How a £200m government pledge could unlock billions in primary healthcare investment
PHP medical centre in Milton Keynes | Credit: PHP
The private sector can ensure that the country has primary healthcare facilities fit for the 21st century.
If any good has come out of Covid-19, it is the reminder to us all of the tireless, risky work that our doctors and nurses put into every shift in our hospitals and day in the primary health centre.
Politically, it is to be hoped that the way the NHS has handled the disease, with entire wards dedicated to Covid-19 treatment, will accelerate the shift to integrated care.
There is now a backlog of nearly seven million hospital appointments, with warnings the waiting list could hit 10 million by the end of the year.
Primary care must play its part in reducing those numbers.
There is no reason, for example, why x-rays and routine endoscopies could not take place in primary healthcare hubs.
Already NHS England is asking primary care facilities to do its bit by acting as bases for Covid-19 swab testing, effectively creating semi-permanent ‘hot’ and ‘cold’ sites within a surgery.
Swab tests would take place in the former, while the latter would remain dedicated to conventional treatment – but facilities will need the flexibility and space to be able to effectively adapt the working environment.
To meet ministers’ ambitions and the fast-evolving needs of primary healthcare, we require just a small commitment from the Government.
By pledging only £200m-300m a year in rent, as decided by an independent district valuer, the private sector would have the income stream needed to build or upgrade up to 750 primary healthcare facilities.
Moreover, this work could be completed in just a couple of years - much faster than hospital infrastructure.
That is just a tiny fraction – around 0.2% - of the NHS budget, a mere drop in the ocean of funding that will now inevitably go to hospitals.
A 0.2% budget assurance to transform healthcare for millions of people.
We estimate this would unlock at least £3bn of private investment, but could be as much as £5bn.
We have written to ministers and the NHS to outline this proposal.
We understand there is some trepidation, even in a Conservative government, about private capital and healthcare.
But the model used here has been in place for well over a half-a-century – it is one with a long history of success and frees up GPs to focus on their patients rather than building maintenance.
To be clear, this is a traditional tenant-landlord relationship, not the crippling absurdity of Private Finance Initiative mortgages or failed LIFT projects.
It is true that some pressure will be taken off primary healthcare, because people are now getting used to online appointments. What is also plain, though, is that many primary healthcare buildings are already struggling with modern treatment and the ramifications of the pandemic will only make this situation worse.
In March 2017, Sir Robert Naylor’s review into NHS estates found that primary care buildings needed at least £3bn of investment, plus a backlog maintenance bill of £5bn. He said private sector investment was necessary – and that need will have only got greater more than three years later.
The private sector can ensure that the country has primary healthcare facilities fit for the 21st century.
All we need is a small commitment from the Government – a 0.2% budget assurance to transform healthcare for millions of people.
Harry Hyman is managing director at PHP, a specialist in the rental of flexible and modern primary health care properties, which has been operating since 1995.
If you would like to get in touch about this issue, please email phpuk@powerscourt-group.com
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