The PFI Multiplier
What NHS trusts borrowed vs what they will repay — selected schemes
Original capital cost
Total repayment obligation
Essex Partnership
Mental health facility
£40m
£1.1bn total repayment
27x
Norfolk & Norwich
University Hospital
£150m
£2.2bn total repayment
14.7x
Barts Health
Royal London / Whipps Cross
£149m/yr unitary charge
£1.1bn
£5.2bn projected total
4.7x
Coventry & Warks
University Hospital
Now in administration
£379m
Est. £3.8bn total
~10x
South Tees
James Cook University Hospital
£76.2m/yr unitary charge
£165m
Est. £1.98bn total
12x
Cumberland Infirmary
First voluntary termination
March 2026
£68m
£547m paid (terminated)
8x
£136bn
Remaining obligations
162
NHS PFI schemes
25+
Trusts: PFI > drugs spend
0.47%
Effective tax rate on fund profits

Between 2000 and 2016, 2,130 PFI equity transactions totalling £17.1 billion achieved average annual returns of 28.7% — more than double what the business cases projected. 100% routed through Jersey, Guernsey, or Luxembourg.

Sources: IPA PFI/PF2 Projects Summary Data (March 2024) · NHS Trust Annual Accounts · HM Treasury PFI Spreadsheet
ESSU Research Report No. 8 (Whitfield, October 2016) · Companies House SPV Filings · CHPI (December 2024)