Sir: MC Fitzpatrick (letter, 22 September ) makes clear that the Private Finance Initiative is a much more expensive way of providing new hospitals. It will also build in permanent conflict between a company whose priority is the highest rate of return for its shareholders, and the hospitals' professional staff still employed by the NHS, whose priority is the care of patients.
If surgeons have a need to operate at night, the company can veto this on the grounds that it cannot afford overtime payments for theatre cleaners and porters. Hospital staff already complain of feeling overstressed and undervalued. They do not need the extra burden of conflict with a private company.
Dr M I HEATLEY MRCPsych