Bosses at a string of privately-financed NHS hospitals are spending more on lease payments than they are on nurses.
Charges for the “build now, pay over the odds later” approach have surged past nurses’ pay packets at five separate healthcare facilities.
The revelation lays bare the toxic legacy of the Private Finance Initiative (PFI), which cost taxpayers £225 million last year alone.
Under the discredited scheme, originally a Tory idea but massively expanded under New Labour, private firms built swanky new hospitals and agreed to maintain them for years to come in return for an annual fee called a unitary charge.
But at the hospitals under our microscope, PFI fees have risen to such an extent they have overtaken the bill for nurses’ wages.
The list includes the Community County Hospital in Invergordon, Ross-shire, where staff numbers have fallen by a third since 2010 and the wage bill has been slashed by £600,000 to £1.3 million.
At the same time, the unitary charge has risen from £1.2 million to £1.4 million.
The situation is even more pronounced at the Stobhill and Victoria ambulatory care hospitals in Glasgow, where the annual fee since they opened in 2009 has rocketed 34% from £18.3 million to £24.5 million.
Over the same period, the nursing wage bill has edged up from £21.2 million to £22.4 million.
Last night, Dr Jean Turner, who was elected an MSP in 2003 to fight plans to downgrade Stobhill, branded the figures a “national scandal”.
She said: “This makes me livid and it doesn’t make me feel better that I and the people who voted for me have been proved right.
“We warned this would happen and we’ve been vindicated.
“What has the health service come to when more is spent on a building than on nurses? It really is crazy.”
PFI saves the NHS from paying up front for new public sector buildings, including schools and hospitals.
Instead, private companies borrow the money and bring in contractors to construct and manage the facilities.
However, the PFI companies often own shares in the projects, meaning they can generate extra profit for themselves by charging expensive fees or cutting expenses to the bone.
Critics claim taxpayers are left to pick up huge bills on contracts which are locked in for decades.
At Edinburgh Royal Infirmary, where the current unitary charge is £46.1 million, patients have complained of “extortionate” parking charges and, in previous years, there have been cases of electricity blackouts and faulty smoke alarms.
The Scottish Government has now replaced PFI with NPD Non-Profit Distribution which means providers are no longer shareholders, but the 27 deals already running cannot be cancelled.
They include St Andrews Community Hospital in Fife, which paid its nurses £2.6 million last year but handed over £2.9 million to a company called Projco, set up specifically for the task of building and managing the premises.
And Clackmannanshire Community Healthcare Centre in Sauchie which also opened in 2009 has a nursing wage bill of £1.9 million compared with PFI costs of £2.6 million.
In total, PFI payments cost the NHS £225.2 million last year 2% of its £11.9 billion budget.
But the bill hasn’t peaked yet and is predicted to reach £291.3 million in 2028.
And as things stand taxpayers won’t finish paying for projects built under PFI until 2042.
Meanwhile, since 2009, nursing staff numbers have dropped marginally to around 58,000 and wages have been squeezed as part of public sector austerity measures.
They will get a 1% pay rise this year, the same as in 2014. A newly-qualified nurse will see their wage increase to £21,818.
The NHS Scotland total nursing wage bill for 2014/15 will be approximately £1.74 billion, which works out at an average of just short of £30k.
Dr Turner, the former head of the Scottish Patients’ Association, added: “If we want an NHS which puts patient care at its centre, management have to realise that a building is not going to be useful in itself.
“You can’t do it without doctors and nurses.
“We don’t have enough staff as it is and they don’t have enough time for all they need to do every department is down to the barest minimum.
“But we can’t fix this if so many millions every year are being poured into the coffers of private business.
“The Stobhill building is very pleasant but we need contracts that are fair to both sides.
“Unfortunately, bad management has signed the NHS up to unfair deals which we are now saddled with for years and years to come.”
Tory Health Spokesman Jackson Carlaw said: “There’s no question that many PFI deals, particularly Edinburgh Royal Infirmary’s, are nothing short of disastrous.
“Patients have suffered in some cases and so has the public purse.
“Unfortunately, once a contract has been signed however poor a deal it is it has to be honoured, and we must ensure these incredibly poor-value deals struck by Labour, when in government, are not repeated in future.”
A Scottish Government spokesman said: “These figures outline in stark terms the damage of Labour’s shameful PFI legacy on our NHS.
“While we are investing record amounts of funding in our NHS, boards across Scotland will still be paying Labour’s PFI debts for a generation to come.
“This is exactly why the SNP scrapped PFI when we took office, replacing it with a not-for-profit model which is saving millions of pounds.”
Stobhill & Victoria Ambulatory Care Hospitals
PFI Payments 13/14: £24.5 million
Nursing Costs 13/14: £22.4 million
Opened: 2009
Contract Length: 31 years
Contract Holder: Glasgow Healthcare Facilities (Edinburgh)
Shareholders: 3i (London), UME Investments (London), InfraRed Capital (London)
NHS Greater Glasgow & Clyde said: “PFI costs have risen because they are linked to inflation. In 2012, we also commissioned a 60-bed rehabilitation unit at Stobhill. Nursing staff play a key role in treating patients but quality care involves a much wider team of staff including doctors and therapists.”
Community County Hospital, Invergordon
l PFI Payments 13/14: £1.4 million
l Nursing Costs 13/14: £1.3 million
l Opened: 2004
l Contract Length: 26 years
l Contract Holder: Robertson Health Easter Ross (Elgin, Moray)
l Shareholders: Robertson Group (Elgin, Moray)
NHS Highland said: “Nursing costs have reduced due to the closure of the Fyrish ward and costs being reinvested into community staff.
“PFI costs have risen, but not significantly, in line with the Retail Price Index.”
St Andrews Community Hospital
PFI Payments 13/14: £2.9 million
Nursing Costs 13/14: £2.6 million
Opened: 2009
Contract Length: 31 years
Contract Holder: Projco St Andrews Hospital (Glasgow)
Shareholders: Dutch Infrastructure Fund (Amsterdam, Holland)
NHS Fife said: “The hospital is a community resource centre and provides inpatient and outpatient services and a full range of community teams providing care in patients’ own homes as well as three general medical practices, a pharmacy, dental services and a minor injuries suite.
“The PFI costs referred to are the total annual capital costs of the entire building and its maintenance, however, the figure for nursing staff refers only to inpatient nurses.”
Clackmannanshire Community Health Centre
PFI Payments 13/14: £2.6 million
Nursing Costs 13/14: £1.9 million
Opened: 2009
Contract Length: 29 years
Contract Holder: Robertson Health Clackmannanshire (Elgin, Moray)
Shareholders: Robertson Capital Projects (Elgin, Moray).
NHS Forth Valley said: “The nursing costs relate solely to the two inpatient wards which only represent one small part of the services on this site.”
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