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Stella Creasy (Walthamstow) (Lab/Co-op)
I beg to move,
That this House has considered the NHS’s role in the eviction of the Walthamstow Toy Library.
It is a pleasure to serve under your chairmanship, Mr Hollobone. I want to start by saying that I am sorry that we must have this debate, because I know there are some incredibly serious issues facing our health service. All our communities are dealing with the consequences of the pandemic. I wish I were asking the Minister about that, because that should be his priority. However, under the cover of the pandemic, something is taking place in my community.
I am hoping this morning for a bit of a Christmas miracle and some positive news for my local community about something that hundreds of residents have expressed concern about, and I know many more will. It is the fate of our local toy library. The Walthamstow toy library has been there for more than 40 years, serving thousands of children and their families locally. It is vital community resource. It does not just loan toys, but helps with children’s social development and provides emotional support to parents in the ninth poorest community for child poverty in the country.
Its mission is to provide a safe and stimulating place for young children and their parents and carers to play, learn and interact. What does that mean in practice? It means a wealth of activities: help to support new mums to breastfeed, mental health support for those with post-natal depression, support for children with special educational needs, advice on healthy eating and living activities, and outreach, as well as the promotion of wider social objectives such as recycling and, of course, loaning toys and encouraging child development.
Do not take it from me, Minister—take it from the users of the service. Stacy, one of the many mums from Walthamstow on a low income, wrote to me:
“As a first time mum, I found the social aspect of motherhood very daunting. The thought of meeting other mothers whilst supporting my child to play and interact with other children seemed almost impossible! This was until I came across the Toy Library. You would assume such facilities and service wouldn’t be available to those who couldn’t financially afford it but this isn’t the case. The Toy Library doesn’t have such barriers in place, so it means if you are a parent who needs that financial support through borrowing of toys or affordable entry/membership it is available. I felt very supported and encouraged to become part of the Toy Library without being judged for my circumstances.”
The Minister might say to me, “That sounds all very nice, but what about health care?” That is ultimately his priority. I want to highlight that we have a very high level of challenge in my local community when it comes to child and maternal health. The World Health Organisation has a vaccination target of 95%. I am sorry to say that my borough does not meet that for any vaccine: under 30% of two to three-year-olds have had the flu jab in my borough this year. Our measles, mumps, rubella rates are well below the England average, with only 83% of children aged 24 months in Waltham Forest vaccinated. Our rates of childhood obesity are also above the national average.
The library supports not just children but their mums. During lockdown, my office has been inundated by mothers with post-natal depression who have had no support since health visitors were taken away. It has been the toy library that has offered vital help for those mums, too. Indeed, during the pandemic they stepped up to support many low income families in Walthamstow, offering one-to-one contact with 150 of them, providing activity ideas and helping to deal with the isolation that so many families have felt in the past months. They offered parents one-to-one support with a trained counsellor, renewed play sessions, when they could, and offered craft packs to nearly 1,000 local children. These are critical services that have never been more needed, which have a health outcome. They deal with mental health and mean we have a connection with some of the hardest-to-reach children in our community.
The Walthamstow toy library has just eight members of staff and an annual turnover of £85,000. That means that the work they do and the impact they have is all the more remarkable. They do not receive any public subsidy. Occasionally, they have a grant from the council, but they fund all their activities through relentless fundraising and a network of alumni, who recognise the value of their work to local children and the community. That is why I am asking for a Christmas miracle from Ministers today. We are in danger of losing this vital resource in Walthamstow, which, importantly, represents value for money.
Walthamstow toy library has been in the same building since 1986. It is a purpose-built building, on the site of the original toy library that was knocked down to make way for the Comely Bank campus, which is the space it is now in. The Comely Bank campus was a local improvement finance trust company initiative for the NHS, which is where the Minister starts to begin to take responsibility for this. The Minister should be worried not just about my local toy library, but about what this episode reveals for the wider NHS property account, for which he has responsibility.
LIFT was supposed to be the not-for-profit version of the private finance initiative—that old chestnut—helping to bring much-needed properties to the NHS, but it is clear that the company running this building is motivated by money, not the needs of my local community. When it was first built and run by the primary care trust, it was agreed that the toy library would have a peppercorn rent, so the toy library would be there, work with healthcare providers and provide all those services to the local community.
