Hospital friends and foes

Public sector finance: The prognosis is poor for NHS volunteer shops. By Paul Gosling

The endearing but amateur tradition of hospital shops and trolleys run by charities may be drawing to an end. Growing commercial pressures are leading NHS trusts to seek the best financial deal when awarding contracts for services provided on hospital premises.

The National Association of Leagues of Hospital Friends, whose members run many of the retail services using volunteers, says it is a misguided approach. Profits from Leagues go to the hospitals, contributing towards improved patient facilities such as books and televisions, and even helping to pay for scanners and other vital medical equipment.

"Commercialisation within the NHS is beginning to bite hard," says Andree Koval, development manager for the association. "Leagues are facing uncompromising pressure to increase their scale of operations, turnover and profitability - or face downgrading or even closure. Some have fought and won battles with their trusts. There are serious consequences for the complacent League with a trolley shop or tea bar."

But it is easy to understand why trusts are reviewing their relationships with charity shops. Commercial retailers recognise the potential for shops on hospital sites, which have local monopolies, and are willing to pay market rents. Trusts have to balance that rent against the donations from Leagues, which can be as much as pounds 50,000 per year.

Doubt over the future of charity shops is just one of many symptoms of the drive towards a more business- orientated approach from trusts. Some trusts are even dispensing with chaplaincy services to cut costs, with remaining chaplains forming themselves into discrete business units, focused on cost-cutting and performance - or "measurable outcomes" as one chaplain refers to it.

Trusts are also examining their property portfolios with a view to selling surplus assets and contracting out the management of nursing and doctors' homes. The review has been driven not only by cost factors, but also by a sequence of reports criticising the NHS for owning too many empty properties, thereby depriving the health service of either capital receipts or income, while leaving some people unnecessarily homeless.

In the North Thames region some of the small cottage hospitals have been sold for use as private nursing homes. Other surplus units are sold to charities and consortia for day care facilities, and for care in the community uses.

Nursing and doctors' homes are a special priority. Many are dowdy, and, after the ending of Crown Immunity, required considerable outlays to meet fire regulations. The homes often have shared bathrooms and kitchens, when staff want fully self-contained flats. The cost of converting blocks of shared homes into flats is substantial.

"The stock had been run down, and the capital investment requirement made trusts shudder," says John Mills, managing director of West London Health Estates, an arm's length agency of the Ealing, Hammersmith and Hounslow Health Authority.

"Sales were made not so much to draw capital for use elsewhere - though if that happened it was a useful bonus - but to find capital from elsewhere to improve our staff accommodation. Our big problem was attracting staff, and why should a nurse work for us, and live in poor accommodation?" asks Mr Mills.

Increasingly, staff accommodation within a campus is managed by a housing association on behalf of the trust. Rental income goes to the trust, with a management fee deducted. Homes that are off-site are more likely to be sold to a housing association, but with the trust retaining nomination rights. The now commonly held view among trusts is that they should concentrate on the thing they do best, offering health care, and allow housing specialists to provide housing.

Last month the Kensington Housing Trust bought 403 accommodation units from the Kensington and Chelsea and Westminster Health Authority, and agreed to provide a further 461 bed spaces, having borrowed pounds 8m from CLF Municipal Bank for the purchase and subsequent development. Staff from the health authority who managed the properties have been transferred to the housing trust.

At Ashford, not only is the trust involved in selling homes and leasing them back, but it has also sold 10 acres on the edge of the hospital complex to Tesco for a superstore. The capital receipts paid for the desperately needed refurbishment of a hospital, built 150 years ago as a workhouse infirmary, with overspill wards in wartime huts.

When hospitals have been forced to cope in such unsuitable premises it is difficult to criticise trusts for taking radical steps to bring health care into the modern world. But many patients and visitors will feel a touch of nostalgia for the old world of the charity trolley and the chaplain on his ward round.

