Obese patients who enrol on commercial programmes such as Weight Watchers lose twice as much weight as those just given advice by the nanny state and doctors research suggests. A paper in the The Lancet found that overweight people who spent a year attending group meetings, being weighed regularly and following diet tips lost an average of 11.1lb (5.06kg).

This is twice the 4.9lb (2.25kg) shed by those who received weight-loss information at their local doctors’ surgery.

In addition, those on the Weight Watchers programme had lower cholesterol levels and smaller waist measurements, making them at lower risk of developing diabetes and heart disease.

Academics commenting on the study say public sector health services – such as the NHS – should consider paying for patients to attend private weight-loss classes than providing treatment themselves.

The study was carried out by Dr Susan Jebb at the UK Medical Research Council in Cambridge and colleagues but funded through a grant from Weight Watchers itself to the MRC.

It states that 1 billion people worldwide are overweight and 300 million obese, putting them at high risk of illness and early death and placing a heavy burden on healthcare systems.

The researchers took 770 overweight and obese patients, mainly middle-aged women, in Germany, Austria and Britain and gave half of them free access to a Weight Watchers programme while the others received “standard care” through their GP.

Those on the commercial scheme were encouraged to attend weekly weigh-ins as well as counselling and group support meetings, and were able to monitor their food intake and activity levels online as well as access meal ideas and take part in community discussions.

After 12 months, weight loss among those in Weight Watchers was “significantly greater” than those given GP advice, and they were twice as likely to have lost more than 5 per cent of their initial bodyweight.

In addition, their insulin, glucose and total cholesterol levels were found to be lower while their waist circumferences had dropped by an average 2.2in (5.60cm) compared with 1.2in (3.16cm) among those on the GP course. Both groups ended up with lower blood pressure.

The researchers say the commercial programme could be more successful at changing people’s behaviour because it offers more frequent weighing and peer support.

The paper claims it could also prove cheaper, at about £50-60 for 12 weeks, because it involves larger groups of people.

The authors conclude: “Data from our study suggest that referral by a primary health-care professional to a commercial weight loss programme that provides regular weighing, advice about diet and physical activity, motivation, and group support can offer a clinically useful early intervention for weight management in overweight and obese people that can be delivered at large scale.”

Kate Jolly and Paul Aveyard from the University of Birmingham write in an accompanying opinion piece: “Evidence that weight loss achieved by fairly brief interventions can be sustained long term without continued support would be valuable.

“However, present evidence shows that the commercial programme assessed by Jebb and colleagues provides a more effective weight management service than does primary care, and is widely available. Such programmes are likely to be an important component of the medical management of obesity in primary care.”

Previous research had suggested that nanny state schemes to “bribe” the obese into losing weight, currently on trial in the NHS, were just as effective as programmes such as Weight Watchers.

From: http://www.telegraph.co.uk/Weight-Watchers-twice-as-effective-as-advice-for-obese

The Department of Health should consider abandoning the disastrous £12 billion NPfIT project to computerise all patients’ medical records according to a powerful group of MPs.The integrated electronic care records system was a central part of Labour’s £12 billion National Programme for IT (NPfIT).

The Public Accounts Committee says that although £2.7bn of taxpayers’ money has already gone on the scheme, it is unclear what the benefits have been and so ministers should think about whether the rest of the cash could be better spent elsewhere.

Although the intention was to create a single network that would allow NHS staff across England to access any patients’ details, the report says this will not happen now and the country has been left with a “patchwork” of costly and fragmented IT systems whose future is uncertain because of reforms to the health service.

The chief executive of the NHS, Sir David Nicholson, also comes in for criticism for failing to oversee the project properly while civil servants provided “late, inconsistent and contradictory” information to the MPs’ inquiry.

Margaret Hodge, the committee’s chairman, said: “The Department of Health is not going to achieve its original aim of a fully integrated care records system across the NHS. Trying to create a one-size-fits-all system in the NHS was a massive risk and has proven to be unworkable.

“The Department has been unable to demonstrate what benefits have been delivered from the £2.7 billion spent on the project so far.

