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Summer 2006

First catch up with some important heritage....

Some time before the 1914-18 war, Mr. A. P. Walford of Over Norton devised a plan to give Hill Lodge to the town as a cottage hospital. His generosity seems to have been shared by Mr. Albert Brassey of Heythrop Hall (grandson of the great railway builder of the 19th century) and together they agreed that Mr. Walford would give Hill Lodge and 1,000 to equip and run it as a hospital, while Mr. Brassey would donate a further 2,000 for the same purpose. Their intention was that the running of the hospital should not become a financial burden on the town. They had been prevented from carrying out their plan by the outbreak of the war in 1914, and before it was over Mr. Brassey had died. When the idea was revived after the war, however, his widow and other members of the family promised to abide by his intentions.

At this point the inhabitants of Chipping Norton began to take a hand in the plan. They were looking for a suitable way to commemorate their fellow townsmen who had been killed in the war, and a proposal was now made that the new hospital should be endowed as such a memorial. A Public Meeting was called at the Town Hall, on Wednesday 12th February 1919, and the Mayor, Mr. W. Toy, took the chair. According to the account later published in the "Oxfordshire Weekly News" there were also on the platform: Major Daly, Capt. Brassey (son of Mr. Albert Brassey ), Dr. O'Kelly, Dr.Birts, Mr. T.H.Burbidge (a local bank manager), Mr. A.E.Mace (Town Clerk), and the Rev. A. J. Ashforth. Mr. Walford himself was unable to be present, perhaps because of the bad weather.

The Mayor outlined the generous offer made by Mr. Walford and the late Mr Brassey, and went on to say that it was estimated that a total of 9,000 would need to be invested in order to provide an income sufficient to run the hospital. He then put to the meeting the proposal that the remainder of this sum should be raised by public subscription over the next six months as a memorial to those who had died in the war. The tone of the meeting, as reported in the newspaper, showed that there was considerable enthusiasm for the idea among the majority of those present. Indeed several offers of assistance had been received before the meeting from those unable to attend. These included one of 1,000 from Mr. C. Baring Young.

Capt. Brassey spoke of the need to endow the hospital with adequate funds from the start. He promised to donate equipment from another war-time hospital with which he had been connected and which was closing, if the target of 9,000 was reached. One of his relatives had also promised to give 500 on the same condition.

A Committee was appointed at this meeting to organise an appeal.

The heads of other religious denominations and representatives of the Friendly Societies were also to be invited to serve. Although the meeting was mainly concerned with the financial aspect of the plan, Dr. O'Kelly also pointed out the need on medical grounds for a hospital in Chipping Norton. He particularly stressed the dangers of sending patients by motor car to Oxford, saying that this was often " a great risk of life". With the cars of those days, he and the doctors of the Radcliffe Infirmary were perhaps justified in their doubts about the ability of patients to survive the journey. The surgeons at the Radcliffe had assured Dr O'Kelly of their willingness to come to Chipping Norton to perform important operations. As a result of the enthusiastic work of those who launched the War Memorial Plan, and the generous support of many others, The Chipping Norton and District War Memorial Hospital was opened in 1920. It had 16 beds and 1 private ward. Minor operations were performed, but there was no proper operating theatre for the first three years

