NHS Capital Investment and Pfi: From Central Responsibility to Local Affordability

At its inception, the NHS was structured as a public corporation, which owned its hospitals. Sixty years on, hospitals are business units or Trusts, which are responsible for capital investment in a local region. The Private Finance Initiative (PFI) has become the predominant mode of financing new hospitals. This paper's purpose is to review the impact of PFI. A literature review traces the various stages of the NHS' hospital investment programme and the research method is a case study. The findings show that PFI is leading to additional costs and complexity that make the achievement of the NHS's objectives difficult.