Expensive PFI hospitals could be left half-empty, NHS managers warn
Expensive new Private Finance Initiative hospitals could be left half-empty as the NHS cuts costs in order to save money, health leaders have warned.
Ministers are trying to reduce the costs of PFI schemes at 22 trusts across England, whose “clinical and financial stability” is at risk because of their growing debt burdens.
But the contracts are due to run for decades and are difficult to renegotiate, while the NHS’s budget has stopped growing and managers are under orders to make £20billion of efficiency savings by 2015.
At the same time, the controversial Health and Social Care Bill will open up more of the health service to competition and could see some state-run hospitals receive less business, while there are growing calls from the medical profession for patients to be cared for at home or in local clinics rather than in expensive wards.
As a result of these changes, experts fear that PFI-built hospitals could be left half empty while trusts still have to pay millions every year in interest payments on the “mortgages”.
David Stout, deputy chief executive of the NHS Confederation, the umbrella body for health trusts, said: “These deals were devised at a time when funding coming into the NHS was growing and income was stable.
“The issue now is that the NHS is undergoing fundamental change and income for hospitals to cover the costs of PFI will become less stable, primarily because the NHS faces an unprecedented financial challenge.
“PFI contracts are long term deals lasting up to 25 years but, in order to respond to the current unprecedented financial challenge, we will need to close some services or parts of hospitals in order to invest in more efficient services elsewhere that are better for patients. With resources locked into PFI contracts, we will find it harder to make these vital changes.
“There is a real danger that we will be paying for hospitals that are not being fully used.”
As The Daily Telegraph has disclosed, the Government has been contacted by 22 acute trusts who claim they are struggling to stay afloat because of the weight of their PFI deals, most of which were arranged under Labour as a way for new facilities to be built quickly with low upfront costs. Private investors fund, build and run the projects in return for annual interest payments that can run for up to 30 years, far outstripping the original construction costs.
The total PFI commitment of the hospitals in question is estimated at £5.5billion, after the credit crunch raised borrowing costs, making it difficult for them to balance their books and so attain the coveted Foundation Trust status.
The Department of Health is working with their chief executives to find ways to make the deals more affordable, with plans due later this year.
Options include the Treasury making one-off payments, akin to paying off a home loan early, or trying to renegotiate contracts.
Struggling trusts could also be merged with more successful ones, with the older facilities shut down in order to make the best use of the “shiny new” PFI buildings.
Andrew Lansley, the Health Secretary, told BBC Radio 4’s Today programme there was an “enormous legacy of debt” within the NHS. “We have looked since the election and are working together with individual trusts to arrive at a place where they are financially, and in terms of the quality of their services, sustainable for the future,” he said.
But some commentators claimed that PFI payments only account for 1 per cent of the health service turnover and represent just a small part of the challenges hospitals face.
Prof John Appleby, chief economist at The King’s Fund think-tank, told Today: “What the Department of Health is doing is to put pressure on hospitals to be more productive while funding is frozen and in cash terms cut. “For those hospitals with PFI they’ve got fixed costs but prices they are able to charge are going down in real terms. That’s where the pressure comes from.”
The British Labour Party’s embarrassing immigration secrets revealed
Reports kept under wraps by Labour showing that immigrants who came to Britain from Romania and Bulgaria had low education levels and were more likely to claim out-of-work benefits are to be released for the first time by ministers.
The figures are contained in five separate controversial studies commissioned by the last Labour government but never published – amid claims the party wanted to avoid a damaging row about its record before last year’s general election.
Ministers accused Labour of a “disturbing cover up” and promised to publish the reports – which cost the taxpayer a total of £165,000 and have now been seen by The Sunday Telegraph – in full within days.
The documents also contain revelations that immigrants from all countries into Britain are more likely to be out of work than the native population – and are less likely to engage in any form of “civic participation.”
More than one third of London’s population, moreover, has now been born outside the UK.
