The Naylor Report (March 2017) is an independent report by Sir Robert Naylor for the Secretary of State for Health; it was endorsed by Theresa May before the election. In an interview with Andrew Neil in May 2017, the PM said: “We’re backing the proposals in the Naylor Report.
What is in the report?
The report looks into ways to raise funds so that new models of NHS care can be put into practice through 44 Sustainability and Transformation Plans.
In his review, Sir Naylor noted that “Without investment in the NHS estate the Five Year Forward View (new models of care) cannot be delivered, the NHS estate will remain unfit for purpose and will continue to deteriorate.”
Sir Naylor estimated that £10 billion is needed in response to these needs, including the “conservative estimate of backlog maintenance at £5bn and a similar sum likely to be required to deliver the (plans)”.
The report blames “historical under-investment and the failure to fully commit capital allocations in the past” for the substantial maintenance backlog.
The recommendation that Sir Naylor makes, and what has now been endorsed by the Prime Minister, is to raise this money through: NHS property disposals, private capital investment in primary care and allocations from the Treasury.
What does this mean for the NHS?
The Naylor report will force the NHS to sell land and property, this will be done in conjunction with private companies who will put up money to maximise the value of the estate and share in any profit made.
If the NHS Trusts do not commit to ‘maximise’ property disposals then ‘they would not be eligible to access public capital funding’.
The NHS will be incentivised to sell land and property as quickly as possible, through a 2 for 1 ‘limited time’ offer from the government.
Research commissioned by the Labour Party has revealed that property in clinical use is on the lists to be sold off.
The Naylor Report also wants private firms to build and maintain primary care facilities and charge the NHS rent on those facilities.
These deals are similar in principle to PFI and are likely to cost the NHS significantly more than if facilities were publicly funded, or if funds were raised through government borrowing.
These deals will be long term and thus tie the NHS into inflexible contracts restricting its ability to adapt to the latest healthcare challenges.
The deals also set the precedent for greater private sector involvement in the NHS, as well as offering them a greater cut of public money.