“It should now urgently review whether it is worth continuing with the remaining elements of the care records system. The £4.3 billion which the Department expects to spend might be better used to buy systems that are proven to work, that are good value for money and which deliver demonstrable benefits to the NHS.”

The integrated electronic care records system was a central part of Labour’s £11bn National Programme for IT in the NHS, which was set up in 2002 and faced repeated criticism since then over its cost and technical problems, most recently from the National Audit Office.

In the report the MPs say the intention to allow rapid sharing of patients’ records was “worthwhile” but the Department of Health has been unable to make it work.

They claim that creating a single system was always a “massive risk” especially as clinicians were not asked for suggestions on its operation.

In the north, midlands and east of England just 10 of 166 trusts have received only a basic system, while no mental health body has received one. Dozens of different interim and local schemes have been devised, at greater cost.

Whitehall officials are said to lack “basic management information” on the number of systems built and their cost, even though there is a body overseeing the whole project with 1,300 staff that has spent £820million.

Sir David Nicholson was accused by the committee of having “lacked the capacity to meet his responsibilities fully” as Senior Responsible Owner for the scheme, leading to “increasing costs and delays”.

The Department of Health is now trying to renegotiate some contracts and is working on a slimmed-down “menu of modules” that hospitals can choose for their patient records systems, but there is no guarantee the systems will work with each other.

In addition, the Strategic Health Authorities responsible for delivery of the programme are being scrapped and there is “considerable uncertainty” over how the new NHS bodies will adopt the IT systems and how much it will cost them.

Andrew Lansley, the Health Secretary, said: “This is yet more evidence that Labour’s botched approach to IT in the NHS failed taxpayers and failed patients. Their one-size-fits-all IT programme has once again been found unworkable.

“This Government is taking action where Labour failed. Already, we have reduced expenditure on Labour’s costly IT schemes by £1.3 billion. We are making sure that systems are not imposed on the NHS from the centre which organisations do not want. And we will shortly announce our plans for even stronger action to deliver value for money for taxpayers and the NHS.”

From: http://www.telegraph.co.uk/NHS-should-consider-abandoning-7bn-IT-project.html

The NHS is spending more than £20 for a loaf of gluten-free bread, 10 times more than the £2 charged for a standard small (400g) gluten-free loaf in Sainsbury’s.
Gluten provokes painful inflammation of the bowel in people who have an immune-response allergy to the protein, found in wheat, rye and barley products. The condition is known as Coeliac Disease.

In the past, gluten-free products were difficult and costly to get hold of, and many people obtained them via prescription. They are now commonly found on supermarket shelves and their cost has come down.

While they cost more than standard versions, typically up to twice as much, the NHS appears to be paying well over the odds.

Darren Millar, the Conservative shadow minister for health in the Welsh Assembly, found out that the NHS in Wales paid £984,185 for 47,684 gluten-free loaves last year — or £20.64 a loaf. In an answer to a question he put to the assembly, he was also told that packets of gluten-free pasta were costing the NHS £11.54 per bag. Similar packs cost £2 in supermarkets.

Ginger snap biscuits cost £10.07, compared with £2.35 in the shops, and wheat-free gravy mix £15.21, rather than £2.59.

Mr Millar said: “It’s currently costing the NHS 10 times more for this bread than the price in a supermarket.

“Many taxpayers will question why they are also footing the bill for hundreds of thousands of pounds worth of snacks such as biscuits and cakes.”

“Foods of this type have become much more widely available and yet the number of prescriptions has risen.”

A spokesman for the TaxPayers’ Alliance said: “It smacks of incompetence that the Welsh NHS is paying so much more than they are available for in the shops.

“This doesn’t look like taxpayers are getting value for money.”

Dr David Bailey, chairman of the British Medical Association’s GP committee in Wales, added: “It makes little sense for gluten-free foods to be prescribed.”

In 2010, the NHS in Wales, which serves a population of three million, spent just over £2 million on gluten-free products.