The release will turn the spotlight once again on the party’s controversial record on immigration. Yvette Cooper, the shadow home secretary, used a weekend interview to admit the party had “got things wrong” on the issue.
Up until 2008 the Labour government was criticised for effectively operating an “open door” policy which saw a massive rise in the number of visas, work permits and extended residency being granted.
Gordon Brown’s government then introduced a new “points based” system which was designed to make it harder for non-skilled people to come to Britain from outside the European Union.
However, particular controversy surrounded the rules governing immigration from countries which joined the EU during the first decade of this century – which included Bulgaria and Romania (which joined in 2007) and Poland (2004).
Labour ministers repeatedly promised that restrictions would be placed on those coming in from Eastern Europe in order to “manage” numbers and protect jobs for British workers. However, the secret reports show that 27 per cent of people coming from Bulgaria and Romania had “low education levels” while as of 2009 more than 15 per cent of them were claiming out-of-work benefits.
The documents, commissioned by the Department for Communities and Local Government (CLG) reveal that immigrants from the two countries are more likely to claim unemployment-related benefits than either non-immigrants or other migrant groups in Britain.
A report said that despite the implementation of a “cap” on numbers, the migration rate into Britain from Romania and Bulgaria increased significantly after the countries joined the EU in 2007.
Meanwhile, migrants from the two countries were shown to be more likely to have four children or more than people coming to Britain from elsewhere – placing a significant strain on the education system, particularly in London where over half the Bulgarians and Romanians who came settled. More than three in every 100 migrants from Bulgaria and Romania had five children or more.
One of the five reports, Identifying Social and Economic Push and Pull Factors for Migration to the UK by Bulgarian and Romanian Nationals, showed that while Bulgaria’s and Romania’s population declined between 2004 and 2010, Britain’s increased considerably.
During that period the two countries’ unemployment rate fell, while the UK’s rose.
Another report on overall immigration, The Socio-Economic Integration of Migrants, claimed: “Immigrants in the UK exhibit lower employment rates than natives….Immigrants are on average less likely than natives to engage in any form civic participation.”
A further document, Drivers of International Migration, stated: “The increase in immigration into the UK since the mid 1990s is entirely explained by a rise in the number of foreign-born people migrating to the UK from abroad, rather than by returning UK-born people.”
At the start of the 1980s the key annual “net immigration” figure for the UK was minus 42,000 – meaning tens of thousands more people left Britain every year than came here. By 1992-95 this figure had gone up to plus 9,200 – while by the period between 2004 and 2007 it had mushroomed to plus 178,000 a year.
Britain’s population was slated to increase by more than four million to 65.6 million between 2008 and 2018, while by 2008 over one third of London’s population (34 per cent) was born outside Britain.
Grant Shapps, the Housing Minister, said: “This is another disturbing cover-up by a Labour Party that failed on immigration and then tried to bury the truth. “‘This Government is bringing immigration under control to restore public confidence in the system left broken by Labour.”
The Coalition’s policy of putting an overall cap on immigrant numbers from outside the EU is designed to reduce net migration to Britain significantly.
David Cameron said in a speech in April that it should be “in the order of tens of thousands each year, not the hundreds of thousands every year that we have seen over the last decade.”
Damian Green, the Immigration Minister, said: “We have cut down on sham marriages, we have brought in a variety of policies which curb the number of people coming into the country and then overstay.
And we will continue to look at how we can further improve the balance between the people who at value coming into the country and those who do not.”
Labour’s record on immigration sparked bitter debates before last year’s election, exemplified by unguarded “bigoted woman” comments during the campaign by Mr Brown, on an open microphone, about Gillian Duffy, a Rochdale grandmother, when she questioned the former prime minister on it.
In an interview this weekend Ms Cooper admitted: “We did get things wrong on immigration. “We should have had the transitional controls on migration from Eastern Europe. We should have introduced the points-based system much earlier.”
