On the face of it there is very little to dislike about the proposal that hospitals should be allowed build or buy accommodation for key staff.
Nurses’ residences were long a feature of Irish hospitals, and many have now been converted to other uses. It is unlikely that such facilities – which sat somewhere between a boarding school and a convent – would now fit the bill, but the much derided shared-living developments that have sprang up over the last decade offer a template.
The provision of accommodation would help overcome one of the most obvious barriers to the recruitment and retention of frontline staff: they cannot find affordable accommodation. There are also less tangible and more long-term benefits in terms of both morale and status of those working in the healthcare system.
Minister for Health Stephen Donnelly has indicated that he is open to making funding available from his capital budget. However, he wants the HSE and the hospitals themselves to take the lead in finding solutions. Therein lies the rub.
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Before he signs any cheques the Minister would be well advised to ask his officials to dig out the Comptroller and Auditor General’s 2002 value for money examination of car parking at Beaumont Hospital in Dublin. It looked at the hospital’s decision to build a 600-space multistorey car park in 1998 in partnership with a developer who built the car park in return for a 13-year lease and the right to charge for parking. There were also significant tax breaks available. The C&AG concluded that the tax-based funding cost more than it would have for the hospital to have built the car park itself – and the hospital did not receive the income it expected from the parking fees.
The read across for HSE and hospitals now considering building or buying housing for staff is clear: avoid financial engineering. It is not their area of expertise. It would be a mistake for hospitals to view the provision of housing for staff as an opportunity to create a financial asset or an income stream. It would be done purely to address a problem in finding skilled staff.
