The 拢422m, 35-year University College London Hospital contract will have to be renegotiated within 10 years, according the project鈥檚 client. The admission puts a question mark over the use of the PFI in health projects in its present form

Peter Dixon, the chairman of UCLH Trust, told 黑洞社区 in an interview this week that developments in medical technology and treatment would mean that design and construction changes would be required within 10 years.

Dixon said the private sector鈥檚 need to control risk meant that PFI deals had 鈥渁 very rigid framework鈥�. Any changes to that framework would have to be agreed with the consortium, and would probably require lengthy renegotiation.

He said: 鈥淚 worry about potential inflexibility going forward. In 10 years鈥� time we know that we are going to want to change parts of the hospital. We鈥檒l have to negotiate a new contract after 10 years. PFI is very specific, very structured over 35 years.鈥�

UCLH has been dogged by criticism, much of it aimed at what architecture watchdog CABE complained was an outdated design. But it has also regularly been used in the media as an example of all that is wrong with PFI projects.

PFI defenders claim that the procurement route is the only way to guarantee that hospitals get built, but Dixon鈥檚 comments are likely to bolster the case for a rethink of the way the PFI operates.

Dixon conceded that it was unclear how costly PFI contracts would be in the long term, but defended their use. He said: 鈥淭he jury鈥檚 out on whether or not it is expensive, but the PFI is the only game in town.鈥�

In the mid-1990s, Dixon publicly criticised the use of the PFI in health, but said that his views had moderated as more projects reached financial close. He said: 鈥淏ack in 1997, nobody signed schemes 鈥� millions of pounds were being spent on lawyers.鈥�

Dixon said one alternative procurement route could be to adopt a housing association model, whereby banks lent the trust money against their fixed assets and operational income. This would give trusts more control over hospital schemes.

He said: 鈥淗ousing associations have borrowed about 拢30bn and no bank has ever lost money. Trusts would not have a 30 or 35-year timeframe during which they could not change things."

One PFI contractor said renegotiations would most likely centre on changes to space requirements and to the facility management part of the scheme. The contractor said renegotiations for a scheme the size of UCLH were 鈥減retty much inevitable鈥�.