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Think tank accuses PFI of 'off-the-shelf 'hospital design

Decisions on hospital design should be removed from local NHS trusts' authority and handed to a specialist group of professionals led by a figure such as Lord Rogers, an influential health care think tank said last week.

In a report which attacked the lack of innovation in the design of hospitals paid for by the private finance initiative (PFI), the King's Fund called for architectural competitions for all new hospitals.

'World-level expertise needs to be brought in because architects are growing quite frustrated with this situation, ' the report's co-author Anthony Harrison said. 'They feel as if they are building cut-price hospitals. Early PFI schemes have taken off-the-shelf designs and have simply failed to rethink hospitals' design needs. '

Harrison said health chiefs and their private-sector backers are reluctant to take the financial risks that are associated with producing better- designed and innovative hospital buildings, despite the fact that £1. 4 billion has already been pledged to building hospitals through PFI contracts.

'Hospital building has been happening in the dark, 'he said. 'Hospitals should not be planned in isolation from other health services and plans for new hospitals should be opened up to design competitions, to bring new ideas for the way hospitals are built, making them more responsive to patients' needs. Medical directors and NHS trust chief executives have very little expertise of this. '

The report coincides with a Construction Industry Council paper, The role of cost saving and innovation in PFI projects, which concludes that more competitions will stimulate innovation. It calls for more time at the early stages of PFI projects to develop innovative proposals.

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