New North Horsham hospital plan rejected

After many years of debate, campaign, and both open and secret negotiations, the hospital plan was put to the area’s doctors and Clinical Commissioning Groups (CCGs).

It was billed as a make or break meeting. Health Secretary Jeremy Hunt was said to be behind a new hospital - part private part public but free at the point of use, with funding coming from 4,500 associated new homes.

However, the power lay with the new GP commissioning groups. The plan would have seen a new hospital, with A&E facilities and a trauma centre, built north of the A264 between Horsham and Crawley. Horsham MP Francis Maude outlined the idea at a meeting on Saturday April 20, telling the doctors that the decision is in their hands.

Recent changes to the NHS have taken the decision-making power from the politicians and civil servants, and put it in their hands.

However, the health professionals were not convinced that setting up and running a new hospital would be the best use of funds.

They acknowledged that the idea of a nearby A&E unit appeals to residents, but said those residents would be better served if the money was spent on improving existing facilities. Thanks to limited resources, shrinking budgets, and the fact that facilities are funded per patient, they said, building a new hospital would simply divert funding away from every other hospital.

One doctor pointed out that in many life-threatening emergencies the important factor is paramedics’ response times, not the distance to the nearest A&E ward.

Dr Jonathan Heatley, a senior partner at Holbrook, said: “I just can’t envisage a fully functional NHS hospital, because we just haven’t got the funding.”

He said a doctors’ chambers - an association of freelance GPs - might be viable, and could be available to take on NHS work. Visibly frustrated by the lack of support for the plan, Mr Maude told them: “It’s now over to you guys. You need to reflect on this, and it’s to your patients that you will be held to account.

“It won’t happen without GP support.”

He added: “It’s been an inordinate amount of effort, and pushing boulders uphill, to get this far.”

Dr Heatley told him: “To say: ‘We’ve made it possible, the GPs are blocking it’ is unfair.”

However, he acknowledged that the public might see it that way.

Helena Croft (Con, Roffey North) said: “One of the advantages of the north Horsham project is its deliverability.

“It will be very difficult to deliver this, politically, without the provision of a hospital.”

REACTIONS

Ideas for a new hospital to serve Horsham and Crawley have been discussed and revised over many years.

This latest version of the plan relies on funding from developers who hope to build 4,500 homes to the north of the A264.

Even before the crunch meeting this weekend, many County Times readers has dismissed the hospital as a bribe and, perhaps more importantly, a bribe which wasn’t big enough to compensate for the influx of new housing.

HORSHAM DISTRICT COUNCIL:

After Saturday’s meeting district councillor Jim Rae (Con, Holbrook East) wrote on Facebook: “The West Sussex County Times asked whether the possible provision of a new hospital within the proposed North Horsham development was ‘a bribe’, of course it was.”

He said the failure of the hospital plan is: “Very bad news for Horsham District as the hopes and aspirations of a decade have been dealt the cruel blow by our residents’ own doctors, not the politicians.

“However, as the GPs have apparently killed any hope of that ‘bribe’ materialising it is possibly a massive relief for the residents of North Horsham.

“Without a full NHS funded A&E receiving hospital I cannot see how such a huge development (4,500 houses) can be justified - can you?”

Godfrey Newman (LDem, Forest) replied: “It is always going to be hard to justify the cost of a hospital, especially as so much cost of running health services is needed in the community. Acute hospitals take up a disproportionate amount of money.

“Getting Horsham based patients moved back to the community, whether through more beds at Horsham Hospital or more support in the home may be more valuable.

“As for ambulance based emergencies, the training of paramedics is so high it might be better and quicker to use their expertise.

“Sussex was the first area to start the training for cardiac incidents and it has been proved to be highly successful.

“A bribe, Jim? Probably. But so is so much of new developments. Barns Green? School instead of affordable or social housing?”

Christian Mitchell (Con, Holbrook West), writing for this newspaper said: “Sadly I do believe that the campaign has run its course and it is time to move on.

“If new housing is to fund the new hospital how long will it take for that money and the consequent new facility take to manifest themselves? Ten years? Twenty years?