From a History of the Hospital by David Eddershaw. READ THE REST OF THE HISTORY


The Hospital Action Group have always been concerned to try and keep the Care Home Beds and the Hospital Intermediate Care Beds as separate as possible in the plans for the new hospital. We were worried that otherwise the Care Home would simply "absorb" the so-called hospital beds. We argued for separate buildings, separate management and separate staff arrangements. We were deeply uneasy about the Order of St John running a hospital. We wanted to try and ensure that into the future we had two clearly separate set-ups with their own names and identities - a residential Care Home and a Hospital. We wanted the hospital to stay in the NHS -as a guarantee of medical standards and appropriate recruitment and employment practices. It was clear all along that the PCT really wanted to have all the beds managed and run by the OSJ with up to 14 of them "let out" as required to the NHS. All in the same building. All with the same nurses. They were looking for every possible economy of scale and cost saving. After some bitter arguments the PCT agreed that the Intermediate Care Beds could be in a separate wing. They also solemnly promised us (and the Oxfordshire Joint Health Overview and Scrutiny Committee) that the nurses working with the Intermediate Care beds would be NHS employees for at least the first three years. However they also made it clear that for "tax and VAT" reasons these nurses would have to be seconded to the Order of St John (the Care Home owners) but clinical management would remain with the NHS. We accepted this proposal with great reluctance because nobody wanted to jeopardise the whole plan. This deal was costed, written up, incorporated into a business plan and discussed and agreed at the Northen Sub-Committee of the Overview and Scrutiny Committee and then in the Full Committee. Plans were produced, An exhibition was held in the town. An Outline Planning Application has been submitted. Discussion recently has come down to the number of car parking spaces. The Timetable says that building will begin at the end of the year. Now suddenly - out of the blue - the PCT says that the advice it received from outside consultants about VAT when it was drawing up its business plan has turned out wrong. So sorry all nursing staff working with the Intermediate Care Beds will have to be full-time Employees of Order of St John after all. We know we promised something else but that's hard luck. The Chairman of the Overview and Scrutiny Committee seems to have accepted that this is OK and the decision doesn't have to be reviewed again because services delivered are not affected. The PCT are up to their old tricks. Trying to sneak through important changes to agreed plans without proper discussion (let alone consultation). They are holding a Board Meeting in Kings Sutton (where) on Thursday25th July to consider these changes to our hospital plans. We have only just found out about all this - thanks to the eagle-eyed interest of our County Councillor Hilary Biles. The meeting is in public. They have scheduled just 30 mins for the whole meeting so they obviously think its a formality. They probably won't let us speak but some of us will try to get there. We believe that this change of heart by the PCT is so fundamental that the Plan needs to be brought back to the Overview and Scrutiny Committee for review so that our elected representatives can have their say. Back door dealing is no way for this sort of thing to be done. What has not been explained is whether the nursing staff employed in the Day Hospital, the MIU and Maternity Unit are also to be OSJ employees. If not, then what is different about their situation from the Intermediate Care nurses. What is obvious to your webmaster who has now read the full business case is that it all comes down to simple cheese paring. The VAT arguments are nothing a good accountant couldn't sort out. Running the hospital in the future (after the three years of "seconded" nurses is over) saves the PCT 100,000 a year compared with what they are paying now. This comes entirely from savings in nursing costs of 100,000 a year. The PCT are looking at these figures and saying..."Why wait for three years Lets have the money now. There's 300,000 to be had". The savings would actually be coming from the erosion of benefits and changes in terms and conditions in the employment contracts of nurses. The NHS could save far more by sacking some of the consultants who write them such flimsy business plans. By the way, the T in PCT stands for TRUST. Who's kidding who Perhaps we should have expected problems because holiday time is always when the PCT spring their nasty surprises. For an update read PARISH PUMP above.


Ever wondered how a hospital gets built

The PCT Business Case makes it easy to follow. Here's a simple step by step guide

STEP 1 Oxfordshire County Council (OCC) will enter into a headlease of the whole site to the Oxfordshire Care partnership (OCP). The Headlease will be for a term of approximately 55 years.

STEP 2 OCP will in turn enter into an underlease with Bedfordshire Pilgrim Housing Association (BPHA) in respect of the whole site for a term of approx 55 years

STEP 3 The Primary care Trust (PCT) will also be party to secure its agreement to take a lease in the agreed form on completion of the Community Health Facility.

STEP 4 BPHA will grant a sub-underlease of the whole site back to OCP for a term expiring on 25 December 2061. Under the terms of this sub-underlease, OCP will pay a finance rent to BPHA to amortise the development costs of the whole development plus an agreed margin. The finance rent will need to be recouped by OCP from (i) the bed rates charged to occupiers of the residential care beds (20 contracted by OCC and 16 FFPs) (ii) the bed rates charged to intermediate care placements (14 all contracted by PCT/ OCC) and (iii) the rent charged to the PCT for the Community Health Facility.