Independent Partners; Do you need financial advice on your investments, pension or insurance? Book a free consultation with an independent Financial Adviser at VouchedFor.co.uk

News
people
News
Richard Blair is concerned the trenches are falling into disrepair
newsGeorge Orwell's son wants to save war site that inspired book
Life and Style
Audrey Hepburn with Hubert De Givenchy, whose well-cut black tuxedo is a 'timeless look'
fashionIt may be a paradox, but the industry loves it
Arts and Entertainment
The pair in their heyday in 1967
music
Life and Style
fashionFrom bathing dresses in the twenties to modern bikinis
Finacial products from our partners
Property search
Latest stories from i100
Have you tried new the Independent Digital Edition apps?
Independent Dating
and  

By clicking 'Search' you
are agreeing to our
Terms of Use.

ES Rentals

    iJobs Job Widget
    iJobs Money & Business

    Guru Careers: Software Developer / C# Developer

    £40-50K: Guru Careers: We are seeking an experienced Software / C# Developer w...

    Neil Pavier: Management Accountant

    £45,000 - £55,000: Neil Pavier: Are you looking for your next opportunity for ...

    Sheridan Maine: Commercial Accountant

    £45,000 - £55,000: Sheridan Maine: Are you a newly qualified ACA/ACCA/ACMA qua...

    Laura Norton: Project Accountant

    £50,000 - £60,000: Laura Norton: Are you looking for an opportunity within a w...

    Day In a Page

    Abuse - and the hell that came afterwards

    Abuse - and the hell that follows

    James Rhodes on the extraordinary legal battle to publish his memoir
    Why we need a 'tranquility map' of England, according to campaigners

    It's oh so quiet!

    The case for a 'tranquility map' of England
    'Timeless fashion': It may be a paradox, but the industry loves it

    'Timeless fashion'

    It may be a paradox, but the industry loves it
    If the West needs a bridge to the 'moderates' inside Isis, maybe we could have done with Osama bin Laden staying alive after all

    Could have done with Osama bin Laden staying alive?

    Robert Fisk on the Fountainheads of World Evil in 2011 - and 2015
    New exhibition celebrates the evolution of swimwear

    Evolution of swimwear

    From bathing dresses in the twenties to modern bikinis
    Sun, sex and an anthropological study: One British academic's summer of hell in Magaluf

    Sun, sex and an anthropological study

    One academic’s summer of hell in Magaluf
    From Shakespeare to Rising Damp... to Vicious

    Frances de la Tour's 50-year triumph

    'Rising Damp' brought De la Tour such recognition that she could be forgiven if she'd never been able to move on. But at 70, she continues to flourish - and to beguile
    'That Whitsun, I was late getting away...'

    Ian McMillan on the Whitsun Weddings

    This weekend is Whitsun, and while the festival may no longer resonate, Larkin's best-loved poem, lives on - along with the train journey at the heart of it
    Kathryn Williams explores the works and influences of Sylvia Plath in a new light

    Songs from the bell jar

    Kathryn Williams explores the works and influences of Sylvia Plath
    How one man's day in high heels showed him that Cannes must change its 'no flats' policy

    One man's day in high heels

    ...showed him that Cannes must change its 'flats' policy
    Is a quiet crusade to reform executive pay bearing fruit?

    Is a quiet crusade to reform executive pay bearing fruit?

    Dominic Rossi of Fidelity says his pressure on business to control rewards is working. But why aren’t other fund managers helping?
    The King David Hotel gives precious work to Palestinians - unless peace talks are on

    King David Hotel: Palestinians not included

    The King David is special to Jerusalem. Nick Kochan checked in and discovered it has some special arrangements, too
    More people moving from Australia to New Zealand than in the other direction for first time in 24 years

    End of the Aussie brain drain

    More people moving from Australia to New Zealand than in the other direction for first time in 24 years
    Meditation is touted as a cure for mental instability but can it actually be bad for you?

    Can meditation be bad for you?

    Researching a mass murder, Dr Miguel Farias discovered that, far from bringing inner peace, meditation can leave devotees in pieces
    Eurovision 2015: Australians will be cheering on their first-ever entrant this Saturday

    Australia's first-ever Eurovision entrant

    Australia, a nation of kitsch-worshippers, has always loved the Eurovision Song Contest. Maggie Alderson says it'll fit in fine