NHS Estate Management (Hansard, 18 May 1988)

§ The Parliamentary Under-Secretary of State, Department of Health and Social Security (Lord Skelmersdale)
My Lords, the Public Accounts Committee examined the chairman of the National Health Service management board on the findings of the National Audit Office report on 9th May. The Government will follow the usual practice of responding to the Public Accounts Committee's report within weeks of its publication.

Lord Campbell of Croy
My Lords, I thank my noble friend for his reply. Since a sample has shown that as much as 40 per cent. of land owned by health authorities may be surplus to requirements is there anything the Government can do, bearing in mind the cost of maintenance of that land and the alternative use to which the value of the assets could be put to benefit the care and treatment of patients?

§ Lord Skelmersdale
My Lords, yes, absolutely. The figure of 40 per cent. mentioned in the report is an estimate derived from a small sample of eight health authorities. Over the National Health Service estate as a whole the Government estimate that almost 13 per cent. of property is available for disposal in the immediate future and a further 12 per cent. should be available over the next 10 years. All proceeds from the sale of surplus property are retained within the health service for reinvestment within that service.

§ Lord Ennals
My Lords, does not that reply conceal what I consider to be two scandalous facts in the report of the Comptroller and Auditor General? First, the DHSS has not even monitored the claim made five years ago that there is now a maintenance backlog of £2 billion in NHS properties. Secondly, health authorities have failed to achieve annual savings of between £300 million and £500 million. That money could have been saved by the effective disposal of surplus property. It could have gone into patient care or contributed towards the maintenance bill.

§ Lord Skelmersdale
My Lords, for someone who is leading a campaign not to close a hospital, that is an extraordinary question, if I may say so. I point out that the backlog of maintenance has been reduced by £500 million in the past five years. About 68 per cent. of the estate is in a condition described as category A or B; namely, as good as new, or adequate with only minor deterioration. If the trend continues, 70 per 318 cent. of the estate should reach this condition during the year 1987–88.

§ Lord Ennals
My Lords, why then did the report not give those figures? Why was it stated that the DHSS had not even monitored the figures claimed five years ago? Was that information available?

§ Lord Skelmersdale
My Lords, as I said, much of the report was based on a very small sample. When the Government respond to the report in full in connection with their response to the Public Accounts Committee, the noble Lord and the House will receive a full answer.

§ Lord Kilmarnock
My Lords, the noble Lord said that the proceeds of such sales are retained inside the health service. Can he clarify that a little further? Are the proceeds retained purely on capital account or are they used for additional revenue expenditure? Perhaps the Minister can amplify.

§ Lord Skelmersdale
My Lords, the normal form is for capital receipts to go into the capital budget for capital improvements.

§ Lord John-Mackie
My Lords, can the Minister say where this land is available? Is it around hospitals?

§ Lord Skelmersdale
My Lords, one example might be a large mental illness hospital with a large amount of land surrounding it. It could be nurse accommodation in a very bad state which it was advantageous to sell and build elsewhere rather than put into a satisfactory condition. It could be an administrative headquarters or anything comprised in the word "estate".

§ Lord Harmar-Nicholls
My Lords, in view of the very clear innuendo behind the question put by the noble Lord on the Front Bench opposite, is there any evidence at all that the National Audit Office enquirers asked questions to which answers were refused?

§ Lord Skelmersdale
No, my Lords, absolutely not. As I said in my original Answer, the Public Accounts Committee which has the right and duty to call officials of my department examined the chairman of the National Health Service management board. I have had no suggestions that he did not fully answer its questions.

§ Lord Ennals
My Lords, bearing in mind the question put and the answer just given, perhaps the Minister would take note of page 4 of the report. At paragraph 11 there is a quite clear statement.

§ Lord Skelmersdale
My Lords, I believe that my answers have been equally clear this afternoon.

Earl Alexander of Tunis
My Lords, I declare an interest as a director of a hospital management company. Is my noble friend aware that negotiations are in progress to enable health authorities to make the best use of available land for medical purposes?

§ Lord Skelmersdale
Yes, my Lords. I am grateful to my noble friend for bringing out that point. Health 319 authorities now have a full guidance package to enable them to proceed with a systematic rationalisation of their estates. And they are doing just that.

§ Lord Cledwyn of Penrhos
My Lords, is it not the case that paragraph 11 of the National Audit Office report makes it clear that the noble Lord's department has not monitored the level of expenditure required to clear backlog maintenance and does not know whether the position has improved or deteriorated since it was assessed at £2 billion in 1982? The noble Lord must reconcile what he has said with what is said in the report. What has he to say about that?

Lord Skehnersdale
My Lords, what I can say is that earlier this year a minimum data set on the estate was agreed and issued to the National Health Service as part of the KŐrner initiative on health service information. I do not accept that we are doing absolutely nothing in this area.