A special town council meeting last Thursday discussed the plans for Castleview. READ THE PLAN


This should all have been so straightforward. Castleview does not meet the new standards for care homes and needs replacing. Lets do it! said the Town two years ago.

The logic seems to have developed like this.....The OCC county-wide strategy calls for a shift of resources to the under-provided south. They are also concentrating on a smaller number of bigger, more cost-effective homes (NOT in Chipping Norton). The arithmetic means a requirement for fewer beds in Chippy in the near future - around 20. This number does not justify a new stand-alone care home. So lets take a look at the crumbling Hospital. They have 15 "intermediate care beds" (ie beds which are used for cases needing skilled nursing care but not the expensive medical skills of the JR or the Horton). Lets incorporate those beds into our plan (and for the moment forget about the fact that nursing someone with a broken leg requires a totally different skills set and environment from nursing someone with Alzheimers - because this is just about getting the money right!). This still only gets us up to 35 beds and we really need 50 to financially justify any sort of new home. At this point the Oxford Care Partnership - a private joint venture company who manage all the county's care homes on a 25-yr 15m per annum contract - step in and offer to incorporate 15 completely Private beds which they will "market" (and for the moment forget about how you happily integrate 20 "free" beds and 15 "private" beds under one roof with one organisation) So BINGO - by some creative cobbling together of interests you have a basic case. Now the vision can take off. Lets add in a new hospital (owned and partly funded by the NHS) maintaining a Maternity unit (run by Oxford Hospitals) and with additional services (funded by Cherwell PCT). An ambulance station (funded by the Ambulance Trust). And the Town Surgeries can come along for the ride. Perhaps Highland Day Centre could relocate there too. It has been described as a "Care Village" (I'm just a patient. Get me out of here!) All this requires more land than the present Castleview + Hospital site so lets shift the whole shooting match up the hill to part of the soon-to-be- vacant Parker Knoll site (and for the moment forget about the fact that must people in the town and the staff of Castleview believe that the best place for a residential care home is where it is!) Obviously none of the parties to this many-headed committee-created monster can actually agree to anything until they know what money they are in for. So let the costings begin! Your Editor's layman view (based on only a lifetime's big company experience) is that this is a genuinely IMPOSSIBLE calculation. There are so many conflicting interests, so many unknowns and so many different possible interpretations of risk.....and no certainty possible about what planning permissions will be approved. More expensive consultants will certainly be required.

Its all very tense because - unspoken - at the heart of everything is Real Estate. Behind all the ideas and visionary proposals is the fact that the Oxfordshire County Council owns a lot of the land, the Ambulance Trust owns land, the NHS owns land (which once belonged to the Town), and Parker Knoll owns land. The Town Surgeries and Highlands own properties And every single one of these bodies will be looking to leverage their property and land assets to the maximum in any financial negotiations - which basically means that they will be trying to get permission for residential development (at the lowest "cost") on any land they sell and minimising their financial contribution to the new facility so that they end up making a killing! ....And since the District Council controls Planning permissions for everything they will be looking to increase the "cost" of any permissions to land owners by extracting other community benefits. And because a large part of the costs of a new development will be financed privately via the OCP and recouped in contract or rental charges - this could be a fantastic wheeze for the County and the NHS to get money in the bank by selling assets now and spreading the cost of their replacements way into the future. There are millions of pounds involved. And it would be extraordinarily difficult to ensure that the OCP do all their work on a genuine "not-for-profit" basis (ie no profit -even in all the sub-contracting - for any part of the organisations of the the two OCP joint venture partners - The Order of St John and the Bedfordshire Pilgrims Housing Association) What an amazing web of conflicting interests! Who could possibly play Solomon If it all happens this will be a case for the Auditor General's office to look at - but this plan will never happen. It will be impossible to reach an agreement between all the parties. The potential for dispute is endless. The costings process has already been extended by three months. Expect further delays.

And by the way - because there are contracts and Private companies involved - all this information is CONFIDENTIAL. So anyone who thinks that local ratepayers might have some right to access details about who gets what out of the proposed plan will have to think again. At least until next year when the Freedom of Information Act comes into full effect. That Act is retrospective - which is something our local councils might think about. We will be able to see the books - eventually!

Not surprisingly The Town Council had a long and tortured debate about this latest proposal. They were not happy. The discussion really came down to just two big simple questions for the town to ask before getting bogged down in the complex swamp of conflicting interests and half-complete costings.

QUESTION 1
Do we believe that people who have lived a large part of their life in the town and qualify for state-funded residential care have a right to get that care in the town itself

The Town Council unanimously believe they do and the fact is that the proposed plan will not provide this. The present Castleview has 50 beds. Its full and over half the places are occupied by Chippy folk. Everyone agrees that the local elderly population is growing and demand for residential care beds will increase proportionately into the future. The new plan only provides for 20 "free" beds. This means that some Chippy old folk will have to be accommodated in Witney and beyond. This just isn't acceptable.

QUESTION 2
Do we believe that the Town has an absolute right to expect that any financial benefit derived from the sale of the Hospital its assets and its land will come back to the town in the form of alternative health care facilities

The Hospital was a bequest to the town and over many years funds were raised to maintain it and add further facilities. The NHS may have the present "legal" title but the Town Council believe the community still has a real responsibility to protect the heritage and the asset created and built up since 1920 (READ THE HISTORY OF THE HOSPITAL). The Town Council needs complete re-assurance about this and so far it doesn't have it.

