What’s it all about

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. If you’re looking for the short version go here

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.

This is where it gets interesting. (are you still here). The short term plans don’t make any money available in 5+ years time

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 400 houses on the site and reduce the size and range of facilities to about 10-20% 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. This has been done.

Extra government money available when selling off land

The thing that could make this situation a whole lot easier is that WHHT have planned to sell off part of the Hemel Hempstead hospital site since 2015 and have in December 2016 changed the plan to increase the number of homes from 200 to 400 . Clearly selling the land if it is really not used is a great idea IF the money is used in the town but there’s no sign of that.

The residents wouldn’t mind if it was used partly to fund a greenfield hospital but that’s not happening. So that money will just go back to keep propping up Watford hospital. Don’t get us wrong, it needs it, but not at the expense of losing the opportunity of a greenfield site, and not at the expense of losing most of the hospital facilities in Hemel Hempstead.

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 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 

SOC approval

The conclusion is a that the SOC was approved by the HVCCG on the 29th of June 2017. It 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 will now go to the STP team, and then NHS England for approval. If approved an outline business case will be made and then a full business case. This will take several YEARS to do.

What’s the problem ?

The PROBLEM with this is that the SOC 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. We believe that their calculations could be made to work but they have refused to discuss the matter instead relying on external consultants who may have only spent a couple of days on the job !

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 but the WHHT and HVCCG STILL decide that it is the right way to go in removing the option from the SOC and pass it to the next stage.

Instead of running a public consultation they have gone to the lawyers who told them that as they consulted in 2003/2007 it was OK.

Instead of asking their finance people to work through the details with independent experts face to face, they have pushed through a plan based on flawed information.

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.

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