Health Minister Lord Markham does not know the meaning of the word 'independent'.

In a letter to a local MP Markham claims that the choice of Watford General for the emergency and specialist hospital was based on 'an independent feasibility study in August 2020,'

This is a misleading statement.

This refers to a Site Feasibility Study (SFS) commissioned by West Herts Trust, which concluded that building a new hospital at Watford General would be much quicker than building on a new clear site. This gave a green light to the Watford project.

But the SFS's conclusions were not supported by the evidence.  It was a poor report, which admitted that its conclusions were only 'subjective'.

Yet absurdly the Government still use the SFS as the only substantial bit of technical evidence for Watford General.

And the SFS was not independent.

Collins dictionary contains this definition:

An independent inquiry or opinion is one that involves people who are not connected with a particular situation, and should therefore be fair.

The Site Feasibility Study was  done by a 'company' called RFL Property Services Ltd (RFLPS). Sounds independent - but it's not.

According to its LinkedIn profile, RFLPS is a 100% wholly owned subsidiary of Royal Free London Group (RFLG).  Set up in 2018, RFL's main job is to be the estates and property department of that big London hospital system.


  1. Is effectively part of the NHS, like the West Herts Trust. Nine of RFLPS's directors over the years have shared their address with the Royal Free London Group or Trust
  2. Were already working on the West Herts projects - something that wasn't disclosed in the SFS

But there's more. The two Trusts have been very close to each other. In October 2018, the Royal Free London Trust and West Herts announced that they had “joined forces as part of a new clinical partnership. The partnership follows months of close collaboration between the two trusts.” It wasn't just clinicians - the Trusts worked together over recent years on digital systems, occupational health and bids for ultrasound contracts

There was no way RFL could take an unbiased, fair and balanced view of the arguments for and against locating the new hospital at Watford General. This is known as a conflict of interest. The close corporate relationships between RFL's owners and W Herts should have been made clear, but they weren't.

The judgement of the SFS is not valid because it is not independent. The Trust have no solid evidence for pushing ahead at Watford General.





Millions of pounds have been wasted as the design for Watford's new tower block hospital  has undergone big changes.

The West Herts Trust has posted a new video and pictures showing selected parts of its new design for Watford General - and it makes major changes from designs published just two years ago.

  • At least one block is now 14 storeys high rather than 12 as the Trust claimed recently
  • The front section of the new design appears to be several storeys higher than in previous designs. It will restrict the views from the main ward blocks behind it, increasing the amount of shade

The Government gave the Trust £53 million in 'scheme development funding' in 2022-23 - some  of that has been wasted as the Trust has kept changing its mind on how to squeeze nearly 1000 beds onto a cramped sloping site.

Just think how many doctors and nurses that could pay for.

This is the 2022 design for the new hospital - the front building was going to be around the same height as the 7 storey multi-storey car park, to the right.

Below is the latest attempt at a design - (from a different angle) All of the front building of the new hospital will now be much higher than the multi-storey, up to 11 storeys.  To the rear is one of the towers - 14 storeys instead of the 12 storeys claimed last autumn. The front building has also been redesigned.

The video is quite glossy (and would have been expensive to make) but only shows one side of the exterior. Here is the link:




Hemel and St Albans Hospitals lose key government funding

The Government’s flagship £20 bn-plus New Hospital Programme (NHP) has pulled out of funding Hemel Hempstead and St Albans Hospitals.

With costs of Watford General’s planned new towering infirmary soaring towards £1.3 bn, the other two hospitals will now have to be funded by the local NHS, including the deficit-ridden West Herts Trust.

That casts serious doubts on the prospects for hospital services in the two towns. There has already been a delay to the construction of some new facilities at St Albans.

The Trust originally assumed that the NHP would allocate money to build at Hemel and St Albans.

Now all the Trust’s NHP capital allocation will go to the Vicarage Road site, where projected costs have doubled in the last four years.

Confirmation that Hemel and St Albans have been cast adrift by the NHP came in a letter from Government Minister Lord Markham to Hemel Hempstead MP Sir Mike Penning.