“And in the meantime, our existing local hospitals - under a death sentence - will be starved of investment and thoroughly undermined by uncertainty.

“And what sort of private/public new hospital will emerge? True, it will be free at the point of use for NHS patients - but will it live up to public expectation or merely be a glorified medical centre?

“In fast changing times can we be certain it would include a full A&E which demands enormous annual subsidy to run?

“It was a bold, brave vision. But my reading of the situation is that without the comprehensive and wholehearted support of the GPs and their new commissioning group the idea is now dead - and should be allowed to respectfully rest in peace.”

THE DOCTORS

The CCGs for Crawley and for Horsham and Mid Sussex repeated their concern that setting up another hospital would endanger the existing ones. In a statement to the County Times on Monday, they said: “It was agreed that the focus of future NHS health care for patient in the north of West Sussex must take into account the needs of local people, what services are currently available, the impact of population growth, investment priorities and the challenging financial position the NHS is currently in.

“Crawley and Horsham and Mid Sussex clinical commissioning groups are currently undertaking a piece of work to examine and explore local healthcare needs, working with NHS and social care partners.

“The study will be published in the summer.

Dr Amit Bhargava, Crawley GP and chief clinical officer for Crawley CCG, said: “The clinical commissioning groups and our local GPs understand that more needs to be done to support people to receive treatment in their own homes or closer to home, avoiding them being admitted to hospital when they do not need to be there, and so community services such as community hospitals will play a vital role in helping the local NHS to deliver this.

“Crawley and Horsham hospitals are a clear priority for the two clinical commissioning groups and our intentions are to further improve what is available closer to home for our patients. All acute care for seriously ill patients, now and in the future, must be provided in a quality assessed, safe and sustainable way.

“Accessibility, geography and affordability are also key in any decision about the commissioning of services.”

Dr Minesh Patel, East Grinstead GP and clinical leader for Horsham and Mid Sussex CCG, said: “The commissioning groups are committed to an open debate on developing NHS care for our communities and we welcome direct patient and public feedback.

“We want to take an integrated approach to develop services at our community hospitals.

“GPs are also taking views from further afield including those who provide health care in East Surrey, Brighton and Coastal West Sussex, because of the potential impact any local changes could have on how we allocate the limited money we have to spend, for example the ability to sustain other hospitals in Mid-Sussex, East Surrey or further afield if a new hospital were to be built in the Horsham area.”

Dr Simon Dean, Horsham GP and clinical director for Horsham and Mid Sussex CCG, said: “As clinical commissioning groups and as local GPs our focus is to ensure that NHS services are working as well as possible for our patients.

“The CCGs are committed to ensuring that local people have access to high quality health and social care services at the right time, in the right place and by the right clinician.”

THE PUBLIC

The plan to build North Horsham Hospital off the back of a 4,500 home development got an unexpectedly negative response on the County Times website’s weekend debate, with 65 per cent of those polled choosing ‘It’s a monumental bribe’ over ‘It’s a golden opportunity’ (26 per cent) or ‘It’ll never happen so what does it matter?’ (10 per cent). Comments on the site included:

Uglybetty: “The development is already going to go ahead (although I don’t want it to) so I guess we should welcome a new hospital if we can get it.

“Would rather not have the 4,500 houses though.”

ConcernedOfHorsham: “Raising the population of Horsham by a quarter, plus all the other planned housing, would change the character of Horsham in a very detrimental way. Hospital provision in the area needs to improve but I, personally, wouldn’t take this colossal bribe in order to achieve it.”

Harry Shand: “Whilst no one wants to see more development the fact of the matter is that more housing has to be provided for future generations and if this going to happen then it is right that maximum benefits for the community are secured.”

BarnOwl said the hospital was a bribe, but that only a ‘Luddite’ would think we can escape the need to build houses.

“But the most important thing is via giving permission for that we could get something we will all desperately need sooner or later. A local hospital with A&E because quite honestly is anyone satisfied with a forty plus minute drive in rush hour traffic to East Surrey? Or Haywards Heath?

“I am certainly not and since the stupid powers-that-be did not see fit to make a motorway access from the M23 to East Surrey instead it’s a slow journey through Horley and Salfords.”