Epsom Hospital Update
Chris Grayling's letter to Patricia Hewitt
To: Rt Hon Patricia Hewitt
Secretary of State for Health
19th December 2005
Dear Patricia
I learned over the weekend from a colleague with reliable contacts in your Department that you are intending to instruct local NHS organisations in my area to scrap plans for a new hospital in Sutton and instead to build at St Helier. I understand that your intention is to issue this instruction once the House goes into recess.
You will probably also now be aware that less substantial rumours, but essentially to the same effect, are circulating widely in both South West London and Surrey.
You will be aware that I have had serious misgivings about the viability of the Better Healthcare Closer to Home programme from the start, and that I have raised these with you.
However if these reports are true, your decision would represent the worst of all the alternatives for patients in Surrey, and would in my view be based on your party's political interests and not the interests of the broader patient population in the Epsom and St Helier area.
The option that you appear set on recommending enjoys no support whatsoever in a substantial part of the area covered by the Epsom and St Helier trust. It will fly in the face of the views of NHS managers, medical practitioners, many of the local authorities and other groups and of patients. It will significantly worsen the availability of services for my constituents.
It also flies directly in the face of the professional judgement of senior managers within the NHS. I know that they believe that the linkage of the new hospital and the Royal Marsden offers the best option for local NHS care - and I know that you will be flying directly in the face of the advice of your senior officials in taking this step. My understanding is that this is the view of all the senior figures in the two Strategic Health Authorities, and that their view is backed by Sir Nigel Crisp. My constituents do not share that view, but I still would find it surprising that their view had been over-ruled in this way.
Furthermore there remain three major uncertainties. You cannot be sure that the St Helier option is viable, since I believe it would be impossible to build or even substantially rebuild on the existing site - and the Metropolitan Open Land opposite the hospital is subject to tight planning controls. Furthermore, I recall that the initial feasibility work showed that it would be difficult to incorporate both acute and local care services on that site without building a very substantial multi-storey building. There is no guarantee that such a permission would be gained on a site with controlled planning status of this kind.
Secondly, it remains highly uncertain whether it is possible for the NHS in the area to build a new hospital, and still afford to finance the promised network of local care centres. The inevitable suspicion will be that the new hospital plan will eventually be abandoned altogether - in which case my constituents will simply see their own local hospital downgraded and services relocated to a building that is increasingly inappropriate for modern healthcare at a location that is impossible for most of them to access easily. Alternatively the local care hospitals will not happen, and all the project will effectively deliver is the construction of a new acute hospital with 600 beds rather than the current 900 available in the area.
Finally, it is highly questionable to site a new hospital only around two miles away from St George's in Tooting which is seeking consent for a £100m programme to expand its own capacity. What assessment have you made of the viability of these two institutions when they are sited so close to each other - and how does this conform to the NHS's intent to move services out of acute centres and to have better local hospitals and fewer "hot" sites?
My understanding was that the process of "calling in" the proposals would lead to an independent assessment of them. I had hoped and expected that you would recognise the real risks of affordability and deliverability in what the NHS in South West London and Surrey were talking about doing, and carry out a proper check into the viability of the project. I had not expected such a direct political decision.
You should be aware that a decision of this kind to relocate the proposed new hospital to St Helier will inevitably face a legal challenge from campaigners in Surrey, who have immediate access to the funds to pursue judicial review.
However should you wish to discuss the impact of this decision on healthcare in Surrey and explore whether there are any ways of heading off the legal challenge, I would be happy to meet you this week to discuss the situation.
Can I also ask you to make a written statement to the House about your intentions before the recess. I'm sure you agree that it would be entirely inappropriate to delay such a significant announcement until the House is not sitting. I would be grateful if you could ask your office to confirm to mine this afternoon that this will happen - or alternatively I will either seek an urgent question or will put a request to the Speaker under Standing Order 24 to ensure that this matter is dealt with before the recess.
I am copying this letter to Sir Nigel Crisp for his information.
Best wishes
Chris Grayling
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