The ‘make do and mend’ health service: Solving the NHS’ capital crisis

Article

The NHS has had historically low levels of capital investment. Compared to similarly advanced economies, this country’s capital investment has been very low. On average, a person living in the UK has missed out on almost £2,000 since 1975 – the equivalent of over £100 billion overall.

Though they were bad deals, private finance initiatives (PFI) were the only mechanism that brought enough capital into the health system. However, PFI specifically has turned out to be a bad deal – and will eventually cost almost £80 billion for just £13 billion of assets. This report reveals that £55 billion of this debt is still outstanding – representing a huge burden on tight NHS resources if the government does not take action.

This report recommends a new settlement to fund capital and support transformation totalling £5.6 billion per year – an 80 per cent uplift. The PFI legacy must also be urgently addressed, through a ‘right to enfranchisement’ for the NHS, which would bring those that represent bad deals back into public ownership.

Related items

  1. A young woman with a long ponytail sits looking out of a bus window

    State of the North 2025 - The kids aren't alright: How to deliver for young people in the North

    This year’s State of the North report highlights how regional inequality exacerbates the growing challenges facing many young northerners. 
  2. An illustration of an ideal public transport system: a smiling family cross a road near a green bus with houses and trees in the background

    The transport challenge for low-income households

    Many people living on low incomes in the UK are limited in their ability to access the building blocks of a good life because of poor transport provision.

  3. Towards universal opportunity for young people

    Outlining a vision for young people which could increase social mobility while also reducing inequality and disadvantage, so that every young person has the opportunity to build a decent life.