HOSPITAL PLANNING APPLICATION DEFERRED FOR THE FOURTH TIME. THINGS ARE NOW SERIOUS!

Reaction has been swift on Tuesday morning. Hilary Biles plans to raise the issue at a full County Council Meeting in Oxford today. Clive Hill (Secretary of the Hospital Action Group) describes the situation as "worrying" and has written on behalf of the town to Keith Mitchell (Leader of OCC) asking for confirmation that OCC are still fully committed to the whole project as it was presented to us at the end of the consultation. Jo Graves (Chairman of the Hospital League of Friends) said "Charles Cotterell-Dormer has posed the question that I think many might be asking. We seem to be experiencing one gaffe after another". What is surely now needed is a Joint District and County Working Group to find out exactly what's gone wrong and how we get it right. Councillor Mike Howes said yesterday "Somebody needs their bottom kicking". This looks like a case for Barry Norton - the most effective bottom kicker in the West! Barry could surely get us out of the hole his Planners have dropped us into. We know he is committed to Chippy getting its new hospital. Failing that - perhaps the Independent Charles Cottrell-Dormer (Planning guru) could get together with LibDem Stuart Brookes (Health guru) and find a way forward for the ruling party.

CONSULTANT CLINICS REPRIEVED
FOR THE MOMENT.
NOW THE REAL BATTLE BEGINS

On Wednesday 18th October at the Council Meeting in Witney Councillor Hialry Biles - who is the Cabinet Member for Health - announced that the PCT and John Radcliffe Trust had now withdrawn their proposals to axe four specialist clinics at Chippy Hospital. This followed a week of heavy protests from many community representatives and a weekend of serious pressure from Hilary. But this is only a reprieve. The matter now moves to the Overview and Scrutiny Committee who will decide whether the proposed changes are "substantive" and whether a full consultation is required. Any one with concerns must make their voice heard now. If you want to keep the four specialist clinics (two gynae, ENT and general medical) then you MUST write now and make your views known. This potentially affects everyone in the town but it is specially important if you or any of your family uses or have used any of these specialist clinics. Another major concern is that if our hospital loses its specialist clinics this will certainly compromise the development of facilities at the new hospital. Please spend a few minutes dropping an e-mail to Hilary Biles expressing your concerns. And be sure to include your name and address. If you have friends or neighbours who are worried please tell them about this. Please do it now!

e-mail:
Write to: Hilary Biles, Maple House, Church Path, Shipton under Wychwood,  Oxon OX7 6BQ
 

'Tory areas targeted for
hospital closure'  
By
 

David Cameron has accused Labour of targeting community hospitals in Tory areas for closure. The Tory leader and Witney MP, yesterday told the Oxford Mail the Government was more interested in politics than patients. His comments came after a nationwide analysis showed Conservative or Liberal Democrat constituencies were bearing the brunt of closure threats. A report carried out by the Community Hospitals Association revealed there are 62 closed or at-risk hospitals in Conservative constituencies, eight in Liberal Democrat seats and 11 in Labour areas. Of the 10 community hospitals closed this year, five fall in Conservative-held seats and four are in Lib Dem areas. In Oxfordshire there are six hospitals under threat of closure or loss of services. Five of them - Townlands, Bicester, Wallingford, Wantage and Didcot - are in Conservative constituencies. The sixth, Abingdon, falls within Lib Dem MP Evan Harris's constituency. Another hospital whose future is under review, Chipping Norton, is also in a Conservative constituency.

Mr Cameron said: "Across the country there are cuts to frontline services that may have been influenced by ministers more interested in political rather than patient outcomes. No wonder Labour have lost the public's confidence in their ability to run our NHS." Earlier this month at his party's annual conference in Bournemouth, his first as party leader, Mr Cameron said his national campaign to defend health services from Government "cuts" had been prompted by threats to services in his own county. He told the Oxford Mail: "What I've seen in Oxfordshire has definitely helped inspire me to make this into a big national campaign. We have got that terrible combination of big deficits and real service reduction. People are not just disappointed but they are perplexed, after all the money that has gone into the health service, that there are such huge programmes of closures and redundancies and cutbacks."

The Department of Health has insisted that Government ministers do not have the ability to choose directly which hospitals close or stay open.

FLAK ALL AROUND ON HEALTHCARE
 

There is so much flak flying at the moment and it seems certain that the temperature of the health debate will rise even further in coming months. What are the strands of the debate which are of particular interest to us in Chippy

1. There's our new hospital and care home which has hit a few snags but (touch wood) is still on track for a Final OK by the County Council Cabinet on November 21st.
2. There's the big consultation which has just ended about long-term Plans for the Oxford Radcliffe Trust - including proposals for the Horton. 
3. There's the short-term cost savings which have to be made in Oxfordshire THIS YEAR to balance the budget. 
4. There's a campaign being mounted by the Conservatives opposing Mr Brown's cuts in the NHS - with claims and figures being hotly contested by the government.
5. Then there's a new and rather different campaign being run by David Cameron accusing the government of closing community hospitals in non-Labour areas - with worrying implications for us! 

