11. Are there realistic alternative roles for private finance than the current PFI-type private finance models? Should the UK be aiming for more diversity in private finance models? Would a national infrastructure bank (such as the proposed Dodd-Hagel NIB in the US) add any value in the UK? Should the public sector have a more hands-on role in financing and/or delivery?
11.1 We believe the LIFT model, which offers a meaningful partnership between the public and private sectors, is a fantastic example of an alternative to PFI. LIFT is predicated on a partnership approach based on a defined geographical area which is not limited to a single project, meaning that the private sector and PCTs' success are totally linked. In addition, the flexibility of LIFT means it can be applied to many different types of projects outside health and its use should be expanded more broadly across social and residential care, social housing etc. There is also a key role for LIFT in working with PCTs to realise efficiency savings and derive maximum value from the NHS estate by ensuring estates management closely aligns with commissioning strategy and local need.
11.2 Benefits of the LIFT model include:
- Local strategic direction and partnerships with community stakeholders ensures development is tailored to local circumstances.
- Realising efficiency savings and deriving value from the NHS estate.
- Role for LIFTCo in supporting PCT partners with commissioning and estates management.
- A reliable long-term approach with national support and standardised documentation.
- Private sector expertise, management and investment.
- Integrated care: co-location of healthcare professionals helps to forge links between primary and social care with benefits for staff and patients.
- Flexible leases and share options help to resolve GP recruitment and retention problems.
- Advanced primary care centres reduce pressure on secondary care and enable care closer to home.
- Provision of new purpose-built GP premises suitable for modern primary care.
- Enhanced patient choice within a patient-led NHS.
- Initial focus on launching LIFT schemes in areas of high deprivation has led to real progress in tackling health inequalities where it is most needed.
- Facilities which act as local community "hubs".
11.3 The creation of a UK infrastructure bank could be used to reduce the cost of borrowing which would subsequently impact on the cost to PCTs.