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Adams, F K (2004) The management of risks in international infrastructural projects, Unpublished PhD Thesis, Department of Business Studies, University of Edinburgh.
Ahiaga-Dagbui, D D (2014) Rethinking construction cost overruns: an artificial neural network approach to construction cost estimation, Unpublished PhD Thesis, School of Engineering, University of Edinburgh.
Al-Remal, A M (2013) Risk-based design of structures for fire, Unpublished PhD Thesis, , University of Edinburgh.
Alsedairy, F S (2019) Dynamics of mega infrastructure decision-making in Saudi Arabia, Unpublished PhD Thesis, School of Engineering, University of Edinburgh.
Baker, A J (2019) ‘Suitable and sufficient’? UK regulation of post-construction fire safety, Unpublished PhD Thesis, School of Social & Political Science, University of Edinburgh.
Baker, H (2021) A multimethod approach to learning from text-based construction failure data, Unpublished PhD Thesis, , University of Edinburgh.
Bartlett, A I (2018) Auto-extinction of engineered timber, Unpublished PhD Thesis, , University of Edinburgh.
Campbell, J M (2008) Safety hazard and risk identification and management in infrastructure management, Unpublished PhD Thesis, School of Engineering, University of Edinburgh.
Dunlop, P G (2005) Investigation, modelling and planning of stochastic concrete placing operations, Unpublished PhD Thesis, School of Engineering, University of Edinburgh.
Eid, M E M (2004) Rethinking relationships in the construction industry: integrating sustainable development into project management processes, Unpublished PhD Thesis, Department of Architecture, University of Edinburgh.
French, T R (2012) Evolutionary optimisation of network flow plans for emergency movement in the built environment, Unpublished PhD Thesis, , University of Edinburgh.
Furber, A (2013) The social and cultural context of rural water and sanitation projects: case studies from Ghana, Unpublished PhD Thesis, School of Engineering, University of Edinburgh.
Glendinning, M (1991) 'Give the people homes!': Britain's multi-storey housing drive, Unpublished PhD Thesis, Edinburgh College of Art, University of Edinburgh.
Graham, D (2005) Stochastic modelling and analysis of construction processes, Unpublished PhD Thesis, School of Engineering, University of Edinburgh.
Hashim, R (2018) Green innovation adoption in the construction sector : the role of absorptive capacity and the effect of environmental requirements, Unpublished PhD Thesis, Business School, University of Edinburgh.
Hellowell, M S (2012) Fair return for risk? An examination of structure, competition and profitability in the market for private finance in the National Health Service, Unpublished PhD Thesis, School of Social and Political Science, University of Edinburgh.
- Type: Thesis
- Keywords: capital investment; competitiveness; complexity; consortia; hospital; investment; markets; policy; private finance initiative; private sector; regulation; specifications; efficiency; sustainability
- ISBN/ISSN:
- URL: http://hdl.handle.net/1842/7895
- Abstract:
Since 1993, the Private Finance Initiative (PFI) has been the dominant form of large-scale infrastructure procurement used by National Health Service (NHS) organisations in the United Kingdom. As of April 2011, 123 PFI projects for new hospital facilities had been agreed between NHS organisations and private sector consortia, representing privately financed investment of £15.9 billion (in 2010 prices), and a projected long-term cost to the NHS of £70.5 billion. Eight additional hospital PFI schemes were being procured or prepared for tender as of April 2011, with an estimated capital investment value of £2 billion. Despite the financial significance of PFI projects to the NHS, the literature has not assessed whether, or the extent to which, the returns expected by investors are excessive. This gap in the evidence base is highly problematic. The presence of excess returns to investors will have an impact on the cost efficiency and affordability of PFI projects, and consequently the financial sustainability of the NHS organisations that pay for them. This thesis evaluates the returns that investors in NHS-commissioned PFI projects expect to earn with reference to the scale of risk being borne by these investors, and explores the sources of the identified excess via an examination of the structure and competitiveness of the PFI financing markets. The study therefore comprises two substantial empirical components. The first draws on the financial models of 11 NHS PFI projects to describe and evaluate the return to investors. Cost of capital benchmarks, constructed on the basis of the Capital Asset Pricing Model, are used as comparators to assess the Internal Rate of Return (IRR) for the 11 projects, and as discount rates to calculate Benefit-Cost Ratios. Both measures agree on the presence of significant excess returns for investors on each project – with large “spreads” between the IRRs and the corresponding cost of capital benchmarks, and high Benefit-Cost Ratio scores. The second empirical component provides an analysis of the structure and competitiveness of the market for private finance. Two indicators of this market’s structure – concentration and entry/exit rates – in addition to the dynamics of the procurement process are the focus of measurement and evaluation. It is demonstrated that: (a) the market for private finance in this sector is an oligopoly, (b) market share is highly concentrated when assessed against UK regulatory standards, and (c) churn and market penetration rates are extremely low. Constraints on the competitiveness of the market are identified as: (i) the low number of bidders; and (ii) the extensive period of non-competitive bidding in the final phase of the procurement process, in which the output specifications of projects are materially altered. The thesis concludes that recent reforms to the procurement process have been ineffective, and the problems underpinning a lack of competitive pressure in procurement may be insuperable, given the inherent complexity of this form of investment and the need to secure external financing. For the NHS, this source of cost inefficiency implies substantial opportunity costs (i.e. foregone opportunities for additional capital investment) and excess costs (i.e. a higher than necessary burden on the revenue budget). A stronger regulatory regime, incorporating regulation of the profitability of PFI projects for investors, is required to minimise the threat posed by this policy to the financial sustainability of the NHS.
