Brown starts shake-up of NHS build programme

Brown has already sounded the death knell for independent sector treatment centres (ISTCs), which are privately run but state funded. He has scrapped some schemes and put the programme on ice.

A scheme in the South, where Carillion was preferred bidder, has been axed and others are expected to be shelved. Carillion had been selected to deliver diagnostic facilities on about 35 sites in Kent and Medway, Surrey and Sussex, and the Thames Valley.

The treatment centres ranged in size from £5m to £30m; some were refurbishments and others were new build.

About 20 ISTCs, which were designed to cut waiting times by offering minor operations and services such as ultrasound and X-rays, have been built. The Department of Health considers them failures because they have not treated as many patients as planned when the government announced the programme in 2003.

Britain plc has done the big hospitals for 20-30 years and now they have to come down in scale

John Hicks, partner at Davis Langdon

The Comprehensive Spending Review in the autumn is expected to reveal the details of new health policies, but it is accepted that there is likely to be a decrease in large, acute hospitals and a shift to smaller community facilities.

John Hicks, a partner at Davis Langdon, said: “There will be some community hospitals that will be more like acute hospitals, bigger than normal, and some smaller that are more like super GP surgeries.

“Britain plc has done the big hospitals for the next 20-30 years; now they have to come down in scale,” he said.

The flow of work from the Department of Health’s Procure 21 framework has remained subdued, but the eight contractors on it have been told that it is expected to increase from September.