STEP 5 OCP will grant to the PCT a 35 year sub-sub-underlease of the Community Health Facility, with a break option at Year 30. For accounting purposes, the PCT will require OCP to bear some of the ongoing maintenance risk associated with this part of the building. This will be achieved by putting in place a facilities management agreement for a period of 4 years initially.


Big Planning Meeting in Witney today (3rd July). The plans for houses on the White House Surgery site were passed - but nothing can happen until the plans for a new surgery are approved (presumably on the hospital site). The eleven houses at Foxfields were approved. Then the application for outline planning permission for the new hospital and care home came up. Its obvious that the owners of Cromwell Park are creating big problems. They had employed a consultant to submit a report on the implications of having all access to the hospital and doctors' surgeries from the Banbury Road - through Cromwell Park Estate. They claimed this would double the number of traffic movements at peak times and create queuing problems at the Banbury Road - holding up everybody from the offices and industrial units. They also claimed to have a covenant which denied access across their boundary on to adjacent land. Perhaps they are just bargaining but it sounded serious. All their claims were refuted by the County Council and their consultants. The biggest problem for the District Councillors was about Parking provision. Just not enough spaces was the clear consensus. Amazingly there are no laid down figures for how many parking places things like hospitals require so everyone was a bit at sea. The OCC Transport and Highways people thought there was sufficient provision (well they would wouldn't they) But nobody even knew how many people would be working on the site in all the three buildings - let alone having any idea about numbers of visitors and patients. Councillor Biles wanted more OCC land used to add spaces. Councillor Hunt thought that a better arrangement of the buildings would generate more spaces within the present borders. Councillor Robinson wanted to go underground. You could provide double the number and it still wouldn't be enough. Councillor Brookes did some back of the envelope calculations and came up with a very large number of spaces required. He quoted his own experience in Hanborough where a new medical centre generates serious parking problems along adjacent streets. Another suggested (ironically) doing away with all the trees and landscaping and just making a huge parking lot. Everybody stressed that this was a building which had to work well into the long-term future and it was essential to get it right. Parking had to be sorted out so a decision was deferred. The District Council are living dangerously. The County will not be pleased.

(Pictured right is District Councillor Chunky Townley.
Chairman of the Hospital Action Group)

The Hospital Action Group issued the following statement on Monday 31st July:

The Hospital Action Group were dismayed by the PCT's decision last Thursday that nurses in the new hospital looking after the Intermediate Care Beds will be employed directly by the Order of St John who will be running the Care Home.- if their appeal about a recent VATruling is turned down. This would be directly contrary to an agreement whch the PCT made last year during discussions with the Action Group and at the Joint Overview and Scrutiny Committee. The people of Chipping Norton have always been clear that they believe they will only get a proper hospital service from fully-qualified nurses who are employed by the NHSand
who are well-paid, highly-motivated,with full access to NHS training and courses. Proper hospital nurses - not care home staff. This view is partly based on the experiences which staff at Castleview in Chipping Norton have had under OSJ management.
ThePCT claim that the financial implications are so serious (up to half a million pounds) that they have no choice in this matter. They are under pressure from the Oxfordshire County Council who are demanding instant confirmation of plans. This VAT question has been raised many times during Action Group meetings with the PCT. Despite numerous requests the PCT have never clarified the issues so that an independent report could be sought. The Action Group were given an absolute reassurance by the last Chief Executive Nigel Webb that a complete answer to the VAT problem could be had by "seconding" nurses. The PCT Business Plan prepared this year by expert consultantsonly recently endorsed this view.To be told at the last minute - after three years of detailed "consultations" that this VAT problem has suddenly come up, must be decided immediatelyand that there is no alternative is simply not acceptable.
The Action Group ask that the latest PCT proposals are reviewed by the Overview and Scrutiny Committee. They call on WODC to support this request. They ask that all the correspondence with the Inland Revenue should be reviewed by an independent expert. They urge the PCT to pursue every possible appeal process to get the Inland's Revenue VAT decision reversed. They call on OCC to stop exerting unreasonable pressure on the situation by imposing deadlines.