We mustn't get these threads all mixed up together. They are different!

1. Chippy's New Hospital
There are three issues (with much more detailed background described further down the page)
(a). VAT. Despite an appeal to the Inland Revenue there is as yet no news. David Cameron wrote to Gordon Brown pleading our case three months ago and still hasn't had a reply so what chance do the rest of us have If the VAT appeal is not allowed the nurses in the hospital will have to be employed by the Order of St John. Not what anyone wants but unavoidable.
(b). The legality of the property deal being proposed. We hear that counsel has now said that the proposed deal is legal but with an important proviso. All the proceeds of an eventual sale of the old hospital must revert to the NHS. That probably means that less money will actually be retained within the town than if some of the proceeds had gone to the County Council because the NHS will regard such funds as part of its overall resources and able to be spent wherever they are needed. Not the ideal outcome but it means things can still move ahead.
(c). Objections to the planning Proposal  These are on transport grounds by the owners of Cromwell Park. The Town Council are also asking for reassurances about bus connections to the new site. Discussions are ongoing with the planners about these issues and they should be solved soon - but they do need to get a move on!
2. The Consultation on the Horton Proposals
There has been huge opposition to the proposals to cut maternity and children's services and 24 hour surgery at the Horton. Now the County Overview and Scrutiny Committee have really cut up rough and said they think the cuts are "unsafe". They have demanded that either the Trust abandon the proposals or get an independent assessment of the effects of the cuts - with the threat of referring the proposals to the Secretary of State. This consultation is not over yet.
3 Money Saving in the Radcliffe Trust
There was a threat that Specialist clinics would be withdrawn - without any consultation. Protests were made by the GPs the Action Groups, the GMC and the Town Council.  Hilary Biles led the blitzkrieg for the District and there has been a temporary reprieve but this crucial battle continues. Loss of specialist clinics could compromise the new hospital.
4. Stop Mr Brown's Cuts
This is blatantly political territory and there is no doubt David Cameron is making big waves by "stealing" the Labour Party's clothes on the NHS. Dave's claim of 20,000 job cuts is ridiculed by the government but at a Press Briefing yesterday the new NHS boss was unable to come up with any other figure. Incredible.
5. Community Hospitals are closed in Tory and LibDem seats
This is a bit difficult to swallow. The Tories have not yet answered the fairly obvious point that most community hospitals are in rural areas which also happen to vote Tory. But we need to watch this carefully because a community hospital in the Tory Leader's  very own constituency looks to be in double jeopardy! As a senior OCC officer said recently - "We shouldn't expect the Ministry of Health to do David Cameron any favours".

The Action Groups in the town - led by the Vicar Steven Weston and District Councillor Chunky Townley will carry on the three year old fight for Chippy hospital and they will do their utmost to keep party politics out of it! We will overcome!

HOSPITAL PLANS DEFERRED AGAIN

The Hospital planning application was deferred for a third time on October 2nd and it was absolutely nothing to do with a shuttle bus or what the Town Council had said. This time the owners of Cromwell Park threw a large spanner in the works. It's clear that the main concern of County Estates (owners of Cromwell Park) is that Cromwell Business Park is going to be completely messed up by having access to the hospital from Banbury Road sharing the same road as their Business Park tenants. There will be congestion, parking problems and getting out into the Banbury Road will be very difficult  for everyone. 

County Estates are furious that no Transport Assessment has been done. No attempt has been made to estimate traffic flows or densities. They are convinced that this would show the access arrangements and main road junctions as being completely unsuitable. They say its clear there is not enough parking. There is no provision for buses to turn round. Public Transport arrangements are unsatisfactory (particularly siting of bus stops and shelters). The applicant the County Council say a Transport Assessment is not required since all that is happening is that existing medical services are being replaced and therefore "there will be no effects on the local transport network". (This seems a very dodgy assertion since so many more people will be accessing the surgeries and the hospital by car now they have a longer distance to go While in the past most people could walk to the West St Surgery the people from (for example) Cornish Road are not going to trek up to the new site on foot!)  County Estates have had three groups of traffic consultants working on this. The Planners summarised their reports extremely briefly at the meeting. One of the consultants (PDPS) says the correct procedure for a development of this size and importance is that before an application is submitted the applicant must ask the Planning Authority for a Screening Assessment. In this the applicant is told what is required. Specifically whether a Transport Assessment is needed (or an Environment Assessment or an Employment Assessment etc).  They go on to say that a Transport Assessment  is particularly important in this case because OCC are both the applicant and the Highways Authority.

