St George's Healthcare NHS Trust Private Finance Deal
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Ian Hamilton (far left) And Myself (centre) With Our Financial And Legal Advisers On The Day We Signed The PFI Deal
In early 1994 St George's Healthcare NHS Trust put forward a proposal to the NHS for re-developing the Cardiac Services that were being provided in the old Victorian accommodation that still existed on the St George's site. It was recognised that the buildings were not suitable to provide specialist cardiac services in and the then Chief Executive Andrew Dillon asked me to come up with an idea for solving the problem.
The idea that I came up with, was that in order to provide twenty-first state of the art facilities in which the cardiac services should be provided and be able to do so without making an astronomic call on scarce NHS services, we should sell the Atkinson Morley's Hospital in Wimbledon and combine the Neuro Services provided there, with Cardiac Services in a new building on the St George's site. I put the proposal to the Executive Group of St George's in August 1994 and subsequently to the St George's Board where it received approval and I am pleased to say was opened in the autumn of 2003. The fact that this new building was needed was underlined when the Commission For Health Improvement completed their report on the heart and lung transplant service at St George's when as the Guardian Newspaper reported on September 13th, "The report paints a shocking picture of the unhygienic, dirty and dilapidated state of the unit. CHI's investigators found mixed sex wards and cramped conditions. Staff complaints included, unit very dirty compared with elsewhere and the squalor was unimaginable". Ian Hamilton himself said in connection with the report, " We know that our facilities are poor, which is why the Trust will be moving cardiothoracic services into brand new facilities in the Autumn of 2003. The Victorian buildings will then be demolished."
It seemed to me extraordinary to me than when I was dismissed by St George's that one of the reasons that was given was, "That I was a no can do person". I had been responsible for coming with an innovative solution to one of St George's most intractable problems and not only that my directorate had done it at a cost far below that incurred by any other NHS Trust. Hansard in column 71w of its report on the House of Commons proceedings for the 17th July 2000 reports in relation to NHS PFI schemes that, "Highest spenders on financial advice were Norfolk & Norfolk (£1.9m), Bromley (£1.8m), and Hereford (£1.2m). The lowest spender was St George's Healthcare at just £181,000." Yet according to St George's Healthcare, despite this performance, I was a no can do person.
I would like to think that after my dismissal things went smoothly with the execution of the deal that I had worked hard to help put together. Unfortunately that was not the case and although the new building has been recently opened this way after the date that agreed in the contract that was signed originally. At St George's Public Board Meeting held on 21st October 2003, hidden away in Kevin Harbottle the Acting Director of Finance's finance report was the following paragraph, "The Trust has also incurred an additional £1million charge in this financial year as part of the PFI Compromise Agreement. The Trust entered into this agreement to secure joint commissioning of the new building and to avoid any delay in the opening of the wing arising from the variations to the original specification". Not much information there then to explain why St George's has given the private sector another million pounds. The whole point of PFI deals is that the risk of cost over runs is transferred to the private sector. I think the words "Compromise Agreement" say it all. Compromise about what??? If St George's are paying out that much tax payers money they should be clearly be able to state what it is they are paying for. Is it payment for some extra facility or service they are getting from the contractor or is it a payment because as I suspect poor management on the part of St George's led to the contractor not being able to complete the work on time because of the Trust delaying on their obligations under the contract. In either case there should be a public enquiry as to why this money was handed over. The local newspapers picked this issue up and reported on it, on the 31st October. The Trust in responding to why the payment give a very interesting response. A spokesman for St George’s Trust, which is already facing a budget deficit of almost £4million, said: “If we had delayed the opening of Atkinson Morley it would have cost the taxpayer more money. "I appreciate that it might seem odd to the untrained eye, but the payment was made to ensure that everything was ready for the opening. In the long term we have saved taxpayers money.” Well I have a trained eye and it seems very odd to me!!!! There is no question in my mind that a full investigation should take place as to why this million has been made, but in today's NHS I doubt if the matter will ever be examined.
Read the local paper coverage of this payment that St George's cannot properly explain and read the Wandworth Guardian article published on the 28th November that indicates despite the payment of £1million the PFI project continues to experience considerable problems.