Lord Markham said:

‘The NHP scheme for West Hertfordshire is for a fully funded new hospital at Watford. Whilst redevelopment work at Hemel Hempstead Hospital and St Albans City Hospital will not be part of the NHP scheme, improvements at these sites will continue to be supported by the Trust in line with their their planned approach and in collaboration with the local Integrated Care Board (ICB)’

The Trust is a long way off the financial stability it will need to fund the new Watford Hospital. It should be nearly breaking even now, but instead it faces an £18 m deficit this year and another deficit next year. Main construction work on the Watford facility will not begin until the end of 2026 – nearly three years away.

The case for a proper review of these impractical and unaffordable plans for Watford General is getting clearer by the day. There is plenty of time to consider the advantages of a new hospital on a clear new accessible site.



West Herts Trust has drastically reduced the number of opportunities for the public to question it about its redevelopment plans.

During the worst of the Covid crisis, senior staff explained and defended their ideas for the future, including Watford's towering infirmary, in a series of online events for the general public.  Hundreds took part.

But in mid-2022 two senior staff with special responsibility for the new hospital project left the Trust - and since then the number of public discussions offered by the Trust has plummeted.

Figures obtained by the New Hospital Campaign (NHC) show that a grand total of just 43 people attended Trust general public events on redevelopment in the whole of 2023.

Not one general public event was in Dacorum, with its population of 155,000. 

But one body  - the St Albans and Harpenden Patients Group - has been favoured with two visits by Trust redevelopment staff in the last two years. The organisation describes itself as 'a group that represents the public, Total recorded attendance at its two events on redevelopment was 8.

This was the St Albans Group's comment on the Trust's redevelopment plans in 2022:  'we strongly support the Trust’s three-site option.'

The figures obtained by the NHC are FOI 7042 attachment 1




Building of the new facility for Watford General Hospital won't start until the end of 2026.  Construction of the 260-foot tower block hospital was originally scheduled by architects to begin in the autumn of 2024.

The new date was announced by Health Secretary Victoria Atkins on a visit to the hospital last week. Perhaps without realising it, the Minister was confirming a two-year delay.

As recently as November last year, the West Herts Trust told local media that construction would start in 2025/26.

The teetering timetable will disappoint the Trust. But it does give the NHS to chance to reconsider this unrealistic plan and look at new site alternatives that could offer a better outcome for patients and taxpayers.


Money Troubles

The continuing hold-up may be linked to the Trust's dire financial problems. A £20 million deficit looms for this financial year, ending in March, with more to come next year.

West Herts is a smallish trust financially - about £500 million income - and it just doesn't have the financial muscle to take on the £1.3 bn towering infirmary project - one of the most expensive of the whole 40 'new' hospital schemes.

This is the height (pun intended) of financial irresponsibility.

The Trust's Chief Financial Officer warned in 2022 that it needed to break even to help it win Government approval for the towering infirmary. The Trust is miles from achieving that, with the 'outline business case' for the scheme stuck in Whitehall.

So severe financial cuts are being applied to try to get the Watford towers project back on track. The delay is giving management the chance to implement tougher measures on the three overspending divisions: emergency, medicine and surgery.

Our vital caring services are being cut back to fund the Watford Hospital rebuild extravaganza. 





The West Herts Trust have just spent £13.6 million on an acre of land that suffers from a high risk of flooding.

And they will have to raise the floor level of a major part of the new Watford Hospital by NEARLY FIVE FEET  to make sure it doesn't get flooded by surface water.

The Trust have had to pay that enormous sum (about four times the going rate for similar land) to accommodate the front entrance of their new tower blocks. They don't seem to have read their own Watford General planning application from 2021, which said that:

there are some small areas of the site, predominantly at the south corner / low lying areas, which are shown at high risk of pluvial [surface water] flooding. This correlates with the existing site topography, the southern corner of the site being the lowest area of the site and, therefore surface water ponding may occur.

A 'high risk' - the worst category for flooding danger - means that ' each year this area has a chance of flooding of greater than 1 in 30 (3.3%).' With climate change, that chance may be growing.

So the Trust's advisers say, in the planning documents:

It is recommended that the proposed finish floor level of the building located at the south corner of the site are set at above 54.5m AOD [AOD is basically sea level] (53.00m AOD TBC +1.2m + 0.3m freeboard),
which is above the predicted probable pluvial flood level.

In plain English, that means that the front entrance of the new towering hospital will have to be 1.5 metres above the existing ground to keep patients and staff in the dry.