OCC did not ask for a Screening Assessment. The Planning Authority did not ask for a Transport Assessment. Country Estates therefore say there has been a serious procedural flaw and have appealed to the Government Office of the South East to rule that a Transport Assesment is necessary before the application is determined. The Planning officer told the committee that until there was a response on this point from the Office of the Government the Planning committee should not try and progress things.  Otherwise they may be found to have made an "illegal" planning decision which would be really serious.

So the Hospital is now awaiting three crucial decisions the Inland Revenue must decide about VAT. Legal Counsel must decide about the Transfer of property from the NHS to the OCC. And now the Office of the Government must decide whether a Transport assessment is needed before planning permission can be given. In attempting to put together such a complex deal the OCC and NHS were always going to be running into the kinds of problems which innovators always have,  At every turn a difficult  problem has cropped up with no easy answer and no precedent to provide guidance.  This kind of thing always takes time and the mistake has been for the OCC to impose such heavy pressure on the whole process claiming that the Castleview  situation could not wait. They are still insisting that there must be an absolute deadline decision on Nov 21^st. This has led to lack of preparation and lack of thorough consultation with stakeholders.  Both the NHS and the OCC have been trying to railroad the plan through.  This has to stop. Lets all take a few steps back and get things quietly sorted. After three years of discussion, the people of Chipping Norton will not easily forgive our local authorities if this Hospital Plan is not brought to a successful conclusion.

Rob Evans Town Councillor and County Councillor for Chipping Norton until last year - said this morning You would have hoped that developers, neighbouring  landowners, OCC and WODC would have ironed these issues out BEFORE getting  to two planning meetings and consequently ending up with two deferrals. Sorting it out at the planning meetings is ridiculous, unacceptable and  wasteful of resources and just leaves us as the local community and the whole scheme vulnerable. Comments are awaited from the other key players in this saga.

"CHIPPY HOSPITAL PROPOSAL
IS LIKE A MAFIA DEAL"

There's only one issue that really really matters in this town at the moment and that's the new hospital. As everybody tries to get things finally tied up last-minute snags keep popping up. Tempers are fraying and some people are accusing other people of delaying things. This is daft. Everybody wants the same thing. The County Council say they are going to make a final,  decision on Nov 21st. Its not at all clear why any kind of deadline is really necessary but they seem to want to put the pressure on.  There are three problems but only one could actually stop the whole project going ahead. First Problem: The VAT man has made a silly ruling which has gone to appeal. If that appeal fails then the hospital nurses will have to be employed by the Order of St John - not the NHS. Nobody wants that but there's no option. Second Problem: The only way the new site works is with frequent, reliable transport links. Ideally we want those services guaranteed before the planning application is approved. There is some posturing going on around this between the Planners, the County Council Transport Department and the Town Council but this will be settled OK. Nobody is going to see this whole project fail for the sake of a shuttle bus! The Third Problem is the big one and potentially very serious. It could stop the hospital project all together. This is how we outlined the problem a few weeks ago.

The NHS have a unique accounting system. Assets (including land and buildings) are increased in value each year by an indexing system with occasional revaluations. Unless you watch these indexed numbers very carefully they can become quite unrealistic. The "book value" of Chippy Hospital has been allowed to increase through indexation to over 3m. The most optimistic estimate of the site's value is just over 1m. When this sort of discrepancy occurs the NHS rules require Trusts to make up the difference between these two figures out of revenue (ie income) when the asset is either sold or closed down. As we know, all Oxfordshire PCTs are desperately short of  ready cash so this is simply not an option.  The County Council and the PCT have devised a scheme to get round this problem and avoid paying the penalty. It makes use of legal provisions which allow the NHS to make grants to a local authority in respect of the supply of healthcare services in which both parties are involved. The NHS will make a grant of 3m to the OCC. The OCC will use that cash to buy the hospital.  A service agreement defines what services will be supplied and by whom and how any proceeds from the hospital's eventual sale will be used. To a layman the whole deal sounds very dodgy. A bit like smoke and mirrors.

