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"This article outlines and critiques the main fiscal and economic rationales for the Private Finance Initiative and examines the impact of the policy on the long-term financial viability of NHS trusts. It concludes that the PFI funding of capital investment is highly problematic. Its high costs...
Italy's health service—the Servizio Sanitario Nazionale (SSN)—has developed Europe's second largest market for healthcare public--private partnerships. This article describes the origins of private finance for SSN infrastructure, examines the programme's scale and key characteristics, and...
Leasing allows organizations to procure fixed assets without the need for upfront investment, and can be an attractive option for public authorities. This article describes the pattern of public sector demand for leases in Italy. While leasing is widely regarded as a model with the potential to...
There is a growing need for investments in hospital facilities to improve the efficiency and quality of health services. In recent years, publicly financed hospital organisations in many countries have utilised private finance arrangements, variously called private finance initiatives (PFIs),...
<title>Abstract</title> The return on capital is a major contributor to the cost of design, build, finance and operate (DBFO) contracts, under which public infrastructure is financed and delivered by private companies. The article presents a method for evaluating the rates of return targeted by bidders and...
<title/> The public expenditure implications of PFI projects in Scotland's NHS are substantial. This article compares PFI capital expenditure with projected unitary charges, examines the annual cost of existing PFI schemes and looks at future costs arising from the planned expansion of PFI. Unless the...
This paper is concerned with the cost-efficiency of Private Finance Initiatives (PFIs) in the delivery of hospital facilities in the UK. We outline a methodology for identifying the “fair” return on equity, based on the Weighted Average Cost of Capital (WACC) of each investor. We apply this...