Agenda item

Rose Gibb, Chief Executive, Bernard Place, Commissioning & Healthcare Director and Laurence Bunnett, PFI Director, Maidstone & Tunbridge Wells NHS Trust and Steve Phoenix, Chief Executive, West Kent PCT will be in attendance for this item.

(Ms R Gibb, Chief Executive, Bernard Place, Commissioning and Healthcare Director and Laurence Bunnett, PFI Director, Maidstone & Tunbridge Wells NHS Trust and Mr S Phoenix, Chief Executive of West Kent PCT were in attendance for this item)

(1)       The Committee received a presentation on the Business Plan for the Private Finance Initiative (PFI) at Pembury, which is attached as Appendix 2 to these Minutes. 

(2)       Mr Horne said that the new Pembury Hospital was required as quickly as possible.  He had specific questions around the renal unit, the diabetes unit, rehabilitation and continuing life care for people with long-term conditions.  He also mentioned concerns relating to the A21 in respect of dualling the carriageway, which he saw as a big issue for the PFI project.  Mr Phoenix said that the West Kent PCT was discussing with Guys and St. Thomas’ NHS Foundation Trust in London the positioning of the renal unit in a new location, which need not be at an acute hospital site.  He referred to the West Kent PCT Board report that was being prepared for the Board’s meeting on 24 May 2007, relating to the Community Hospitals review, which would mention the renal unit.

(3)       Mr Phoenix also said that diabetes services did not have to be at an acute hospital site either.  Mr Place said that some intense short-stay rehabilitation would be at the new hospital but the rest did not necessarily have to be provided at the hospital.  Mr Bunnett said that upgrading the A21 was not a critical precondition of the hospital getting built, but there could be a helpful congruence of these two issues.  He said that issues around the A228 would also not be an obstacle to the project going ahead.  The Trust were working on the question of traffic profile.

(4)       Mr Phoenix said, in response to the question about long-term care, that this would not be provided in acute hospitals.  Once again, he referred the Committee to the proposals on Community Hospitals – although these were not necessarily the best place either for people who needed care but not medical care; they were better looked after at home or in “more homely settings”. 

(5)       Members asked a series of questions about the source of funding for the PFI; whether the building would be environmentally sustainable; and ensuring that car-parking would not be a “cash cow”. Ms Gibb responded that the construction project would not be publicly funded but, as a PFI project, would use wholly private finance.  Sustainability and environmental issues would be looked at. The government’s review of the project had stated that health issues needed to be reflected in the plan.  Local labour would be used where relevant and appropriate, but the project would be in competition for local labour with the 2012 Olympics.  Ms Gibb confirmed that cancer patients who had to attend the hospital on a regular basis for treatment would receive a car-parking pass.  In answer to a question around the funding of the PFI and whether Value Added Tax would be payable, Mr Bunnett confirmed that VAT was not applicable in the case of a PFI project.  If the hospital were to be built under traditional public-sector procurement arrangements, then VAT would be payable.

(6)       Mr Vye asked some questions around mental-health provision and said that co-location of these services at the acute hospital site would be a good idea.  Mr Phoenix confirmed that the PCT was looking into this with mental-health colleagues as regards bed availability.  However, he said it was unlikely that the PFI project would include a dedicated mental-health unit.  Mr Phoenix informed the Committee that in West Kent there was a lack of mental-health beds in a community setting. He said that also they were not making the best use of what beds they already had. Therefore, it was not appropriate to be including a mental-health building in the plans for the new PFI project.  The Trust representatives responded to questions relating to the provision of individual rooms for all patients within the PFI project.  Regarding how the hospital was to be paid for, Mr Phoenix confirmed that this would be through annual payments by the Trust to the PFI company from funds supplied by commissioning PCTs for services provided (which was, of course, taxpayers’ money).

(7)       The Committee noted that the travel plan would address the road issues.  Mr Horne returned to the dualling of the A21 and improvements required for the A228.  He said that the A21 was a trunk road and so not a County Council responsibility. However, the matter should still be raised with KCC’s Highways department.  He said it was important that both patients and doctors had decent road connections.  The Committee noted that work on the PFI project would start early in 2008.