LIFTCos also meant that the NHS would have some control over GP services and primary care facilities in those buildings. Although the PCTs only had a small stake, they had some ability to determine how local facilities were built and used. Since PCTs were abolished and their stake referred to a company called Community Health Partnerships, all that local control has gone.
LIFTCo behaviour is now dominated by their private financers, often hidden from view, who are seeking to maximise their returns by charging extortionately high rents and service charges. As this case shows, the overriding drive of Community Health Partnerships is not what our community needs or wants, but how it can generate as much income as possible to pay back the debt and provide a return to its shareholders, known as RWF Health and Community Developers Ltd.
For eight years, and through multiple ownership structures of the building, including the eventual abolition of the PCT and then working with the NHS Waltham Forest Clinical Commissioning Group, the Walthamstow toy library has frankly been treated as a nuisance by the CCG and CHP. Those organisations have also failed to provide adequate healthcare services to my community. Indeed, the CCG is one of the services most complained about to my office.
For years, the volunteers who work at the Walthamstow toy library have been trying to sort out their lease, to work with the CCG and to be commissioned to provide services to help address issues such as the poor vaccination rate or childhood obesity. Frankly, the CCG has not just refused but has been point-blank rude about those offers, including to me and the volunteers. The volunteers have tried, in vain, because they know how much it means to the community and because they have suddenly started getting bills for hundreds of thousands of pounds for the building.
Suddenly, Waltham Forest CCG wished to claim that the cost of having a toy library there is around £60,000 a year. For property aficionados, let me be clear what we are talking about: it is 120 square metres, with a kitchen, two toilets and a garden. I know everybody thinks that Walthamstow village is fancy and expensive, but I have talked to local estate agents and even if it were the most swanky building, the most they think such a building should cost is £30,000 a year, with service charges. I thank community estate agents, such as Strettons, for helping us and for being so shocked for our community.
It is not just about the rent they are trying to charge. When we look at the amounts of money that the CCG and CHP seem to want, the toy library’s charges seem to have increased at a much higher rate than for the property as a whole: from £77,000 in 2019 to £102,000 in 2020-21—an annual increase of 32%—yet the overall lease for Comely Bank seems to have increased by only 2.8%. One might query why the toy library, a charitable organisation, is suddenly being asked to pay an excessive amount of rent and charges, compared with anyone in the rest of the building.
Leaving that aside, the CCG itself—it has not negotiated with the toy library but summarily issued documents—has agreed to pay for the presence of the toy library, honouring the original agreement for a peppercorn rent so that the toy library could be in Walthamstow. However, it should trouble the Minister, given the concern that I know he has for value for money, that any one side of the NHS should be charging another double the cost of a building, before service charges. I think that the honest truth is that that is why the CCG has refused to work with me and residents to try to save the toy library, and why, indeed, it is colluding in evicting it.
It should also trouble the Minister that Andrew Meakin, the regional property director for CHP, wrote to me threatening to send bailiffs to the toy library to recover nearly £200,000-worth of debt that he claimed it owed in building and service charges. He argued that CHP is a publicly-owned company and could not see any option except to progress debt collection through the usual channels, to recoup public funds. That was in October. Those were costs that the CCG had already claimed it would pay and, indeed, that CHP knew about and subsequently, mysteriously, issued credit notes for. However, one can imagine what it must feel like for volunteers to receive a bill for £200,000 from an organisation claiming to represent the NHS.
I draw to the Minister’s attention the detail of the coronavirus legislation that places a moratorium on commercial landlords evicting people. The current time of great uncertainty in funding and operations for the toy library means that it is hard for it to raise funds. Mr Meakin is acting as the Christmas Grinch in trying to chase revenue sources for which he has already been paid twice, to justify evicting the toy library. It gets worse, however. He demanded that the toy library should act as a commercial operator and charge fees for services that it does not provide, suggesting that its offering is less commercial than those of its rivals in my constituency, as though the building was a commercial one. The whole point about the service is that it is not commercial. It is open to everyone. That is the benefit.