The Joint Health Overview and Scrutiny Committee discussed the issue in depth on Thursday 21st September. Our representative District Councillor Ian Hudspeth played a blinder. He pressed really hard and demanded to know from the PCT why just when we think everything is sorted, another problem appears. Why on earth wasn't this "property" problem foreseen After all, these plans and preparations have been going on for years now. Three times he put the question. And he finally got an answer from a top executive from the new All-Oxfordshire PCT - a lady we have never met before. She as good as admitted that the old PCT had simply not had the expertise to deal with with this kind of very complex "accounting" matter. Which was one of the reasons why the new larger PCT authorities - with more specialist managers - would be so much more able to deal with the restructuring plans now underway in the county. Personally I found this totally credible and convincing - almost the first time any senior PCT executive has really communicated with us honestly and straightforwardly. Quite simply first Cherwell Vale PCT and then North Oxfordshire PCT were "winging it".They were out of their depth. It certainly explains why we got different figures and different explanations at every meeting we had with them. The Committee tore into the NHS rules and regulations and thought they were barmy. The way these rules confused "capital" and "revenue" was simply getting in the way of sensible planning. They determined to write to the Department of Health and ask them to reconsider their accounting procedures. One councillor said that if a District Council tried to handle its capital account in the way the NHS did, then John Prescott would be down on them like a ton of bricks. Why the double standards They then moved on to consider the proposed solution. The air got blue. "Money-laundering" "Like a Mafia Deal" were the sort of descriptions being used. "There must be a catch." Indeed there is a catch - which is that the whole plan may not be legal. Apparently the Strategic Health Authority had no suggestions to make but the PCT were told in no uncertain terms that it was the PCT's responsibility to stay within the law. No comfort or support there then. So the PCT and the County Council are getting some expert legal advice and taking counsel's opinion. It probably all depends on how the basis of the grant from the NHS to the OCC is expressed. If the grant is simply for the OCC to buy a hospital from the NHS then that would be such a transparent fiddle that it would not pass the lawyers. Committee members had some constructive suggestions for more creative wording. But this hasn't all been defined yet and counsel is waiting on the wording to give an opinion. We were assured that this would all be clear in time for the OCC November meeting. Some committee members thought it could take longer. Nail biting weeks ahead. The reason everyone is taking it all so seriously is that there are many other NHS assets around the county where the same kind of valuation nonsense could scupper local plans. Its just our bad luck in Chippy that we seem to be the first case in the county to raise such complex challenges. Fingers firmly crossed everyone! A new Chippy hospital now depends on one bigtime lawyers say so!

Town council demands blamed
for causing hospital delays

CHIPPING Norton Town Council has been accused by a local district councillor of delaying plans for the proposed new hospital, care home and GP surgery for the town.  Cllr Robert Townley (pictured right) said a decision by West Oxfordshire District Council's planning committee had had to be deferred - for the second time this year - because of demands by town councillors. The council had called for more parking spaces to be included in the plans, which were redrawn to include 30 extra spaces. Last month they wrote to Cherwell Primary Care Trust and West Oxfordshire County Council asking for a shuttle bus service as a priority to help residents get to the site, plus pedestrian crossings in London Road and Banbury Road. Cllr Townley told Monday's town council meeting: "I cannot imagine anyone is going to commit to providing a shuttle bus service for a hospital that is only a proposal. I cannot see any point in delaying the plans at this stage." He suggested the town council writes to district planners making it clear they would like the hospital proposal, currently at an outline stage, to go ahead but pointing out they want the issues taken into consideration at a later stage. However, the town council was unapologetic and remained adamant that the site at Rock Hill should have the dedicated shuttle bus service agreed now. Cllr Rob Evans (pictured left), said: "From the start we have said we want improvements to bus services and a shuttle bus to enable people to get on to the site. We have asked the county about this and received no response. This has to be a decision by the county council's cabinet." The town council's transport committee is hoping to meet district planners and county officers next week.