Given that the population of Britain is some 20 times that, it is likely that the overall NHS bill stands at £40 million, although in England some patients pay prescription charges.

Mr Millar commented: “That’s a heck of a sum of money. When cash is short, should we really be spending public money on such things? I think not.”

Sarah Sleet, chief executive of the charity Coeliac UK, said the high costs resulted from bureaucratic supply chains in the NHS.

She called for greater efficiency but said such items should still be available on prescription for sufferers.

“It’s in the interest of the NHS to keep people with coeliac healthy, and prescriptions play an important role in this,” she said.

A spokesman for Lesley Griffiths, the Welsh health minister, said: “Work is now under way to identify savings that can be made in reducing the number of gluten-free products prescribed by the NHS.”

From:
http://www.telegraph.co.uk/NHS-pays-20-for-a-loaf-that-costs-2-in-a-supermarket

NHS patients face a potential security breach after computer hackers gained access to health service passwords.
The group, which calls itself LulzSec, said that it had accessed a system that handles sensitive patient data. Last week it stole a million data records from a Sony website.

It published an email showing that it had informed the NHS of the security breach and saying “we mean you no harm and only want to help you fix your tech issues”.

It had taken master “admin” passwords from the system “months ago” while searching the internet for other materials, but had not exploited them.

On its Twitter account, which it uses to boast about its attacks, LulzSec claimed it had reported the security vulnerability after the dying wishes of Alice Pyne, a 15-year-old British terminal cancer sufferer whose online “bucket list” has become an internet phenomenon.

It said: “Greetings … we’re a somewhat known band of pirate-ninjas that go by LulzSec. Some time ago, we were traversing the internet for signs of enemy fleets. While you aren’t considered an enemy – your work is of course brilliant – we did stumble upon several of your admin passwords.”

The Department of Health admitted that the system had been breached, but said it was only on a local level. It has reported the incident to police.

“This is a local issue affecting a small number of website administrators,” a spokesman said. “No patient information has been compromised. No national NHS information systems have been affected.”

The incident is the latest in a string of computer security breaches, and has raised concerns about the security of patient data, which is being digitised en masse and uploaded to a national system as part of the much-delayed NHS national programme for IT.

LulzSec emerged in May when it published a database of more than 70,000 American X Factor contestants’ personal details, including their dates of birth and phone numbers. In a hacking spree, it has attacked Nintendo and Sony, and an FBI-linked security association. It says its attacks are for entertainment purposes.

From: http://www.telegraph.co.uk/Fears-for-patients-data-after-hackers-hit-NHS

Scrapping the controversial and delayed NHS electronic records project could cost more than seeing it through to completion, a parliamentary committee has heard.
The project to install electronic patient records systems at health trusts in the north and east of England and the Midlands is years behind schedule.

The programme has been described as not being “value for money” in a report from public spending watchdog the National Audit Office (NAO) and critics have called for the project to be abandoned.

But yesterday, Department of Health (DoH) CIO Christine Connelly told the parliamentary public accounts committee that cancelling the contract with supplier CSC could potentially leave the DoH “exposed to a higher cost than the cost to complete the contract as it stands today”.

She said if the contract were terminated, the resulting contractual costs could run up to “several hundred million pounds”, with the possibility that the supplier could seek damages.

Still further costs could be incurred during the process of moving health trusts over to new care records systems, she said.

But Connelly went on to say that the DoH is still considering all options for the contract with CSC, which the DoH has previously stated includes termination.

Sir David Nicholson, chief executive of the NHS, told the committee that the DoH is not currently minded to cancel its contract with CSC: “That’s not what we’re planning to do at the moment.”

Bizarrely he said the DoH could still get something “really good” out of its contract with CSC.

Care records systems are being installed across the whole of England, although progress has been slowest in the north, east and Midlands, the NAO report found.

CSC has repeatedly missed it’s required targets- known as milestones, for the rollout of the care records systems.

By March this year, CSC had missed 67 milestones set under its Local Service Provider (LSP) contract, and recently suffered a further setback when one of four trusts chosen to be early adopters of the care records system pulled out of the project.

