The Conservative government of Theresa May is proposing to sell off billions of pounds in National Health Service (NHS) property.
The move was prepared by a review by Sir Robert Naylor. The former boss of the NHS trust that runs University College Hospital published his report in March after Health Secretary Jeremy Hunt commissioned him to look at what could be done with “surplus” NHS property and old buildings and to “develop a new NHS estate strategy.”
A number of proposals include selling off £2 billion of NHS land, equivalent to 5 million square metres, more than five times the size of London’s Hyde Park. The land could be used to build 26,000 new homes. This figure could rise to £5 billion if extended to high-value land in London.
Naylor’s review is based around the cynical justification that because many NHS units are “unfit for purpose and will continue to deteriorate”—which is entirely due to a lack of investment going back years—the health service faces a £10 billion infrastructure funding gap.
Writing in the manner of a company executive, Naylor states there is “no traditional business case” to justify the cost of fixing and maintaining buildings and equipment. What is required instead is the sale of land occupied by NHS services that are no longer used in order to facilitate further billions in cuts to be imposed throughout the NHS in sustainability and transformation plans (STPs) by NHS trusts nationally. Naylor’s review notes that Hunt has already taken action to begin the design of a new NHS Property Board. This “powerful new NHS Property Board … provides leadership to the centre and expertise and delivery support to Sustainability and Transformation Plans (STPs),” writes Naylor.
Currently all NHS land is under the control of the publicly owned company NHS Property Services Ltd. NHS trusts own 1,200 sites across England, with Deloitte’s estimating the total value at £9-11 billion. These sites consist of 6,500 hectares of land and buildings with a gross internal area of 26 million square metres.
The list of property identified for sale includes ambulance stations, clinics, staff accommodation, and trust headquarters. Recommendations are set out on how the government can sell buildings it is claimed are too expensive to maintain and land that it no longer uses.
Last month May told the BBC’s Andrew Marr, “We’re backing the proposals in the Naylor report.” She claimed it would help towards £10 billion in extra funding for the NHS as outlined in the Tories general election manifesto. The reality is that Conservative-led governments since 2010 are in the process of cutting over £40 billion in NHS funding via “efficiency savings” with many services to be reduced and closed entirely.
A large amount of the land is owned locally by NHS trusts, rather than centrally by the Department of Health. The Naylor report makes it clear that individual trusts will have to be pushed to sell assets. At present trusts are already charged 3.5 percent a year on the value of their land, but Naylor recommends going further by blocking trusts from being able to obtain capital funding from the government unless they set targets for the sale of land.
This would mean that they would not have access to funds to be able to carry out building and repair projects, and buy new essential equipment such as beds and monitoring equipment, in effect forcing them to sell off land, and other assets.
The property portfolio held by the NHS is vast and the Naylor report recommends selling it as quickly as possible, hoping that no one will notice before it’s too late.
The government will provide a monetary incentive to speed up this process, so as to facilitate the selling off of NHS assets as part of its agenda to end publicly funded health care. They will offer to double the amount of money to those hospitals that sell off land for a limited period on a first come, first served basis.
With trusts being forced to rush through the sale of assets, the only beneficiaries will be those who are buying. The property speculators and financial parasites will be waiting in the wings to snap up state assets at a bargain price.
For example, an NHS land parcel could be sold for £1 million that has a real value of £2 million. However because the government subsidy will cover the other part of the transaction, the taxpayer has footed the bill for a gift to the speculators.
Deborah Harrington, of the National Health Action Party, noted that some of the buildings labelled “surplus” were in fact forced to close through cuts and staff shortages. She gave the example of community hospitals in Devon.
Since the introduction of the Health and Social Care Act 2012, there has been a vast increase in private-sector providers offering services in financially lucrative areas of the NHS. These include a growing “market” in property and rental space to be exploited by big business.
Assura is the leading healthcare real estate investment trust in the UK, with an NHS business in rental property for general practitioner surgeries across the country. It declared its profits for 2016-17 as £95.2 million before tax, a rise of 230.6 percent over the £28.8 million in the previous year, 2015-2016.
Assura sees the Naylor Report as an unprecedented opportunity. CEO Jonathan Murphy said, “During a period of political and economic uncertainty, Assura has continued to deliver significant growth built on a secure and long-term income stream. Following the Naylor review, it is clear that mainstream thinking is strongly in favour of further investment in primary care premises.”
In its full year report released in May, the company stated that it was a “sector leader in a market that is in critical need of investment and … well placed to provide the NHS with cost effective and convenient premises.”
The NHS has an enormous backlog of maintenance work that needs to be carried out and its high-risk maintenance backlog is rising fast. This is defined as where repairs/replacement must be addressed with urgent priority in order to prevent catastrophic failure, major disruption to clinical services and safety, liable to cause serious injury and/or prosecutions.
The NHS has been deliberately run down with under-investment and a lack of maintenance under both the Tory and Labour governments. What is now taking place is a virtual “yard sale” of public assets to speculators, and profiteers in the name of making the NHS more “efficient.”
The Naylor Report elicited only the most token opposition from Labour. Last week an Early Day Motion sponsored by Labour MP Rachael Maskell received the support of just five other Labourites and just one Scottish National Party MP.
The assets being sold for a pittance were built up over generations by the working class in the post-World War II period and led to vast improvements in the lives of millions. There has been a systematic attack on all these gains, from the selling off of local authority housing, with the introduction under the 1979-1990 Thatcher government of the right to buy, to the privatising of lucrative areas of the NHS, and now the attempt to sell off its valuable land.
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[28 December 2016]