Private finance to power NHS move into community - other options? - Is it a backward step

6th August 2025

An article in The Lowdown web site 1 August 2025.

The government's recently unveiled 10-Year Health Plan wants to set up to 300 "neighbourhood health hubs." - local one-stop centres to offer diagnostics, outpatient treatment, mental health support, and preventive services, to relieve pressure on hospitals. To fund the plan, the government is turning to the private sector, but what does history teach us about the impact of this approach and what other options for public borrowing could be considered?

Read the full article HERE
The National Audit Office provided a final conclusion about the higher costs of PFI schemes, after a whole series of academic reports on the costs of individual schemes and the substantial profits that were being passed on to investors

"The cost of capital for a typical PFI project is significantly higher than for government borrowing. A government department can currently borrow at a rate of around 1.5%-2.5%, whereas the cost of capital for a typical PFI project is between 6% and 7%."

The UK Government published on 19 Jun 2025.
UK Infrastructure A 10 Year Strategy
The document is 106 page so here is a summary -

UK Infrastructure: A 10 Year Strategy - Key Points
Overview
Strategy sets out the government's long-term plan for economic, housing and social infrastructure to drive growth, boost living standards, and connect people to jobs and services.

Backed by at least £725 billion of government funding over the next ten years, with updates every two years and oversight by the National Infrastructure and Service Transformation Authority (NISTA).

1. A New Approach to Drive Growth
Fixing failures of the past by prioritising long-term outcomes over short-term announcements.

Providing certainty and stability to attract private investment and enhance delivery efficiency.

Emphasising cross-sector coordination between government and industry to speed up planning and execution.

2. Encouraging Private Investment
Publishing a clear, long-term pipeline of major projects to build investor confidence.

Strengthening regulatory frameworks and streamlining approvals to reduce barriers.

Leveraging public finance institutions, including the National Wealth Fund, to crowd in private capital.

3. Unlocking Regional Growth
Working with devolved administrations to tailor infrastructure plans to local needs.

Establishing regional hubs to coordinate delivery, share best practice, and accelerate projects.

Aligning infrastructure investment with local growth ambitions and housing plans.

4. Becoming a Clean Energy Superpower
Driving the UK's clean energy mission toward net zero by 2050.

Scaling up offshore wind, hydrogen, and carbon capture, usage, and storage (CCUS).

Upgrading electricity networks and boosting grid resilience to support decarbonisation.

5. Delivering High-Quality Social Infrastructure
Rebuilding and refurbishing schools, expanding prison capacity, and modernising hospitals.

Improving digital connectivity and water resilience to support communities.

Integrating social infrastructure planning with economic growth objectives.

6. Improving the Environment
Investing in flood defences and nature-based solutions to enhance climate resilience.

Promoting biodiversity net gain in new developments.

Advancing sustainable transport and circular economy initiatives to reduce environmental impact.


Implementation and Governance
Strategy overseen by NISTA, with progress reviews and updates every two years.

Coordination with the modern Industrial Strategy and skills investment to maximise benefits.

Transparency through an annually published infrastructure pipeline and performance reporting.

Do we really want to go back to another PFI/PPP set up even if disguised under a new name and terminology.