It is interesting to me that CHP demands commercial behaviour and transparency from the toy library while it is unwilling to be honest about its own activities. Despite being a public sector body, it is wholly unaccountable about revealing how much it makes through charging such extortionate rents. For any other PFI deal I could go to the Treasury database and see the interest on the loan that is driving the situation, but it has refused to reveal that information, even with a freedom of information request, claiming that to do so would prejudice the commercial interests of CHP and its private developers, RWF Health and Community Developers Ltd. It then argues—this is surely meant to be ironic—that revealing how much money it is making would impact on its abilities in relation to services in areas of high social and health need, which I presume means areas such as my constituency.
I am not sure what the commercial interests are with respect to what is supposedly an NHS building, but I guess that some of them are overseas. In the FOI response it was claimed that there have been no subsequent sales of shares in the project since it was first commissioned. However, a look at the company accounts shows that the subsidiary and the ultimate parent company, HICL, have been part of nine different holding companies for the building. Indeed, Barclays sold its share in this LIFTCo to HICL in 2013. It is not clear how much Barclays sold the share for, but, as we have all seen with PFI, HICL was registered offshore in Guernsey at the time, and remained so until 2018.
It is also clear that around £3.2 million in management fees has been extracted from the subsidiary of the LIFTCo between 2007 and 2020. It looks as though that is in addition to the returns to shareholders and the interest on debt repayments. That sum would be more than enough to cover the alleged cost of having the Waltham Forest toy library in there for decades to come.
I ask the Minister, as a starting point—given that he is a stakeholder, and that ultimately CHP is owned by the Secretary of State—whether he can tell me what the internal rate of return is. I am sure that he would agree that it is in the public interest to know that. What does he think the commercial interests are? It is my understanding that the CCG is colluding with CHP to evict the Walthamstow toy library so that it can put another tenant in the building. However, that is the same CCG that will, I have no doubt, come to the Minister at some point for funding for property. Essentially, one side of the NHS is asking the other for over-inflated rents—robbing Peter to pay Paul. That would irk me less if the CCG had not presided over a building that has been under-occupied for years. The under-occupation rate has been 20% since 2016, and in the last year it has been 30%—all in a building whose lease finishes in less than 10 years.
In the absence of being able to hold CHP accountable, I have come to the Minister to ask for his help and to ask whether he believes that the decisions that are being taken square with his statutory duties under the Health and Social Care Act 2012 to reduce inequalities and promote a comprehensive health service. It is not acceptable to say that these are just decisions for the local LIFTCo or CHP, when CHP is owned by the Secretary of State and it is refusing to answer questions. There is a vacuum in which the interests of private finance have come before the public in Walthamstow.
This is not just a constituency problem, because CHP manages 5% of the NHS property estate. If it is behaving in such ways in other parts of the country, other communities are also being overcharged for their properties. In other parts of the NHS, social prescribing has been the way forward, working with community organisations, such as at the Michael Burke Wellbeing Centre in Suffolk or Houghton Primary Care Centre in Houghton le Spring.
We know that PFI was the wrong move—Governments of all sides have recognised that—and we all want to sort it out, but LIFTCos have not had the same level of scrutiny. Can the Minister tell me who will own the building in less than 10 years’ time? Can he tell me how much it is costing us as taxpayers? Can he tell me whether he believes that in evicting the Walthamstow toy library, CHP is adhering to the original lease, as it is required to do, which talked about non-NHS use and working with local communities? Above all, can he offer me some advice and help on how I can support my local community, which is struggling in the pandemic, and those children who rely on the toy library, to make sure that we have a toy library for many years to come in Walthamstow?
I know the Minister has been told one thing by the CCG and CHP, but I would be happy to inform him of my experience of dealing with these organisations and the truth of the attempts at negotiation. With Christmas just a few days away, will he play Santa to the children of Walthamstow and commit today to supporting the Walthamstow toy library and helping us to save it?
Mr Philip Hollobone (in the Chair)
The debate can last until 11.30. I call the Minister.
The Minister for Health (Edward Argar)
It is always a pleasure to serve under your chairmanship, Mr Hollobone. I will endeavour not to qualify for the Grinch’s green suit in what I am about to say to the hon. Lady. I congratulate her on securing this debate. It is always a pleasure to appear opposite her and she has always been a strong and vocal champion for her constituents in this House.
The hon. Lady has raised a number of points, and I am grateful to her for highlighting in advance the outline and contours of the issue, which means that I have had an opportunity to look into some of it. I will come back to this point later, but I make the offer that I am very happy, as soon as we return after the Christmas recess, to meet her to go into more detail about the issues she has raised and some of the history and chronology of what has happened here, if that is helpful to her.