Several town councillors felt that if the present Hospital and Castleview sites were sold with Planning permission and strong Planning Gain (Section 106) agreements there would be more than enough money to build modern replacements on some publicly-owned land on London Road - without involving private financing and so maintaining the number of free beds. So what was the problem Which is when the multi-agency fog and the spider's web of strategies descended and confused the discussion again.

All this is yet another example of where "increased efficiency" "private partnerships" and split responsibilities between different agencies results in complex - often impenetrably confusing - proposals which actually mean services being cut back in the town. The irony is that all this complexity which is working against our interests is being produced by armies of new highly-paid council bureaucrats who we are paying for. The Castleview situation started off simple and has ended up as a Planning and Financial dog's breakfast. But don't worry. We are guaranteed another Public Consultation process. Which will be another opportunity for the bureaucrats to ignore our views. So here's yet another battle to be fought - following fast on the swimming pool and the ambulance station. St Jo will be needed at the barricades again soon.

READ THE PLAN

In the March issue of the Chipping Norton News an authoritative article
deals with the question of how many beds are needed for Chippy residents.
Its reproduced here with acknowledgements

Does Chippy need more beds

Will Chipping Nortons elderly residents be able to get free local residential care if they need it Some key facts from a recent (2003) detailed local survey* tried to deal with some of these uncertainties.

1. What is the current local provision for the elderly There are currently an estimated 158 residential care or nursing beds for the elderly within 3 miles of the Town, and 222 within 6 miles. Castle View has 47 of these.

2. How many are free There are no longer publicly run free beds. Private companies or trusts now run all homes, including Castle View since 2002. The County Council has an obligation to buy enough beds from the providers either long term or on the spot for residents who qualify for free places. They can, and do, buy them from either Castle View or elsewhere.

3. Are Chipping Norton residents well-supplied The County as a whole has 93 care or nursing beds for every 1000 residents over 75 years old. Chipping Norton local area has 145 (56% higher than the county) and well above the national average of 123. The local area beds are 93% occupied but many of these beds are not used by Chipping Norton residents. In Castle View in particular only 14 out of the 41 people in residence came from within 3 miles of the Town.

4. What will Chippys future elderly residents need For all the known reasons there are expected to be 25% more residents over the age of 85 in 7 years time. Some will want free places in homes, some will be paying. Many, according to Age Concern, will want to stay longer in their own homes or in very sheltered housing with more care provided in their home as planned by social and health services.

5. So will there be enough local free places The key issue is that the public service funders will have to make sure they can pay for places locally for all Chippy people who qualify. The County Council have said they need 25-30 residential beds for state supported needs for Chipping Norton. It may of course be higher and they will have to find them. The new development to replace Castle View will include 35 beds some already block booked. If necessary the County will have to pay for some of the others being marketed by the new Castle View owner or other homes in the area.

*The Need for Supported Housing and Housing-with-care for Older Persons in West Oxfordshire by Laing & Buisson, August 2003

CASTLEVIEW
UPDATE
For the last year or more a Local Stakeholders Group has been meeting to consider the future of the Castleview Residential Care Home. They reached a "preferred option" recommendation back in November. The original plan was for this to be discussed at an OCC Executive meeting in January. Then the OCC meeting was put back two months - more costings were required. The plan now is for the OCC to decide in March which options should be put forward in a public consultation process. We now know what the Chippy Group's preferred option is and it will soon be discussed at a Town Council Meeting. Broadly and as simply as possible - the Stakeholders group want to replace the outdated 47-bed (long-term care) Castleview PLUS the present Hospital with a new 50-bed care home PLUS a "Primary Care Facility" (ie Community Hospital providing outpatient treatment, physiotherapy and maternity). But we are not really comparing like with like. These new 50 care beds will consist of 20 long-term care beds contracted to the OCC, 15 fee-paying beds marketed by the Private Sector and 15 "intermediate care" beds of the sort currently provided by Chippy Hospital. This is an ingenious solution to a number of problems - the County don't need as many long-term care beds in the future in Chippy so funding for a new set-up has to be attracted from other sources. Apart from the Private Sector money, the "intermediate care" beds will be paid for by the local Primary Care Trust. Mind you everyone is still doing their arithmetic on all this! This whole operation could just about be accommodated on the present Castleview and Hospital sites (although the Ambulance Trust is not yet playing ball over their soon to be closed ambulance station). But - controversially for some people - the Group favoured "on balance" exploring larger, more suitable sites like Parker Knoll and the OCC-owned Cromwell Park allocated housing site. This would allow other services to join what is described as a "Care Village" (ugh!!) The West Street Surgery and Highlands might be interested along with other possible new services being considered by the PCT in their review of Community Hospitals. But things start getting very complicated now because West Oxfordshire District Council - as the Planning Authority - will have to weigh up a number of different very important demands on these development sites - not least the provision of employment. Everyone is at great pains to emphasise that the Community Hospitals Review - now completed - contains no plans to close Chipping Norton Hospital. However the Stakeholder's Group Preferred Option raises big questions about just what a Chippy Hospital might consist of in the future and where it might be.

READ MORE DETAILED BACKGROUND (PART 1)
READ AN ACCOUNT OF THE FIRST CONSULTATION MEETING (April 7th)