Scotland is currently investing nearly half a billion pounds in the biggest hospital building programme in the history of the Scottish NHS. Four new hospitals are complete, with two due to be finished by the end of this year, and another two by the end of 2003. Half of these have been funded using PPP.
Planned capital spending includes £285m for 2001/2 and £290m for 2003/4. Spending will increase to £300m for 2004/5 – more than double that of 1997. This will provide another three hospitals and a purpose-built, state-of-the-art cancer centre for Glasgow. Another £33m will be spent on rebuilding or renovating 69 local health centres across Scotland, and 12 A&E in 12 major centres will see an £11m upgrade. On top of this, PFI/PPP initiatives could potentially yield £145m in 2001/2, £180m in 2001/2 and £209m in 2003/4.
Healthcare facilities were allowed to run down under direct rule from Westminster, so health minister Ms Bairbre de Brún has taken a clean-sweep approach by ordering an independent review of healthcare provision. The Acute Hospital Review will look at how healthcare is structured in the region, and has identified the need for over £1bn worth of investment for healthcare facilities and equipment including at least one new hospital. The review is currently out for public consultation and the minister is expected to make a decision either later on this year, or early in 2002. Against this there is a provision of only £50-55m for capital expenditure annually.
PFI hasn't been used to fund healthcare facilities in the region and will form one funding option, to be evaluated on a project-by-project basis. It is expected that PFI could provide up to £100m for capital expenditure over the next five years.
Current capital expenditure is currently running at £23m. This will increase to £47m for 2002/3, and it is planned that this should be sustained or improved upon in future years, either through direct investment or PPP.
As part of the Health Improvement Programme, rolling five-year plans will be produced, covering all investment needs. These will specify the balance to be struck between public-sector funding and PPP.