Management of NHS Property

Debate between Karin Smyth and John Howell

Wednesday 4th July 2018 Westminster Hall

[John Howell (Henley) (Con)]

Will the hon. Lady join me in condemning how the parking company Smart Parking operates its fines system at the Townlands Hospital in Henley? It is a monstrous way of dealing with people; intimidating them when they are at their most vulnerable.

[Karin Smyth]

I cannot comment on the specific company, but trying to understand accountability and how systems work is frustrating for local people. Many of us are trying to make sense of it.

The estate was an afterthought for the coalition Government and their disastrous Health and Social Care Act 2012—the Lansley Act. Their laissez-faire approach, which bordered on contempt, has saddled communities across the country with burdens and consequences ever since. The current Government recognised that in their response to the Naylor review, stating:

“The structural changes in recent years have distracted attention away from the importance of the estate as an enabler of high quality care, and the NHS has lost valuable expertise and knowledge in strategic estates planning, development and management.”

As we are developing the 10-year plan to transform our NHS into a more community-based, joined-up system, the function of the community and primary care estate as an enabler of service transformation becomes more critical. Although the Government said in response to Naylor that they want to incentivise local action, in practice there are no mechanisms to do so. My focus is therefore on the local roles of two national bodies: NHS Property Services and Community Health Partnerships.

The Lansley Act nationalised health centres, GP premises and, in my constituency, the South Bristol Community Hospital overnight. When the Government realised that no one was responsible for property managed by primary care trusts—mainly GP premises and health centres in poorer areas—they set up NHS Property Services, which became the landlord and asset manager on behalf of the Secretary of State. Community Health Partnerships took over the primary care trusts’ 20% control of local infrastructure finance trusts—LIFT companies—which were public-private partnerships for new GP premises and community-based services, such as South Bristol Community Hospital.

A key part of the LIFT incentive was that the companies made a profit and from that a dividend was returned to all shareholders, including the primary care trust. The Lansley Act passed that 20% local share to the Secretary of State. That LIFT company is still operating, as others are across the country. Bristol Infracare LIFT paid dividends totalling £823,000 last year and £2,344,000 in 2016. Community Health Partnerships received 40% of that, but 20% should have been retained in the Bristol health economy. In the last two years, that amounts to £633,400 in Bristol alone, and that is replicated across the country. I am here today with a simple message for the Secretary of State, via the Minister: I want control of this asset to be given back to the local health economy, and I want our money back.

The closer one looks at the labyrinthine structures that govern NHS properties, the more it seems that the opaque and impenetrable way in which these companies operate is not accidental. They appear to be purposefully disenfranchising and disempowering local people. Whatever the merits of the Lansley Act—I contend that there are not many—it was supposed to drive devolution, liberation and accountability.