BBC turns its back on year of Our Lord: 2,000 years of Christianity jettisoned for politically correct ‘Common Era’
The BBC has been accused of ‘absurd political correctness’ after dropping the terms BC and AD in case they offend non-Christians. The Corporation has replaced the familiar Anno Domini (the year of Our Lord) and Before Christ with the obscure terms Common Era and Before Common Era.
Some of the BBC’s most popular programmes including University Challenge, presented by Jeremy Paxman, and Radio 4’s In Our Time, hosted by Melvyn Bragg, are among the growing number of shows using the new descriptions.
The BBC’s religious and ethics department says the changes are necessary to avoid offending non-Christians. It states: ‘As the BBC is committed to impartiality it is appropriate that we use terms that do not offend or alienate non-Christians. In line with modern practice, BCE/CE (Before Common Era/Common Era) are used as a religiously neutral alternative to BC/AD.’
But the move has angered Christians, mystified other faith leaders and been branded unnecessary by the Plain English Campaign. Critics say the new terms are meaningless because, just like AD and BC, they still denote years in relation to the life of Christ.
Dr Michael Nazir-Ali, the former Bishop of Rochester, said: ‘I think this amounts to the dumbing down of the Christian basis of our culture, language and history. These changes are unnecessary and they don’t achieve what the BBC wants them to achieve. ‘Whether you use Common Era or Anno Domini, the date is actually still the same and the reference point is still the birth of Christ.’
Marie Clair of the Plain English Campaign said: ‘As with most politically correct innovations, I am sure this was done with the best of intentions. But it is difficult to see what the point of the changes are if people do not understand the new terms. It sounds like change just for the sake of change.’
The website for BBC Religion and Ethics, headed by commissioning editor Aaqil Ahmed, who is a Muslim, is littered with references to Common Era and Before Common Era. However, the BBC bizarrely insists the bbc.co.uk/religion website has nothing to do with Mr Ahmed and is actually the responsibility of BBC Learning.
The terms are not confined to religious output and have also been used in news bulletins. Some reports add to the confusion by switching between both terms in the same item.
A report on historic monuments in Jerusalem, for instance, informed viewers that Temple Mount, a shrine which is sacred to both Jews and Muslims, was built in ’70 AD (the Common Era)’; while a recent report on frankincense quoted one reference to 7000 BC before describing another event as taking place in the 1st Century BCE.
One of the BBC’s study guides highlights Greek philosopher Demokritos, whose dates are given as 460-370 BCE, while a section on GCSE Bitesize on American playwright Arthur Miller says that the first tragedies were written by the Greeks in the 5th Century BCE. Similarly, a section about the rules of Hindu warfare refers to 3000 BCE.
Often viewers have no idea why presenters, contributors and guests are using the new terms. In an edition of In Our Time broadcast in March, one contributor made several references to the Common Era in a discussion on sacred Hindu texts. Melvyn Bragg did not feel the need to clarify it.
This is not the first time the BBC has caused controversy over its use of alien language to promote a politically correct, Europhile agenda. Its increasing reliance on metric measurements rather than the imperial system and its occasional reference to expenditure in terms of euros rather than pounds has infuriated many viewers.
Several prominent Christians last night blasted the Corporation for sidelining Christianity.
The Rev Peter Mullen, Anglican chaplain to the London Stock Exchange, said: ‘This is absurd political correctness and these new terms do not mean anything to anyone. ‘I think it’s an example of the BBC trying to undermine Christianity by pushing an aggressive secularism. ‘I would be very surprised if any other faith had complained about the use of Anno Domini and Before Christ.’
Ann Widdecombe, the Catholic former Tory Minister, said: ‘I think what the BBC is doing is offensive to Christians. They are discarding terms that have been around for centuries and are well understood by everyone. ‘What are they going to do next? Get rid of the entire calendar on the basis that it has its roots in Christianity?’
