True costs of healthcare

Nick Cohen ("How a hospital woke up democracy", 19 March) refers to the Edinburgh Royal Infirmary. He suggests that the cost to the taxpayer of what will, on completion, be one of, if not the most modern teaching hospital in Europe, will be £900m over 30 years under a PFI contract. He contrasts this with the £180m cost if the government had paid for it directly. He is not comparing like with like. The £900m (the true figure is actually somewhat less) covers the debt repayment and life-cycle maintenance, plus the cost of ancillary services (eg, security, cleaning, catering, grounds maintenance). The £180m covers purely the capital cost of building the facility. It is unfortunate that Cohen's research did not include the "Full Business Case" for the new Royal Infirmary, which has been in the public domain for more than two years. This demonstrates the sound value of investing in a new hospital building to provide excellent healthcare services for people in south-east Scotland into the 21st century.

Trevor Jones
Chief executive, NHS Scotland

This article first appeared in Duel for the Tube

2001-04-09