HOSPITAL APPLICATION
DEFERRED AGAIN

There was a surprise decision at the Planning Committee this week. A revised Planning application for the new hospital was not approved for a second time. Suddenly we are just not sure what on earth our District Council is up to. Worries about Parking spaces had been addressed since the previous meeting. Thirty new spaces had been added, but this time the Town Council had once again pressed concerns that we should be guaranteed a frequent and regular public transport service linking the new site on London Road to the Town Centre. Eve Coles had said at the Town Council's discussion...."A shuttle bus or very frequent buses at all times is essential and that was the main understanding or proviso of most of those local folk eventually accepting this new edge of town site". In their submission to the planners the Town Council said...."Council is agreed that a dedicated shuttle bus service should be provided for the site. The planning permission given should ensure that a shuttle bus service is provided and maintained as a key feature of the development.  This service should include pick-up points around the town so that residents without cars will be able to visit the care home, hospital and doctors' surgery with relative ease. It is clear to Council that, for convenience of access of the shuttle bus, the vehicular access within the site requires change. It is suggested that, from the Care Home Access point from "Rock Hill Farm Court", the Cycleway and Pedestrian Link is expanded to allow a shuttle bus access to all parts of the site".  "Access provision to the site for pedestrians should also be improved: pavements on both sides of the Banbury and London Roads should be improved as required and pedestrian crossings should be installed on both roads to ensure the safety of persons using the site." The Town Council expected that planning permission would be granted but subject to its concerns about access being met. Instead the Planning Committee deferred the whole thing. Its not at all clear why they did that. District Councillor Chunky Townley - Chairman of the Hospital Action Group was very unhappy and thought the application should have been passed to allow building preparations to go ahead - and discussions started to sort out the transport and access arrangements. There was plenty of time to do that while the building work was taking place. Town Councillor John Grantham said afterwards...."The Town Council pointed out the transport issue yet again, It need not have resulted in another delay....this problem was raised many times during the consultation but nothing has been done to address it. Surely the District Planning Committee could have let the outline application go on to the next stage, and deal with the transport and other issues under "reserved matters" Clive Hill - secretary of the Hospital Action Group said "The Town Council were right to raise these issues. These problems were raised throughout the consultation process and in numerous meetings with OCC and PCT who have both failed to include any satisfactory binding commitment on transportation in their plans. Perhaps some of the money that OCC will make from this scheme could be 'ring fenced' specifically for the provision of a mini bus shuttle service'   Rob Evans - previously County Councillor for the town said; "It is bizarre and frustrating to have an outline planning  application deferred in this way"

What's needed now is some fast and serious talks between the planners, the County Council and the Town Council to sort out the transport and access problems and avoid any delay to the project. Building work is scheduled to start very soon.

CRUNCH TIME FOR OUR NEW HOSPITAL 

On Monday a revised planning application for the Care Home and Hospital should be approved by the Planning Committee - now that provision for car parking has been increased by 30 spaces. However there are still three serious snags to be sorted out - at least one of which could still potentially wreck the whole deal.  The Hospital is not safe yet!

Hopefully you all still remember the plan. Here's a quick reminder. Land on London Road opposite the Parker Knoll site - which is owned by Oxfordshire County Council - will be leased to the Oxfordshire Care Partnership. The OCP is a joint venture involving  two private companies - the Orders of St John who run Care Homes - including all of Oxfordshire's - and the Pilgrim Housing Trust who build houses and hospitals. The OCP will build a new Care Home and Hospital using private finance. The Care Home and Hospital will be physically separate with their own identities and entrances. The Orders of St John will run and staff the Care Home. The NHS will run and staff the Day Hospital and the Maternity Hospital.

There will also be 14 Intermediate Care Beds. The original plan was for these to be provided to the NHS by the Orders of St John (to benefit from economies of scale by sharing services with the Care Home like catering and laundry) The nursing staff would be NHS staff. However this has proved to be a problem.

Care Homes and Hospitals are both individually exempt from VAT but there was a danger that a Care Home which supplied a partial service to a third party Hospital might lose its VAT exempt status for the whole Care Home operation. Even more seriously, the initial construction costs of the Care Home would be subject to VAT. This would have disastrous financial consequences for the economics of the entire development. So to avoid any complications it was reluctantly agreed that the Intermediate care nurses would be "seconded" to the Orders of St John but they would remain long-term employees of the NHS. This way the day to day management of the Intermediate Care Beds would be completely under the control of the Orders of St John - a simple extension of the Care Home operation. Everybody was quite confident that this arrangement would be acceptable to the VAT authorities.

SNAG No 1

The VAT man has refused to play ball and has ruled that unless the nursing staff manning the Intermediate Care Beds are actually employees of the Orders of St John, then the Care Home operation will  be liable for VAT. In most people's view this is absurd. Hospitals don't pay VAT. Care Homes don't pay VAT. But if they get together to try and utilise resources more efficiently a huge tax is slapped on. The PCT have appealed against the ruling. David Cameron has written to the Chancellor (.....but as a Senior Officer of the OCC commented at our meeting - why would the government want to do David Cameron a favour) The result of the appeal is expected any day now. Keep your fingers crossed.  If the VAT ruling is upheld the PCT Board have said the Intermediate care nurses will be transferred out of the NHS to the Orders of St John. The Action Groups are deeply unhappy about this. They believe it is inevitable that the standard of Intermediate nursing care will soon deteriorate if it the responsibility of a company with virtually no experience of running hospitals. Nurses will not be part of an NHS career structure and will not have access to NHS training.  Recruitment will become even more difficult. Some of the nurses are very unhappy and there is a real possibility that many will choose not to stay - rather than transfer over.  The Petition of two years ago which attracted 11,000 signatures clearly called for Intermediate Care nurses to stay in the NHS - so the Action Groups have no mandate to negotiate on this point. This matter needs to be reviewed by the County Overview and Scrutiny Committee but they are showing great reluctance to be involved. This really is disgraceful since that Committee is the only watchdog the public now has over healthcare services. 

