Uncategorised

'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.

by philip

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.

by philip

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

by philip