The Refinancing of the Norfolk and Norwich PFI Hospital ; Report, Together with Formal Minutes, Oral and Written Evidence PDF Download
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Author: Great Britain. Parliament House of Commons. Committee of Public Accounts
Publisher:
ISBN:
Category :
Languages : en
Pages : 47
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Book Description
Author: Great Britain. Parliament House of Commons. Committee of Public Accounts
Publisher:
ISBN:
Category :
Languages : en
Pages : 47
Get Book Here
Book Description
Author: Great Britain. Parliament. House of Commons. Committee of Public Accounts
Publisher: The Stationery Office
ISBN: 9780215028549
Category : Medical
Languages : en
Pages : 47
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Book Description
In 1998 the Norfolk & Norwich University Hospital NHS Trust (the Trust) let one of the first PFI hospital contracts to a private sector consortium, Octagon. In 2003, two years after the new hospital opened, Octagon refinanced the project. The total refinancing gain was £116 million. £82 million of the gain was retained by Octagon increasing its investors' internal rate of return, which it had said would be 19 per cent when it bid for the contract, to 60 per cent. There was no contractual arrangement to share in refinancing gains, but the Trust negotiated to receive £34 million of the gains (29 per cent, far below the normal 50:50 basis common in new PFI contracts). To maximise the refinancing gains, the Trust agreed to extend the minimum period of its PFI contract by five years to 2037, but the Committee feels it need not have incurred the risks of extending the contract. The Trust's liabilities could now also include all the additional borrowings by Octagon, and it could have to pay up to £257 million more if it needs to end this PFI contract early. This refinancing has produced a balance of risks and rewards between the public and private sectors which, even for an early PFI deal, is unacceptable. The Committee concludes that the consortium's dealings with the public sector have shown the unacceptable face of capitalism.
Author: Great Britain: Parliament: House of Commons: Committee of Public Accounts
Publisher: The Stationery Office
ISBN: 9780215555922
Category : Business & Economics
Languages : en
Pages : 40
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Book Description
The Department of Health and the Department for Communities and Local Government (the Departments) are responsible for sizeable portfolios of PFI projects covering hospitals and social housing. By April 2009 there were 76 operational PFI hospitals in England and over 13,000 homes had been built or refurbished through PFI. The letting of contracts and the responsibility for managing them is devolved to NHS Trusts and local authorities. The Departments are responsible for overseeing their PFI programmes and reporting to the public and Parliament on value for money. The Committee can find no clear and explicit justification and evaluation for the use of PFI in terms of its value for money. In many cases local authorities and Trusts chose the PFI route because the Departments offered no realistic funding alternative. Other concerns are central government's failure to use the market leverage that comes from overseeing multiple contracts, and the lack of robust central data to support effective programme management. It is clear that the implementation of PFI projects could be improved. Many PFI housing procurements have taken very much longer, and cost a great deal more, than originally planned. On hospitals, most are receiving the services expected at the point contracts were signed and are generally being well managed. There are, however, wide and unexplained variations in the cost of hospital support services, such as cleaning, catering and portering. Departments are not using their own buying power to leverage gains for the taxpayer.
Author: Great Britain: Parliament: House of Commons: Committee of Public Accounts
Publisher: The Stationery Office
ISBN: 9780215555502
Category : Business & Economics
Languages : en
Pages : 48
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Book Description
The 2008 credit crisis had an enormous impact on the Government's public infrastructure programme. Severe restrictions on bank lending at that time meant no sizeable Private Finance Initiative (PFI) contracts could be let. This affected the viability of a large number of infrastructure projects, including school and road building schemes, with a total investment value of over £13 billion. The Treasury's response was to make project finance available by lending public money on the same terms as the banks. However the Treasury did not put pressure on government-supported banks to either make lending available or reduce the extent of increased financing costs. Overall, bank financing costs increased by 20-33 per cent compared to bank charges before the credit crisis. This added £1 billion to the contract price, payable over 30 years, for the 35 projects financed in 2009. Other alternatives to the high cost bank finance were not properly explored during the credit crisis. Greater use of Treasury loans, or direct grant funding, could have put pressure on banks to lower their charges. Neither did the Treasury adequately explore how lower cost finance sources such as life insurance and pension funds could be encouraged to invest more in PFI projects. The Treasury also could have made more use of funding from the European Investment Bank. The appropriate mix of financing sources for future project contracts, including public and private finance, is an issue that needs serious reconsideration.
Author: Great Britain: Parliament: House of Commons: Committee of Public Accounts
Publisher: The Stationery Office
ISBN: 9780215561237
Category : Business & Economics
Languages : en
Pages : 70
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Book Description
There are legitimate concerns being expressed about the continuing financial cost of PFI for public organisations such as NHS Trusts. The Committee believes that some of the Government's case for using PFI has not been based on robust analysis, but on ill-founded comparisons and invalid assumptions. The costs and benefits identified in business cases need to be revisited after contracts are signed and periodically thereafter, to inform future procurement decisions. In particular, the Committee's view is that the Government should revisit the tax assumptions it builds into the cost and benefit case for PFI. Taxpayers could get a much better deal from PFI, and the taxpayer's position is also made worse by poor transparency of investor and contract information alongside patchy public sector commercial skills. The Treasury and departments should make full use of existing contractual rights of access and further investor information to increase transparency and find ways for taxpayers to get a share of the profits made by PFI contractors. At present, PFI deals look better value for the private sector than for the taxpayer. Private sector funds have built up portfolios of PFI projects from the large market that government has created, benefiting from potential economies of scale without any obligation to share such volume gains. Government, in contrast, has a fragmented approach and is not making use of its bulk buying power. The Treasury is seeking further efficiency savings, but achieving any savings on existing contracts will depend on voluntary agreements with investors and suppliers.
