Appraising and Evaluating PFI for NHS Hospitals

This paper explores the use of appraisal in the development of proposals to use private finance to provide acute hospitals under the Private Finance Initiative (PFI). It addresses the extent to which value for money (VFM) and affordability (which must be satisfied to enable a scheme to be approved) are demonstrated in the documents prepared by hospital Trusts. It identifies a number of issues (such as the transfer of risk and the development of public sector comparators) that pose new problems for investment appraisal, which are specific to its application to PFI.