1 In July 1988, the North West Thames Regional Health Authority submitted a proposal to the Department for a 665-bed hospital at a cost of £136 million. The Regional Health Authority aimed to have the hospital open to patients by September 1992. By the end of 1992, the total estimated cost had slipped to £236 million and the expected opening time had been pushed back to March 1993. The Committee of Public Accounts' report included the following recommendations:
iii We are concerned that the health authority assumed that planning agreement would be forthcoming and were therefore unprepared for the difficulty and consequent delay that actually occurred at a cost of some £16 million.
xi We expect the NHS in future to take a more cautious approach on projects which rely on the property market to fund developments. We also expect to see a full sensitivity analysis on all major capital projects to establish the impact of any problem in financing the projects.
xvi We wish to emphasise some themes which emerge from our examination of this project which would be relevant to any major construction project financed from public funds. They are:
a the agreement of the planning authority must be clearly established in a formal way before significant expenditure is incurred for detailed design and development work;
b the project should be considered in the broadest geographical and organisational context and not limited to narrow local factors, however attractive the proposals may be to local interests;
e there should be a full sensitivity analysis to establish the impact of any problems in financing the project.
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13 Committee of Public Accounts (1993) The Chelsea and Westminster Hospital, Twenty-Sixth Report 1992-93 (London: HMSO).