12/10 Patrick Burns's blog ~ Blog of Asad Mirjat

Patrick Burns's blog

"It's PFI or bust": a hospital drama of ironic twists and turns

December 10, 2010 at 4:22 PM

'Super hospital' - the Queen Elizabeth in Birmingham

"If it's new hospitals you want, it's PFI or bust."

So said Alan Milburn MP on his appointment as a Health Minister immediately after the New Labour landslide thirteen and a half years ago.

It's always struck me as one of those political statements which reveal far more than they're meant to. This sound-bite conveys something of the tortured politics behind the Private Finance Initiative and explains why he and his then ministerial colleagues went on to embrace it so enthusiastically.

It was the previous Conservative Government which cautiously dipped its toes into the water of PFI: bringing private investment into the development, management and, yes, the ownership for anything up to 30 years of some of the prize assets always considered an integral part of our great public services.

Tories never tire of pointing out the irony that their comparatively modest early PFI projects were opposed tooth and nail by Labour as 'the privatisation of the National Health Service'. But once in office, Labour adopted the idea with a will, pressing ahead with Britain's first PFI Toll Motorway parallel to the M6 in the West Midlands as well as a new generation of 'super hospitals' including the £0.5bn Queen Elizabeth in Birmingham.

One explanation for Labour's rapid conversion is that the use of private funds meant the vast sums required for these enormous capital projects did not show up in the public finances in general or the Public Sector Borrowing Requirement in particular. No wonder PFI was such a hit with the then Chancellor, Gordon Brown.

Now consider possibly the biggest irony of all: Birmingham's new 'QE', one gigantic gleaming symbol of the Labour Years was chosen by Gordon Brown for the launch of his 2010 election manifesto. It went on to receive its first patients just a month after his election defeat.

There's another irony, though, which works the other way round. The QE was commissioned while the local MP Gisela Stuart MP (Labour, Birmingham Edgbaston) was herself a Health Minister. While over 100 of her party colleagues were being driven from their seats last May, she somehow managed to cling-on in what had been one of the Conservatives' top targets.

And our saga of ironies doesn't end there. It comes to something when one of the first acts of a newly-elected Conservative MP is to urge private investors to pay significantly sums of money back to the government!

That's exactly what Jesse Norman MP (Conservative, Herefordshire and South Herefordshire) is doing. He reckons Labour were so eager (desperate, even) to have their new hospitals that the terms written into the deals were unduly advantageous to the private consortiums who will continue to maintain and own these precious assets for years to come. Critics say, "it's like mortgaging the future of the NHS".

(Mr Norman quotes an example from his own PFI hospital in Hereford, where he says the replacement of a television aerial by an approved contractor cost more than £900. In the days of the old NHS trust they'd have found a local handyman for £50!).

So now Mr Norman is proposing that the PFI companies should pay what amounts to a rebate to the Government. This, he says, would compensate the hard-pressed taxpayer for those excessively generous PFI contracts negotiatiable under Labour when the economy appeared to be in so much better shape than it is now.

Mr Norman is clearly hoping ministers will take the hint and introduce measures to encourage the private financiers to go with the grain of the Government's efforts to drive-down costs in the public sector as a whole.

There is another to this debate of course. I recall a sunny summer morning six months ago when the Queen Elizabeth Hospital's Chief Executive, Julie Moore, was celebrating the remarkably smooth transfer of patients from the old buildings to her shiny new complex.

Far from accepting that dig about the NHS being expensively mortgaged, she asked what kind of a mortgage which guaranteed the buildings would be maintained, the equipment would be kept working and even the lawns would be mown. She also warned any down-grading of the PFI process would risk Britain losing the expertise that had developed these top-class hospitals in the first place.

This is the debate which we'll be taking up on this week's BBC Politics Show (12 noon, BBC One, Sunday 12 December 2010). I'll be joined in the studio by another of our Conservative MPs with a PFI acute hospital in his constituency, Robin Walker MP, Worcester.

We'd like to know what you think about all this. Email us at:

politicsshowwestmids@bbc.co.uk

And of course I hope you'll be watching on Sunday.

Health and safety? It's more than my job's worth, mate

November 29, 2010 at 7:46 PM

It's one of those things 'everybody knows'!

