THE decision as to whether to build a new Malvern Community Hospital is to be made next spring and an outline business case put to the board.

The House of Commons Health Select Committee is investigating the disadvantages, risks and track record of PFI borrowing for hospitals and has looked at the adverse experiences of other countries using a similar model.

It has found that for-profit hospitals have higher admin costs and spend proportionately less on nursing. Smaller replacement hospitals are much more expensive relative to larger hospitals.

Since all PFI-built hospitals so far have reduced bed capacity and staff levels to keep costs down one does wonder what kind of replacement service there might be in Malvern?

The new WRI experienced cost overrun by 188 per cent during negotiations from £49m to £108m. 219 beds at Kidderminster were closed to release £7.2m to pay for the new hospital.

Worcester residents will have inpatient acute capacity one third of the English average. Plans show that it will have 32 per cent fewer ancillary staff and 17 per cent fewer nursing.

One does wonder as well what might be commercially attractive to the blue-chip company showing an interest through a third party in building a Nursing Home in Malvern while local ones are closing down?

Might it hope to mop up some business from the Government's recent guidelines on NHS-funded Intermediate Care to last only six weeks? And thereafter user charges, means testing or private insurance?

The Select Committee concludes that there ought to be a complete separation of the NHS from the private sector and a halt to the effective ring fencing of NHS funds for long term mortgage commitments to private healthcare lenders. Will New Labour listen or is it blinkered by ideology?

WENDY HANDS, Church Walk, Upton-upon-Severn.