This was always going to be a very complex deal to pull off with so many different interests involved. But it now seems as if the PCT did not do their basic homework on the most fundamental of points. As a result, what many people feared might happen may now come to pass. The so-called Hospital could turn out to be no more than a glorified Care Home. 

SNAG 2

The NHS have a unique accounting system. Assets (including land and buildings) are increased in value each year by an indexing system with occasional revaluations. Unless you watch these indexed numbers very carefully they can become quite unrealistic. The "book value" of Chippy Hospital has been allowed to increase through indexation to 3m. The most optimistic estimate of the site's value is just over 1m. When this sort of discrepancy occurs the NHS rules require Trusts to make up the difference between these two figures out of revenue (ie income) when the asset is either sold or closed down. As we know, all Oxfordshire PCTs are desperately short of  ready cash so this is simply not an option.  The County Council and the PCT have devised a scheme to get round this problem. It makes use of legal provisions which allow the NHS to make grants to a local authority in respect of the supply of healthcare services in which both parties are involved. The NHS will make a grant of 3m to the OCC. The OCC will use that cash to buy the hospital.  A service agreement defines what services will be supplied and by whom and how any proceeds from the hospital's eventual sale will be used. To a layman the whole deal sounds very dodgy. A bit like smoke and mirrors.  Or as somebody described it last week - a three card trick. But you have to understand public finance and accounting to really find your way round this particular maze. However,  the PCT told us in a meeting last week that the scheme has not yet been approved by the lawyers and there is a risk that it may not be. In that case there will be no new Hospital or Care Home. This looks like a second area where the basic homework was simply not done by the PCT. Didn't anyone notice that the "book Value" of the hospital had got so far out of line with reality

If the new scheme does fail, it is ironic that these arcane financial rules will pretty much guarantee that the old Hospital will not be closed for a very long time to come. The NHS couldn't afford to pay the 2m penalty.

SNAG 3

Townspeople have always felt that since the Hospital was "bequeathed" to us and has been kept going over the years with the help of massive fund-raising, the Town has some kind of tangible and rightful stake in the place. This is not just any old asset to be traded between temporary trustees of our heritage. Each generation needs to fight to re-assert the legacy of the founders and the hospital's role as a War Memorial. We had hoped that after all the wheeling and dealing over land, fees, leases and contracts was finished  there would be something in the new hospital that would represent a clear continuity with the original bequest and which would maintain a sense of ownership by the local community. We don't want our history to simply disappear in a fog of leases and sub-leases. Ideally - after all the agreements have been worked out - we would like the town to end up as Freeholders of the land on which the hospital is built. This seems to us to be no more than equitable given that the NHS, the County and the Oxford Care partnership all seem to stand to benefit from this development scheme. The County say that if they become the owners this will be the same thing as the town as owners. The County will represent the local public interest. Will they forgive us for not quite seeing things the same way

A  PRESENT FROM THE PCT

The PCT came to town on the Monday before Christmas - along with the Orders of St John and the OCC - to meet the Healthcare Users Group. The Vicar was in the Chair.  The PCT assured us that insofar as it is possible for the NHS in Oxfordshire to be absolutely certain about anything at the moment, the new hospital is still firmly scheduled and planning is on time - with building due to start next Autumn and to last eighteen months. The opening is scheduled for April 2008. And at last the PCT had some plans to show us. These were still being finalised and would be on public exhibition in early February. The PCT hoped to have a model by then as well. But the drawings were very reassuring and gave everyone at the meeting a real feeling of optimism that things were now firmly on track. The buildings look modern and stylish. The Care Home and the Hospital are in two separate wings arranged around a courtyard. They have completely separate entrances. The hospital section contains provision for a 24-hr clinical room - the services are to be settled in an upcoming consultation. All beds are in single rooms but use is made of glass partitioning to facilitate nursing care. Maternity is on a floor of its own and contains two birthing pools. The PCT are still exploring ways in which a long-term commitment of the NHS to the site and the town can best be evidenced. Ownership of the land may not be the most cost efficient means of achieving this but other ideas were outlined - which sounded really positive. Provision is being made for the White House Surgery to re-locate to the site. Arrangements for public transport arrangements are being discussed. The League of Friends are being invited to to develop facilities which will help give the hospital a "family feel".  All in all a great way to end the year.

