| 1. |
INTRODUCTION |
6 |
| 2. |
SUMMARY | 8 |
| 3. |
ECONOMIC ENVIRONMENT | 14 |
| 3.1 | GDP |
14 |
| 3.2 | INFLATION & INTEREST
RATES | 15 |
| 3.3 | UNEMPLOYMENT |
16 |
| 3.4 | HOUSEHOLD CONSUMPTION |
17 |
| 3.5 | HOUSING & CONSTRUCTION |
18 |
| 3.6 | STERLING |
19 |
| 3.7 | POPULATION PROFILE |
20 |
| 3.8 | CONCLUSIONS |
22 |
| 4. |
HEALTHCARE SECTOR OVERVIEW – THE PUBLIC SECTOR |
23 |
| 4.1 | OVERVIEW & STRUCTURE OF
THE NHS | 23 |
| 4.1.1 | Legislative Drivers |
24 |
| 4.2 | THE PRIMARY CARE MARKET |
25 |
| 4.2.1 | Overview & Primary
Care Trusts | 25 |
| 4.2.2 | GP Surgeries & Health
Centres | 25 |
| 4.2.3 | Treatment Centres |
26 |
| 4.2.4 | Walk in Centres |
27 |
| 4.2.5 | Dental Provision |
27 |
| 4.3 | SECONDARY/ACUTE CARE
MARKET | 28 |
| 4.3.1 | Overview & Structure |
28 |
| 4.3.2 | Types of Hospital |
28 |
| 4.3.3 | Emergency Care |
29 |
| 4.3.4 | Hospices |
30 |
| 4.4 | HEALTHCARE SPENDING IN
THE UK | 30 |
| 4.4.1 | Total Healthcare
Spending | 31 |
| 4.4.2 | NHS Spending |
31 |
| 4.4.3 | Primary Care Spending |
33 |
| 5. |
THE PRIVATE ACUTE HEALTHCARE SECTOR IN THE UK |
35 |
| 5.1 | OVERVIEW AND SIZE |
35 |
| 5.2 | PARTNERSHIP WITH THE
NHS | 36 |
| 5.3 | ACUTE HOSPITAL
PROVISION & LEADING PROVIDERS | 37 |
| 5.4 | PRIVATE DENTAL CARE |
39 |
| 6. |
CONTRACTORS OUTPUT IN THE UK HEALTHCARE SECTOR |
42 |
| 6.1 | TOTAL CONSTRUCTION
OUTPUT | 42 |
| 6.1.1 | Value of Output -
Construction New Work | 42 |
| 6.2 | CONSTRUCTION OUTPUT BY
SECTOR | 43 |
| 6.2.1 | Repair & Maintenance |
44 |
| 6.3 | CONSTRUCTION OUTPUT IN
2007 AND BEYOND | 45 |
| 6.4 | CONTRACTORS OUTPUT IN
THE HEALTHCARE SECTOR | 46 |
| 6.4.1 | Outlook for
Healthcare Construction Work | 47 |
| 6.5 | THE NHS BUILDING
PROGRAMME/PRIMARY HEALTHCARE ESTATE IN THE UK |
49 |
| 6.6 | CAPITAL EXPENDITURE IN
THE NHS | 50 |
| 6.6.1 | Capital Funding
Reforms | 51 |
| 6.7 | HEALTHCARE WORK OUTPUT
– GOVERNMENT TARGETS & PROGRESS TO DATE | 52 |
| 7. |
PROCUREMENT OF HEALTHCARE CONSTRUCTION WORK |
55 |
| 7.1 | OVERVIEW |
55 |
| 7.2 | THE PRIVATE FINANCE
INITIATIVE | 55 |
| 7.2.1 | Size of PFI
Healthcare Market and Progress to Date | 56 |
| 7.2.2 | Leading Players in
the PFI Healthcare Market | 58 |
| 7.2.3 | Problems with the PFI
Process | 60 |
| 7.2.4 | Affect of Government
Policy on PFI | 61 |
| 7.3 | NHS LOCAL IMPROVEMENT
FINANCE TRUST (LIFT) | 62 |
| 7.3.1 | Background & Overview |
62 |
| 7.3.2 | Investment in NHS
LIFT | 62 |
| 7.3.3 | Scheme Update and
Progress to Date | 65 |
| 7.3.4 | Principal Consortia
and LIFT Partners | 67 |
| 7.3.5 | Affect of Government
Policy on NHS LIFT | 70 |
| 7.3.6 | Future of NHS LIFT |
70 |
| 7.4 | PROCURE21 |
72 |
| 7.4.1 | Background & Overview |
72 |
| 7.4.2 | Investment in
Procure21 | 73 |
| 7.4.3 | Scheme Update and
Progress to Date | 73 |
| 7.4.4 | The Effect of
Government Policy on P21 | 74 |
| 7.4.5 | Future of Procure21 |
75 |
| 8. |
CONTACTOR PROFILES | 77 |
