ANY CONTRACTOR sitting down this week to read the 'warts and all' survey of at titudes to hospital PFI projects among senior NHS trust managers could be forgiven for feeling a little uneasy.
It seems everybody is ready to criticise PFI, while conveniently forgetting that at least there is a hospital building programme worth arguing about.
Would we really have 24 major new hospitals and a dozen or so under construction if it was attempted any other way?
The image problem arises from the fact that all too often public debate about PFI is locked in political and ideological dogma rather than a fair assessment of the actual impact of the process.
Hopefully all this will change in light of the latest survey of senior trust staff, which amounts to a ringing endorsement of the use of PFI to the benefit of the NHS.
If there is a complaint, it is that choosing a contractor is too bureaucratic and too expensive.
At the same time senior NHS trust staff recognise that their own lack of project expertise is hampering progress.
These findings will spread broad smiles across the faces of contractors, who have argued as much for the past two years.
In response to the findings, the inf luential NHS Confederation, which conducted the survey, has called for a centralised approach to training key personnel involved in delivery. The group also wants to strip away the number of approvals and reviews needed in the procurement process with the introduction of an approved list of contractors for big schemes.
As far as contractors are concerned this is just what the doctor ordered.
It is clear to everybody concerned that the Private Finance Initiative has delivered in the hospital sector.
It is also fair to say there are still real concerns about the quality of hospital design and whether there is sufficient flexibility to meet future unforeseen demand in public healthcare.
What is abundantly clear, at least to contractors and NHS trusts, is that the time has come to update the whole hospital PFI process.
Unusually this is a united message, derived from real experience. And it is one that the mandar ins at the Depar tment of Health cannot afford to ignore.