HOSPITAL ACCESS COULD BE KEY POLL BATTLEGROUND
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.
TRUST IN DENIAL AS DOUBTS GROW OVER MONEY AND DESIGN FOR WATFORD'S TOWERING INFIRMARY
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.
CAMPAIGN HITS PARLIAMENT WITH ATTACK ON BOTCHED NEW HOSPITAL PROGRAMME
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
SIR MIKE BACKS CAMPAIGN CALL FOR REVIEW OF WATFORD PLANS
Hemel Hempstead MP Sir Mike Penning has backed New Hospital Campaign calls for a review by senior NHS officials of redevelopment plans for Watford General Hospital.
A scathing report by spending watchdog the National Audit Office has recently uncovered serious problems with the NHS's efforts to deliver 40 'new' hospitals, including the proposed collection of tower blocks at Watford, by 2030.
In a letter to the Hertfordshire and West Essex Integrated Care Board (ICB), which oversees the conduct of the West Herts Trust, Philip Aylett, NHC Co-ordinator, shows how the NAO report helps to undermine the Trust's case for Watford. Key issues include :
- Confusion over the amount of money needed to build the 260-foot Watford structure. The Trust have suggested it will take about £1.2 bn, but the NAO reveals that it could cost up to £2 bn;
- Concern that any new Watford building will be too small to serve the rapidly growing and ageing population of West Herts. The Trust is having to look again at its 'costs and scope' to make it fit within national guidelines;
- Lack of capacity in the construction industry. Few building companies will risk taking on massive projects like Watford General, where a severe and potentially contaminated slope alongside a busy existing emergency hospital makes the site very unattractive. That could mean higher costs and delay for the Trust's plans;
- Failure to consider alternatives that could offer better services for patients, and better value for money, which is a key factor for the spending watchdog.
Mr Aylett calls on the ICB to carry out 'a new review of possible sites for an emergency care and specialist hospital in West Hertfordshire.' That should include a new, independent and comprehensive review of potential clear, new accessible sites away from Vicarage Road.
Sir Mike has sent the NHC letter to Health Secretary Steve Barclay and West Herts Trust Chief Executive Matthew Coats, saying that he fully concurs with Mr Aylett's letter. Sir Mike continues:
'We have a great opportunity here to make sure that we have a hospital facility for the 21st and 22nd Century, and I urge all recipients of this letter to take the contents of it very seriously and treat it with the respect that it deserves'.
The NHC letter to the ICB is here.
'FULLY FUNDED' FUDGE OVER WATFORD GENERAL IS CRUMBLING AWAY
Remember the big Government statement on 25 May that new buildings for Watford General and 39 other hospitals were to be 'fully funded' ?
Some MPs, and the West Herts Trust, got very excited at the apparent confirmation of billions of money for new hospitals. in their constituencies.
But that phrase 'fully funded' is turning out just to be a bit of a fudge. The cheque is not in the post.
There is absolutely no guarantee that the W Herts Trust will get the funding for their 'preferred option' - a gloomy 260-foot towering infirmary on the current car park - or anything like it.
There are three reasons why 'fully funded' could be fake news for Watford General:
- The Government said the 40 Hospitals would be 'fully funded' first in October 2020 - but it turned out not to be true. The National Audit Office watchdog has attacked the Government for saying this, because Ministers had only set aside a fraction of what would be needed - £3.7 billion, when well over £30 billion will be needed to build the 40 hospitals, The Government were at it again in May this year, claiming that £20 billion would 'fully fund' the new hospital programme. That is simply not enough. 'Fully funded' is not a promise you can rely on.
- The Government has form in not being clear with the public over what 'fully funded' means for individual public services. It could just mean that a category of services or projects are being fully funded. The official statistics watchdog criticised the Government recently for suggesting that it would 'fully fund' the extra spending for teachers' pay rises in each school. That wasn't the case - they were only funding the whole category of schools, and some individual schools might not be able to fund the pay rise. If the Department of Health are pulling the same trick as their Whitehall pals, there is no guarantee at all that the individual project at Watford would be funded fully for what the Trust wants to do. Here is an article about the education case.
- It's all up for review, if you look at the small print. The Department of Health's press release on 25 May admitted that: Final funding will be subject to future spending reviews. Those reviews could be tough, as the Government tries to drive down the public spending deficit, especially in the years after 2025, when the Trust hopes to start building - and paying for - the Hospital. The Opposition has made similar statements about reviewing public spending projects. It doesn't look likely that the Watford General scheme - one of the two or three most expensive of the new hospital proposals at between £1 bn and £2 bn - will have an easy time in any reviews. It will certainly be poor value for money compared with a new hospital on a clear new site, with a lot of extra money being spent on shoring up the tower blocks on very sloping ground.
NO WAY OF KNOWING WHY WATFORD WAS CHOSEN FOR A NEW HOSPITAL
Audit Office says no documented evidence for final selection of Watford General
The Government’s decision to choose Watford General for a new hospital was made without proper recorded evidence, according to the public spending watchdog.
In scathing comments on the list of sites for development under the New Hospital Programme, a new National Audit Office report says it cannot determine ‘whether there was an evidence-based process for selecting these schemes as opposed to others.’ (page 24)
The NAO says civil servants have admitted that ‘the final selection of [NHP] schemes involved choices and judgements for which no further documentation is available ... there is no basis for us to determine why DHSC selected these schemes (page 22).
