Horsham MP Francis maude has said there is a ‘powerful synergy’ between attaining a new public/private acute hospital for the area and development plans for 4,500 north of Horsham.
But what do you think? Is provision for a new hospital on the North Horsham development a golden opportunity or a monumental bribe to develop 800 acres north of the town?
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SPECIAL REPORT by Theo Cronin
After years of debate, behind the scenes wrangling, and open campaigning, a new hospital for Horsham is now ‘a perfectly practical possibility’, says the MP for Horsham Francis Maude.
Significant pieces have all fallen into place, with one key exception – the support of the local GP community which is to be garnered at an especially convened meeting this Saturday in Horsham.
From April 1, extensive changes to the NHS put local decision-making firmly into the hands of GPs and their Clinical Commissioning Groups (CCGs).
Mr Maude maintains it is they that now have the power to make or break a deal which could see a new acute hospital built as part of the 4,500-home North Horsham development first revealed by this paper 15 months ago.
In a letter to GPs requesting their attendance at a meeting on Saturday he wrote: “There is some urgency here. There is a powerful synergy between a new acute hospital and a major housing development between Horsham and Crawley, which would both meet housing demand and fulfil the longstanding desire of local communities for a world-class accessible hospital.”
It is a position strongly advocated by Ray Dawe (Con, Chantry), the leader of Horsham District Council – the local planing authority which will determine the North Horsham planing application once submitted.
“This is make or break time,” he told the County Times. “The politicians, MPs and local councils have now brought it to a point where it has got to come down to the GPs.
“The GPs must decide if they want this or not, because if they are prepared to support it, it can go through to the next stage and we can look at it in more detail.”
Last December Mr Maude and Mr Dawe, accompanied by representatives from Crawley Borough Council, Liberty Property Trust , and Circle, which is Europe’s largest healthcare partnership, met with the Secretary of State for Health Jeremy Hunt.
“We have had a positive meeting with Jeremy Hunt where we presented the opportunity,” said Mr Maude. “He made clear that this exciting new model of acute hospital provision is entirely consistent with the NHS reforms, and that the key to success would be the support of local GPs and the new commissioning groups.”
However, speaking to the lead clinicians at both the Horsham and Mid Sussex CCG as well as the Crawley CCG, the County Times has been told doctors will not be rushed into making a non-evidence based decision.
It also became apparent that the concept of a new acute hospital is at odds with their drive to grow and improve more community based healthcare in the area.
FOCUS ON COMMUNITY CARE
The lead GP for Horsham and Mid Sussex CCG, Dr Simon Dean, said: “As a CCG we are keen to continue with our work supporting community services. At the moment our focus is very much on improving services offered by the existing Horsham Hospital.”
The doctor, who is now in part responsible for an annual medical budget of more than £230million in Horsham and Mid Sussex, added: “The new model of a hospital is different to what people may have traditionally thought of. To my mind a hospital is now principally based around day-care, day-surgery, investigations, scanning, some step-down beds and rehabilitation.
“That’s the model that I understand is going to be much more widely applied across the country in the future.
“The model of just admitting a patient to a bed and just trying to sort them out is not the model we want to be going forward with.”
Dr Dean’s colleague at the Crawley CCG, its clinical chief officer Dr Amit Bhargrava, concurred.
He said: “Our focus is on community services, a health campus philosophy. What we are trying to do is move services that would ideally be placed in the community away from the hospital and invest in those.”
However the Crawley clinician did add: “Whatever decision is made has to be very measured, very deliberate, and it has to look at intended and unintended consequences of what would happen.
“So I don’t have a view on hospital services, but I am very clear that we have to have sustainable, quality assured safe services.”
MORE EVIDENCE REQUIRED
Dr Dean also maintained that his current position is not set in stone – rather that as yet to his mind there was not the evidence base upon which to establish such a crucial decision as the provision of a new hospital.
Instead his CCG has already commissioned a study investigating the health needs of the local population both now, and into the future, with an ever-ageing population a particular focus.
“I hope this work will allow us to formulate our opinions,” he said.
It is a position that will likely frustrate Mr Maude who has categorically stated ‘there is some urgency here’, yet the CCG’s report may not be published until late summer.
URGENCY NEEDED SAYS MP
When the paper put to Mr Maude that Dr Dean wanted to wait to base any decision on this new evidence, he said a little tersely: “The opportunity may well have gone by then. We can’t operate on the basis that we have to start thinking about everything again from scratch.
“This has been endlessly discussed and endlessly analysed, and you cannot simply put everything off on the basis that more work needs to be done.
“There comes a moment when as a matter of principle local GPs can say this is something that can benefit our patients, would benefit my local constituents, and other things being equal, we are in favour of it.
“That’s all they are being asked to say,” he said - a point he intended to make firmly at Saturday’s meeting.
