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... NHS.

Many investors feared that the legal status of the NHS Trusts might not protect investors in the event of financial failure, leading to intense suspicion of the PFI. As a result, the government had to pass two new acts to make sure that the banks would lend; “thus, the NHS Residual Liabilities Act was passed by the Conservative Government in 1996 and the NHS (Private Finance) Act 1997 followed. The latter Act, although conceived by the Conservatives, was passed virtually unchanged by the Labour Government shortly after they reached office, indicating the level of their commitment to PFI (Broadbent, et al, 2002).”

Today, there ...

... and culture of the NHS achieved or planned.

The following chart represents the organisational changes initiated by the new PFI-driven NHS model (Warne, et al, 2002, DoH, 2002).

1948 NHS Model New NHS Model

Values: free at the point of service

Spending: annual lottery

National standards: none



Providers: monopoly


Staff: rigid professional demarcations

Patients: Handed down treatment


System: top down


Appointments: long waits

Values: free at the point of service

Spending: planned for 3/5 years

National standards: NICE, NSFs and single independent healthcare inspectorate/regulator

Providers: Plurality – state/private/voluntary

Staff: modernised flexible professions benefiting patients

Patients: choice of where and when get ...

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