s Hospital and fighting to defend the NHS as a whole.

The new hospital in Liverpool, the Royal is being built with a PFI too, albeit one that is only slightly less expensive than Cumbria thanks to the detailed campaign waged against the original plans Alderhey Children’s hospital new building was built with PFI too. First bill to be paid each year is the PFI.

A PFI, however it is dressed up, means the first call on the money of a hospital budget is the PFI. Nationally and locally Money that should be spent on patient care and staff salaries, goes on the PFI

Doctors and nurses specialise in a field, such as Gynaecology, Heart issues, others in dermatology and many more. Not all doctors, nurses, and midwives know about PFI, or about STPs or about health economics, though many do. They should not need to know about this any more than they know about other specialisms. Their workload is heavy enough. In 2017, though, we all need to know in detail about this. PFI does though does affect everyone: doctors, nurses, patients, taxpayers, citizens are all affected. Of course, the very, very rich make money from it, far above the normal rate of interest or rate of profit. If you, friends, or family do work in the NHS, please do spread the word.

Why use this cumbersome and massively expensive system of financing hospitals? Two reasons It stays off the government balance sheet; the national debt looks a bit better, and it makes a pile of money for big business. These companies work for profit not for health care, and boy do they make profit.

Campaigners in Carlisle want the hospital nationalised so it becomes the property of us, the citizens.

If the Government spent the money on the hospital as ordinary capital spending it would cost the taxpayer millions less.

We want nothing to do with PFI

THE CCG in Liverpool has its self inflicted difficulties but the system of CCGs is flawed. Doctors were put in the front line of planning, something few doctors train for, then were given “expert” providers from the big corportaions whose business is to make profit.

The Carlisle debacle happenned before CCGs but it would be twice as foolish not to learn the lessons from Carlisle

We say Fire Safety check the new Royal repeatedly as it is being built.! Do it again and again

Liverpool Women’s Hospital should remain on site and be improved. The cost of providing extra staff, doctors and midwives and extra resources, to try to reduce the 15 transfers a year, to pay for for intensive care and improved blood services all pale into nothing compared to the cost of PF

Save Liverpool Women’s Hospital#onsite

Thanks to camapigner Peter Doyle from Carlisle for talking to us about it.