A spokesman for the Church of England said that although both terms were common, BC and AD ‘more clearly reflect Britain’s Christian heritage’.
Several of the BBC’s most well-known presenters said they saw no problem with the established system of AD and BC. John Humphrys, who presents Radio 4’s Today programme and TV’s Mastermind, said: ‘I will continue to use AD and BC because I don’t see a problem. ‘They are terms which most people use and are clearly understood.’
Historian Simon Schama, who has presented several programmes for the BBC, said: ‘As a Jew I don’t have any problems with AD or BC. But CE and BCE are used frequently in Jewish circles. ‘I have been familiar with them since the Fifties, so it’s not like the BBC have just made them up.’
Dr Ghayasuddin Siddiqui, of the Muslim Institute, said: ‘I don’t know anyone who has been offended by AD and BC, so why change them?’
British Police tell cafe owner: Stop showing Bible DVDs, or we will have to arrest you
Police have threatened a Christian cafe owner with arrest –for displaying passages from the Bible on a TV screen. Jamie Murray was warned by two police officers to stop playing DVDs of the New Testament in his cafe following a complaint from a customer that it was inciting hatred against homosexuals.
Mr Murray, 31, was left shocked after he was questioned for nearly an hour by the officers, who arrived unannounced at the premises. He said he had turned off the Bible DVD after an ‘aggressive inquisition’ during which he thought he was going to be arrested and ‘frog-marched out of the cafe like a criminal’.
But he added: ‘I have now checked on my rights and I am not going to be bullied by the police and the PC lobby out of playing the Bible silently in my cafe. It’s crazy. Christians have to stand up for what they believe in.’
The Salt and Light cafe in Blackpool has for years repeatedly played the entire 26-hour-long Watchword Bible, a 15-DVD set produced in America in which a narrator reads the whole of the New Testament, on a small flatscreen TV on the back wall.
The sound is turned down but the words flash on to the screen against a series of images. The cafe, which opened eight years ago, also prides itself on being an oasis of calm in a high-crime area of Blackpool.
Mr Murray said the two uniformed officers from Lancashire Constabulary arrived at lunchtime on Monday, the cafe’s busiest time of day. WPC June Dorrian, the community beat manager, told him there had been a complaint and he was breaching the Public Order Act 1986.
Mr Murray said: ‘I told them that all that appeared on the screen were the words of the New Testament. There is no sound, just the words on the screen and simple images in the background of sheep grazing or candles burning. I thought there might be some mix-up but they said they were here to explain the law to me and how I had broken it.
‘I said, “Are you really telling me that I am facing arrest for playing the Bible?” and the WPC fixed me with a stare and said, “If you broadcast material that causes offence under the Public Order Act then we will have to take matters further. You cannot break the law.” ’
Mr Murray, who worked in a homeless shelter for five years before taking over the cafe three months ago, said he realised the only way to appease the police was to pull the plug on the Bible.
‘I was worried about being handcuffed and led out of the shop in front of my customers. It wouldn’t have looked good so I thought it was better to comply. It felt like a betrayal. They left the shop and told me they would continue to monitor if we were displaying inflammatory material. At no stage had they spoken to me like I was a law-abiding citizen trying to earn a living. I felt like a criminal.’
Mr Murray said he had been given no indication of who had complained or which verses of the New Testament had caused the offence, but he guessed it may have been a reaction to the Book Of Romans that had been playing the week before. The Book takes the form of a letter from the apostle Paul to the people of Rome, in which he rails against all manner of godlessness.
In verses 26-28 of Chapter One he says: ‘God let them follow their own evil desires. Women no longer wanted to have sex in a natural way, and they did things with each other that were not natural.
‘Men behaved in the same way. They stopped wanting to have sex with women and had strong desires for sex with other men. They did shameful things with each other, and what has happened to them is punishment for their foolish deeds.’
