What’s it all about ?

Old buildings and un-used land

Last updated 14/6/19

For many years there have been 3 hospitals in the area known by the local NHS as West Herts. This is an administrative area who’s definition is explained on the FAQ’s.

The hospitals in Watford, St Albans, and Hemel Hempstead are all old crumbling buildings that have been patched up, and added to since Victorian times. This is already the case with Watford Hospital  – parts of which were built as a workhouse in 1836. Parts of the other hospitals are in similar condition either being closed due to asbestos contamination or are just unfit for use.

As the years have passed, parts have been added, and parts have been closed on each site and now all 3 are in major need of some TLC or a bulldozer. Maintenance is already tens of millions of pounds behind schedule and there is slim chance of catching up.

The immediate problem is that money is tight, and it is nearly impossible to  either maintain what is there OR building a new hospital let alone doing both. We recognise that and so do the NHS locally. The government have hard targets for the NHS to meet and without getting into politics (this is a non political group), it is a challenge JUST to balance the books let alone maintain what we have OR build new.

So it’s difficult. We know that and so do the NHS. We sympathise…. really we do.

The problem for everyone is that while having to do things short term (as dictated by the government with it’s STP program – which basically only looks at things in the next 5 years) the future MUST be considered NOW or yet another generation will have to put up with sub-standard facilities.

Several years ago the local NHS started making plans for the long term. Nothing happened. Today, there are new plans on the table that look at long term things BUT are tied up with short term issues like not overspending and having enough money to maintain what is there. So in a nutshell, there is not enough to do BOTH; compromises have to be made. Clearly this makes good business sense in anyone’s book.

The good news is that there are some funds that may become available if the extra land that exists on all 3 sites was sold off and the money used to maintain and/or improve services and facilities. Some of this has already been done in Watford with the establishment of the Watford Health Campus which is actually private housing and commercial buildings. Other ideas are being explored in Hemel Hempstead with discussions between the current owners WHHT and Dacorum Borough council to put  houses and a school on the site and reduce the size and range of facilities to about a third of the existing size.

Clearly there are loads of issues to take into account and lots of detailed work for professional people to look at over many years.

Extra government money available when selling off land

The thing that could make this situation a whole lot easier is cash raised by selling off unwanted land. There have been plans to sell off part of Hemel Hempstead Hospital   site since 2015 and build 200 houses and a primary school. 

In December 2016 Dacorum Borough Council consulted on upping the number of houses from 200 to 400. 

In April 2017 this was clarified by the council who said

“There appears to have been a misunderstanding. The Council intends to increase the part of the site allocated for residential – to the detriment of the land earmarked for health use. This is not the case. The change incorporated through the Main Modification reflects new technical evidence which suggests that the existing area proposed for residential use will be able to be delivered at a higher density than originally envisaged – hence the overall numbers of units increasing.”

It’s a neat response but it basically means that they didn’t say why it had increased it from 200 to 400 and then made the incorrect assertion that the readers had been provided with the full information that it had been increased by selling off more land when actual fact it had been doubled by packing the houses in at double the density for the same amount of land.

Dacorum Borough council updated their site allocation document in June 2017 confirming that the area was 6.96 hectares which might enable 400 houses. See page 29 and 97.

Unfortunately the trust don’t seem to be aware of this as at the public meeting on the 13th of June 2019 they said that 200-240 houses would be built on the Hemel site and the area of land being disposed of was 2.1 hectares of the 6.96 hectares site.

Clearly selling the land for much needed housing and a new school could be a great result but the “preferred option 1 (June 2019) will see 97% of projected £350m spent outside Hemel Hempstead. The only money spent in option 1 is to re-build the urgent care centre.

Fresh ideas about selling off land ?

The other thing going on at the moment is the Naylor review. This was  endorsed by the government in the run up to the election as it promises the NHS that if it sells off surplus land, the government will triple the money so it can invest in the future. Read about the Naylor review here .  There is an excellent Youtube video that is mostly accurate and really easy to understand.

NHS Improvement tell the trusts to consult with the public

On the day that the CCG board voted to approve the previous failed SOC the head of NHS England Jim Mackey wrote to 14 CCG’s across the country who had previously written to him saying they didn’t have enough money. He told them this

NHS trusts should also consult the public and “ensure that patients and staff are engaged throughout the planning and implementation stages of CEP”, especially if plans ultimately involve the downgrading or closure of A&E or maternity units.

Source The guardian 29th June 2017 

2017 SOC approval

The conclusion back in 2017 to the first Strategic Outline Case (SOC) was that the document approved by the HVCCG on the 29th of June 2017 will ONLY look in more detail at 2 options

The extract above is from the SOC (Strategic Outline Case) which is available here

The SOC went to the STP team, and then NHS England for approval. What happened next was the document actually went to the treasury (who didn’t look at it) but said “There’s no money so go back to the drawing board. Which is where we are now.

What’s the problem ?

The PROBLEM with this is that the current SOC (due to be released to the public 20th of June 2019) does NOT include ANY plans for building a NEW hospital on a greenfield site. It ONLY includes plans to either re-develop or re-build the site in Watford. The answer everyone in West Herts needs isn’t even in the SOC for comparison purposes. The reasons for this are long and difficult with lots of argument and counterargument from all over the place.

Suffice it to say that WITHOUT the SOC having provision for a NEW hospital that is accessible to everyone in West Herts, we will not be satisfied.

The case for a greenfield site

Taking in all of the debate, discussion and positions, it would seem as though the case for a greenfield site remains strong.

  • Best solution for all of West Herts YES
  • Ideal clinical position YES
  • Community support YES
  • Political support YES
  • Accessible site YES
  • Enables all 3 towns to have local hub Yes
  • Saves money – about £220m
  • Open sooner – 6-7 years

The only REAL reason WHHT and HVCCG really have after listening to their CEO’s at their board meeting is money & politics.

Hasn’t this taken years to go nowhere ?

Yes.

The CCG and trust admit it has taken years to get agreement on what to do. The position today (14/6/19) is the local NHS want to submit their latest revised SOC to NHS England & NHS Improvement at the end of July for it to then be included in the Government spending review that takes place after the summer break.

Currently that will probably say they want to pursue option 1. In fact they said as much at last nights public meeting. “Option 1 is the EMERGING preferred option”

Which is where we come in. Our proposal (which we are taking to the the local NHS on the 21st of June 2019) will bring a new option to the table. More details will follow, but at this stage, this is all we have time to get out there.

We don’t think that the local NHS will change from the “Emerging preferred option” and the “Preferred option” will still be option 1 on the 20th of June when the public get to see the current SOC .

However we will do all we can in the short space of time there is – 7 days from seeing the detail on the “Emerging preferred option” – to put forward an “Alternative  Emerging Preferred Option”

So where does that leave us ?

The opportunity is there to sell some land, invest in the future, put a new hospital in a location that works for the entire population of West Herts. Our proposal probably won’t make it into the SOC put forward to the spending review BUT considering how long it’s taken to get this far (please don’t laugh), that shouldn’t be a problem.

HVH is presenting a positive vision of Acute Hospital provision for the 21st century, using the step-change advantages of “Patient-Flow” design to unlock massive efficiency gains, transformed patient experience and staff working conditions, AND reach a completion of development faster.

It will also ensure we do the very best to keep local services in the towns where practically and economically realistic.  

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