The NAO report found that £2.7bn has been spent installing care records systems across the whole of England, and that there is a further £4.3bn still to be spent.

The care records system is being installed in the north, east and Midlands by CSC under the terms of its LSP contract, which is worth just over £3bn, but the DoH has said it expects negotiations will reduce the contract’s value by about £500m.

From: http://www.silicon.com/doh-cio-warns-on-cost-of-scrapping-e-records-project

NHS patients are getting “precious little” from the NHS electronic care records system in England, the National Audit Office (NAO) has found.
The £7bn system to replace paper files is falling further behind schedule and in places where it has been introduced it is not working as it should.

The National Audit Office also said some patients would not even get one as large chunks of the NHS had pulled out.

In conclusion, the NAO said the system was not providing value for money – something the government rejected.

The Electronic care records are the key part of the overall £12.4bn NHS IT project.

The scheme was launched in 2002 by Tony Bliar with the aim of revolutionising the way the health service uses technology and also includes developments such as digital x-rays and fast internet connections.

It is the third time the NAO has looked at electronic records – and each time the findings have been more damning.

The report from the NAO presents a depressing account of delays, contractual wrangling and technical glitches.

The original vision for the scheme was compelling – a national network connecting hospitals, GP practices, ambulance services and mental health trusts, and an end to the tortuous paper trails that have caused frustration and misery for doctors and patients alike.

But the complexity and cost of the scheme meant it was always seen by many as a high risk strategy. And when it ran into trouble the plans were scaled back, and the original vision set aside.

Many GPs and hospitals are now working with different systems, prompting the NAO to question whether further investment in the national programme would be pouring good money after bad.

The latest report details a range of problems that the programme is struggling with.

In London, all GP practices and more than half of hospital trusts have pulled out, while in the south three-quarters have. However, this has not been accompanied by a proportionate drop in cost.

Meanwhile, the contract covering the rest of country is currently being renegotiated. Even after such a scaling back, roll out in places that remain part of the system is still proving difficult.

The NAO said it doubted the final deadline of 2016 – which is already six years later than originally envisaged – would be met.

And even in those trusts that have electronic records, there are problems. For example, some hospitals have struggled to introduce electronic prescriptions.

The NAO said the difficulties were caused by a range of factors, including the government being too ambitious, difficulties with technology and the complexity of the NHS.

The problems have prompted some critics to call for the entire scheme to be scrapped – although this is something the NAO stopped short of suggesting.

The government has already announced there will be a review of the project. This is due to start next week.

Tory MP Richard Bacon, a member of the House of Commons’ Public Accounts Committee and long-standing critic of the plans, said: “It is perfectly clear that throwing more money at the problem will not work.

“This turkey will never fly and it is time the Department of Health faced reality and channelled the remaining funds into something useful that will actually benefit patients. The largest civilian IT project in the world has failed.”

But the Department of Health said while the original vision “was flawed”, the project still had the potential to deliver value for money.

Dr Chaand Nagpaul, of the British Medical Association, said: “We cannot turn the clock back, but this report provides useful lessons on how best to use resources in the future.”

From: http://www.bbc.co.uk/news/health-13430375

Health authorities should stop wasting money on “ineffective” operations like tonsil removals and wisdom teeth extractions, according to the quango Audit Commission.
It has calculated that the NHS could save £500 million a year by doing so, that could be put towards more worthwhile treatments.

Its briefing, Reducing expenditure on low clinical value treatments, found that a clearer approach among primary care trusts (PCTs) to what it called “ineffective or inefficient treatments” would ensure more consistency across the country.

It came as another report, by the health think-tank The King’s Fund, criticised “persistent and widespread variations across England in patients’ chances of undergoing surgery for common medical problems”.

Both reports, by coincidence issued on the same day, agreed that some patients were undergoing operations “that do not benefit them”, in the words of The King’s Fund.

However, while the Audit Commission report focused on the potential cost savings of reducing operations, The King’s Fund called for an end to the “unfair” and “inefficient” variations in accessing worthwhile surgery.