I know the hon. Lady has been an active supporter of and campaigner for the Walthamstow toy library, which is an important local charity, and she started the campaign to save it from possibly having to move from the current premises, as she has talked about today. As she highlighted, the building is owned by one of the NHS local improvement finance trust companies, CHP, and that is one of the companies that is managed by the Department for Health and Social Care, or owned by the Secretary of State for Health and Social Care. It is now the head tenant for the property, having taken over from the PCT in 2013, when PCTs were abolished. CHP sublet to GPs and other providers of NHS services that received the majority of their income from the local CCG.
I note at the outset that the hon. Lady may wish to challenge some of these points when we meet, as she has done today. As has been related to me, in 2005, the toy library was incentivised to relocate to the new building following the destruction, for want of a better way of putting it, of its old building, by being offered a lease at a peppercorn rent, with a small contribution towards running costs for 10 years, which started on 27 September 2005. It occupies about 9% of the building.
That original lease was between the PCT and the toy library, meaning the PCT bore the cost. In 2013, when the lease was transferred to CHP and the local CCG, they agreed to honour that previous subsidy. My understanding is that during 2015 there were extensive negotiations between CHP, the toy library, the CCG and Waltham Forest children’s services on the expiry of the lease. It was recognised then by the CCG that the toy library would at the very least need time to review the options available to it and to explore securing alternative accommodation, other funding sources to increase its income or, for example, a contract for commissioned services from the council in order to pay its rent. As such, the CCG agreed to subsidise the occupancy for a further three years, beginning on 1 April 2015, at a cost of £50,000 per annum, with contributions also coming from the LIFT company and CHP for the balance of that.
By 2018, my understanding is that no progress had been made in sourcing alternative accommodation, and that the CCG agreed to a further three years of subsidising the rent on similar terms, continuing to contribute £50,000 per annum to costs, with a continued contribution from the LIFT company. The position of the CCG and the LIFT company is that this was always intended to be an interim measure for three years. They state that they sent a clear message to the toy library that, by March 2021, it was expected to pay the full cost of occupancy if it was to remain a tenant. The hon. Lady has put on the record a different interpretation of that, which I am happy to explore with her. If she wants to intervene, I will happily allow it.
Stella Creasy
It may be useful to clarify that at no point has the CCG told the toy library that it is to leave the building; indeed, the CCG keeps telling me that it is not evicting the toy library. More importantly, in the chronology that the Minister talks about, if the toy library had been told to find an alternative building, why was it working on commissioning services together with the CCG? I fear that the Minister has been sadly misled by Selina Douglas and the Waltham Forest CCG on this matter.
Edward Argar
I was about to make one final point, which is that I understand that a further three-month extension was agreed until 30 June 2021. However, I highlight what the hon. Lady said, not only just now but previously, which clearly suggests that a different complexion has been put on this issue. That is why my meeting her would be useful.
I will put on the record one or two points. It is important to note that the subsidy paid by the CCG is an arrangement that is not offered to any other charitable or voluntary group within the borough. I recognise, as the hon. Lady set out, the value that this charity brings. In my distant past when I was a Westminster city councillor, before I was a Leicestershire MP, I recognised the value that toy libraries and similar charities brought to the local community in London. I put that on the record because we must always remain conscious of fairness. There are specific circumstances, but I just wanted to highlight that point.
The hon. Lady talked about social prescribing, and she is absolutely right. That goes to my experience in seeing the huge value that charity facilities such as this can bring not only to those who are in need, but to others within the community more broadly who access the toy library and come together in that context. Such facilities are hugely important in the communities where they exist. They bring people together and provide mutual support, often to families and individuals who may not have a medical need, or who may not want their needs to be dealt with through medical means, but who find the support they need—help through a difficult time, or just more broadly—through such facilities. I recognise their value.
During the time that the toy library has been in this building, the CHP and the CCG suggest that a substantial debt for service charges and utility bills has accrued, which they assert that the toy library clearly agreed to pay as part of the original lease, separate from the rent. I see from the hon. Lady’s expression that that will feature in our discussion. I appreciate that there are different perspectives on the form that engagement has taken. CHP and the CCG have engaged with the toy library on a number of occasions to explore solutions to the issues that have arisen. Those solutions have included moving to a more sustainable business model, becoming a social enterprise or having the council commission services. They state that the toy library has been supported in those discussions to find alternative premises, with options explored including whether it could be relocated or co-located with other services for children and families.
