INTRODUCTION and OVERVIEW 

AMA Research has published the first edition of a report covering "PFI in The UK Health Sector 2002" - incorporating primary research and drawing upon extensive primary and secondary sources, it focuses upon the development of PPP/PFI for the health sector, assessing recent history, and future prospects for the sector, the latter particularly relevant given the recent budget announcements of additional funding for health.

Over 120 pages, the report covers:-

• PPP/PFI in the UK Health Sector - market size, development of funding, Local Authority influence, Mix of Care Categories.

• Major New Initiatives - new hospitals, new schemes, Refinancing etc.

• Key Issues - NHS LIFT, NHS Pro-Cure Insurance, Design Quality, Payment Mechanisms Waiting Lists, Concordat, etc.

• UK Public Health Sector - a perspective.

• Major Players in PFI are also covered. International Perspective.

The recent budget highlighted the current state of Healthcare in the UK and introduced a programme of additional funding to take the total amount spent on healthcare to £108 billion by 2007/2008. This includes all healthcare expenditure, but capital expenditure on IT and buildings should be raised significantly over the next 10 years from £2.2 billion to £5.5 billion per annum, meaning that approximately one third of all hospital real estate and all GPs surgeries would be replaced or refurbished.

The market for capital investment is therefore likely to remain buoyant over the next few years as the level of capital expenditure is increased, making this an attractive sector for any company providing building products, construction or outsourced facilities to the health sector.

Other Reports in the PPP/PFI Industry:

• PPP/PFI in the UK Defence Sector 2002.

• PPP/PFI in the Republic Of Ireland 2002.

• PFI Issues in the UK 2001.

• PFI Intelligence Bulletin - Ongoing.

• PFI and Specification Issues in UK Social Housing 2002.

• PFI in the Local Authority Sector 2002.

Key areas of coverage in the report will include:

DEVELOPMENT OF PFI/PPP IN HEALTHCARE

• The role and development of PPP and PFI within the healthcare sector.

• Total Healthcare expenditure in the UK, NHS expenditure. Relative to GDP, comparison with Europe.

• Government's commitment to improve Healthcare in the Public Sector. The NHS Plan, limitations thereof, increased capacity. Health Authority and NHS trust expenditure.

• Signed Project List 1995-2001.

SCOPE FOR PFI/PPP IN THE HEALTHCARE SECTOR

• NHS LIFT - a major initiative to improve Primary Care conditions and delivery. The need for a committed local partner. Project size issues, Project bundling, local management capacity scheme deliverability.

• The scale of the task and the limitations on capacity increases in terms of internal and external resources. Summary Cash Plans - health sector, local authority sector.

• Outsourcing of ancillary staff. Soft and Hard FM provision - trend to the latter.

• Assessment of the differing sectors of Primary, Intermediate and Acute Care and the issues associated with each of these areas. The scope for layering of hospital facilities.

• Progress To Date - cumbersome process, projects are complex, output specifications, levels of service, delays.

• Experiences in Scotland, particularly on residential projects.

• Percentage Mix of Health and Community Services.

• Value £m of signed PFI projects 1995 to 2001.

CASE STUDIES

• UNIVERSITY COLLEGE LONDON HOSPITAL, UCLH - Background, New Facilities, Procurement Process, Special Technical Characteristics, Facilities Management, Contractual, Financial, Comment.

• CHESTER LE STREET COMMUNITY HOSPITAL - Background, Description of Facilities, Basis for PFI Option, Financial Envelope, Procurement Process, Comment.

• HIGHLAND PRIMARY CARE TRUST - Background and Description, Advantages, Procurement, Comment.

• SUMMARY - helpful pointers for the evolution of PFI projects in the Healthcare sector

• STATUS OF MAJOR PROJECTS

KEY ISSUES

• At a general level these include - Site redevelopment, Refinancing of loans, Insurance and performance guarantees, The competence and commitment of the client, Design quality and designation as fit for purpose.

• At a Healthcare specific level Key Issues in the UK include - The transfer of personnel, The provision of clinical services, The length of waiting lists, The Concordat with the private sector, The use of foreign facilities, The hypothecation of NHS revenues.

• The recent budget, the Wanless Report.

• Major suppliers of finance and construction and facilities management companies.

OTHER ISSUES

• Procurement process and step by step analysis.

• International Perspective - Sweden, France, Germany, Spain. Bismarck and Beveridge schemes.

• Consolidation within the PFI/PPP industry.

• Future Prospects - influence of the recent Budget, Likely developments etc.

• GDP analysis, population statistics, inflation and interest rates.

This 125+ page report provides a comprehensive overview of PFI in the Health sector.