PARLIAMENTARY DEBATE
Healthcare Facilities: Weybridge - 21 November 2022 (Commons/Commons Chamber)
Debate Detail
Contributions from Dr Ben Spencer, are highlighted with a yellow border.
Motion made, and Question proposed, That this House do now adjourn.—(Andrew Stephenson.)
21:52:44
Dr Ben Spencer
Runnymede and Weybridge
I am very grateful for having secured this debate. May I start by congratulating our England football team on a resounding victory today? I am hoping to have equal success after this Adjournment debate is completed.
In 2017, Weybridge Community Hospital burned down in a raging inferno so intense that local residents sought shelter in St James’s church. Weybridge Community Hospital was a much-loved community hospital that housed the Church Street and Rowan Tree practices, community nursing, physio, imaging and a walk-in centre in which people could be seen on the day. Now, both practices and community nursing operate out of temporary portakabins and buildings on the site. Even before the pandemic they faced challenges, with concerns around their ability to provide the sort of care that they wanted to provide out of the portakabins standing there.
The pandemic crystalised those pressures on the staff. They are a great team, and I thank all those who work there day in, day out for the benefit of local residents. We owe them and local residents more. I have visited the portakabins, and, quite simply, there is not enough space. Staff work out of rooms without any windows. The working environment is a sight to behold. People are crouched behind desks with files above, below and either side of them. They need more space for their working environment. It is not a pleasant environment to work in. The lack of availability of free rooms hampers the amount of clinical activity that they can do. They have difficulty recruiting. Despite that, they are doing their best and, again, I thank the team working there. But five years on, people living and working in Weybridge need permanent healthcare facilities to be rebuilt, not temporary facilities.
I know from speaking to my residents at their doors and in correspondence that this is a major concern in Weybridge. It is not purely about the current provision of care, which remains a challenge. Both Church Street and Rowan Tree practices have much larger numbers of patients per GP than the national average. There are also several housing proposals being mooted for Weybridge. My constituents already struggle to see a GP or healthcare practitioner. They are rightly saying to me that if the planning authority approves the proposals, it will only get worse. We urgently need improvement in our local infrastructure, of which healthcare is a key part.
Where are we now? Since 2017, there has been much consultation but progress has been hampered by repeated delays, the pandemic, the complexity of joint project working and now, of course, the challenges in terms of inflation. Many people loved the walk-in facilities that the community hospital used to have, but there is an understanding that in the post-pandemic world a walk-in centre is not possible. If we distil the essence of what the community hospital offered and meant to people, we get same-day access to care, whether that is advice from a pharmacist, nurse or member of the extended multidisciplinary team, or speaking to or seeing a GP. I am delighted that in response to feedback from me and other key stakeholders, the clinical commissioning group—now the integrated care system—has confirmed that that is what it is going to provide.
There has been much exploration of how the rebuild could be incorporated into wider town centre redevelopment, which would be of huge benefit to Weybridge. Over the past few years, discussions have included the redevelopment of the Weybridge library building, the development of a super-surgery, incentivising active travel and the creation of a broader community hub. Although the benefit to Weybridge of such improvements is irrefutable, my concern throughout has been the need to prioritise the rebuilding of the health facilities that are urgently needed. Although I share the ambition for town centre redevelopment and improvement, I worry that it would delay the provision needed today. I have argued that we need a two-phase approach to the work: first, get the permanent healthcare facilities rebuilt, and then secondly, move on to the more general town centre community rebuild. We should make sure that the rebuilding of the health facilities leaves options open in terms of the town centre redevelopment.
Many people have been involved in the project over the past five years. I give my personal thanks to Councillor Tim Oliver, who is both a county councillor for Weybridge and the leader of Surrey County Council, for his work and leadership in driving this issue forward. He is not only a county councillor but is involved in the ICS. Alongside the NHS team, which I also thank, he has led the work to drive this matter forward. I also thank the WeyBetter Weybridge team, which has been working on this issue and the wider redevelopment project. In particular, I give my thanks to David Arnold, the chair of the Weybridge Society. I am grateful for his discussions and feedback, alongside all the feedback I have received from local community groups. I thank residents for their engagement at community events and for their feedback to me.
Five years after the fire, our GPs, nurses and admin staff are still operating out of portakabins, not permanent healthcare facilities in Weybridge. Residents are waiting for appointments and not getting same-day access. Patients are still travelling to St Peter’s for physio and diagnostics rather than getting it in their community. We are at the point where work on the detailed plans is under way but no agreement has been reached for the sign-off of the funds needed. This is the crux of the issue.
