General Health Co-operative (GHC) in Seattle is selling its last hospital.
In future GHC will provide healthcare to over 600,000 people by using hospitals belonging to other organisations. Outside healthcare this would not be seen as a radical idea; airlines often do not own the aircraft they use and department stores lease space to other retailers. But in hospital care the buildings and the history associated with them have been seen as inseparable from the service.
This paper proposes a system in which some trusts would choose to operate as clinical groups that use assets provided by a property management organisation. This would deal with a number of problems with misaligned incentives in the current market. It would also create opportunities for much more imaginative models of commissioning, provision and the design of health buildings.