The higher PFI costs have led to hospitals being designed and built on a smaller scale than a realistic projection of demand would warrant. Why? To make the PFI hospitals appear "affordable".
This is true of the NNUH. Whereas in 1989 it was estimated that a new hospital would need 1,650 beds to replace the two old hospitals, this had been shrunk to 701 beds by the mid-1990s so that the PFI contract would be "affordable". Then once approval had been given for the PFI contract, the number thought to be required went back up again in the late 1990s-to its present size of just below a thousand. Even so, the new hospital has 18% fewer beds than the two old hospitals it replaced and the PFI hospital is on red and black alert with distressing frequency. As a result the new hospital functions at a very high occupancy rate and is unable to treat all the patients in its catchment area. The Primary Care Trust (Norfolk NHS) has had to buy in treatment from privately-run hospitals in the area. In 2007-08 the additional cost of this buying-in was £1 million (see Edwards C, June 2009, 12 and 67-70).
This downsizing to make the PFI hospitals appear "affordable" has not been limited to the NNUH. It has been widespread (see Hellowell and Pollock, 2009, 16).