A BIG QUESTION - STILL UNANSWERED

The biggest question of the day was - What is happening to the money that will be raised from the sale of our old hospital - which was bequeathed to the town This question is still hanging fire. The PCT say it is against the "rules" for them to acquire an appreciating capital asset - like buildings or land. One plan had been for them to buy the land on which the new hospital will be built. The official line is that when the cash is in hand, then the PCT will have to make a business case to the Health Authority to invest the money in services (NOT capital assets) at the hospital which would represent an appropriate use for the money. We really need to press harder on this because nobody seems to have a clear concept of what such services may be. It looks as if that big "black hole" is re-appearing. We need a plan!

It was busy on Saturday in the Town Hall. A constant stream of people coming in from the cold to look at the plans for the new hospital. There were at least a hundred visitors in the hour I was there and the people from the PCT and OSJ were being bombarded with questions. All in all the reception for the plans was extremely positive. There was enormous relief that the proposals do seem to allow for all the services everyone wants - like intermediate care beds, X ray, Maternity, an MIU (or First Aid Room as the PCT are now trying to call it), and rooms for visiting consultants. Some people had got a bit confused with the comings and goings of the last year. This all looked more certain. Disappointment that the Minor Injuries arrangements are not sorted out yet. Worries about whether there is enough parking. Concern that you can't actually drive all the way round the site. Real interest in what transport arrangements will be made. Will there be a shuttle bus  As for the design. A few said it didn't look like a Chippy building and one lady said it looked like Legoland! The plans go to the Planning Committee next month and preliminary discussions with the District Planners start now. I was told by OSJ that their architects were expecting to be told either that the design should be more Cotswolds and would therefore need to incorporate more traditional features (like Cotswold Stone faced walls and more traditional window shapes) OR that it should look much more modern. For the time being they were steering a middle course. Which perhaps explains the rather bland feeling of the drawings. This is going to be a very prominent and important civic building in the town. It would be great if it was one to be proud of - and a worthy successor to the old Hospital building. But even our most senior citizens have got used to the idea that things have to move on......." My consultant will just stop coming to have clinics in Chippy if they don't bring it up to date." Quite so!

  
Left : District Councillors Mike Howes and Hilary Biles - enjoying a lighter moment.
Right : Mayor-Elect Gina Burrows and Guild Chairman Maureen Shepherd in a serious discussion about parking on the new site

 
Left: Dawn Matthews-Smith County Director (Order of St John), District Councillor Eve Coles, Jonathan Coombes (North Oxfordshire PCT); Stephen Weston Chairman Chipping Norton Hospital Users Group and Town Councillor Rob Evans   Right: Town Councillor Jo Graves explains a crucial point to Jonathan Coombes (One false move and I'll shoot!)

CHIPPING NORTON COMMUNITY HOSPITAL
PLANS FOR REDEVELOPMENT  
STILL ON COURSE FOR OPENING IN 2008

Plans to redevelop Chipping Norton Hospital at Rockhill Farm in London Road, are progressing and the PCT is working with Oxfordshire County Council and the Orders of St. John to get detailed plans ready for a planning application in the New Year. It is hoped that if all goes to plan, the new care home and NHS facilities, will be open by 2008.The PCT has recently met with representatives of the Chipping Norton Health Users Group and the Hospital Action Group to clarify the information available so far and to answer some of the questions being asked. The following Questions and Answers should prove helpful.

What will the new building look like
The new building will consist of two separate parts; the 20-bed residential care home will have a separate entrance from the NHS-commissioned part of the building, which will contain a six-bed maternity unit, a state-of-the-art X-ray department, an emergency treatment room, and 14 intermediate-care hospital beds. This hospital part of the new building will be dedicated as the new Chipping Norton War Memorial Hospital, and it is envisaged that the stone over the entrance at the existing hospital will be transferred to the new building together with other important items, for example, clock, framed documents and so on. The hospital beds will consist of 14 single-bed units - for good reason, because the external inspections of Orders of St. Johns premises stipulate single-bed units. However, nursing staff and other clinicians have yet to be consulted, and glass partitions may be used to make nursing care easier for nursing staff.

How much money achieved from the sale of the existing War Memorial Hospital will be re-invested in the new building
The intention is, if at all possible, that the NHS part of the building will be on land eventually owned by the NHS; however, cash-flow problems will not allow that possibility until after the current hospital site is sold. The District Valuer has valued the existing hospital building at 2.1 million and the land at 900 000, but the true market value (what developers may be willing to pay) will not be known until it is sold. As the building wont be marketed until after the new building is complete, its true value wont be known till then.

Is there any guarantee that the existing hospital will not be closed until the new hospital is up and running
Yes there will be nowhere else to put the patients !

