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Profiting from the NHS
EDITOR,--Chris Ham seems gloomy about private finance for NHS trusts for building projects.1 This could, however, herald a new era, providing modern health service building without the restrictions of the public sector borrowing requirement.A crisis is developing in the management of acute care through the reduction of trainees' hours of duty, the introduction of higher standards2 and new treatments, and, in my specialty, an acute shortage of candidates for consultant posts. It is essential, therefore, to concentrate emergency services on as few sites as practicable; this may mean rebuilding, which would also introduce an opportunity to provide the facilities required for the appropriate level of care.3
In the United States "not for profit hospitals" (analogous to trusts) raise money at interest rates that depend on their credit rating and are based on their history of repayment of loans, the status of the institution, and inspection of the project. NHS
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BMJ 1995 310: 415-416.[Extract] [Full Text]
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