Building new hospitals could turn out to be both wasteful and inappropriate

Anthony Harrison, Kings Fund

He said plans for new hospitals should be opened up to design competitions, to bring in new ideas for the way hospitals are built, making them more responsive to patients' needs.

He added that new developments should be commissioned regionally and not by individual NHS trusts, as at present, to ensure they meet the needs of the local community.

"Building new hospitals, under 30-year binding contracts with private companies, without also planning community services, could turn out to be both wasteful and inappropriate," Mr Harrison said.

The government has approved the development of 34 hospitals through PFI since coming to power in 1997.

Ministers say it is the only way to fund the construction of new facilities but the policy has been criticised by doctors and some politicians.

PFI will pay for a government pledge to create 7,000 extra hospital beds and 100 new hospital schemes over the next 10 years.

Sonia Mills is chief executive of the Swindon and Marlborough NHS Trust which is replacing the Princess Margaret Hospital in Swindon with a new building at a cost of �150 million, under the PFI.

She told the BBC that she had been involved in two PFI projects, and in both cases the health authority and the local primary care groups were involved in the early stages of planning.

"Planning needs to be driven locally," she said.