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This update on hospital redevelopment in West Hertfordshire comes from the New Hospital Campaign (NHC), which is calling on the Government and the NHS to locate a new emergency care hospital for the area on a clear central site.

West Hertfordshire has been promised funding as one of the first of the new hospitals in the Government’s programme, but it’s vital that this investment is made in the right place. An emergency care hospital should be accessible to everyone across West Herts, offering a healing environment and providing value for money.

A hospital on a new site, convenient for all, could provide:

  • A good environment for care, with buildings on a human scale, decent landscaping and room to expand as our population grows
  • Convenient, easy parking, especially for people with mobility problems
  • Planned access by road and public transport from all of the area
  • Buildings that help achieve zero carbon, are suited to new technology, and offer single rooms for privacy and infection control
  • Speed of construction, as building can go on without interruption or disruption

There are several possibilities for clear new sites, easily accessible from everywhere in the area, but none has yet been properly assessed by the West Hertfordshire Hospitals NHS Trust (West Herts Trust), who continue to insist that new hospital facilities must be located at or around Watford General Hospital.

The NHC case was put to the Health and Social Care Secretary, Sajid Javid, on 7 February, when representatives from the Campaign took part in a delegation led by Sir Mike Penning MP. We look forward to positive results from that meeting.

Refusal to consider alternatives

The West Herts Trust say that redevelopment must take place at and around the increasingly cramped current site of Watford General in Vicarage Road.  They constantly manipulate the facts to support this view.  They did not, for instance, properly assess the risks of redeveloping at Watford General before the decision was taken to reject all new site options in favour of Watford in October 2020. This was a serious error.

But other trusts are taking a different route

The West Herts Trust’s attitude is baffling: in nearby Harlow the Princess Alexandra Hospital Trust, faced with the same choice of blundering on with redeveloping an existing, cramped town centre site or building anew on a clear ‘out-of-town’ site, have chosen the new site.

The Harlow Trust have analysed the evidence for a hospital on a clear site, and concluded it would be built much faster and more cheaply and give far better results for patients.

The huge flaws in the West Herts Trust’s plans

West Herts NHS Trust stubbornly refuse to admit that


That refusal to look at alternatives flies in the face of common sense and is – unsurprisingly – creating a number of critical problems.

Lack of space is one of the biggest difficulties for their Watford plans.

The Trust are trying to fit a 1000-bed new hospital facility into a plot that is half the size of the current one. It’s a mystery why the Trust have given up so much of their land. But the answer may lie in the murky depths of the so-called Watford Health Campus, an agreement under which developers and Watford Council have been planning large amounts of residential and other development on and around the current hospital site.

Squeezed into a small space, the Trust have had to plan to build high. The Trust’s current proposals would see demolition of most existing buildings at Watford and the building of three tall towers, the biggest 270 feet high – making it the tallest NHS building outside central London. It would of course look ridiculous among the (mostly) two-storey houses of West Watford. Furthermore, if the unthinkable were to happen, local fire services are not adequately equipped to deal with a fire in a building more than 150 feet high.

The Trust have also known for nearly a year that these towers would break the budget – it would cost over £900m to build and equip the three towers as designed. The money simply isn’t there from the Treasury for what the Trust plan to do.

So the Trust will have to curb their enthusiasm for their towering infirmary. But redeveloping at Watford General in other ways would almost certainly  mean having to retain and refurbish the existing buildings – which are in a desperate state.

Over three years ago, an expert survey of the condition of the Watford General buildings concluded:

  • Almost all of the buildings were in an unsatisfactory condition and not ‘functionally suitable’
  • The site services infrastructure – including electrical, steam heating system and hot water – was at the end of its life
  • It would cost at least £240 million to catch up with the maintenance backlog

The situation has got worse since that survey was done – there are over 1000 maintenance call-outs a month at Watford.

But any redeveloped or new facilities at Watford General would suffer other serious problems:

  • A poor environment – there will be serious overdevelopment of the constrained site around Watford General, with a total of 1500 flats and houses, a hotel, a school and industrial units either built or planned
  • The likely move of the Mount Vernon Cancer Centre to the Watford General site will add further congestion
  • The Watford site is mostly steeply sloping, and there are pollution and flooding problems that have not been properly investigated. That makes development expensive and subject to many risks
  • The construction noise, dust and pollution just a few metres away will disrupt the lives of patients and staff at the existing Watford hospital for many years – probably for the rest of the decade
  • The expense needed to redevelop Watford would deprive the Trust’s other hospitals, at Hemel Hempstead and St Albans, of much-needed investment.
  • Already poor access will get worse as car park places are cut and the site’s overdevelopment increases traffic. Greener travel is vital, but the Watford General car park spaces are being reduced immediately – with no funded plans in place for alternative means of transport in the near future
  • Travelling to Watford from Hemel Hempstead, St Albans and elsewhere across West Herts is bad enough now – it will only get much worse.

The Trust seem to have run out of Watford redevelopment options that would be good for patients, as well as being both affordable and providing value for money. They are struggling to produce a preferred option – that is months away from being decided.


There are a number of realistic possible alternatives to the Trust’s faltering and delayed plans for Watford. These would see an easily-accessible emergency care hospital on a clear new site, combining with vibrant local hospitals to serve the whole community of West Hertfordshire.

This would not have to re-invent the wheel – there are elements of the Trust’s existing plans which could be adapted to fit with an emergency care hospital on a new central, out-of-town site. All that is needed is a rational approach which moves away from the Trust’s obsessive determination to redevelop emergency care at Watford General.

The Trust should now reconsider their decision to reject new site options for an emergency care hospital. They need to commission a proper independent study of all the alternatives, this time based on credible evidence.

The New Hospital Campaign is a collaboration between Dacorum Health Action Group, Dacorum Patients Group, and campaigners from Berkhamsted and St. Albans to share ideas and strategies to fight specifically for a new A&E hospital for West Herts in a more central location.

*Journalists and members of the media, please click here for our full press release