YOU OPINION COUNTS
Mr Maude and Mr Dawe are both urging residents to petition their GPs about a new hospital. Meanwhile Horsham and Mid Sussex CCG is hosting a public event from 10am, April 30, at Pavilions in the Park, Horsham. CCG chair Dr Minesh Patel said: “The changes to the NHS are all about tailoring local services to local need. It’s up to the public, combined with doctor’s expertise, to help us to decide where best to focus our attentions to deliver health and wellbeing that really meets the community’s needs.”
IS DEVELOPMENT GOLDEN OPPORTUNITY OR MONUMENTAL BRIBE?
The North Horsham development plans were first revealed in this paper in January 2012 with provision for a new acute hospital initially indicated at the west end of the 800 acre site to the north of the A264, close to Langhurstwood Road.
In the intervening time it has become apparent that a more favoured site would be further east closer to Crawley and Liberty Property Trust, the developer behind the scheme, has produced the illustration opposite, with hospital location in purple.
The vision statement for the development states it includes provision for ‘a new regional A & E hospital’.
The land, which is at present mostly agricultural and greenfield in character, could also accommodate according to the statement; 4,500 homes of mixed type and tenure; 25 acres of land for employment opportunities; a new railway station and associated parking; provision for two primary schools and a secondary school; three local village centres; a mix of community and leisure uses; a new country park; and significant enhancement to local biodiversity.
Andrew Blevins MD of Liberty commented this week that they were committed to providing significant economic development as part of the North Horsham project to provide up to 4,000 new jobs.
“We will also continue to work with the local authority and other interested parties to help deliver this much needed medical facility for the region,” he said. “Should this receive the necessary backing we can certainly accommodate a new A&E Hospital as part of the scheme.”
But is this a golden opportunity for the people of Horsham or simply a monumental bribe in favour of nearly 5000 new homes on green field land, growing the town population by a quarter?
We put this to those promoting the hospital scheme this week, as well as the doctors at the CCGs now charged with making a decision.
Before answering the leader of Horsham District Council, Ray Dawe (Con, Chantry) let out a long sigh, and then said if the council could get a better facility for Horsham, it should be trying to do so.
“You could regard it as a bribe,” he also said. “Clearly if you throw a hospital into the equation it is quite obvious to anybody it is more persuasive than without a hospital.”
He cited personal experiences that had convinced him that the current facilities offered at East Surrey Hospital were inadequate, and that the council and its members would look more favourably on development plans that could address the paucity of primary healthcare services in the north Horsham area.
It has long been suspected that the North Horsham development would be the council’s preferred large-scale housing proposal for the district – the leader’s latest comment and actions only serve to consolidate this opinion.
Meanwhile, in response to the monumental bribe suggestion, Francis Maude said: “It isn’t that at all. It is a fantastic opportunity.”
“We’re a popular fast growing area, and frankly whatever the planning framework, there is always going to be a necessity for local councils to cater for housing need.
“What better way to do it than to couple it with the creation of a new acute hospital.”
Dr Dean, lead GP of the Horsham and Mid Sussex CCG gave a more circumspect response, declaring it neither a golden opportunity nor a monumental housing bribe.
“You have to consider the middle ground carefully,” he told the County Times, questioning: “What is it that we want? What is different from what we have at the moment? What services are we going to be needing in the future?
“We must also take into account the wider health economy? You cannot just put a building into the middle of a development and then just say, there you go, now use it!
“That is not the way to go about it,” he said.
But do other GPs in the local area share this point of view, Dr Dean was asked? “I think they are very supportive of the CCG’s stance,” he answered. “It is about improving the services that we are offering out of Horsham Hospital.”
There seemed to be tacit concern that any new acute hospital for Horsham would sound the death knell for the existing Horsham Hospital in Hurst Road, as well as Crawley’s existing local hospital.
Comments made by the leader of Horsham District Council corroborated these concerns.
With the caveat that the district council does not run health services, he said: “Is it realistic to have the two running side by side? The answer is no it probably isn’t.”
At a time when the local CCG is actively expanding and improving community services from Horsham Hospital, its potential demise could explain opposition the new hospital plans may receive from the wider GP community.
However, the majority of GPs are not active within the local CCG, merely represented by it. It is the wider GP community Mr Maude and fellow protagonists hope to persuade, in addition to the CCG clinicians, at the meeting this Saturday.
Mr Maude says on the table is ‘an exciting new model of acute hospital provision’ and the Government minister has been in talks with Circle, Europe’s largest healthcare partnership.
A spokesperson at Circle told the County Times: “‘Francis Maude has campaigned for more hospital capacity in Horsham for years.
“If doctors and nurses in the area think we could help make a difference, we will do everything we can to help deliver it. At the moment, there are no firm plans on the table.”
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