Attila the Humph attempted to interview Mr Lansley on the Today Programme earlier this week. Attila was in Gatling mode, achieving as usual more noise than hits. Lansley, on the other hand, was operating in lounge lizard mode, and the lizard just kept on talking. He also slithered a lot, but Atilla’s attacks bounced off him like dried peas off a plate glass window. The problem was that Atilla, despite having been tipped the big question by his previous interviewee, the King’s Fund’s John Appleby, was stuck in semi-automatic mode, and stayed stuck, like the proverbial to a blanket, while the lizard sped off, like the proverbial from a shovel.
The news story, such as it was, was that twenty-two NHS trusts were also in poo on account of burdensome private finance initiative (PFI) contracts. Attila accused the lizard of lizarding, and the lizard obliged, blaming the ruinous PFI deals on Labour. It was all a bit of a non-story, all the more so since a Select Committee chairman had only a month ago declared – on Today – that PFI was ‘ripping off taxpayers’ – as if we didn’t know, but then one supposes it does take time for politicians to catch up with the rest of us.
Whether PFI alone was pushing the trusts to the ‘brink of financial collapse’ is of course a moot point – some trusts do fine despite PFI, while others manage to get themselves to the brink without PFI burdens. Furthermore, the extra – marginal – cost of using PFI, compared to traditional funding, is small, of the order of three percent, even if over the course of a twenty-five year contract the sums do add up.
But if, on balance, we stick with Andy Pandy Tyrie, the Select Committee chairman’s – a Tory MP no less – view that PFI is the private sector ‘ripping off’ the tax payer, then the real question is, as Appleby spotted, and Attila missed, not whether PFI is the sole cause of certain trusts being on the brink of collapse, but the far larger question of what on earth are the Tories doing by introducing what amounts to PFI not just into the bricks and mortar side of the NHS, but into the providing of services as well?
So we have this bonkers position: Tory MP (Select Committee chairman) says PFI is a rip off; and the Tory health secretary says PFI is pushing trusts to the brink of financial collapse. So what do they do? Introduce PFI (dressed up as any willing provider/very willing cowboys) in vastly extended form to provide NHS services as well as buildings. And we already know – Southern Cross – how the private sector manages to provide care. Bonkers – or what?