| 8.1 | STRUCTURE AND SIZE OF
THE CONTRACTING INDUSTRY | 77 |
| 8.2 | KEY CONSTRUCTION
COMPANIES AND CONTACTORS | 78 |
| 8.3 | PRIVATE SECTOR
CONSORTIA IN THE HEALTHCARE SECTOR | 82 |
| 8.3.1 | NHS LIFT Consortia |
84 |
| 8.3.2 | Procure21 |
84 |
| 8.4 | CONTRACTOR PROFILES |
84 |
| 8.4.1 | Alfred McAlpine |
84 |
| 8.4.2 | Balfour Beatty |
85 |
| 8.4.3 | Bluestone
Construction | 86 |
| 8.4.4 | Bovis Lend Lease |
86 |
| 8.4.5 | Carillion Plc |
87 |
| 8.4.6 | Costain Group Plc |
88 |
| 8.4.7 | Galliford Try |
89 |
| 8.4.8 | HBG (Hollandische
Beton Groep) | 90 |
| 8.4.9 | Interserve Project
Services | 90 |
| 8.4.10 | Kier |
91 |
| 8.4.11 | Laing O'Rourke |
92 |
| 8.4.12 | Robertson Group |
93 |
| 8.4.13 | The Rydon Group |
93 |
| 8.4.14 | Skanska |
94 |
| 8.4.15 | Willmott Dixon |
95 |
| 8.5 | HEALTHCARE DEVELOPERS |
96 |
|
TABLES AND CHARTS |
| TABLE 1 | SUMMARY OF MAJOR
CAPITAL SPENDING PROGRAMMES IN THE PUBLIC HEALTHCARE SECTOR |
9 |
| CHART 2 | INTEREST RATES AND
INFLATION (CPI) FROM 1990-2009 | 16 |
| CHART 3 | PDI & SAVINGS RATIO
AT CURRENT PRICES 1990-2009 | 17 |
| TABLE 4 | EXCHANGE RATE
FLUCTUATIONS 2000-2007 - STERLING TO THE DOLLAR, AND THE EURO, SPOT RATES |
20 |
| CHART 5 | AGE DISTRIBUTION OF
THE RESIDENT UK POPULATION 2001 (‘000) | 21 |
| CHART 6 | VALUE OF UK NHS
EXPENDITURE 2003-2010 (£ BILLION) | 32 |
| TABLE 7 | UK NHS PRIMARY CARE
TRUST SPENDING ALLOCATIONS – 2003-2010 (£BN) |
34 |
| CHART 8 | PRIVATE ACUTE
HEALTHCARE MARKET - % BY SECTOR (£ BILLION) 2005-2006 |
35 |
| TABLE 9 | LEADING UK PRIVATE
HOSPITAL PROVIDERS | 38 |
| TABLE 10 | MAJOR DENTAL
COMPANIES IN THE UK | 40 |
| CHART 11 | VALUE OF
CONSTRUCTION OUTPUT NEW WORK 1999-2009 (£ BILLION) |
42 |
| CHART 12 | VALUE OF
CONSTRUCTION OUTPUT NEW WORK BY SECTOR - % BY VALUE 2006 |
43 |
| TABLE 13 | CONTRACTORS’
OUTPUT OF HEALTH SECTOR WORK (PUBLIC/PRIVATE) 1996-2006 (£M) |
46 |
| TABLE 14 | UK NHS CAPITAL
SPENDING – 2003-2010 (£M) | 50 |
| TABLE 15 | CONSTRUCTION
ACTIVITY IN THE UK HEALTHCARE SECTOR – PROGRESS TO DATE DECEMBER 2006 |
54 |
| TABLE 16 | PFI HOSPITAL
SCHEMES – BY STAGE OF DEVELOPMENT 2006 | 56 |
| TABLE 17 | LEADING PFI
CONTRACTORS BY TOTAL WORK WON (INCLUDING HEALTHCARE WORK) (£M) – TO DECEMBER
2006 | 59 |
| TABLE 18 | LEADING PFI
CONTRACTORS BY TOTAL PFI HEALTHCARE WORK WON (£M) – TO DECEMBER 2006 |
59 |
| TABLE 19 | NHS LIFT SCHEMES –
ENABLING FUND ALLOCATIONS (2005-06) (£M)* | 64 |
| TABLE 20 | NHS LIFT WAVE 4 –
PREFERRED BIDDERS | 66 |
| TABLE 21 | MAJOR NHS LIFT
PREFERRED BIDDERS/CONSORTIA TO DATE | 68 |
| TABLE 22 | MAIN PRIVATE
CONTRACTORS - BY NUMBER OF EMPLOYEES 2006 | 78 |
| TABLE 23 | UK’S TOP 20
CONTRACTORS BY GROUP TURNOVER 2005/2006 | 80 |
| TABLE 24 | LEADING HEALTHCARE
CONTRACTORS AND PRINCIPAL PRIVATE SECTOR CONSORTIA |
83 |
| TABLE 25 | PRIMARY HEALTHCARE
DEVELOPERS/INVESTMENT COMPANIES | 98 |
| TABLE 26 |
HEALTHCARE CONTRACTING – GLOSSARY OF TERMS |
102 |
