THE NHS has admitted that it lacks the skill to choose contractors for PFI hospitals and conceded that the process is hopelessly slow.
The admission was made in a 'warts and all' report from the NHS Confederation, which represents 90 per cent of NHS organisations.
It ref lects comments made this summer by 15 anonymous senior managers from 13 NHS trusts involved in PFI schemes.
The report said the NHS has benefited from PFI but there were major problems with the initiative.
Worries included the NHS's lack of PFI knowledge, doubts over how PFI can cope with changing NHS funding, poor design innovation, a lack of market interest in refurbishment and the major problem of slow procurement.
Sylvia Wyatt, the report's manager, said: 'We fear that there is a very real risk that private contractors could walk away from both individual PFI schemes and from major PFI healthcare developments as a whole unless the current PFI process is streamlined to reduce the cost both financially and in terms of time.
'We believe there is scope for cutting both the number of reviews and approvals that are part of the current PFI process.
'For example, there could be an agreed list of contractors for schemes nationally, which would eliminate the need for the prequalification questionnaire stage of PFI.' The report also recommended that the Department of Health creates a core negotiating team and training scheme so that NHS trusts are closer to contractors in their knowledge of PFI.
Another suggestion was design competitions to increase innovation.
Stephen Ratcliffe, director of the Major Contractors Group, said: 'This report is music to our ears.
Contractors have long been arguing that PFI is delivering but the procurement process is tied up in red tape, which makes it too costly and prone to delays.
'The MCG's own survey of contractors carried out earlier this year came to the same conclusion. There is clearly a need for a more efficient process and to ensure greater PFI procurement expertise in the public sector.' Mr Ratcliffe said he would refer the report's findings to Lord Warner, the minister for NHS delivery.