A CONTRACT which costs the NHS £60 million a year has once again come under fire after it emerged that health bosses have only been able to impose fines of less than £30 per day when a PFI firm’s blunders left operating theatres out of action.
Patients saw operations cancelled last year when flies were found in the sterile operating suites and Consort, the company that built and runs the ERI on behalf of NHS Lothian and has responsibility for the building’s maintenance, was blamed.
The PFI firm was told penalties for causing the unavailability of the theatres last summer would be imposed as the health board considered the infestation, believed to have been caused when a pigeon accessed internal hospital areas and died, to be avoidable and prolonged.
But it then emerged that under the terms of the PFI contract, which was agreed in 1998 and is widely viewed as one of the most disastrous agreements of its kind ever signed, Consort would be liable to pay just £28.24 per day when it caused an operating theatre to close for four hours or more.
The revelations come after hundreds of emails between NHS Lothian, Consort and its partner Balfour Beatty around the issue of pest control at the Royal Infirmary were revealed for the first time.
Gordon Beurskens, who obtained the documents under Environmental Information Regulation laws on behalf of the Action to Save St John’s Hospital Party, said: “£28 is a pathetic figure. It won’t buy much theatre time from Consort, or the private sector where delayed patients might end up. If PFI was properly scrutinised, many of these absurd deals wouldn’t have been signed in the first place.”
NHS Lothian is now taking other measures to recoup cash by attempting to reduce the PFI firm’s rating of 98.668 per cent, which it awarded itself in November, meaning performance-related payments would fall.
The rating could be slashed by more than 10 per cent, which would mean NHS Lothian would be paid back up to £40,000, while a further £188,000 could be held and retained if the ongoing situation with flies is not resolved.
NHS Lothian has said the rating should be cut as netting and mesh put up to detract birds covered up faults in the ERI’s construction which allowed them to access internal areas. It has also said no significant repair work took place until November – five months after the original incident – and that roofing above operating theatres was not watertight.
It is understood that NHS Lothian expects to recoup a significant sum – but almost a year after two theatres were closed for a combined 11 days, a deal has not yet been hammered out.
Theatres were also shut in August and November after isolated flies were found in theatres, causing an infection risk and requiring deep cleans to be carried out.
Scottish Conservative health spokesman Jackson Carlaw said: “The fact operations had to be cancelled because of a pigeon infestation is humiliating enough. Now Consort’s refusal to take any kind of credible blame for the incident, and the toothlessness of the contract meaning the health board isn’t holding any aces, is making that even more stark.”
Flies and pigeons accessing the ERI are only the latest scandal to hit Consort.
A year ago, a patient was operated on by torchlight after the firm cut power to an operating theatre and previous issues have emerged with hospital cleanliness, staff criminal background checks and alarm systems. NHS Lothian bosses have privately expressed exasperation with their PFI partners, who they are tied to under a long-term deal that will not see the health board automatically take ownership of the hospital once it expires. By 2028, NHS Lothian will have handed over £1.26 billion.
But George Curley, director of operations in facilities, said working relationships had improved over the past 12 months and insisted NHS Lothian is currently happy with Consort’s performance.
He said: “This is a self-monitoring contract and Consort monitor their performance, however this is reinforced by our own internal checks. In this specific instance we felt that their application of the contract did not reflect our position on the matter.
“We are close to reaching an agreement with Consort around this issue. NHS Lothian believes this to be a fair and reasonable offer.”
No-one from Consort was available to comment.
List of unwelcome guests
In the e-mails, a series of concerning pest discoveries at the ERI are revealed.
As recently as February, a fly was found in a windowless room near operating theatres, causing a senior critical care boss to express serious concerns and ask why photographic evidence that work had been carried out had not been provided.
Pupae were found in a sterile storage room in December after ceiling screening was found not intact. Other incidents include “thousands” of flies seen above an assessment unit in August, beetles on a theatre windowsill and pigeons heard in a roof void. Some have blamed flies on windows left open,
but others maintain building fabric is to blame.