Essential insight into England’s biggest health economy, by Ben Clover

There was an interesting range of responses to my “Naylor’s gold” piece last week on the London estates whose sale could earn the NHS £5bn.

Readers pointed out several things that London Eye had failed to consider.

I’ll start with the largest.

The politics of inner west London has stymied bold thinking about Imperial’s estate, one contact tells me.

While people are focused on how hot a site Charing Cross might be in the future, there is another possibility.

St Mary’s Hospital is right next to Paddington Station. It does vast amounts of NHS work but it is need of significant refurbishment.

The argument goes: build a new wing somewhere on the site and earn around £2bn from the rest of the land. Plus, you’re not having to refurbish when it might be cheaper to rebuild somewhere else.

Obviously, this would amount to a pretty significant “St George’s-ing” (a term London Eye has coined to describe moving a powerful teaching hospital out of Zone 1 where hardly anyone lives and into the suburbs where many more people live). So it is pretty unlikely.

But in retrospect this is probably one of Sir Robert Naylor’s five £1bn-plus sites and might have been included to illustrate just what a prize was available if the government was prepared to be very bold.

Another possibility London Eye overlooked last time was Great Ormond Street Hospital.

It’s a global brand that is surely bigger than any mere location. GOSH’s central London home would also be worth a considerable sum, possibly north of £1bn.

London Eye is not sure if Sir Robert’s team examined where hospital services would be placed after their eviction from valuable land but there would surely be possibilities in outer London.

Readers took advantage of the anonymity available in the comments section of hsj.co.uk to point out several interesting things:

Outer north west London contains Harefield Hospital (part of the Royal Brompton) and Mount Vernon (a cancer centre that is part of Hillingdon Hospitals Foundation Trust) – these are both just within the M25 but it’s not clear that their disposal would generate much in the way of revenue saving or capital receipts. Also, the Harefield site gives the sometimes embattled Royal Brompton a few more options.

Sometimes embattled? The congenital heart disease consultation has already threatened work at the Royal Brompton, with knock-on effects on the other work the trust does. Is it unimaginable that the centre wouldn’t mind the trust losing this service and the related services, lessening its case for staying in Chelsea?

The trust’s intention is to stay and HSJ reported in 2013 that it had investigated and ruled out relocating to Cambridge, White City or part of Battersea Power Station.

In this context, it was interesting to see another commenter say the aforementioned Imperial had been “quietly on manoeuvres about the Brompton recently. And not for the first time.”