|Volume 47 Number 10, May 27, 2017||ARCHIVE||HOME||JBCENTRE||SUBSCRIBE|
On Monday, May 22, in a BBC interview with Andrew Neil, Theresa May was asked about the Conservative manifesto pledge on health that it claims would implement "the most ambitious programme of investment in buildings and technology that the NHS has ever seen". In her answer Theresa May claimed that there would be an extra £10bn of capital funding for the NHS over the next Parliament if the Conservatives won the general election. She claimed that building and technology funding was "separate from the NHS revenue funding" and said that the capital funding would come from a "variety of sources" but refused to give further details other than to say that "we are backing the proposals in the Naylor Report".
What does the Naylor Reporti say? Sir Robert Naylor's "independent report" was commissioned by the Secretary for State for Health, Jeremy Hunt and was published in March 2017. The report set out "a new direction of strategy for NHS estates in England". Yet while the report claims to be dealing in part with the backlog of repair estimated at £5bn to existing NHS estate he claims that such a back log can no longer be fully funded when he says "this review was predicated on widely accepted assumptions that the NHS estate is not currently configured to maximise benefits for patients or taxpayers." So, his report starts by saying that: "My review set out to develop a new NHS estate strategy, which supports the delivery of specific Department of Health (DH) targets to release £2bn of assets for reinvestment and to deliver land for 26,000 new homes." Further: "This work suggests that the NHS can release £2bn of assets and deliver 26,000 homes and with an effective programme of interventions in high value propositions in London, this could significantly increase the property receipts to a figure exceeding £5bn in the longer term."
In other words, a new Conservative government and NHS England will cover over massive cuts to existing infrastructure in "investment in buildings and technology" through selling off NHS land and buildings for housing plots for the big housing corporations. In line with this direction the Naylor Report also recommends the "acceleration" of Sustainability and Transformation Plans (STPs), which mean the closures of District Hospitals and other locally based NHS services through "incentives". The report says, "At a minimum, the Department of Health (DH) and HM Treasury (HMT) should provide robust assurances to STPs that any sale receipts from locally owned assets will not be recovered centrally provided the disposal is in agreement with STP plans. This report recommends that HMT should provide additional funding to incentivise land disposals through a '2 for 1 offer' in which public funds match disposal receipts."
To enact this great land and building sell off the Naylor Report also recommends the establishment of a powerful new arms-length NHS Property Board "which provides leadership to the centre and expertise and delivery support to Sustainability and Transformation Plans (STPs). It should be a strategic organisation, at arms-length from the Department of Health and structured so that it empowers speedy executive action and professional credibility within the sector. To include a regional structure, which is aligned with NHS England (NHSE) & NHS Improvement (NHSI) and brings together functions of NHS Property Services (NHS PS), Community Health Partnerships (CHP) and other fragmented NHS property capabilities into a single organisation."
NHS Property Services (NHS PS), formerly NHS Propco, was set up in 2012 following the Health and Social Care Act, having taken over £5bn worth of property - some 3,500 properties, including offices, primary care and community health facilities formerly used by the Primary Care Trusts. On this the Naylor report says a shadow form of the NHS Property Board should be set up immediately and "consider if the functions and residual assets it inherits from the abolition of Primary Care Trusts (PCTs) should be divested back to providers." Otherwise all this property will become part of this great sell off of NHS property being implemented by a future Conservative government, or part of it as Trusts are forced to dispose of NHS property and land through the STPs or to cover their "deficits".
In reporting on the comment of Theresa May that this funding would come from a "variety of sources" the Health Service Journal said, "HSJ understands that although some will be new money from the Treasury, much will come from private sources and sales of existing NHS estate." On this the Naylor Report says: "Substantial capital investment is needed to deliver service transformation in well evidenced STP plans. We envisage that the total capital required by these plans is likely to be around £10bn, in the medium term, which could be met by contributions from three sources; property disposals, private capital (for primary care) and from HMT."
It is no wonder that Theresa May was reluctant to mention more details, when she said that "investment in buildings and technology" would be funded by a "variety of sources" and when this includes the greatest NHS property sell off ever seen and the increasing use of private capital and privatisation of community health services implicit in this report. In this respect the creation of the Accountable Care Organisations (ACOs) modelled on the US style private health care system are already being talked about as one of the models for the STPs which the next government will use.
In the present battle to safeguard the future of the NHS and to build an alternative future, what is being further revealed by Theresa May's plan for NHS infrastructure is the neo-liberalisation of health care and the aim of destroying the social ownership of the NHS and the destruction of public assets and public authority by a central government that represents the neo-liberal interests of health and and other monopolies. This contemporary development is a systematic attempt to wreck the public health care system by centralising the destruction of public authority over the NHS and hive off its assets to the rich. It is why the people should continue to fight to establish themselves as the new public authority that upholds the right of all to health care and demands social ownership of the NHS by building the independent political movement of the working class and people to safeguard the future of the NHS.