By way of background, I should say that the NHS self-insures, which means that when there is an event such as the destruction of a building, the money comes out of the funds allocated to the whole NHS estate. That makes sense and saves the taxpayer money, but there is a drawback to the approach. If one approaches an insurance company, it pays out, after the usual wranglings. Where the company finds the money is not the problem of the person who has made the claim. There is a contract, liabilities and expectations. Under the self-insurance model, the contractual arrangements we would see in the private sector do not exist, so we are waiting for NHS Property Services to sign on the dotted line. I understand that it has offered only a proportion of the total amount of money needed for the rebuild, not the full cost, with the ICS and county council left to make up the difference. Not only does that put pressure on my local county council to make up the deficit, but it adds further delay and uncertainty. We already know the pressures that health services and local authorities face, with increased demand for health and social care. My residents should not be forced to face cuts in other local services in order to have adequate health services returned to Weybridge. That is the challenge in delivering the money that is needed for the project.
In summary, although local services are doing the best they can, we need this project agreed now, to provide certainty for residents.
In 2017, Weybridge Community Hospital burned down in a raging inferno so intense that local residents sought shelter in St James’s church. Weybridge Community Hospital was a much-loved community hospital that housed the Church Street and Rowan Tree practices, community nursing, physio, imaging and a walk-in centre in which people could be seen on the day. Now, both practices and community nursing operate out of temporary portakabins and buildings on the site. Even before the pandemic they faced challenges, with concerns around their ability to provide the sort of care that they wanted to provide out of the portakabins standing there.
The pandemic crystalised those pressures on the staff. They are a great team, and I thank all those who work there day in, day out for the benefit of local residents. We owe them and local residents more. I have visited the portakabins, and, quite simply, there is not enough space. Staff work out of rooms without any windows. The working environment is a sight to behold. People are crouched behind desks with files above, below and either side of them. They need more space for their working environment. It is not a pleasant environment to work in. The lack of availability of free rooms hampers the amount of clinical activity that they can do. They have difficulty recruiting. Despite that, they are doing their best and, again, I thank the team working there. But five years on, people living and working in Weybridge need permanent healthcare facilities to be rebuilt, not temporary facilities.
I know from speaking to my residents at their doors and in correspondence that this is a major concern in Weybridge. It is not purely about the current provision of care, which remains a challenge. Both Church Street and Rowan Tree practices have much larger numbers of patients per GP than the national average. There are also several housing proposals being mooted for Weybridge. My constituents already struggle to see a GP or healthcare practitioner. They are rightly saying to me that if the planning authority approves the proposals, it will only get worse. We urgently need improvement in our local infrastructure, of which healthcare is a key part.
Where are we now? Since 2017, there has been much consultation but progress has been hampered by repeated delays, the pandemic, the complexity of joint project working and now, of course, the challenges in terms of inflation. Many people loved the walk-in facilities that the community hospital used to have, but there is an understanding that in the post-pandemic world a walk-in centre is not possible. If we distil the essence of what the community hospital offered and meant to people, we get same-day access to care, whether that is advice from a pharmacist, nurse or member of the extended multidisciplinary team, or speaking to or seeing a GP. I am delighted that in response to feedback from me and other key stakeholders, the clinical commissioning group—now the integrated care system—has confirmed that that is what it is going to provide.
There has been much exploration of how the rebuild could be incorporated into wider town centre redevelopment, which would be of huge benefit to Weybridge. Over the past few years, discussions have included the redevelopment of the Weybridge library building, the development of a super-surgery, incentivising active travel and the creation of a broader community hub. Although the benefit to Weybridge of such improvements is irrefutable, my concern throughout has been the need to prioritise the rebuilding of the health facilities that are urgently needed. Although I share the ambition for town centre redevelopment and improvement, I worry that it would delay the provision needed today. I have argued that we need a two-phase approach to the work: first, get the permanent healthcare facilities rebuilt, and then secondly, move on to the more general town centre community rebuild. We should make sure that the rebuilding of the health facilities leaves options open in terms of the town centre redevelopment.
