4.5 This was not a local scheme for the local NHS, given the nature and scale of the Campus scheme. It had explicit national dimensions in the integration with Imperial College's research work and the national services provided by both NHS Trusts. However Departmental policy under Shifting the Balance of Power within the NHS10 was that all funds would be allocated to local NHS budgets so the solution to any funding issue was also local. The Department had no formal position on whether or not the Campus should be built. It explained to us that the initial 2000 scheme was approved by the local NHS and that the Department had no role in this. Both NHS Trusts, Partnerships UK and Westminster City Council all told us that they had been uncertain whether the Department did in fact want the Campus scheme to go ahead.
4.6 The Department provided advice for the scheme through its Private Finance Unit and guidance through its Capital Investment Manual. Under the system of delegated authority by which the Department allows a degree of autonomy to the local NHS, it did not see its role as policing schemes' compliance with the Manual because local NHS organisations developed plans for capital investment.
4.7 Once the scheme involved complex land transactions (from April 2004 onwards) the Group Delivery Director at the Department became much more closely involved. He had at least 24 meetings with Campus partners and related third parties between April 2004 and the collapse of the scheme in May 2005. No substantive steps were taken by the Campus partners during this period without his consent although it is equally true that the Department did not sponsor or request any scheme initiatives.
4.8 Some of the advice and guidelines provided by the Department to the Campus partners were ephemeral. It said a scheme with a capital to revenue ratio of over 1:1 was likely to be unaffordable (the Campus was 1.8 :1) but later agreed that this was not the case. It also expressed concerns over capacity in north west London but later said this problem could be managed after the OBC was submitted, as long as the Strategic Health Authority planned to address it. This created uncertainty on the part of the Campus partners.
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10 Shifting the Balance of Power within the NHS, Department of Health, 2001.