London, November 21, 2025
Labour MPs, academics, campaigners, and patients have united to urge Chancellor Rachel Reeves to abandon plans to fund new NHS buildings through private finance initiatives (PFIs) or public-private partnerships (PPPs) ahead of the UK Autumn Budget scheduled for November 26, 2025. They warn that reviving these schemes risks repeating past financial failures that have heavily burdened the NHS.
Labour MPs and Campaigners Demand Reversal of Private Finance Plans
Senior Labour MPs including Simon Opher, Richard Burgon, and Steve Witherden have joined forces with over 53 accounting and finance academics, patient groups, and campaign organizations like We Own It to pressure the Chancellor to halt any move toward PFIs or PPPs for funding neighbourhood health centres. Their call is reinforced by a petition signed by more than 17,000 supporters, submitted directly to Chancellor Reeves.
Concerns Over Historical PFI Failures and NHS Debt Burden
Critics emphasize that PFIs, initially introduced in 1992 and expanded under Tony Blair, have resulted in significant long-term costs to the NHS. Taxpayers have reportedly paid around £80 billion under PFI contracts for assets worth just £13 billion, with some NHS trusts repaying multiples—one trust repaid 27 times its original debt. This financial strain has forced difficult choices within trusts, such as balancing debt repayments against spending on medicines and frontline care.
Background: Private Finance Initiatives and Their Cost to the NHS
PFIs involve the government contracting private firms to build and maintain NHS infrastructure, with repayments stretching over decades. As of April 2024, PFI-related NHS debt across the UK stands at approximately £306 billion. Despite Labour’s announcement of a 10-Year Health Plan that includes substantial cash investments and proposes PPPs for neighbourhood health centres, opposition voices describe revisiting private finance as risking another “disaster” for NHS finances.
Labour Government’s Policy Context and Budget Implications
The current Labour government reports a yearly 3% real-terms increase in funding for NHS services, highlighting record investment in day-to-day operations. However, the ongoing consideration of private finance models for capital projects remains controversial within the party and among its supporters. The Autumn Budget, due November 26, 2025, is expected to clarify the government’s position on this contentious issue.
Campaign and Academic Opposition
Academic experts in finance and accounting have publicly criticized the private finance plans, likening such borrowing to families resorting to payday loans, a comparison underscoring fears about the sustainability and appropriateness of these funding models for public health infrastructure. Campaign groups and Labour MPs aim to prevent repeating the decades-long financial challenges caused by PFIs, which detracted vital resources from frontline NHS care.
Chancellor Rachel Reeves’ Response and Budget Priorities
Chancellor Reeves has indicated that this budget will prioritize tackling the cost of living, reducing NHS waiting lists, and lowering national debt levels. Yet, she has not definitively ruled out the use of PPPs or new PFI schemes in NHS infrastructure funding, maintaining a cautious stance amid mounting pressure from across Labour and civil society.
As the UK government prepares to announce its financial strategy in the upcoming budget, the debate over private finance for NHS buildings remains at the forefront. The decision will have lasting implications not only for NHS debt management but also for public trust and the allocation of resources in the country’s health system.