The Government’s failure to provide any explanation of why Watford General was chosen for the NHP rather than other sites - including clear new sites within West Hertfordshire - undermines the case for redevelopment there.
New Hospital Campaign Co-ordinator Philip Aylett said today:
“This is a devastating blow for the Trust. Neither they nor the Government have ever produced a shred of objective evidence for choosing Watford General for a new building.
“We now know that the Government’s choice of Watford General for development was based not on reliable evidence but on ‘choices and judgements for which no further documentation is available’. It is absurd that the future of our hospitals for the next 60 years should rely on such feeble, secretive foundations.
“The Trust may claim that they have examined and rejected the case for an alternative to Watford General following the three-year-old ‘Site Feasibility Study’. But that's grossly misleading The SFS study report admitted that its judgements were ‘subjective’. The Government’s own spending rules make clear that investment decisions must only be made on credible objective evidence. This whole process has been riddled with subjectivity - bias - from the start“
The NAO report contains many other criticisms of the NHP process. The New Hospital Campaign will be publishing a fuller analysis of the NAO report in the next few days. Here is the New-hospital-programme-report.
HOSPITALS ANNOUNCEMENT - MAINLY HOT AIR?
The Government got a lot of publicity for the announcement about the New Hospital Programme (NHP), including Watford General, last week.
But what did it mean? Maybe not that much.
The key headline was that many of the NHP schemes will be 'fully funded'. To a normal person, that would mean that the Trusts would know exactly how much money they will be getting. They would also know what buildings they are being allowed to construct.
But Governments with an election in the offing don't follow the normal rules.
In fact 'fully funded' is a misleading term. There is a very long way to go before the funding is secured and a design decided on.
This is what the NHP website says about funding:
All schemes within the New Hospital Programme follow a business case process, including being reviewed and agreed by ministers. Final individual allocations for schemes will only be determined once the Full Business Cases have been reviewed and agreed.
Watford General and the rest have not yet finalised the next stage of their applications - the Outline Business Case. The West Herts Trust have got to adapt their 260-foot tower block design to national standards based mainly on factory-made prefabs. That won't be easy, especially given the small and steeply-sloping Watford General car park site.
The Full Business Case may be many months off and a lot could happen before the Treasury finally agree the money.
Schemes won't start main phase construction until 2025 - after the Election.
Watch this space - a lot could happen in the next two years.
WATFORD GENERAL FUTURE - STILL MORE QUESTIONS THAN ANSWERS
The 25 May relaunch for the New Hospital Programme, including news on Watford General's redevelopment, leaves many vital questions unanswered.
The Trust have failed to gain government approval for their preferred option, and are now in the middle of a rushed redesign to meet the Treasury's demands for a standardised national approach based on 'modular' buildings produced in factories, known as 'Hospital 2.0'. No one has explained exactly what 'Hospital 2.0' means.
Tower blocks will be needed to squeeze 1000 beds onto the current surface car park. How high will they have to be? 16 storeys, maybe more.
Whatever happens at Watford General, the problems of access to a constricted and congested site in a highly built-up area will remain. The impact of building work on patients during construction will be severe.
Meanwhile, there is no detail on the future funding of Hemel Hempstead or St Albans Hospitals.
The fact is that the Vicarage Road site is a very bad place to put an emergency care and specialist hospital.
The NHC response to 25 May announcement is here
The Government press release about the announcement is here
BOTCHED WATFORD GENERAL PLANS MUST BE REVIEWED
A letter demanding an independent review of the West Herts Trust's botched plans for redeveloping Watford General Hospital has been sent to key health decision-makers.
The letter is jointly signed by Sir Mike Penning, the MP for Hemel Hempstead, and Philip Aylett, the Co-ordinator of the New Hospital Campaign. It has gone to Health Secretary Steve Barclay and the Integrated Care Board for Herts and West Essex.
The letter shows that Watford General is not a suitable site for redevelopment. It is extremely congested, inaccessible - and unpopular.
All options for the Vicarage Road site are unaffordable or offer very poor value for money - or both. Taxpayers will lose out if the Trust persist with their plans.
The Campaign believes a completely new emergency care and specialist hospital on a clear and accessible new central site would be the better way forward.
Public confidence in the Trust’s plans for redevelopment at Watford General is in doubt and political support is weak.
The letter calls for a fully independent review. This must allow for a genuine assessment of all options. The Trust should not conduct or even supervise the review, given its history of error and confusion over the project.
The full letter is below:
WHAT'S NEEDED FOR WEST HERTFORDSHIRE
- New state-of-the-art emergency care and specialist hospital, centrally located in the area and offering safe and good quality healthcare
- Working with other hospitals and health services in the area
- On a clear site that’s easy to get to
- Good public transport connections and affordable parking
- Zero carbon, in a green and healing environment
- Future-proof with room to expand
West Hertfordshire Teaching Hospitals NHS Trust insist that the redeveloped emergency care and specialist hospital must be at Watford General. But Watford General is the wrong site for the redeveloped hospital. That’s because new facilities at the Vicarage Road site would be:
- Squeezed into a densely-packed urban area with congested roads and poor public transport links
- Some way down busy roads from major centres of local population such as Hemel Hempstead and St Albans
- On a sloping site with difficult access
- Massively disruptive during many years of construction, as the main work would happen just a few metres from the existing operational hospital
- At the centre of what is planned to be Watford’s largest new housing estate, with up to 1500 flats and houses being built very close by – a recipe for even more disturbance during construction and even worse traffic congestion for ever
This is not a healing environment.
