Agenda item

Liz Shutler, Director of Strategic Development, Howard Jones, Director of Facilities, East Kent Hospitals NHS Trust, Lynne Selman, Director of Citizen Engagement, Sheila Pitt, Head of Practice-based Commissioning, and David Meikle, Director of Finance, Commissioning and Performance, Eastern and Coastal Kent PCT, will be in attendance for this item.

(Liz Shutler, Director of Strategic Development, Howard Jones, Director of Facilities, East Kent Hospitals NHS Trust; Lynne Selman, Director of Citizen Engagement, Sheila Pitt, Head of Practice-based Commissioning, and David Meikle, Director of Finance, Commissioning and Performance, Eastern and Coastal Kent PCT, were in attendance for this item at the invitation of the Committee.)

1)     The Committee had before it a copy of a letter from the Patient and Public Involvement Forum for Eastern and Coastal Kent PCT, formally referring to the Committee the matter of healthcare services in Dover (dated 5 February 2008), along with a paper, setting out the reasons for referral, that was sent to the PCT (on 20 December 2007) and an annotated version of the paper, containing the PCT’s responses. These papers are attached to these minutes as Appendices 1 and 2.

2)     The Chairman reported that he had received a letter from Gwyn Prosser, the Member of Parliament for Dover and Deal, stating that he would have liked to attend the meeting, but was unable to do so, due to the lack of notice given. Mr Prosser had also gained the impression that he would not have been allowed to speak if he had attended the meeting.

3)     The Chairman said that he wished to apologise to Mr Prosser and emphasised that local Members of Parliament were always welcome to attend and speak at meetings of the Committee. Copies of Mr Prosser’s letter were circulated to Members.

4)     Lorraine Sencicle, formerly a member of the Patient and Public Involvement Forum for Eastern and Coastal Kent Primary Care Trust, addressed the Committee, at the Chairman’s invitation. Ms Sencicle said it had been stated that the basis for the Dover Project was the White Paper Our health, our care, our say. She believed that applying the principles of the White Paper to healthcare services in Dover must mean the establishment of a community hospital in the town – not a cottage hospital or a polyclinic. Funding had been made available for community hospitals, but Eastern and Coastal Kent PCT and East Kent Hospitals Trust had not put in a bid for this.

5)     Ms Sencicle said that Dover was entitled to a community hospital providing: outpatient clinics; diagnostic services; phlebotomy; chemotherapy; physiotherapy; occupational therapy; renal dialysis; podiatry; orthopaedics; a Minor Injuries Unit, open from 6am to 9pm, seven days per week; day surgery; in-patient observation beds; intermediate care beds; end-of-life care; and other services.

6)     Reg Hansell also addressed the Committee at the Chairman’s invitation. He said that Dover lacked hospital services and had poor transport links to other areas where these were being provided. Buckland Hospital was “dying from a thousand cuts”.

7)     Mr Hansell read out a message from Gwyn Prosser MP, supporting enhanced facilities at the Buckland Hospital site. He also read out a message from Charlie Elphicke, the Conservative Prospective Parliamentary Candidate for Dover and Deal, saying that he fully supported the idea of a community hospital in Dover, with an Emergency Care Centre similar to that existing at the Kent and Canterbury Hospital.

8)     Mr Hansell also read out a message from Dr Joe Chaudhuri, of the Dover and Aylesham Practice-based Commissioning Consortium, explaining that the Consortium would be working with the PCT to commission services closer to home.

9)     Cllr David Lloyd-Jones, of Dover District Council’s Scrutiny Committee, addressed the Committee at the Chairman’s invitation. He explained that his committee was conducting its own scrutiny on the issue of healthcare services in Dover. While he could not report on the outcome of this, as it would not be concluded until July, he could say that there was great public unrest and anger in Dover caused by fear that the town’s hospital was going to disappear.

10)David Meikle Director of Finance, Commissioning and Peformance, Eastern and Coastal Kent PCT, explained that the PCT recognised the work done under the heading of the Dover Project had been narrow in perspective. The PCT was now working with the local Practice-based Commissioning cluster and developing a Joint Health Needs Assessment.