Author: Great Britain: Parliament: House of Commons: Committee of Public Accounts
Publisher: The Stationery Office
ISBN: 9780215029683
Category : Medical
Languages : en
Pages : 52
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Book Description
Strokes are one of the top three causes of death in England and a leading cause of adult disability. There are 110,000 strokes each year in England, with a quarter occurring to people under 65 years. Some 300,000 people in England are living with moderate to severe disabilities as a result of a stroke. As the NAO report on this subject pointed out (HCP 452, session 05/06 NAO ISBN 010293570X), it costs the economy in total about £7 billion a year, with the direct cost to the NHS about £2.8 billion. This Committee of Public Accounts report takes evidence from the Department of Health and sets out a number of recommendations. The cost of stroke, in both economic and human terms, could be reduced by re-organizing existing services more effectively. Brain scans of many stroke patients are being delayed, everyone who suffers a stroke should be scanned as soon as possible after arrival in hospital, and should not wait more than 24 hours. Stroke patients should spend longer in hospital on a stroke unit, this could reduce the number of deaths. There needs to be an increase in the number of consultants who have training in dealing with strokes, as well as therapists and other specialist staff with expertise in stroke care across the primary and secondary healthcare sectors. The Department of Health should improve provision of information to stroke survivors and carers, so they are made more aware of the support services available. The Department should run an awareness campaign to improve public knowledge about strokes
Author: Great Britain: Parliament: House of Commons: Committee of Public Accounts
Publisher: The Stationery Office
ISBN: 9780215029621
Category : Medical
Languages : en
Pages : 52
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Book Description
Everyday the NHS successfully treats over 1 million people. However there are risks and treatments can go wrong. A report by the Chief Medical Officer in 2000, ('An organisation with a memory', ISBN 0113224419) estimated that one in ten patients admitted to hospital were unintentionally harmed and that a blame culture and lack of a national system for sharing experience were key barriers to reducing the number of patient safety incidents. In Government's response included plans, timetables and targets to promote patient safety and the establishment of the National Patient Safety Agency. This report finds that insufficient progress has been made. In particular there is a question mark over the National Patient Safety Agency because of cost over-runs and delays in its National Reporting and Learning System and the limited feedback it has so far provided to trusts.
Author: Great Britain: Parliament: House of Commons: Committee of Public Accounts
Publisher: The Stationery Office
ISBN: 9780215028457
Category : Political Science
Languages : en
Pages : 48
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Book Description
In 2004-05 HM Revenue and Customs paid £15.8 billion of Tax Credits. The Department recalculates each award annually and has identified that for 2003-04 it overpaid some £2.2 billion to 1.9 million families. It believes that 2004-05 will see a similar level of overpayment. This is partly due to the nature of the scheme where awards are provisionally based on previous income whilst the final award is based on actual income. However the level of overpayment has been higher than was initial estimated and repayments have caused distress to some families. This report looks at measures being taken to reduce overpayments; claimant error and fraud; and the settlement with EDS over problems with the computer system. The Committee attaches great importance to this subject and wish to return to it in the future.
Author: Great Britain: Parliament: House of Commons: Committee of Public Accounts
Publisher: The Stationery Office
ISBN: 9780215028440
Category : Political Science
Languages : en
Pages : 44
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Book Description
The complexity of the benefit system is a key factor affecting the performance of the Department for Work and Pensions. Although this complexity is often necessary in order to administer the system cost-effectively and protect public funds against abuse, it can also result in high levels of error by staff, confusion for customers and help create a climate where fraud can more easily take place. The Committee's report finds that although the DWP has taken steps to address this problem (for example, in the design of Pension Credit, simplifying claim processes for several benefits and better sharing of information with local authorities), these are rather piecemeal developments and it is difficult to tell whether the system as a whole has become more or less complex as there is currently no objective way of measuring it. Some of the steps taken to simplify processes for customers are a way of managing complexity, rather than eliminating it. Managing complexity requires well-trained staff supported by accessible guidance and assistance and efficient information technology systems, and the DWP should also improve its written communications with customers.
Author: Great Britain: Parliament: House of Commons: Committee of Public Accounts
Publisher: The Stationery Office
ISBN: 9780215029164
Category : Law
Languages : en
Pages : 48
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Book Description
The prison population in England and Wales has been increasing since the 1990s and by November 2005 it reached a record level of 77,800, resulting in increased levels of overcrowding and stretched resources. Following on from a NAO report (HC 458, session 2005-06 (ISBN 0102935696) published in October 2005, the Committee's report examines how the Home Office, the Prison Service and the National Offender Management Service (which has responsibility for managing and accommodating prisoners) are dealing with the challenges involved in accommodating this record number of prisoners, the construction and use of temporary accommodation and the impact on the delivery of education and other training for prisoners. The Committee makes a number of conclusions and recommendations including in relation to: the deportation of foreign nationals, the use of alternatives to remand such as electronic tagging, contingency planning to ensure greater flexibility in accommodation plans including pilot testing new accommodation to identify possible problems early on, the application of best practice in anti-suicide monitoring measures, and the impact of moving prisoners around the prison estate on their training needs.
