Have a little trust

However, I can assure you that the story of PFI can be exciting and productive. I'm a non-executive director of Darenth Valley Hospital, the first greenfield PFI hospital, where the experience has been very different from that portrayed in your report.

Certainly, in the early days, many similar problems could be seen at Darenth Valley, but with time and a constructive attitude from the hospital staff, hospital management and the PFI providers, matters have improved substantially. Most of the early problems were related to the sheer scale of the undertaking, closing old facilities and moving to a new hospital. The operational details were being developed with little previous experience to guide the way and the negotiation of the concession agreements had more to do with legal correctness than an appreciation of hospital administration.

The major problem the trust still experiences is related to the number of beds, but this provision was based on health service forecasts of the local need and was not a result of being a PFI hospital. And even here the trust has addressed the issue directly and among other things has become a leading developer of the use of 23-hour surgery.

The future looks bright. A renegotiation of the terms of the PFI financing has significantly corrected any budget difficulties, and new capital works involving extensions to A&E and the construction of a Diagnostic & Treatment Centre are under way. Along with a positive attitude between the parties to the PFI, these all underline the ambition of the trust to improve their service to the residents of Dartford and Gravesend.