The cost of not doing PFISkanska has been waiting for the go-ahead for the Barts scheme for two years and it deserves to get going.

All NHS PFI contracts ensure that patients get a good service at the point of treatment and the fabric of all hospitals is crying out for the good practice and effective maintenance of their building stock that a PFI scheme brings.

At many hospitals there has been only reactive maintenance since the decision to go down the PFI route nine years ago. Funds are being diverted to patient services, administration and management costs, and away from the estates. Without a good estate you cannot have good services.

C Spedding, Carillion