The former identified tonsil removals as “relatively ineffective” and hysterectomies in cases of heavy menstrual bleeding as less cost-effective than alternatives.

Wisdom teeth extraction was often not worthwhile, because of a “close benefit and risk balance”, while some procedures, such as orthodontics, were nothing more than “potentially cosmetic”.

Some PCTs, of which there are about 150 in England, could save more than £12 million a year by reducing such operations, the soon-to-be-abolished spending watchdog calculated.

Andy McKeon, its managing director of health, said: “PCTs across the country are currently paying for treatments that cost the taxpayer money, and according to clinical experts have little or no real value to patients. This needs to change.”

The King’s Fund report – Variations in Health Care: the good, the bad and the inexplicable – found that tonsil removal operations in children were 10 times more common in Coventry than in Kingston, even though the procedure “has been queried since the 1930s”.

But it concentrated on lack of access to operations that did work.

For example, it found that rates of admission for hip and knee replacement varied by up to 400 per cent, with people in poorer areas much less likely to receive one.

Rates of coronary artery bypass grafts varied from 34 per 100,000 in Westminster to 197 per 100,000 in Berkshire.

John Appleby, chief economist at The King’s Fund, said: “This report confirms research over decades, both in the UK and internationally, which has shown persistent and unwarranted variations in use of and access to even the most common surgical procedures. This is unfair to patients and inefficient for the NHS.

“Remedying this is urgent given the need to improve quality of care while the NHS grapples with the biggest financial challenge in its history.”

From: http://www.telegraph.co.uk/Tonsil-removals-and-other-ineffective-operations-cost-NHS-500m-a-year

A hospital trust will save £14million after becoming the first in the country to buy its way out of a Private Finance Initiative (PFI) deal.
The NHS body was due to pay £2m a year for the next two decades to the private firm that built West Park Hospital in Darlington, County Durham.

But after reviewing the costs, Tees, Esk and Wear Valleys Mental Health Foundation Trust decided to take advantage of a break clause in the deal.

It paid £18m upfront to get out of the PFI contract 23 years early, but it now owns the hospital outright and expects to save £14m over the course of the deal once maintenance and inflation is taken into account.

The move, disclosed in the Health Service Journal, comes after The Daily Telegraph uncovered evidence that hospitals are closing accident and emergency departments in order to pay the interest on PFI deals for new buildings.

Some PFI hospitals – built and run by private firms and effectively rented back to the state – will end up costing taxpayers more than 10 times their capital value.

“We concluded that the best option was to exercise what exists in the PFI projects, which is a clause called ‘voluntary termination’,” said Colin Martin, Director of Finance at the Tees, Esk and Wear Valleys trust.

“It effectively means we pay off the mortgage early.”

However he added that the trust – which runs mental health services in County Durham, the Tees Valley and along the North Yorkshire coast – did not regret the original deal and was committed to two other PFI deals.

“We wouldn’t have had the hospital if we’d waited for the traditional financing route,” Mr Martin said.

PFI deals became the preferred way of paying for public sector infrastructure projects under Labour, as they allowed new buildings to be constructed while avoiding large initial outlays of money.

Under the complex deals, private contractors carry out the building work then own the structure for up to 35 years, while the public sector body gives them annual interest and repays the capital sum as well as paying for maintenance.

However because of the length of the deals and the amount of interest involved, taxpayers end up paying several times the original value of the project.

In the first known example of an NHS hospital buying its way out of a PFI deal, the North-East mental health trust decided to purchase West Park Hospital outright.

It had agreed a 32-year deal with Norwich Union Public Private Partnership Fund to build the 116-bed facility, which opened its doors in 2004.

The hospital – which is also home to the trust’s headquarters – cost £16m to build but under the deal, the trust was paying the contractors £1.4m a year in interest payments and a further £600,000 in maintenance and paying back the principal.

In 2009, the trust reviewed its PFI deals and decided it had enough cash in the bank to pay the £18m break clause and so buy West Park outright. It gave the project company the required statutory notice and after the legal process was completed, the deal ended in December.