The toy library of course has the first option on this space, certainly until the end of that period of extension, but I understand that, in the meantime, a feasibility study has been commissioned by the CCG on prioritising use of the building for health purposes. There are no signed agreements yet, but NHS parties state that they are reserving the right to reconfigure the building for what they deem to be its primary purpose: in their words, to get best value for the local health economy. However, to the hon. Lady’s point, we must always be conscious of the need to look at value not just in financial terms or in purely primary care terms, but in terms of broader health benefits and broader benefits to the community. Value, for want of a better way of putting it, takes many forms, not always with pound signs involved: there are broader, more intangible measures of value. Again, I am very happy to explore that aspect of the issue with her when we meet.
The view and perspective of CHP, the local CCG and the LIFT is that they have sought to engage constructively with the toy library since they first assumed that relationship—in 2013, if my memory of what I just said serves me—but they do need to look to the future. The suggestion of finding an alternative space at a similar peppercorn rent, for example, may be a way forward. However, I again note what the hon. Lady said: this is a purpose-built space for the toy library, and a shared space with others coming in and coming out would not necessarily work with the model for the services that are provided to the people who use it. I hope that as we look to the future, both the toy library and—equally, and hugely importantly—the CCG and CHP will try to engage, genuinely and openly, to explore options around either finance or genuinely viable alternative premises. I also hope that throughout, they will engage directly, and indeed courteously, with the hon. Lady as a representative of her constituents in this House.
The hon. Lady raised two specific points that I am happy to look at and discuss with her: one was about the IRR, and one was about levels of management fees. If she will permit me, I will take those away and look at them, and when we meet we can discuss those points.
This is a challenging situation, and clearly, some compromises may have to be made on both sides to move us forward. I have therefore already asked the CCG, CHP and the LIFT company to engage further with the toy library, openly and constructively, and to report back to me with a jointly agreed update on progress at the end of February. The hon. Lady has raised some significant issues, and I would hope to meet with her well before that stage, because I am keen to hear from her in a way that is not always possible in debates in this House. Although debates may raise the profile of an issue and highlight scrutiny of it, we can sometimes get into more detail in a private conversation. I am very happy to meet her and see whether we can find a constructive way forward that genuinely meets the needs of her community. Thank you, Mr Hollobone.
Mr Philip Hollobone (in the Chair)
Order. I am afraid that the hon. Lady is not allowed a right of reply. Generously, I will allow her to intervene on the Minister, if he agrees that he has not finished his speech, but the intervention has to be brief.
Edward Argar
Apologies; when I said “Thank you, Mr Hollobone”, I thought that I had caught your eye and you were about to stand, so I sat down. If I may, I will finish my conclusion, and should the hon. Lady wish to intervene on me, I am happy to take that intervention.
Stella Creasy
I thank the Minister for letting me intervene, and for the good Christmas cheer that he is bringing. Can I confirm that a side letter was sent by the CCG to the Walthamstow toy library in, I think, 2018, committing to paying all the costs of it being in the building? As such, the suggestion that charges were outstanding is another misleading statement. When he looks into the issue, could he also clarify who will own the building after 2030, when the original lease runs out? We are fewer than 10 years away, and surely any redevelopment of the building has to take place in that context.
I will very much take the Minister up on his offer of a meeting, because I think a way forward can be found to save the Walthamstow toy library where it is. I hope CHP and Waltham Forest CCG are listening very clearly, and that they will finally start to engage properly with my community. In view of that, I wish everybody a merry Christmas.
Edward Argar
I am grateful to the hon. Lady. If she is able and happy to forward me a copy of that letter—she may have to do so in confidence—I am very happy to look at it, because it will be useful for me to see it before we meet. She has raised a number of other questions; forgive me, because I did not pick up on that one when I answered. Again, in so far as I am able to discuss that issue with her, I will do so, and my office will get in touch with hers after this debate to try to get us a meeting in January. I hope that, as I say, we will be able to find a constructive and positive way forward that works for the NHS, for her community and for all parties involved, including the toy library.
Motion lapsed (Standing Order No. 10(6)).