10 projects worth £900m given the green light in second wave of PFI

Half the money will be spent in London, where four schemes put on hold until Sir Leslie Turnberg completed his review of London health services have now been allowed to proceed.

The other developments are schemes included in the first PFI prioritisation exercise last June and a new scheme drawn up by West Berkshire Priority Care Services trust.

Projects which were not given the green light last year were told they would be eligible for consideration by a new capital prioritisation advisory group.

It looked at 11 schemes put forward by regional offices this spring, four of which have not been included in the second wave of PFI approvals. Three of these schemes were also unsuccessful last year.

However, health minister Alan Milburn announced on Tuesday that an eleventh project to redevelop Gloucester Royal Infirmary would go ahead with£25m of public money.

'We cannot build an NHS for the 21st century with hospitals built in the 19th century, ' said Mr Milburn.

'We are committed to providing the best new facilities for patients and giving NHS staff the best environment to deliver high-quality care.'

The announcement on Tuesday came as Unison attacked the government over PFI at its annual health service group conference in Brighton.

General secretary Rodney Bickerstaffe said building more hospitals with private money was a 'reckless leap in the dark' that would 'cheat' the public, patients and staff.

'All the evidence is that building hospitals with public money offers a much better deal.' He urged health secretary Frank Dobson to 'get the Treasury to change its mind on PFI'.

The row intensified as managers this week confirmed Unison claims that a£96m PFI scheme for County Durham, signed last week, almost collapsed at the 11th hour.

The scheme, to build a new district general hospital in north Durham, was put in doubt when Initial, which was to provide hotel services, withdrew within days of contracts being signed.

'It was a very significant development coming so late in the process. It could have posed a very major problem, ' North Durham Acute Hospitals trust chief executive Bill Worth told the Journal .

Consort Healthcare, the consortium behind the project, reached agreement with another private backer, Hayden, to take on responsibility for hotel services, possibly via sub-contracting.

The deal was only clinched after Mr Dobson sought 'clear assurances' from the trust and Consort to protect staff.

TUPE arrangements will be underpinned with 'additional protections', the trust said. There will be no redundancies without consent for at least two years and no changes to NHS terms and conditions for five years.

'Mr Dobson took a very close interest, ' Mr Worth confirmed this week.

Mr Bickerstaffe, citing the Durham scheme at the Unison conference, claimed it had almost foundered because of the drive for 'more profit'.

Unison deputy head of health Malcolm Wing said: 'It makes you wonder what promises have been given by the government. What was the price paid by the NHS to stop this scheme collapsing?

There is far too much secrecy with PFI.'

Mr Worth said of the Durham scheme: 'It was very unfortunate the development occurred almost at the last tick of the clock.'

But he stressed that no extra resources were committed to ensure the project went ahead.