This is what our Health Service can do when it wants the best for patients.

It's the design by the Princess Alexandra Hospital NHS Trust for a new hospital for Harlow in Essex, on a new site away from the centre of town.

A spacious site with plenty of greenery and space. There are car parks, but they will have trees. Buildings are functional but on a human scale, a maximum of seven storeys. There is room for expansion.

Harlow's wise NHS managers rejected town-centre options which would have been short on space. 

This is the link to the Harlow Trust's redevelopment plans:


This is what should be possible in West Hertfordshire - but our local Trust stubbornly persist in planning for Vicarage Road tower blocks of up to 16 storeys - a height of 260 feet or so. The £1.3 bn-plus towering infirmary will be surrounded by up to 1500 flats and houses. Access and transport are poor, and will remain poor.

The only real landscaping at the new Watford Hospital will be ... on the flat roofs of the tower blocks.

The cost will put the Trust's fragile finances under pressure for years. That is plain irresponsible.

Why can't West Herts have this quality of hospital? Why must the Trust continue with its plans for a looming hospital on a cramped and difficult site?

What motivates the Trust to refuse even to contemplate a new hospital on an accessible new site? 


Hospital issues - especially the difficulty of getting to Watford General Hospital - could become an important issue in the polls that are coming up, including the General Election.

That's clear from the results of a major public consultation on plans for the future of South West Hertfordshire.

With the results in several marginal Herts parliamentary seats looking too close to call, candidates will need to listen to complaints about the location of the Vicarage Road hospital. Access to GPs will also be a big issue.

The consultation on the South West Herts Joint Strategic Plan covered thousands of respondents and showed that:

  • One of the biggest issues for residents was access to healthcare
  • The 'principal concerns' on infrastructure 'related to Watford Hospital and the fact that this was hard to access.'
  • People frequently mentioned Health and Transport under the 'biggest single issue' category.
  • In the summary of responses - Hospital concerns about Watford featured highly.

A startling 'Word Cloud' showed which issues loomed largest for the people surveyed - and Hospital and Transport came up top.



The West Hertfordshire Trust was in full denial mode last week as it insisted that all was well with its 260-foot tower block hospital for Watford.

But there's growing uncertainty that the Trust will get the money to build the hospital - or approval for its preferred design.

  • On finance, a Trust Board meeting on 5 October was assured that there was 'full funding' for its triple-tower, 400-foot wide design. A Trust official claimed not to know that funding could be changed under future government finance reviews. Yet the Department of Health made clear in a press release in May that funding could be altered by government. In tough times for public spending, that financial uncertainty casts doubt on the Trust's £1.1 bn plus Watford plans - among the most expensive of all the 'new' hospitals.
  • On design, Watford Borough councillors will be taking a very close look at the Trust's present plans and may seek big changes. The Council's policy is to keep new buildings in the hospital area to a decent height of about six storeys. That could mean lopping over one hundred feet off the height of the present enormous design, which runs to the equivalent of 20 plus storeys. The Council's development management committee warned last month that it will also be looking at the quality of the design after doubts were raised about the amount of shadow that would be created by the three tall towers - crammed together just 15 or so metres apart.

The Trust needs to get real and accept that its plans just won't work.


The New Hospital Campaign has sent Parliament a scathing attack on the Government's hospital-building efforts, especially the plans for Watford General.

The Campaign has submitted to the House of Commons Public Accounts Committee a detailed report setting out the many failings of the Government's New Hospital Programme. The Programme aims to build 40 new (or refurbished) hospitals in England by 2030.  The Campaign's report says that:

  •  The reasons for the choice of sites for new hospitals, including Watford, have never been explained. There was no proper evidence to say why one hospital is to be given a new building while others are to be left as they are;
  • Plans for 'Hospital 2.0', a standard system of building, using factory-made components to cut costs and construction time, have been very slow to emerge. The West Herts Trust have been allowed to waste years on their absurd 260-foot high tower-block hospital, which will never fit Hospital 2.0;
  • The Trust will struggle to find any company to build their big and expensive hospital because there is not enough capacity in the construction industry. The narrow, sloping site right up against a working hospital makes Watford an unattractive proposition for contractors.

The Committee is likely to publish a very negative report on the Government's programme, and the NHC criticism will certainly play into that.

The NHC report to Parliament is here