11)In May 2008 the PCT would be discussing with GPs the “first cut” of a plan for enhanced local services, and discussing with East Kent Hospitals Trust how those services could be delivered. One of the main issues that needed to be considered was the buildings that would be used to deliver services.

12)Howard Jones, Director of Facilities for East Kent Hospitals Trust, explained that the Trust had come up with two options for the future of the Buckland Hospital site:

·        a general upgrade of the site, at a cost of £8 million;

·        the construction of a new building, at a cost of £11 million.

13)The Trust was currently discussing with Dover District Council other possible estate options in the area. Late July / early August had been set as the deadline by which the options for consideration should be set.

14)A consultancy report, by G V A Grimley Ltd, had been prepared regarding the possible disposal of Buckland Hospital and the construction of a new healthcare facility in Dover.

15)The market value of the Buckland site had recently been estimated at between £3 million and £4 million. The figure of £16.6 million, which had been quoted in the briefing paper provided to Members, was the “book value” for the site given by the District Valuer, not the market value. The site was not a “cash cow” for the Trust.

16)A Member pointed out that the Committee would need detailed information in order to be able to undertake scrutiny of the options that were to be considered. Sheila Pitt, Head of Practice-based Commissioning at Eastern and Coastal Kent PCT, said that the details were still being worked on and would be available by the end of June 2008, once they had been agreed by the PCT Board.

17)Mr Meikle said that the PCT welcomed scrutiny and criticism in the interests of improving services.    A commitment was given to bring a detailed financial appraisal, with fully costed proposals, to the Committee for scrutiny.

18)Mr Jones said that the Trust would share detail as it became available. Plans for the options involving the Buckland site were currently being drawn up by architects for the Trust.

19)A Member asked whether the detailed options could come before the Committee for consideration in June or July 2008. The Chairman agreed that the detailed options should come before the Committee but said no guarantee could be given regarding when this would be.

20)Lynne Selman, Director of Citizen Engagement for Eastern and Coastal Kent PCT, assured the Committee that Practice-based Commissioning plans would be the subject of patient and public engagement and consultation, as well as coming before the Committee.

21)Responding to a question about the availability of adequate resources, Liz Shutler, Director of Strategic Development for East Kent Hospitals Trust, said that resources were not an issue for the Trust; Dover was a priority. The Board did want to reinvest in services, either at the Buckland site or an alternative Dover location, as the existing estate was not good enough.

22)Mr Meikle emphasised that the local Practice-based Commissioning cluster was committed to seeing a full range of diagnostic and other services available in Dover. Account was being taken of the voice of local GPs.

23)Ms Shutler said the Trust was planning to reprovide all services currently provided at the Buckland site. Practice-based Commissioning plans were currently awaited; if GPs wanted additional services to be provided, that would then have to be discussed.

24)A Member queried how services would be provided locally during rebuilding work at Buckland Hospital, if that option were to be adopted.

25)Another Member praised the quality of services at the Community Hospital in Deal (the Victoria Hospital), which was a refurbished building.

26)Responding to a question about public consultation, Ms Selman said that the PCT wanted to involve people all the way through the process of planning new services in Dover.

27)A Member queried whether it was an appropriate use of NHS money to have architects working on plans for the Buckland site when no decision had yet been made on which option to pursue.

28)Mr Hansell mentioned the availability of a site at Whitfield that he thought would be superb. Mr Jones said that the Trust did not think that a site at Whitfield would be suitable.

RESOLVED unanimously, on the motion of Dr Robinson, seconded by Mr Marsh, that:

The Health Overview & Scrutiny Committee of KCC strongly recommend & support E K Hospitals Trust working closely with the ECK PCT & Dover District Council to locate a central site in Dover for the Community Hospital Services for the population of Dover & the surrounding areas.

This proposal to be delivered to the EKHT by the end of August 2008.  This third option to be considered & evaluated alongside options I & 2 concerning the Buckland Hospital Site.