For the last two years we have been told that the present Hospital site would be sold off and part of the sale proceeds would be invested in some way in the new hospital. Two years ago the NHS told us at the huge Public Meeting in the school that the hospital and its land had been valued at 800,000. (there were shouts of disbelief at that figure) The following year a value of 2m was quoted. We were told it should be possible for appx 1m of this to be invested in the new hospital. The favourite option among townspeople was for the NHS to buy the land on which the new hospital was to be built from the present owners - OCC. Everyone thought this would be an appropriate and tangible way of perpetuating the Walford/Brassey bequest. Their gift would live on. Recently the PCT have started suggesting difficulties about this specific plan but the broad intentions remained clear. Now suddenly everything has changed.

As the accountants keep hitting last minute snags, they are devising financial solutions which make no sense to the layman. We simply don't know whether what is being proposed is best for our community or not. At the PCT Board meeting last week the Financial Chief said the need for last-minute changes was all about "arcane" NHS rules. She didn't explain anything. We have asked the PCT and the OCC to come and answer our questions - but that's difficult because hey it's holiday time. Will mid-September be OK

The PCT say that the hospital has been on their books valued by the District Valuer for its existing use at 3m - although this figure has never been mentioned before and seems extremely high. Our completely new hospital is costing 3m! Now (we are told) the hospital has been valued by an independent valuer on an open market value basis at from 330,000 to 1,110,000 (Goodness knows how this surprising valuation was made and by whom. If you got planning permission to convert the hospital building into flats and build twelve new houses in the grounds my friendly developer friend would pay you a lot more than that). Apparently when this kind of discrepancy happens in the NHS world the difference between book value and open market value has to be paid as a sort of penalty out of PCT funds. This means that selling off the hospital would lose the PCT a lot of money. But (we are also told) "There is a legitimate mechanism for transferring ownership of the building to a Local Authority at book value with no revenue implication for the PCT (other than the saving on capital charges). Further, if a rent free period is agreed, then there would be a revenue saving to the PCT so long as the old hospital is in use.". In other words - Just give it away. Now it is at this point that us lesser mortals who have grown up in the commercial world simply stop following what on earth is going on. And asking questions never seems to get you any further in following the logic. "That is just the way it is", you are told. The County Council apparently acquires a valuable building and piece of land for nothing - but even more importantly they add it to the Ambulance Station (which the OCC have bought) and the Castleview site (which already belongs to the OCC) and wow! The word goldmine springs to mind. A huge development site worth millions.

We are in no position to understand the ins and outs of the wheeling and dealing which now seems to be going on. We acknowledge that we will be getting a new Care Home and a new Hospital about which we are very content. We would have preferred them not to have been privately financed and run by a private company but we do understand that the NHS and the OCC are under the cosh of government dogma. However the big downside is that a huge swathe of the town centre will be intensively redeveloped and a chunk of greenfield land will disappear. In addition an asset - bequeathed nearly 100 years ago to the town will simply be "traded in". That legacy could simply vanish.

The people of this town really want one thing most of all out of this development which is to know that a substantial part of the profits which are going to be made from the Hospital/Care Home scheme are ploughed back in a tangible, lasting and identifiable way into Healthcare for the town. We have no assurances whatsoever about that yet. We believe that is our right.

Nor are we talking about "ring fencing" money which can only be accessed with match funding through a Town Partnership. We are talking about at least a million pounds allocated to Health projects in Chippy which will be over and above the plans discussed so far for the Hospital.

Some of us always thought that it was going to be a very tall order to try to and realise the assets from a Hospital (owned by the NHS) and a Care Home (owned by the OCC) and then to get a private third party (the Oxford Care Partnership made up of the Pilgrim Housing Trust and the Order of St John) to finance, build and manage a strange new hybrid facility consisting of a Care Home and Hospital all in one - on greenfield land owned by the OCC. Working out who would work for who and who owed what to who and establishing equity through leases and contract fees was always going to be a nightmare. And so it is proving.

The PCT clearly don't think that chippingnorton.net is "on message" so they have produced a briefing document for you with all the background. They have asked us to put it on this site which we are happy to do. Please read it for yourself and see if it provides the reassurance you want. READ THE PCT BRIEFING