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Thurs 3 April 2003

PFI hospitals fail patients and staff - Speaking out in UNISON against PFI

"I think this hospital has been built as cheaply and as nastily as possible" - a porter, Hairmyres Hospital, East Kilbride

"The hospital seems to be continually in a beds crisis" - a stroke nurse, Norfolk;

"The doors cost as much as £1,000 each, and are an accident waiting to happen" - UNISON rep Worcester

"...they can't put shelves on the walls, since they are not designed to take the weight." - UNISON reps, Royal Infirmary, Edinburgh.

"the path lab flooded three times in 18 months, twice with raw sewage." - UNISON convenor - Carlisle.

These are the voices of NHS staff talking about their experiences of working on the front line in Private Finance Initiative (PFI) hospitals across the UK.

A new report* from UNISON, the UK's largest health union, examines in detail life in nine PFI hospitals and paints a damning picture of the effect of PFI on patient care and staff .

UNISON is calling on the Government to carry out an independent review to establish if PFI is delivering and whether it represents good value for taxpayers' money.

PFI is also the subject of a number of critical motions at the UNISON Health Group Conference to be held in Harrogate next week (Monday 7 - 9 April).

Dave Prentis General Secretary of UNISON said: "The Government are sticking their heads in the sand about the growing financial costs of PFI. But if they won't listen to us when we say PFI is failing miserably, perhaps they will listen to the staff on the frontline. They are telling us loud and clear it is not delivering improvements in patient care and it is not benefitting staff.

"The report is a damning indictment of the whole PFI process. It is tragic that such a large and welcome hospital investment programme should have produced such universally poor results."

Jim Devine, UNISON's Scottish Organiser (Health) said "As UNISONScotland is saying in our Revitalise our Public Services campaign, Increased investment should be directed to provide frontline services rather than into the pockets of shareholders via expensive PFI projects. The recent BBC poll shows that people find it very important that hospitals and schools should be run by public authorities and not by private companies. These comments show how right they are to be concerned.

"In Scotland, NHS staff have increasingly been brought back in-house, a far more effective way to deliver a proper service, and what the people of Scotland want."

The report is based on a series of interviews with nurses, porters, cooks, cleaners and admin and clerical staff. A number of key issues came up time and time again:

Bed shortages: Edinburgh UNISON reps point out "The final bed figure they settled on is 852. We used to have about 1200. ...So we've got bed shortages already and its going to get worse."

A porter in Worcester "The other day I had to collect a dead patient from a ward. They said hurry up we've got somebody here to go into that bed."

And from a nurse at Hairmyres Hospital "...compared to the old hospital they are trying to shove patients out quicker."

All of the first-wave PFI hospitals are desperately short of beds, putting nursing staff under pressure to discharge patients more quickly. Several of these hospitals - all opened since 2000 - are looking to build new extensions, or are resorting to the use of Portakabins, old buildings that should have been demolished, or local private sector beds to bridge the gap in capacity .

Reduced levels of patient care: A staff nurse at the Cumberland Infirmary in Carlisle reported "The room in outpatients where the patient had his cardiac arrest was so small they couldn't get the equipment in."

In Hairmyres Hospital one nurse complained "The place is manky, because the cleaners also have to do the beds and do the meals: those jobs come oout of their cleaning time."

Most support staff are concerned by the reduced level of care they are able to give. Domestics work unpaid extra hours to clean wards and complain they are still not able to clean to their satisfaction. Catering staff resent the fact that they don't get to cook anything any more, and cannot take more time to help patients eat their food.

Poor design and quality: From Hereford Hospitals NHS Trust a privatised engineering services worker with over 20 years experience in the NHS remarked, "it's cheap and nasty. The boiler house opened with no water treatment plant and we had a temporary boiler stuck outside on a trailer for 6 months.

At the Edinburgh Royal Infirmary a UNISON rep said "We have had several roof collapses so far and we are not even a year in." All of the buildings visited were riddled with structural and design problems. Estates staff were universally scathing about the quality of most of the materials and fittings that had been used - refuting any idea that the private sector would "engineer in quality" to hold down maintenance costs.

Financial problems: A UNISON rep in North Durham Hospital said "the PFI deal is costing the Trust £12m a year, index linked and it's a 27 year deal." In Edinburgh, "The cost of the building itself was £184m., but that included selling off the City Hospital, and the Princess Margaret Rose Hospitals and the Dental Hospital for £12m. The Land under the City Hospital and the Princess Margaret Rose is now worth in excess of £200m. So the land itself could have paid for this, no problem!" .

All the Trusts visited were facing extremely serious financial problems, partly through the costs of PFI and partly as a result of the pressure on front-line capacity. Some had lost vital nursing staff and were struggling to recruit and retain enough permanent staff to avoid running up hefty agency bills.

*The PFI Experience ' voices from the frontline' researched for UNISON by John Lister, London Health Emergency. Available at http://www.unison.org.uk/acrobat/13383.pdf as a pdf file.


For Further Information Please Contact: Jim Devine, (Scottish Organiser - Health) 0845 355 0845(w) 07876 441 239(m) Chris Bartter (Communications Officer) 0845 355 0845(w) 0771 558 3729(m) copies of the report from Anne Mitchell on 0207 383 0717