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Just to pick on one glaring error in the McKinsey analysis - the level of potential savings indicated from interest rate in the PFI transactions reductions - this is simply NOT available.
And, before the world goes off on one on the PFI programme. For those of us born well before 1979 (thatcher) or 1997(Blair) , we remember decades (thats multiples of 10 folks) of NO investment in hospitals and often what was built was really shoddy buildings. So the launch of the PFI programme in 1992 was seen (and is) a good thing. As at April 2009, HM Treasury figures show there were 102 signed PFI/PPP projects with a combined capital value of over £10.5 billion. The shortest term (duration) of these is 25 years and the longest 37 years - and in every single case the financing is long-term and EITHER fixed rate to the PFI contractor or where it is variable, managed through some form of index linked SWAP - AND so there can be NO "easy saving" - when current interest rates are low, relative to the price of the SWAP instrument or the coupon rate on the bond - it is very very very very expensive to chage these deals. SO, if I may - Dear Mr McKinsey - perhaps yet AGAIN you top down approach needs to be tempered by a little reality, particularly when it comes to numbers, money, financing, etc.. . Or perhaps reality cannot reach to the top of your particular ivory tower.