Hsiao, C C (2000) Constructing a sustainable impact assessment methodology : an evaluation of Taiwanese EIA of high-rise building, Unpublished PhD Thesis, College of Art, University of Edinburgh.
Jackson, D J (2020) Addressing the challenges of reducing greenhouse gas emissions in the construction industry: a multi-perspective approach, Unpublished PhD Thesis, Business School, University of Edinburgh.
Jiménez-Moreno, P (2020) Mass customisation for zero energy housing: the potential of Japanese manufacturing practices in the context of sustainable housebuilding in the United Kingdom, Unpublished PhD Thesis, , University of Edinburgh.
Kanellopoulos, G (2022) External fire spread from timber lined compartments, Unpublished PhD Thesis, , University of Edinburgh.
Kim, S (1998) Sustainable building practices: minimising the life-cycle environmental impact of high-rise apartments in Korea, Unpublished PhD Thesis, Department of Architecture, University of Edinburgh.
Knebel, V (2006) Preserve and rebuild: the built environment, status transformations and identity construction in eastern Germany after reunification, Unpublished PhD Thesis, Department of Sociology, University of Edinburgh.
Koutsomarkos, V (2023) Developing a fire robustness index for the built environment, Unpublished PhD Thesis, , University of Edinburgh.
Marquardt, G (2017) Economic analysis of contract choice, feelings of entitlement and contract enforcement in relationships governed by incomplete contracts, Unpublished PhD Thesis, School of Economics, University of Edinburgh.
McArthur, J (2023) Enrolment, technical mediation, and the obligatory passage point: a socio-technical examination of the Canada Green Building Council, Unpublished PhD Thesis, , University of Edinburgh.
McMeel, D (2009) The artistry of construction: an investigation into construction as a creative process and the influence of mobile phones within domestic scale construction projects, Unpublished PhD Thesis, Department of Architecture, University of Edinburgh.
Oliver, A K (2020) Perceptions of sustainability and their influence in the design and delivery of Scottish housing, Unpublished PhD Thesis, School of Engineering, University of Edinburgh.
Oswald, D (2016) Investigating unsafe acts on a large multinational construction project, Unpublished PhD Thesis, School of Engineering, University of Edinburgh.
Raman, P G (1977) Information and architectural design: A study of certain theoretical aspects, Unpublished PhD Thesis, , University of Edinburgh.
Rodger, R G (1976) Scottish urban housebuilding, 1870-1914, Unpublished PhD Thesis, , University of Edinburgh.
Ronzani, M (2019) Designing for complexity: Data visualizations in megaproject management, Unpublished PhD Thesis, , University of Edinburgh.
Saoud, E A B (1996) Expert systems for management training in the construction industry, Unpublished PhD Thesis, Department of Civil and Environmental Engineering, University of Edinburgh.
Sidwell, N C (1957) A critical examination of new constructional techniques and their influence on productivity in the building industry with special reference to housing in south-east Scotland, Unpublished PhD Thesis, School of Engineering, University of Edinburgh.
Smith, S D (1994) Production estimation of earthmoving operations using a discrete-event simulation model, Unpublished PhD Thesis, Civil Engineering, University of Edinburgh.
Yang, S-A (1995) Kics: Representation of regulatory information and the use of case-based reasoning to support the relaxation process, Unpublished PhD Thesis, , University of Edinburgh.