File on 4 Investigates Folgen

Over the last month Britain's biggest provider of care homes for the elderly, Southern Cross, has been beset by financial woes. But across the country an even deeper crisis is unfolding as local authorities implement massive budget cuts.This week File on 4 investigates how cutbacks are leaving elderly people with insufficient care, and councils with a major financial headache.The programme also hears from small care home providers who say they are being forced out of business because the fees local authorities now pay them are too low.And with the report from a Government commission due in a few days, the programme asks whether the gap in funding for the care of elderly people can be closed.. Reporter: Fran Abrams Producer: Gail Champion.

A review into the care of patients in vegetative or low awareness states has been launched by the Royal College of Physicians. There are thought to be as many as 5000 such people in the UK. The working party will look at concerns that assessment and diagnosis of patients is not consistent across the country and will ask whether the cost of long term care is affordable to the NHS. Ann Alexander examines calls for a reform of the process to end the life of such patients where their families believe their loved one would no longer wish to be alive. The programme reveals how some hospitals appear unaware of the law and hears how the process can be lengthy and costly, putting families under further strain. Producer: Paul Grant.

For two decades, the Private Finance Initiative has been a controversial way of building new hospitals, schools, roads and prisons. Well over £200bn of taxpayers' money has been committed to the companies managing these projects. The coalition government describes some PFI contracts as 'ghastly' and wants some of this cash back. One cabinet minister says 'the people on the other side must have been laughing all the way to the bank'. But, while public services are facing cuts, PFI payments are guaranteed under watertight contracts. So experts say the government can win only small amounts in rebates. Much of the money has already gone offshore. Huge profits have been made by selling and reselling many contracts in a secretive 'secondary market' - with none of the proceeds returning to the taxpayer. Gerry Northam investigates gaps in HM Treasury's knowledge of this trade and asks if PFI represents value for public money. Producer: Rob Cave.