NHS assets for sale
A government-commissioned report has recommended the NHS release cash by selling off land it no longer needs. Critics warn that a ‘fire sale’ of assets, including trust car parks and staff accommodation, is on its way.
is on its way.
A government-commissioned report has recommended the NHS release cash by selling off land it no longer needs. Critics warn that a ‘fire sale’ of assets, including trust car parks and staff accommodation, is on its way
What do an air-raid shelter, a cricket pitch and a kitchen garden have in common? The surprising answer is that they are all on a list of nearly 500 NHS-owned sites that have been declared ‘surplus to requirements’ and deemed suitable to be sold off.
Nurses may cast a nostalgic eye over the disused buildings that once housed state-of-the-art services and the grand old houses which were once part of hospitals’ estates. But should they be alarmed about plans to sell off land and buildings?
Arguably, it makes good sense for the NHS to sell land it has no use for. However, some of the long list of proposed sell-offs may give cause for concern. They include a number of car parks, staff accommodation and even a mothballed hospital nursery. In some cases, the properties proposed for sale are still being used to provide healthcare.
In Reading, staff accommodation about two miles from the main hospital has just been sold as part of a wider sale of land to a developer who is expected to apply for planning permission for 217 properties. Staff who were living in the partially occupied 28-flat complex have been helped to find accommodation elsewhere but, with no guarantee that the new properties will be affordable, there could be a loss of available accommodation for staff. The proceeds of the sale will be spent on resources and equipment for the trust.
Regional head of health for Unison in the south east Tony Jones says: ‘It is particularly galling that in places like Reading, which regularly features in lists of the most expensive places to live, that trusts must contemplate selling off staff accommodation simply to close the under-funding of the NHS. As a consequence, permanent staff become harder to recruit and retain and agency staff bills simply make matters worse.’
The argument for selling off some assets was made in a government-commissioned report by Sir Robert Naylor, former chief executive of University College London Hospitals NHS Foundation Trust. He warned that current NHS capital investment would be unlikely to be enough to fund transformation of services and maintain its buildings. The report suggested the NHS could raise some cash by selling off land and buildings it did not need and that this could help it to provide buildings better suited to modern healthcare and cheaper to maintain.
There would be incentives for trusts to put land up for sale – including preferential capital funding from the Department of Health – to do this, but also sustainability and transformation programmes (STPs) and trusts that did not act to dispose of unused buildings might not get access to other funding.
Selling the family silver
Suggestions of private company involvement in the sale and development of these sites have provoked a storm of criticism. There are concerns that the NHS may not get the best price for its assets – and that it is effectively ‘selling the family silver’ to get it through a short-term crisis. Labour has accused the government of a fire sale and shadow health secretary Jon Ashworth said: ‘The NHS needs an urgent injection of funding to make up for years of Tory underfunding, but the answer is not a blanket sell-off of sites which are currently being used for patient care.’
It’s likely that the number of potential sell-offs will increase further as STPs crystallise their work on future service models and how they will be provided. Often the focus on treating people at home will affect community hospitals – Dorset, one of the most advanced STPs, already has a number of community hospital sites on the potential sale list. Other areas are likely to follow. For some nurses this is likely to mean needing to change their place of work.
RCN London operational manager Jude Diggins says such moves can be difficult for nurses, even when they are in urban areas like London. ‘We have a lot of members who physically can’t get to their new bases if they have childcare commitments and so on,’ she says.
For others, the sell-offs could be disruptive. One proposal, for example, is that land could be freed up by building multi-storey car parks on hospital sites – and selling off the spare land released. But what happens while work is underway and what does it mean for staff parking spaces? Ms Diggins says that even proposals with longer-term benefits to staff can be disruptive in the short term.
‘Car parking is a contentious issue. Where trusts say they will cut back on car parking and provide more buses for example, it never seems to fill the gap,’ she adds.
But there may be a silver lining in the Naylor report. One of the recommendations was that land vacated by the NHS should be used to develop homes for staff, where this was needed. This could be done through housing associations and would be aimed at providing affordable housing for less well paid staff. Sir Robert suggested that these homes should not just be rented but could be leased in a way that would allow staff to benefit from the increase in value.
Much of the high value land likely to be released is in London, and this approach could be a game changer for nurses in the capital – although property would have to be affordable if nurses are to live close to hospitals in the centre of the city.
‘A lot of our members talk of paying between 60% and 70% of their income on transport and accommodation,’ says Ms Diggins. ‘They would certainly welcome more affordable housing.’
Research by the RCN has highlighted the difficult conditions faced by many nurses in the capital with most renting and only just over one third owning their own property, she adds. The quality of housing is also poor with more than half experiencing damp or mould in the past year, and nearly half having heating problems. Two thirds of nurses who responded to the college’s survey said the cost of housing had caused them to consider leaving London to work elsewhere.
In other parts of the country, there have been developments of NHS buildings that have seen keyworker accommodation provided but with some houses and flats sold off – such as at the former Frimley Children’s Centre in Camberley, Surrey. In Birmingham, where the Sandwell and West Birmingham Hospitals NHS Trust will vacate some buildings as it moves into a newly built hospital, land on the City Hospital site is to be used for social housing – although there is no indication healthcare staff will get priority.
However, with NHS finances in a critical state and little money for investment there are fears that this positive side of sell-offs could fall by the wayside as trusts use property receipts to help balance their books. Ms Diggins fears this could be the case in London where a number of STPs are in the capped expenditure process – meaning there is additional pressure on them to make savings. ‘If they are trying to save £60 million to £100 million and have some real estate to sell, people will have to make tough choices,’ she says.
Alison Moore is a freelance health journalist