There’s much resting on the outcome of the U.K. General Election on June 8. While much attention has been paid to Brexit (most of which is speculative, since few hands have been revealed), there is plenty resting on the domestic front. One area that is of great concern to the British populace is healthcare and the cherished free-at-the-point-of-need National Health Service (NHS). In most opinion polls, the NHS is something that’s typically seen to be safer in the hands of the Labour Party (which founded the NHS in 1948) than the Conservative Party (which has, when in power since 1979, steadily introduced market-style reforms).
In March 2017 the Naylor Review was published (full title “NHS Property and Estates: Why the estate matters for patients”). This is a 42-page “independent report” that sets out recommendations on how the Government can fund NHS reforms. At first glance the report looks very dry and the executive summary reveals three key recommendations that, as simple statements, appear relatively innocuous:
The establishment of a new NHS Property Board;
The development of Sustainability and Transformation Plans to encourage and incentivise local action;
Substantial work on capital investment plans for funding.
However, what these recommendations mean is the selling land the NHS may no longer need and disposing of buildings (whether in use or not) that are expensive to maintain.
The report was written by Sir Robert Naylor ( formerly the Chief Executive of University College London Hospitals (UCLH) NHS Foundation Trust). Conservative Health Secretary Jeremy Hunt asked Naylor to look independently at what should be done with so-defined “surplus” NHS property, which Mr. Hunt alludes is only in the form of crumbling old buildings.
The key argument within the report, as discussed by The King’s Fund (which is broadly in support of the report), is that land occupied by disused services should be sold to fund reforms known as sustainability and transformation plans (STPs). However, putting the points made into context, the report suggests that to do so could involve ward closures and thus cuts in hospital bed numbers. Naylor proposes to give all ‘property capabilities’ to NHS Property Services Ltd. The report goes onto state “and other fragmented NHS property capabilities into a single organization.” This means one big estate agent.
Some independent reports disappear; others become popular soundbites from certain politicians, but do not make it onto statute to become bills and later parliamentary acts. The Naylor Report might be different and avoid slipping into obscurity. As part of the election campaign, Conservative Party leader Theresa May was recently interviewed on a BBC television show (as The Independent reports). When the interviewer (former Sunday Times editor Andre Neil) asked Mrs. May how the Conservatives plan to pay for their promise of “the most ambitious programme on investment and buildings and technology the NHS has ever seen”, the Prime Minister said: “We’re backing the proposals in the Naylor report.”
This simple reply has alarmed health campaigners and the opposition Labour Party. The reasons why many have become concerned with Theresa May’s plans is because the report would signal the Conservative Party’s intention to shrink the health service and to hand funds from land sales (and associated charges) away from the public purse and into the hands of the private sector.
This counter-argument against Mrs. May adopting the Naylor recommendations has been set out by an IT specialist called Chris Holden in a video posted on YouTube. The video has been promoted by health campaigners and activists, including the singer Charlotte Church.
According to Holden: “the report makes a passing reference to maintaining and looking after old buildings, but then quite literally in the next paragraph, it says there is no business case for this, so let’s just flog everything off.” The video has received over 150,000 views to date.
In essence, Nolan reveals, what the Naylor Report would mean in practice is that government would tell NHS hospital trusts that they will not get funding (or at least any funding increases) unless they sell many of their assets to the private sector for below market rates. This is embedded within the report, which recommends that NHS trusts that fail to draw up “sufficiently stretching plans… should not be granted access to capital funding.”
Such is the desperate need for additional funding for the NHS, trusts could well be under pressure to sell more than just disused areas. Interviewed by The Daily Mirror, health activist Deborah Harrington states: “It’s simply not true that all of this land and all of these buildings are surplus to requirements. The truth is that this is the biggest ever drive to sell off the assets of the NHS in its history.”
Such far-reaching issues indicate that perhaps it is time to shift the focus away from Brexit and back onto domestic policy in the last week of election campaigning.
