This week’s big story is the state of the Health and Social Care Bill

The coalition’s Health and Social Care Bill is in a mess. Faced with widespread opposition from MPs against plans to give GPs the purse strings, health secretary Andrew Lansley this week promised to put proceedings on hold while he “pauses, listens and engages”.

You may surmise that the interlude is more about preventing this emotive policy area from becoming a political own goal than reversing the ideology behind the bill. Healthcare capital projects are a case in point.

This government views PFI as a dirty word and the days of mega £1bn hospitals have long gone, although there are still projects using the PFI model that are being procured below the radar.

But this leaves Whitehall with a dilemma: how can it continue to harness private sector funding to build more hospitals and health centres while at the same time making the procurement process look more accountable for this age of austerity?

In “What’s the prognosis” we investigate the complex area of NHS commissioning alongside new-look procurement routes such as joint ventures, albeit on a smaller scale and focusing mainly on the refurb of community facilities.

As part of Lansley’s new consultation (he seemed to sidestep the previous one), he will hear again from angry unions, but also from bewildered GPs fearful of being in the eye of the procurement storm, and construction representatives urgently seeking clarity as to who, exactly, its client will be.

The tensions in the political row will inevitably focus on accountability, cost and access to quality healthcare. But also at stake are acres of undeveloped land and the £36bn property estate, which is currently in the hands of soon to be abolished Primary Care Trusts.

Then finally, and once the wrangling is over, Lansley needs to think about the amount and type of procurement guidance the state is going to provide for remodelled health clients. This is the number one area of concern for contractors (and probably doctors too), working outside of the Procure 21 framework.

They want to know what the rules of engagement are to be and who will provide the type of invaluable assistance and direction that has thus far come from PCTs and Strategic Health Authorities. After all, you wouldn’t want the NHS being run and managed in the same way that you would, say, Tesco, would you?

Tom Broughton is brand director of Building