The verses take 30 seconds to play and the Bible translation used is the 2005 Contemporary English Version (CEV), a plain English text by the American Bible Society. Experts at the British Bible Society, whose patron is the Queen, have described it as a well-respected text that, while using straightforward language, fairly reflected the meaning of the original.
The Christian Institute, which is supporting Mr Murray, said its lawyers had told him he is free to display the Bible in any way he chooses, and they are preparing a complaint against the police.
The Institute’s spokesman Mike Judge said: ‘I have no problem with the police looking into a complaint, but once they realised it was just the words of the Bible being shown on the screen then they should have walked away. ‘They did not even look at the offending DVD. They simply told Mr Murray that he had to stop showing the Bible and warned him that they would continue to monitor what he was doing. This is intimidatory and completely unacceptable.
‘It is a problem right across the country that the police are under huge political pressure to be seen to respond to anything homophobic.’
Lancashire Police said they had received a complaint on Saturday afternoon from a female customer who was ‘deeply offended’ by the words she had seen on the screen. A spokesman said they were ‘duty bound’ to respond to the complaint and had concluded the cafe could be in breach of Section 29E of the Public Order Act, which warns that people who play images or sounds that stir up hatred against homosexuals could be guilty of an offence.
However, it also says criticism of sexual conduct ‘shall not be taken of itself to be threatening or intended to stir up hatred’.
A police spokesman said: ‘At no point did the officer ask the cafe owner to remove any materials or arrest the man and we took a commonsense and objective approach in dealing with the complaint. We believe our response and the action we took was completely proportionate and our officers are always available should the cafe owner want to discuss the matter or need any advice in the future.
‘The Constabulary is respectful of all religious views. However, we do have a responsibility to make sure that material that communities may find deeply offensive or inflammatory is not being displayed in public. ‘No complaint has been received about the conduct of the officer in question and we are satisfied that they performed their duties professionally.’
British Labour Party leader refused to call people who falsely claim welfare benefits ‘cheats’
Ed Miliband faced criticism from Labour MPs last night – for refusing to describe people who falsely claim welfare benefits as ‘cheats’.
The Labour leader was urged by aides to denounce welfare scroungers as ‘cheats’ in a speech this summer but insisted the word was not included in his final draft. He would not attack people on benefits in such stark terms, protesting: ‘You want me to accuse people who defraud the system of being “cheats”? I can’t do that.’
The disclosure came on the eve of the Labour conference in Liverpool, where Mr Miliband hopes to respond to growing claims that he has failed to make an impact since becoming Opposition leader a year ago today.
Labour MPs said Mr Miliband’s failure to condemn welfare cheats in explicit language undermined his claim to be taking a tougher line on people who abuse the benefits system. One Labour MP said: ‘Ed has got to convince people he is just as determined to end the obscenity of people who rip off benefits as he is to end the obscenity of bankers who get paid obscene bonuses. ‘He won’t do that by shying away from denouncing welfare cheats. ‘Ordinary people call them cheats, why can’t Ed?’
A Labour spokesman said he had ‘no recollection’ of Mr Miliband refusing to call welfare scroungers ‘cheats’. He claimed the Labour leader’s condemnation of ‘abuse’ of the system went further than calling the abusers ‘cheats’. ‘He has said people who abuse the welfare system must be stopped,’ said the spokesman.
‘Abuse is a much stronger word than cheat. For the record, he does believe people who do that are cheats and he is prepared to use the word.’
However, he did not do so in a keynote speech on the subject in June. The Mail on Sunday can find no record of him denouncing ‘welfare cheats’ in public.
Mr Miliband’s speech in June was hailed as an attempt to shrug off his ‘Red Ed’ image and relaunch his leadership by talking tough on welfare scroungers and overpaid bankers. He called for greater social responsibility from the idle and super-rich.
