Editing Private finance initiative (section)

===Employment===
When spending is tight, hospitals may prefer to retain medical staff and services by spending less on building maintenance. But under PFI, hospitals are forced to prioritise the contractual payments for their buildings over jobs and, according to figures published by the [[Department of Health]], these committed payments can account for up to 20% of operating budget.<ref name="Timmins 2011"/><ref name='Spending Squeeze'/> Nigel Edwards, head of policy for the [[NHS Confederation]], noted that:

{{blockquote|"A hospital with a PFI scheme [is] contractually bound to keep the maintenance up – and if you are spending 10 or 15 per cent on your buildings it means all the other efficiency and productivity gains you need have to come out of only 85 or 90 per cent of your budget."<ref name='Spending Squeeze'>{{Cite news
  | last = Timmins
  | first = Nicholas
  | title = Spending Squeeze To Hurt Hospitals The Most
  | newspaper = Financial Times
  | location = London
  | date = 23 January 2010}}</ref>}}

Dr Jonathan Fielden, chair of the [[British Medical Association]]'s consultants' committee has said that as a result of the high costs of a PFI scheme in Coventry "they are potentially reducing jobs".<ref name="phpc"/> In fact by 2005 the hospital trust in Coventry was anticipating a deficit of £13m due to PFI and "drastic measures" were required to plug the gap including shutting one ward, removing eight beds from another, shortening the opening hours of the Surgical Assessment Unit, and the "rationalisation of certain posts" – which meant cutting 116 jobs.<ref name="gfme"/>

Under PFI, many staff have their employment contracts automatically transferred to the private sector, using a process known as [[TUPE]]. In many cases this results in worse terms of employment and pension rights. Heather Wakefield, [[UNISON]]'s national secretary for local government, has said:

{{blockquote|Local authorities and health authorities have very good final-salary pension schemes. We have surveyed contractors in 'best value' [contracting out] deals. At only one company in the past three years was any pension provided. And that is the pattern [in transfers] across the public sector – not just in local government, and not just 'best value'. It happens in PFI too. TUPE does not apply to pensions. The Government is supposed to have revised TUPE, integrating the Acquired Rights [[Council Directive|Directive]] from the [[European Union|EU]]. That has not happened.<ref>
{{Citation
  | last1 = Morgan | first1 = Oliver
  | last2 = Mathiason | first2 = Nick
  | title = Public-private discord: Taxpayers will foot the bill if the City has got its sums wrong on PFI
  | newspaper = The Observer
  | date = 6 October 2006
  | url = https://www.theguardian.com/business/2002/oct/06/publicservices.publicservices
  | location=London}}
</ref>}}