For a start the government is doing its world leader bit. They have built a hospital in St Helens which is alleged to be the best in the world. It was built under a system known as Private Finance Initiative, or PFI, whereby the NHS makes an agreement with the private sector to design, build and finance projects, such as this, and then the NHS repays the capital and interest over decades. In praising the design they highlighted, of all things, the skirtings and walls, which were curved so that the bugs could not take hold. As an engineer I can appreciate the increased costs both in design and construction that this type of initiative can add to a project, and I suspect that this is not the only case of experimental design. It is not clear who has the final say in the details of the design, and the cost is always in the detail. The Tories naturally are cavilling, possibly with reason, as this is just part of a huge scheme of 31 projects, allegedly at a cost of 12 billion, but the Tories suggest it will be closer to 50 billion. When I hear of talk of curved skirtings, so the bugs can’t take hold, I began to worry, because this is pure flummery. If it were designed with no skirtings, but a coven joint between wall and floor, cleaning would be easier and construction cheaper. The staff won’t care, and neither will the patients even notice, and who is to tell that the bugs can’t solve this problem like they do the rest?
The private sector may or may not have the interests of the NHS at heart, but what is certain, they are not in it just for the ride. I do question how much supervision is given to the initial overall specification, and later to the detailed design and execution, or are we just buying a hospital off-the-shelf, and picking the prettiest one on offer? As some of these contracts have already been constructed and others let, this credit crunch must come as an awful shock to the financial section of the NHS, who are going to have to foot the bill for decades to come, for any amount of new hospitals, and will they even get the additional money, or will there be cutbacks here as well?