Evaluating the Private Finance Initiative in the National Health Service in the UK

Abstract

This paper seeks to develop a system of how to judge the merit and worth of Private Finance Initiative (PFI) projects in the UK National Health Service (NHS) once they are operational. This concern is couched in relation to whether PFI can be seen to provide long‐term “value for money” (VFM) using a broad definition of this term. This paper does not attempt to further the debate that has focussed on the broader macro economic VFM arguments; rather, the focus is upon developing a model for evaluation at the organisational level where there is a paucity of direction and clarity. Whilst there are many VFM criteria available to guide whether PFI in the NHS should be pursued at the pre‐decision stage, there is little in the way of post‐project evaluation systems to judge VFM once decisions have been taken. Little thought has been given to the design of these post‐project evaluation systems let alone the experiences of how such systems may operate. This paper is addressing these lacunae but only in the sense of suggesting a design for a system for post‐project evaluation. This is drawn from PFI pre‐decision processes, post‐project intentions of some PFI schemes and evaluation theory. It is not about the judgements that come from the use of such a framework which the paper conclude will take some time to be forthcoming.