John Lister comments

Merton Council has decided to refer the proposal to build a new hospital in Sutton and downgrade and downsize both Epsom and St Helier hospitals to the Secretary of State, Matt Hancock.

The controversial plans and a skimpy “Decision Making Business Case” were rubber-stamped on July 3 after perfunctory discussion at a Committees in Common meeting of South West London and Surrey Heartlands CCGs.

Merton council sums up its objection as threefold, arguing:

“the CCG’s consultation on the IHT has been inadequate in relation to content or time allowed,

“the context of the increased demands on NHS resources as a result of the COV19 pandemic (and potential future pandemics),

“and … the Council considers that the proposed decision would not be in the interests of the health service in its area.”

The council includes in the reference back its own document criticising the “Improving Healthcare Together” plan, and responses from Siobhain McDonagh MP, Community Action Sutton, Merton Voluntary Services, Sutton council, Dr Rosena Allin-Khan MP for Tooting (covering St Georges Hospital), Epsom and St Helier Unison branch, Merton & Sutton Trades Council, GMB union, and  local campaigners (KOSH and KOEH).

Acute bed numbers slashed

Indeed the £500m plan that would effectively halve the number of available acute beds to cover a population of 770,000, and concentrate all acute beds and consultants on the Sutton site, has not only failed to win support from either of the London boroughs directly affected by the plan, but also been opposed by Epsom Tory MP and former minister Chris Grayling.

Perhaps surprisingly Grayling’s letter, centred on redirecting the available investment to Epsom Hospital, and ignoring any wider issues, makes some valuable points.

He notes that “the public consultation did not give a clear mandate to build at Sutton, and the analysis of it only showed a marginal preference following a pretty intense campaign by the NHS leadership to sell its preference.”

Grayling also argues that “there is now not sufficient funding available to guarantee that the project can go ahead at Sutton. … The expectation in the construction industry today is that costs will rise by as much as 20% following the pandemic.”

And he echoes the unions in noting that “Unless a fully workable vaccine is found for the virus, some degree of social distancing will remain necessary for the time being and this must be factored into the projected costings.”

However the attempt by Merton and Sutton TUC to draw a response to the IHT plan from the Independent Chair of South West London’s so-called “Integrated Care System” has underlined the hollow claims of the ICS.

The letter that eventually came back to TUC Secretary Kevin O’Brien stresses that for all the talk of integration and coordination, the ICS (the South West London Health and Care Partnership) “is not a statutory organisation” and that responding to the proposals is a role only for statutory bodies (CCGs).

Old arguments

Rather than respond to the points on behalf of the ICS, the Independent Chair, Millie Banerjee, apparently delegated the CCG’s senior responsible officer Sarah Blow to produce a 3-page letter which rehearses the old arguments for the Sutton Hospital.

The letter is principally remarkable for completely ignoring the concerns raised and the opposition to the scheme by both of the London boroughs – which are allegedly “partners” in the SW London ICS.

Ms Blow also managed to craft a reply that ignored specific questions from the Trades Council about the conflict between the IHT plan to slash numbers of front line acute beds and the explicit guidance to the contrary from NHS England in January, followed by more recent guidance in the light of the Covid pandemic from NHS England Estates director Simon Corben.

Perhaps even more remarkably the letter makes no mention at all of the pressures and problems to be faced by the NHS in the post-Covid situation.

Ms Blow uses weasel words to dodge around the TUC’s argument that locating a new acute hospital in Sutton would inevitably increase the numbers of patients referred to it from the Royal Marsden’s Sutton site next door, which has no operating theatres – arguing only that “there are no plans to use the acute beds … for private patients from the Royal Marsden.”

The combined CCG, which now incorporates Merton and Sutton CCGs (which, with the leaders of the Epsom & St Helier Trust, have driven the IHT plan) might feel able to duck and dive, but the referral of the plan to the Independent Reconfiguration Panel (IRP) could bring a more sober overview.

As Merton council’s letter to Hancock says:

“The Council is confident that the IRP would conduct a proper analysis of the merits of the proposal and will see the obvious flaws in the approach taken by the CCGs.”



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