How private companies made £831 million building NHS hospitals, in 7 charts

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Getty Images/Christopher Furlong

LONDON – Private companies that build NHS hospitals have generated £831 million in pre-tax profit over the last six years, according to a new report by the Centre for Health and the Public Interest.

Under the Private Finance Initiative scheme, companies take on the initial cost of building hospitals in return for annual repayments, with interest, over a contracted length of time, typically between 25-30 years.

Repayments made by NHS Trusts and local authorities are on average seven times the actual cost of building the hospitals – although in three cases repayments total 20 times the initial cost.

Last year, the emergency closure of 17 PFI-funded schools in Scotland prompted MP Steven Paterson to call for a debate on what he called the “great PFI swindle.”

The CHPI’s analysis is based on the Treasury’s 2015 database of 125 NHS PFI projects, and accounts of private PFI companies held by Companies House. An updated Treasury database, however, lists an additional two NHS projects, which has added £850 million to authorities’ debts.

According to the CHPI, eight companies have equity stakes in 92% of the 125 schemes, prompting questions about how competitive the tendering process is. This is despite the fact that PFI reforms in 2012 recommended that the government “act as a minority equity co-investor in future projects.”

According to Treasury data, IUK Investments appears to be the only government-owned company with a stake in any healthcare PFI project, although this is only a 10% stake in a single project.

The critical report recommends using public sector loans to buy out PFI contracts, and capping the amount of profit private companies can make from NHS projects.

“Of the 125 PFI contracts reviewed in this report, 118 were negotiated by the last labour government, which saddled the NHS with a crippling £80 billion of debt and costs our hospitals nearly £2billion a year to service,” said Minister of State at the Department of Health, Philip Dunne MP.

“This government has refused to sign up the NHS and taxpayers to such appalling deals like Labour did, and has instead committed to increase the NHS budget by at least £8 billion per annum in this parliament.”

Keep scrolling for a summary of the data, in seven charts:


The 2015 database shows 125 PFI contracts between NHS Trusts and private companies. These buildings have a combined capital value of £12.4 billion, but repayments will total £80.8 billion. To date, fewer than half of these repayments have been made.

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Data from Treasury / CHPI

Between 2010 and 2015, the NHS and local authorities have spent £10.7 billion on PFI hospitals and healthcare facilities, from which private companies have made £831 million in pre-tax profits. This is about 8% of the money paid, money which has not been available for patient care.

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Data from CHPI

Between 2010 – 2015, the deficit across all NHS hospitals was roughly £3.4 billion. If the NHS had not been paying pre-tax profits on the projects, this underfunding would have been reduced by almost a quarter.

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Data from Treasury / CHPI

Between 2015 – 2020/21, the government will give an additional £4.5 billion to the Department of Health, in real terms.

According to the CHPI’s estimations, if PFI companies continue to generate profit at the same rate as in 2015 over these years, they will earn approximately £973 million before tax – or 22% of the new money set aside for the NHS.


Case study: Health Management (UCLH) Ltd., which runs London’s University College Hospital (UCH), made £139.7 million in pre-tax profits between 2010 and 2015 alone. Between 2005 – 2015 the NHS Trust responsible for UCH paid £724.8 million for it, out of which Health Management made £190.4 million. The capital value of the hospital according to the Treasury is £292 million.

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Data from Treasury / CHPI

The three most expensive projects are, i) a group redevelopment of three Manchester hospitals, ii) a District General Hospital in Walsgrave and iii) an ‘acute site rationalisation’ of Barts Hospital, in London. Total repayments for these three projects alone will total £14.2 billion, although their combined capital value is only £2 billion.

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Data from Treasury

Barts’ payments alone are expected to peak at a whopping £284 million in 2047-48.

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Data from Treasury

Since the CHPI’s analysis, two additional projects have been added to the existing 125. They have a combined capital value of £556 million, and combined total repayments are expected to be £850.6 million. Here’s a chart of the total repayments that will be made for all 127 projects, which are predicted to peak in 2029/30 at £2.7 billion.

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Data from Treasury



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