Intended for healthcare professionals

Head To Head Head to Head

Should we welcome plans to sell off NHS land?

BMJ 2017; 358 doi: (Published 27 September 2017) Cite this as: BMJ 2017;358:j4290
  1. Robert Naylor, national adviser on NHS property and estates,
  2. Kailash Chand, GP
  1. Correspondence to: Robert Naylor robertanaylor{at}, Kailash Chand kchand{at}

The government seems likely to back the recommendations of Robert Naylor to raise capital by selling off inefficiently used assets, but Kailash Chand worries that services could be threatened and that public consultation is lacking

Yes—Robert Naylor

The Organisation for Economic Cooperation and Development rates the NHS as the most cost effective health system in the world,1 but with more than £5bn (€5.6bn; $6.8bn) of backlog maintenance the quality of our buildings and equipment leaves much to be desired. Our doctors and nurses—and particularly our patients—deserve better.

The 1962 Hospital Plan for England2 created the hospital system we have today, but the NHS has failed to modernise—18% of buildings predate the NHS itself. Last year’s Carter report3 evidenced poor management and unacceptable variations in estate costs. It recommended that hospitals have strategic plans to create modern healthcare facilities. In response, the government commissioned me to carry out a review 4 to develop a strategy to identify unused or underused estate, with specific targets to release £2bn and to deliver land for 26 000 new homes.

Homes for NHS staff

My review concludes that the disposal value of wasted estate could be as high as £5.7bn and the new homes target could be delivered in the London region alone. These “affordable” homes should be prioritised for NHS staff in high cost residential areas to tackle escalating staff shortages. Local decisions should determine if land should be sold, leased for development, or developed by the NHS itself.

Additionally, the disposal of this estate would boost local economies and save the NHS £1bn every year. These funds, together with Treasury and private sector funding, to a total of £10bn, should be fully reinvested in the NHS to deliver a modern estate.

This is absolutely not privatisation or a “fire sale” but a reinvestment of wasted assets to …

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