Everybody knows 'health and safety' has become an industry in its own right. We are pathetically 'risk-averse', victims of a so-called 'compensation culture', of 'ambulance-chasing lawyers' preaching their mantra of easy litigation, 'no win, no fee'.

Stories abound, some no doubt apocryphal, of children being banned from playing conkers in the schoolyard, or at least being required to don heavy-duty goggles; of schoolboy cricketers being required to wear helmets when batting against bowlers significantly slower than Graeme Swan; and of decent public-spirited folk at risk of being sued if they dare to clear the snow from pavements or driveways and so turn an Act of God into a potentially actionable act of negligence. (For the record, there are apparently no documented cases of anyone having been injured in a fall going on to take their well-meaning neighbour to court).

Some years ago I remember seeing the apparently endless paper trail of form-filling, risk assessments, licensing and insurance documents that had to be signed-off before a party of no more than a dozen children could join an excursion from their primary school at Leamington Spa in Warwickshire.

Their mission? To the North Face of the Eiger perhaps? The Amazon Basin?

No. Travelling with their teachers in the school's own mini-bus they were to venture no further afield than the grounds of Charlecote Park less than 10 miles away for a nature studies lesson, sketching whatever landscapes and wildlife they happened to see: ducks and squirrels, yes. Lions and tigers, certainly not.

With an air of weary resignation, the teachers explained how the time and effort involved in even the most basic school trips acted as a powerful disincentive to teachers taking their pupils beyond the secure confines of their classrooms.

Quite apart from the impoverishment of the school experience, was there not a risk these young people would eventually arrive in the world of work, ill-educated in the day-to-day realities of identifying risks and deciding how to act.

It was against this richly embroidered anecdotal backdrop that in December last year the then Opposition Leader David Cameron asked the former Conservative Cabinet Minister Lord Young to examine the burdens of Health and Safety and that 'Compensation Culture'.

After the election, his project became a Government Review.

At least he got out his final report, 'Common Sense - Common Safety', before having to resign as a Government adviser after his unguarded comments about many people having 'never had it do good' during these generally straitened times.

It aims to separate the mythology from hard reality. It's broadly supportive of the role of the Health and Safety Executive. But its principal aim is clear: "to free business from unnecessary bureaucratic burdens and the fear of unjustified claims and legal fees."

It goes on to propose simplifications of the risk assessment procedure for low hazard workplaces such as offices, shops and... yes... classrooms. It also recommends employers should be exempt from having to complete risk assessments for home workers.

Lord Young wants insurance companies to scrap the requirement for low hazard businesses to employ health and safety consultants to carry out their risk assessments.

And in schools, he calls for a balance to be set between the level of risk on the one hand, and the benefits of an activity on the other: so outward bound adventures and white-water rafting, for example, would remain subject to the most stringent level of scrutiny.

But perhaps the most eye-catching of Lord Young's recommendations is the clampdown on those 'no win no fee' lawyers.

One person who'd give this a resounding welcome is David Leggett, the Managing Director of MetSec plc, a rolling mill at Oldbury in the Black Country. He worries that too much of his company's time and effort is being used up unproductively on lawsuits brought by 'no win no fee lawyers' claiming hearing damage suffered by employees who were made redundant about 10 years ago when the firm slimmed down its workforce.

The firm's view is that if their former workers who have nothing to lose are being tempted simply to try their luck in the courts.

But a more cautious view comes from Steve Pointer, the Head of Health and Safety Policy at the Engineering Employers' Federation. He worries that H&S, as it's called in the trade, may slip; insurance companies and the regulators are, he says, the real drivers behind ensuring firms are as safe, and hence, as productive and efficient as they possibly can be.

We'll have more on this on this week's Politics Show (12 noon, BBC One, Sunday 5 December 2010), when I'll be joined live in the studio by Lorely Burt MP, Solihull, the Chair of the Liberal Democrats in the House of Commons and by Roger McKenzie, the Midlands Secretary of the public sector union, Unison.

There is of course a wider political question here: are we witnessing the beginning of a concerted effort by the Coalition to deconstruct some of the measures brought-in during the Labour's years which led to the creation of what became known to some as the 'Nanny State'?

I hope you'll join me for what promises to be a live and lively conversation on our programme this week. Let us know what you think about this by emailing:

politicsshowwestmids@bbc.co.uk