3.7 The Trust pays THC Dartford a monthly amount for the provision of hospital areas that are available for use. During the minimum contract period (covering the first 32 years of payments) this availability payment will remain fixed in real terms with adjustments if the Trust asks THC Dartford to vary the level of facilities provided. If the Trust then continues the contract, the availability payment will be renegotiated every five years in line with THC Dartford's expected costs for operating and maintaining the buildings. If the Trust is not able to agree with THC Dartford's prices at these five yearly reviews the parties will use the contract's Disputes Resolution Procedure. The Trust would expect to negotiate with THC Dartford a reduced availability payment after the minimum contract period has ended as THC Dartford would have repaid the borrowings used to build the new hospital.
3.8 If the Trust wishes to commission additional building facilities then it has the flexibility to choose the method of procurement although THC Dartford approval is needed if the work is to be contracted for outside the PFI contract except where it relates to a proposed free-standing building on the site. The Trust has found conventional NHS funding to be the most economic option for small variations. It is also funding some larger variations conventionally, for example its recent A&E variations and a proposed new Heart Centre. Where the Trust wishes to consider commissioning additional building work under its PFI contract the Trust can invite THC Dartford to submit proposals. The Trust can take steps to test whether THC Dartford's proposed pricing for the building work is value for money, for example by requiring THC Dartford to obtain alternative quotations for the building work. If THC Dartford cannot obtain funding for the work on reasonable commercial terms, the Trust may pay for the additional work using funding mechanisms other than the PFI. These arrangements are designed so that, in theory, the terms for additional works should not be less favourable than under conventional procurement where the Trust would be able to tender for competitive quotes for any additional facilities.
3.9 The Trust considers that its PFI contract gives it no less flexibility to reduce activity than a conventional hospital and does not expect there to be any significant difference in the cost implications. The Trust would certainly expect to be able to reduce the level of payments on facilities management services if it ceases to use part of the hospital. It may, however, be less easy for the Trust to avoid expenditure on maintaining areas not in use compared with conventional procurement where a NHS Trust can make immediate decisions to stop, or reduce, expenditure on maintaining areas no longer in use. This is an aspect the Trust would have to negotiate with THC Dartford.
3.10 THC Dartford says it is prepared to accept some form of price reduction if the Trust stops using part of the hospital but THC Dartford notes that it will need to continue charging a good part of the current availability fee to ensure that it can cover its capital and interest payments to its bondholders. THC Dartford says it would only be prepared to accept some reduction to the availability payment if there was a corresponding relaxation in the standard the building has to be in when THC Dartford hands it back to the Trust at the end of the contract period. THC Dartford has also given an explicit undertaking to its bondholders that there will be no reduction to the availability payment if the size of the hospital is reduced.