Sir Ian Botham: bring in corporal punishment and ban reality TV to save today’s youth
Ian Botham is one of Britain’s greatest cricketers but has also been very active in charity work. As such he is very well-known so his call for corporal punishment to be reintroduced into the schools might just break the ice on that subject
Sir Ian Botham, the former England cricket captain, believes a combination of cricket, corporal punishment and a ban on reality television can help to prevent the kind of break down in law and order that occured in the riots during the summer.
As the England cricket captain he showed ruthless determination and self-discipline on the pitch.
Now, in the wake of the August riots, Sir Ian Botham wants to see today’s youth given the same combination of team sports and tough love which he credits for making him a success.
The former all rounder has set out how he believes parents must be allowed to deploy corporal punishment, the cane should be used to restore order in schools, police given respect – and reality television should be abolished.
And he also launched an attack on the previous Labour administration, saying they had to take some of the blame for the breakdown of law and order in the summer, which he found himself caught up in when looting and street violence affected Birmingham.
Sir Ian who has three grown-up children and four grandchildren aged from 18-months-old to 17-years-old, spoke as he launched his own sports initiative, to get inner-city youngsters and young offenders playing a version of his sport known as cage cricket.
The six-a-side version of the game is designed to be played on concrete in cities and towns.
The brainchild of former Hampshire player Lawrence Prittipaul, it is played in a “cage,” with separate coloured zones for scoring, positioning and refereeing, each game takes 30 overs to complete with just six players.
He said: “We desperately need to create an opportunity for youngsters to mingle, release and discipline themselves, play a game and also, make it national. The youth of today won’t get bored with cage cricket either – this is when the problems start and carnage can set in as it did with the riots.
“The government can lie as much as they want, but half the playing fields are being sold off. I want to give these kids the opportunity to keep out of trouble.
“And who knows, we could find ourselves a cricketer, who’d never have had this chance, in the systems of schools where most don’t play, unless you go to a private school. That is a fact.
“The same goes for those in prison. We give hard criminals a bat and a ball and they are pleased about playing. It’s the best way of engaging the most disengaged of our population.”
But he said that more radical measures than his own initative were needed. “Britain is in a mess,” he said. “I believe in the cane. It didn’t do me any harm as a child at school. Bring it back. Youngsters today, need discipline, and to get off their backsides.
“Parents also have to take greater responsibility too. I am afraid, at the end of the day; most of it is down to them.”
Sir Ian told the Sunday Telegraph he believes these measures are the only way of solving Britain’s deep-rooted social problems following the recent riots, which he was caught up in.
The 55 year-old was forced to lock himself in his Birmingham city centre hotel when rioting flared on the streets. Extra police were called when vigilantes smashed shop windows, looted stores and tried to hijack a bus.
Sir Ian said the experience has made him more resolute to get youngsters from deprived inner-cities off the streets and out of trouble, as well as engage prisoners with something positive.
He said: “Everyone thought Birmingham was going to go AWOL that night. We all sat there in total silence. No one went out. The hotel doors were locked, its shutters pulled down.”
He said the experience had strengthend his resolved to get youngsters off the streets and involved in sport – especially after witnessing the racially tensions which followed the deaths of Asian men Haroon Jahan, 21, Shazad Ali, 30, and his brother, Abdul Musavir, 31, in a hit-and-run allegedly carried out by a young black man at the height of the disorder..
He said: “If it wasn’t for the dignity of Tariq Jahan’s father, I honestly thought Birmingham city centre could have gone up in flames.”
Sir Ian ultimately blames the riots on the previous Labour government, holding them responsible for bankrupting the country. He said: “We have Ed Miliband telling us where the Conservatives are going wrong. But hang on a minute Ed. You are the ones who landed us in this situation, and we are in a perilous situation.
He added: “You guys borrowed ridiculously and sold our gold reserves at the lowest price. Have you forgotten about that dumpy thing called Brown? He’s now in hiding. The man who was never elected and never to be re-elected. “Then they leave a note for the new Chancellor, saying, ‘By the way, there’s nothing left in the box. PS -Have a good time.”