NHS competition chaos: why we need to protect the health service

In November, the Royal Brompton hospital in West London announced a major new program of investment to be funded by the sale of old buildings and land owned by the hospital trust. Described as a “property bonanza” (particularly given its West London location), it has been courted by a number of property developers who are keen on the site and the potential for profit.

So when the Royal Marsden – the world-leading cancer hospital – proposed plans to buy the building, they were rejected in favour of the property developers. The Marsden’s wanted to buy the extra space so that they could, in collaboration with the Institute of Cancer Research (ICR) expand facilities for cancer care and research. Both the Royal Marsden and ICR are world leading cancer organisations committed to cancer care and research. However, the current working plan is for the Royal Brompton to sell the site at a much higher price to develop the area into a luxury housing development.

As highlighted in the London Evening Standard, “The Marsden values the building at between £25 million and £30 million, well below the sum sought by the Brompton, which believes it can raise £500 million from its entire site.” As the figures suggest, the sale will create a significant financial benefit for the Royal Brompton at the expense of land and buildings designed for community use. In order to deliver its ambition investment plans, it is difficult to criticise the activities of the Royal Brompton, which is merely working in with rational self-interest. In fact, it is entirely right for them to pursue a sale for the best price available in order to benefit their patients and maintain excellent services. Yet, this dispute – dubbed the “Battle of the Royals” by locals – is a microcosm of much wider national problem that deserves attention by the Labour party.

Following Lansley’s reform agenda, the system is broken. While competition at its best tends to increase quality and reduce costs, Lansley’s reforms have done exactly the opposite. Although there will be a significant financial gain for the Royal Brompton, the wider NHS service provision will be damaged. In a recent consultation, the current plan “has the potential to severely constrain the Institute of Cancer Research’s ability to carry out and expand our world-leading cancer research in Chelsea.” The Royal Marsden is a great hospital and delivers world class cancer care – it must be protected and continue to flourish. In contrast to the development of luxury flats, the Marsden expansion will be of great benefit to the borough, London and the UK. As Professor Field warned back in 2011, “If you had a free market, that would destroy essential services in very big hospitals but also might destroy the services that need to be provided in small hospitals.”

On a national level, the potential Labour plan to increase funding for the NHS is a vitally important measure and will help funding shortfalls across the wider healthy service. However, Labour should put a freeze on further reforms, and conduct an investigation into successes and failures of current Tory plans. Following this, we must repeal measures where it is evident that competitive tendencies hinder rather than help patients.

In a controversial meeting of the Tory Reform Group, the public health minister, Jane Ellison ominously suggested that the “Lansley act … gave away control of the NHS”. In response, we must reverse this competition chaos, save our NHS and make sure that world-class public healthcare is protected for the benefit of all.

Oliver MacArthur works on the investment team at a charitable endowment, has worked with the Royal Bank of Canada and occasionally tweets @olliemacarthur. He is a member of Labour in the City.