Treasury figures suggest it would have the remainder of the deal would have cost a further £32m, so it has saved £14m by getting out of it.

However it is unlikely the pioneering move will be copied by many other trusts, as most PFI deals are so large as to make early repayment impractical.

Aviva, the company that now runs the PFI firm that built West Park, was unavailable for comment.

From: http://www.telegraph.co.uk/Hospital-saves-14m-by-getting-out-of-PFI-deal

NHS Hospitals are wasting up to £500 million a year by paying too much for basic supplies, according to Britain’s spending watchdog.
The National Audit Office found that some health bodies are paying twice as much as others around the country for dressings, clothing and medical equipment.

In some areas, individual hospitals are purchasing 177 different types of surgical glove and putting in hundreds of small orders for A4 paper.

It comes even though the National Health Service is under orders to make £20  billion in efficiency savings over the next four years.

The NAO recommends that the Department of Health make it easier for trusts to compare the prices of products they buy, and that hospitals collaborate with each other to buy in bulk and so save money.

Because local trusts are independent of Whitehall control, the NAO says they should be held to account by Parliament to improve on the “poor value for money” they provide in procurement.

Margaret Hodge, the chairman of the powerful Public Accounts Committee, said: “It is simply unacceptable that so many hospital trusts are currently paying more than they need for basic supplies. Even for some of the commonest items, the price hospitals pay varies by more than 100 per cent.

“Too much purchasing is still done through multiple, low-value orders, which incur high admin costs.

“And the range of similar products that trusts buy is sometimes so wide as to appear ridiculous: how can it be, for instance, that while one trust does its work with just 13 different types of surgical glove, another requires 177?

“These are well-known recipes for poor value for money that really ought to have been addressed by now.”

The NAO report states that England’s 165 NHS hospital trusts spend about £4.6bn a year – a tenth of their total expenditure – on “consumables”, such as surgical dressings, drinks, staff uniforms, pacemakers and replacement hip joints.

Because there is no central system for buying these products, managers in individual hospitals make deals with 17,000 different suppliers. One trust employed 45 people in its procurement team.

Although it is “standard practice” in the private sector, health bodies are not required to give each product they buy an individual code, which would help them analyse data and reduce errors.

As hospitals do not know how much others are paying for products, and they buy items in different quantities at different times, price variation is common and the NAO estimates that up to £150m could be saved if it were eliminated. In some cases the amount paid varied by as much as 183 per cent.

In addition, NHS bodies are putting in on average 4,501 order for surgical gloves a year, and could potentially save £7m a year in admin costs just by reducing orders.

Further savings could be made by buying in bulk or joining regional “hubs” with other hospitals to make economies of scale and improve their bargaining power with suppliers.

Hospitals are also encouraged to standardise the products they use – one trust used 287 different types of tubes known as cannulas, while another bought 15 variations of A4 paper.

Amyas Morse, head of the National Audit Office, said: “At least 10 per cent of hospitals’ spending on consumables, amounting to some £500 million a year, could be saved if trusts got together to buy products in a more collaborative way.

“In the new NHS of constrained budgets, trust chief executives should consider procurement as a strategic priority. Given the scale of the potential savings which the NHS is currently failing to capture, we believe it is important to find effective ways to hold trusts directly to account to Parliament for their procurement practices.”

The Health Secretary, Andrew Lansley, said: “We welcome the publication of this report. The more efficient the NHS becomes, the more we can invest back into patient care. That is why it’s so important for hospitals to deal with wasteful procurement.

“While it is up to local hospitals to decide how they purchase products, Government has a role in providing support and robust information. We are therefore considering launching a review to help hospitals get better value for money from procurement, drawing on the expertise of Government advisers.”

From: http://www.telegraph.co.uk/Hospitals-wasting-500m-a-year-on-basic-supplies

Whilst Health Direct applauds the NAO’s research, we know that they are under quoting the waste.

On January 11, 2011 we piublished: NHS wasting £1 billion a year on supplies when we found that the NHS is wasting more than £1 billion of taxpayers’ money a year as managers spend vastly differing amounts on the same supplies, the head of a government backed healthcare efficiency drive has claimed.

