Minutes:
Q:- Only three months ago we saw plans and design proposals for the development of Kings Ave and there was no question that it would not go ahead. We are alarmed that plans got that far advanced but now the building stops and we would like a fuller explanation of why the project has now been pulled.
A:- In developing the business case full consultation had to take place; including engagement events with local residents to discuss the plans and service provisions. However, the project does not now represent value for money for the local health economy. The scheme now is financially unworkable.
Q. There have been meetings about Kings Ave for at least four years. The shortfall in revenue funding was identified in 2008. The amount of time and money already spent is a disgrace. Didn’t you have doubts about the project before now?
A. The service requirements have changed and services are being delivered elsewhere. However, a number of things identified in health care provision will be of use whether or not we went ahead with Kings Ave.
Q. What action did the non-executive members take?
A. When we inherited the project from Ashford PCT we were very optimistic and of course everyone is now disappointed. The whole Board decided that the scheme is not viable. They recognized that we can’t invest in a new building when existing buildings are not fully utilized.
Q.How much have you spent to date?
A. Over the years £1.5m has been spent on the project but over £1m would have been spent anyway to dispose of the old hospital and clear the site. Also much of the consultancy work has been salvaged for use elsewhere in providing services.
Q. What services would have been better provided if you had not wasted that money?
A. That money will come back into the public purse once the site is sold.
Q. We can’t believe the scheme was going ahead while at the same time you were enhancing the services with local GPs and you did not know this would have an adverse impact on the viability of the Kings Ave.
A. Expanding and offering services to meet health needs in GP surgeries and community settings like the Gateway and Stour Centre
was planned but there are other reasons which also informed the PCT Board’s decision to stop the proposed development like the revenue gap, the capital requirement, the impact of the economic downturn as well as less activity required at Kings Ave.
Q. Where was plan “b” for the revenue shortfall? And will Costain the contractor get compensation for the broken contract?
A. The process meant there was no formal contract with Costain. It was thought that there would be value in delivering services in one place however there are now alternative locations providing this and we face new financial challenges. The figures did not add up and there was no advantage to just scaling back some of the proposed services for Kings Ave. We have been working for a number of years to get care closer to home and we are delivering a lot of care already in the community. Kings Ave was only part of the picture. So much is now delivered in local GP surgeries.
Q. We still feel there has been a lack of foresight and we don’t understand why you did not make the decision to stop over a year ago.
Accessibility and transport to William Harvey hospital and other health Centres remain a problem for the elderly and medical notes between one place and another often go astray. Kings Ave was a one-stop provider and being on the Smart Link bus plan and was best placed to deliver a range of services.
A. Its right to be disappointed and right to criticize the PCT but we did not want to give up too early and have been working all the time to consider all the options. GPs decided that Repton Park was better than Kings Ave and there will be new provisions in Cheesman’s Green and Chilmington. We still retain the option of opening a small provision of health care on the King’s Ave site if needed.
Q. I understand you are still putting in the planning application. Is this just to increase the value of the site?
A. We have a duty to maximize the sale of the site.
Q. Many GP surgeries are already over crowded and yet you want to expand them and I am concerned that you mentioned using Gateway. When the new library is built, it will include Gateway and yet there will only be two parking spaces. Aren’t your ideas over optimistic?
A. We are not making assumptions that all GP’s will want to expand services. Already the Gateway in Park Mall is providing services successfully. What we are saying is that a large number of services can be provided in a range of different locations. This is getting best value.
Q Four years ago the Ham Street GP surgery wanted to expand services but was put on hold because Kings Ave and St Stephen’s Health Centres were thought best placed to provide services. We are frustrated that there is no joined up thinking.
A. That’s a fair comment but we are now hoping to expand Ham Street practice. Further development of services throughout Ashford will be done incrementally.
Q. I think the decision not to build on Kings Ave is a bad one. You have done the people of Ashford a injustice. Ashford is expanding and Kings Ave would have been ideal. Only a few months ago you were saying it would be impossible to meet the health care needs for Ashford without King’s Ave and now you have changed your mind. What is the next change in your thinking going to be?
A. We share your disappointment. A real injustice would have been £800,000 shortfall every year in revenue that would have meant fewer services being provided. It is better to invest in services rather than a site. We need to get best value for every pound spent.
Q. Staff in Western Ave have been told to move out without King’s Ave where are they going to?
A. We have concluded a move to St. Stephen’s. In any case King’s Ave would have been entirely clinical not for office space.
Q. You referred to services “closer to home” but what does that mean as GPs are not going to provide everything.
A. GPs throughout Ashford want to provide as many services as possible. Specialist services in hospital can be a problematic with delays in service and in transfer of records. However in primary care this is not the case. Its often easier to get to the GP and its easier to park at surgeries. If a patient is entitled to transport to hospital they can get the same transport to their GP.
Q. In my opinion the PCT has been poorly advised over King’s Ave and the situation is regrettable. But maybe this decision will speed up a second hospital which will be needed in the future.
A. There are no plans for a second hospital in Ashford.
Q. What about the Singleton Medical Centre. It only has one doctor. Are you looking at that? Its wrong to expect GPs to take on more services. Appointments are already taking longer. What I don’t understand is if you are now utilizing existing space and capacity why did you not look at that before you started the King’s Ave project? Is this a cover up of your failure?
A. GPs are independent contractors. They decide whether to take on more services and we are not able to force them to do so. We are not expecting they will provide all services.
Q. You keep talking about more services but what happens when GPs and existing health centres can’t take on any more. Why can’t you build Kings Ave to manage the growth that undoubtedly is coming to Ashford?
A. We can’t build in anticipation of growth. We will have plans for the future when the demand is there. Obviously will we keep health services under review.
Q. Have you considered making King’s Ave more viable by adding more services and moving some from the William Harvey?
A. We looked at changing the size of the building, at providing more services or less with a smaller building but in the end this project is just not viable.
Q. Did you not have a contingency if costs over ran?
A. Yes for capital costs there was but not for ongoing revenue costs.
Q. I don’t think there has been any cover up but would see this as very poor project management. Do you agree and what lessons have been learnt?
A. As we have said we are all very disappointed with the decision. However, I don’t accept poor project management. We needed to test out ideas for the site. Lessons have been learnt on how we manage change and uncertainty. We need modeling for when we get knocked off course. We have written a review which will be shared with the Ashford Local Strategic Partnership. Our process has been robust but accept that it incurred some costs which with the benefit of hindsight may not have been spent. We could have carried on with the project but the services throughout Ashford would have been hit. We believe we have made the right decision.
The chairman thanked the PCT for coming this evening but said he still felt costs had been put in front of services. He hoped they would come again in the future with good news.