Published: 03/11/2005 Volume 115 No. 5980 Page 12

Private finance initiative hospital building schemes take too long to negotiate, are too inflexible and do not deliver innovative design, according to a confidential survey of NHS staff involved in PFI.

Future Health Network, which carried out the survey of project directors, project managers and directors of nursing at 13 trusts that have been through PFI, found the system too rigid to adapt to payment by results and patient choice.

It found that the process of finding a PFI partner took too long - an average of 2.5 years - and was too expensive. FHN project manager Sylvia Wyatt said: 'A major complaint from trusts was that it takes on average more than two years from placing an advert to signing a contract.

There is scope for cutting the number of reviews and approvals.

For example, there could be a national list of contractors, which would eliminate the need for the prequalification questionnaire stage.'

The survey revealed declining UK private sector interest, with an average of six bidders per scheme in 1997, compared to just one by 2005.

FHN, part of the NHS Confederation, incorporated the findings in its report The Future of PFI. It says the Department of Health should consider setting up a core negotiating team and central training for trusts considering PFI, and introducing public design competitions to encourage the creation of landmark public buildings.