14 Jul 2025
Dear Wes Streeting,
Open letter: No new private finance in our Neighbourhood Health Centres
In your new 10 Year Health Plan, you introduced a plan to include new private finance in our NHS. You have outlined your intention to ‘develop a business case for the use of Public Private Partnership (PPP) for Neighbourhood Health Centres’, with a final decision being made by the time of the Autumn budget.
We Own It represents the majority of people in this country who want a truly publicly owned NHS.
We absolutely oppose PPP – in all its forms – in our NHS.
PPP is a financial agreement which invites private companies to invest in public infrastructure for profit. PFI (Private Finance Initiative) is a type of PPP which is structured in a specific way: it uses debt and equity finance, and it involves public sector repayment in yearly instalments. We don’t know which form of financial agreement you intend to use for our NHS, and how much the private sector is expected to profit.
Because of their astronomical interest rates, previous PFI contracts have had disastrous consequences for the NHS, its workers and the patients it cares for. Research demonstrates that NHS trusts in England with current PFI debt will have paid back on average almost 8 times the PFI capital they received. Essex Partnership University NHS Foundation Trust is paying 27 times what was borrowed.
Your own 10 Year Plan acknowledges this shocking waste of public money, describing PFI as a ‘costly mistake’. The plan says you will ‘learn from previous experience’ but doesn’t say what these learnings are, let alone how they will be implemented.
The only lesson we can learn from PFI is to scrap private finance in our NHS.
We oppose Public Private Partnerships in all their forms because:
-
They are a rip-off for our NHS: PFI deals have cost almost £80 billion for just £13 billion of actual investment. Money which should be spent on saving our NHS is going into the pockets of private companies.
-
They are dangerous for patients: NHS infrastructure is crumbling because hospitals are repaying PFI debts instead of fixing urgent maintenance problems. Collapsing ceilings, sewage leaks and broken machinery became the new norm under PFI.
-
They are threatening patients’ medical care: under PFI, some NHS trusts are spending more than twice the amount on PFI debt as they do on drugs. For some trusts, PFI repayments take up to 13% of their income. This means that patients are not receiving vital healthcare.
As Health Secretary, we have some pressing questions for you about the threat of public finance in our NHS:
-
What will these new PPP contracts look like, and how will they be any different from the disaster of PFI?
-
Who is developing the business case for PPP in Neighbourhood Health Centres?
-
Which companies have expressed an interest in investing?
-
How are the public involved in the decision about PFI in our NHS?
In 2024, Labour promised in its manifesto that the NHS ‘will always be publicly owned and publicly funded’. We urge you to keep your promise, and ensure that private equity is not extracting profit at the cost of human life and health. Keep PPP out of Neighbourhood Health Centres.
Signed
We Own It
Share this page