When will drawings of the new building be available
Outline drawings of the new building have been produced and when they have been approved by hospital staff and other healthcare workers, the Orders of St. John will produce fuller drawings.

Is there any guarantee that the NHS beds and nurses will not be annexed into the care-home
Yes. It is not possible for the 14 intermediate care beds to be used outside the NHS. Even if there are staffing shortages after the new hospital is commissioned, the NHS beds will not be transferred they may be closed, but they will stay as an NHS resource.

Will the nurses in the new hospital work for the NHS
In the new hospital, staff for intermediate-care beds will be seconded to the Orders of St. John. NHS staff (ie, nurses and other professional staff) would work seconded to OoSJ but remain NHS employees, having full access to the training, support, pay and conditions, and pensions that the NHS provides or commissions. New staff, for at least the first three years from the date of the commissioning of the new hospital beds, would be replaced by NHS-employed staff working under the same conditions as above. After 3 years, there would be a review of future terms and conditions of new staff. At that point, NHS-employed staff would remain working under the same previously-agreed contracts.

Day-to-day clinical management of the hospital beds will be carried out by someone with a background and training in clinical issues. The Primary Care Trust will determine the policies by which access to the 14 intermediate-care beds is managed by the nursing staff, and will have a hands-on, commissioning responsibility to upgrade and not downgrade the standards of service.

What about the treatment of minor injuries
At present, nurses will not treat some injuries as they are not confident or necessarily competent in doing so; where there is any complication or uncertainty indicated, they will refer minor injuries to the Horton or the John Radcliffe Hospitals. In the hospital part of the new building, there will be an emergency treatment room. The question of who delivers minor injuries treatment, especially out of hours, is the subject of further public consultation.

Following the Exhibition of Hospital Plans
Chunky Townley - Vice-Chairman of the Healthcare Users Group (HUG) has written to Jonathan Coombes at the North Oxfordshire PCT

The members of HUG wish to express their thanks to the PCT and OSJ for organizing the public display of the plans for the proposed Hospital/Care Home. Also a special thanks to those members of Staff who gave up their Saturday to explain the drawings and answer questions from both members of our group and the public. The general response from the public of Chipping Norton and District has been very favourable, with most feeling optimistic that this new facility will be built and open within the next two years. HUG held a meeting last evening to discuss the reaction and comments of the public together with our own opinions and concerns of the design, layout and other outstanding issues.

The main items of concern regarding the layout and design are:-
1.There is a serious lack of parking spaces.
2. There needs to be good access for buses to stop and able to turn to exit the site.
3. Is there to be a parking area for an Ambulance stationed at the new Hospital.
4. The site seems very cramped especially with regard to parking. Is there scope to extend further into the extra land beyond. Where would a second Doctors Surgery be housed, should they wish to re-locate.
5. Are there sufficient rooms for visiting Consultants, only one is shown on the plan.
6. Are the doors in the Intermediate Care rooms of sufficient width to allow access for beds to be moved through.
7. Are the staff rooms to be shared by both Hospital and Care Home staff.
8.Will the external walls of the building be built in stone (either natural or re-constructed).

The other major concerns of HUG/HAG and indeed the public are:-
1. Will the Intermediate Care beds be available to patients of all ages, not only elderly people
2. Will there be a substantial re-investment of the capital raised from the sale of the existing Hospital into the new Hospital. Will part of this money be used for the NHS to purchase the land on which the new Hospital will be built.
3. Will arrangements be agreed to ensure a frequent bus service to the site-either by including a hospital stop on existing routes or by means of a shuttlebus. Can any steps be taken to ensure adequate financial provision for this at the Planning Approval stage
4. A separate letter is being sent to the PCT regarding the MIU, however will a Paramedic be stationed at the new Hospital during Doctors out of hours.
5. Will any 106 agreements be imposed by the Planning Authority on this development, if so, have you any schemes in mind.

We look forward to your reply in the near future.

DAVID PRESENTS CHIPPY PETITION

The recent Health White Paper promised care close to home yet the PCT is still pushing ahead with cuts and closures to the very hospitals that can provide it.  It is time for Ministers to act to make sure that the PCT has the resources and will to protect vital local services. Patricia Hewitt has repeatedly been warned that closures are going ahead. She should issue immediate guidance to local health bosses on how to implement the proposals in the White Paper. Closures are still being driven by financial, not health, considerations, with only token nods to the White paper and this must be addressed by Ministers.

The Chipping Norton Hospital Action Group participated on 28th March  The Chippy delegation was led by Clive Hill. Several hundred signatures in support of this record attempt by CHANT were collected  in Chippy Market Square last Saturday morning.  Chippys own petition last year collected over 10,000 signatures.