Labour’s Private Finance Initiative- NHS hospitals will cost taxpayers 60 years of pain.
Under Private Finance Initiative schemes, British taxpayers are committed to pay £229 billion for new hospitals, schools and other projects with a capital value of just £56 billion.

Official figures show that, under Private Finance Initiative (PFI) schemes, British taxpayers are committed to pay £229 billion for new hospitals, schools and other projects with a capital value of just £56 billion.

Several contracts are due to run for 60 years, documents released under freedom of information requests show, meaning taxpayers will be paying for the projects for generations to come.

Private contractors who agreed PFI deals with the Government are set to make billions of pounds in profit, with some due to see returns of up to 71 per cent.

In a series of reports, UK media lines disclose the heavy costs and administrative burdens caused by PFIs. The deals are a way of building large public projects using private finance, which were relied upon by the Labour government. The disclosures will lend weight to MPs calling on PFI companies to refund a share of their profits to the taxpayer.

The PFI deals include:
• A hospital which charged £52,000 for a job that cost £750. Demolishing a shelter for smokers resulted in the PFI contractor charging £2,600 a year for the additional work .
• A hospital in Bromley, south London, which will cost the NHS £1.2billion, more than 10 times what it is worth.
• An empty school which will cost taxpayers £370,000 a year until 2027. Another school had to pay £302 for a socket, five times the cost of the equipment it wanted to plug in.
• Military dog kennels which would have ended up costing more per night than a room in the Park Lane Hilton, London. The deal to replace facilities at the Defence Animal Centre in Melton Mowbray resulted in the sacking of the contractor and the scrapping of the contract.
Under a PFI, a private contractor builds a school, hospital or other asset, then owns it for typically between 25 and 35 years, effectively renting it to the taxpayer for that time. In exchange, the contractor has responsibility for maintenance.

Treasury papers suggest that payments on PFI contracts already signed run until 2048. The Daily Telegraph (a UK daily broadsheet) has uncovered deals, signed in the late 1990s, which include special clauses meaning that they last for up to six decades.

So a 21 year-old leaving university this year will pay taxes for the PFI until they are almost 70.

By then, some of the facilities will have been obsolete for years. Political pressure on the PFIs, introduced by John Major but greatly expanded when Gordon Brown was chancellor, was mounting last night after The Telegraph established the scale of profit-making by some of those involved.

An almost unknown City company, Innisfree, with only 14 staff, is the largest single player in the PFI market, owning or co-owning 269 PFI schools and 28 hospitals.

According to accounts filed at Companies House, Innisfree’s profit margin was 53 per cent last year. A successful FTSE 100 company makes margins of around 6 per cent. David Metter, the founder and chief executive of Innisfree, owns almost three-quarters of the company and collected pay and dividends of £8.6 million last year.

Jesse Norman, the Conservative MP for Hereford has been quoted as saying that Innisfree have made money like it is going out of style, and that a tiny number of individuals have made more money for less work than any other group of people he can think of. Innisfree said its directors were at a conference abroad yesterday and unable to comment, although there is no suggestion that Innisfree has done anything improper or illegal.

Mr Norman heads a new cross-party group of MPs demanding that Innisfree and other PFI beneficiaries return a portion of their profits to the taxpayer, saying that it’s scandal.

Labour’s last health secretary, Andy Burnham, who was in charge of 221 PFI projects, admitted last year that mistakes were made. Innisfree co-owns the Princess Royal University Hospital in Bromley, opened in 2003, which cost an estimated £118million to build and equip according to Treasury figures.

However, Treasury calculations indicate the NHS will have paid Innisfree and its PFI partners a total of £1,210 million for the hospital over the 35-year life of the contract, but this does include support services. The National Audit Office says the deal will produce a return for the PFI contractors of around 70 per cent.

From: http://www.telegraph.co.uk/Private-Finance-Initiative-hospitals-will-bring-taxpayers-60-years-of-pain