Many people have been involved in the project over the past five years. I give my personal thanks to Councillor Tim Oliver, who is both a county councillor for Weybridge and the leader of Surrey County Council, for his work and leadership in driving this issue forward. He is not only a county councillor but is involved in the ICS. Alongside the NHS team, which I also thank, he has led the work to drive this matter forward. I also thank the WeyBetter Weybridge team, which has been working on this issue and the wider redevelopment project. In particular, I give my thanks to David Arnold, the chair of the Weybridge Society. I am grateful for his discussions and feedback, alongside all the feedback I have received from local community groups. I thank residents for their engagement at community events and for their feedback to me.
Five years after the fire, our GPs, nurses and admin staff are still operating out of portakabins, not permanent healthcare facilities in Weybridge. Residents are waiting for appointments and not getting same-day access. Patients are still travelling to St Peter’s for physio and diagnostics rather than getting it in their community. We are at the point where work on the detailed plans is under way but no agreement has been reached for the sign-off of the funds needed. This is the crux of the issue.
By way of background, I should say that the NHS self-insures, which means that when there is an event such as the destruction of a building, the money comes out of the funds allocated to the whole NHS estate. That makes sense and saves the taxpayer money, but there is a drawback to the approach. If one approaches an insurance company, it pays out, after the usual wranglings. Where the company finds the money is not the problem of the person who has made the claim. There is a contract, liabilities and expectations. Under the self-insurance model, the contractual arrangements we would see in the private sector do not exist, so we are waiting for NHS Property Services to sign on the dotted line. I understand that it has offered only a proportion of the total amount of money needed for the rebuild, not the full cost, with the ICS and county council left to make up the difference. Not only does that put pressure on my local county council to make up the deficit, but it adds further delay and uncertainty. We already know the pressures that health services and local authorities face, with increased demand for health and social care. My residents should not be forced to face cuts in other local services in order to have adequate health services returned to Weybridge. That is the challenge in delivering the money that is needed for the project.
In summary, although local services are doing the best they can, we need this project agreed now, to provide certainty for residents.
Motion lapsed (Standing Order No. 9(3)).
Motion made, and Question proposed, That this House do now adjourn.—(Andrew Stephenson.)
Motion made, and Question proposed, That this House do now adjourn.—(Andrew Stephenson.)
Dr Spencer
We need permanent healthcare facilities rebuilt in Weybridge. When the Minister responds, will he therefore address my concerns regarding the self-insurance model, confirm that NHSPS will cover the cost of the rebuild in its entirety, and agree that rebuilding health services in Weybridge is vital and already long overdue? I will continue to work to support local partners to get permanent healthcare facilities rebuilt in Weybridge. I again thank everyone involved in driving this project forward for all our residents.
Will Quince
The Minister of State, Department of Health and Social Care
First, I congratulate my hon. Friend the Member for Runnymede and Weybridge (Dr Spencer) on securing this important debate. He has been a strong advocate for the rebuild of the Weybridge hospital site, which he rightly said is owned by NHS Property Services. He met the former Secretary of State for Health and Social Care, my right hon. Friend the Member for Bromsgrove (Sajid Javid), in July this year to discuss progress on the rebuilding plans, and ministerial colleagues wrote to him on 16 August. Although we have discussed this issue—at least once, if not twice—I am sorry that we have yet had the chance to formally meet, as we discussed last month. However, I know that Lord Markham, who has ministerial responsibility for NHSPS, will be happy to do so following this debate.
My hon. Friend referred to the terrible fire in July 2017, which resulted in the immediate closure and demolition of the site on safety grounds. Following the fire, the local health system and NHSPS acted quickly to provide alternative accommodation for the provision of services. As the landlord, NHSPS installed temporary portakabins on the site, enabling the two GP practices, community services and a pharmacy to continue operating. I know that my hon. Friend and his constituents have been frustrated by the apparent lack of progress in producing a plan for the site. I am aware that re-providing for the services currently housed in portakabins, with all the difficulties that he so well described, is an absolute priority for him and his constituents.
As my hon. Friend appreciates, it was important for all the local stakeholders to consider the long-term commissioning requirements and the associated property needs. That included exploring the potential for configuring services differently across the centre of Weybridge. As he pointed out, the previous hospital did not reflect modern healthcare needs—for example, it contained bedded wards that were no longer in use. That work was led by Surrey County Council, working in collaboration with the other public bodies. I echo my hon. Friend’s thanks for the work of council leaders and the WeyBetter Weybridge team on this project.
The decision was rightly taken that the hospital rebuild should progress first as a stand-alone project to be delivered by NHSPS, with a capital contribution provided from central budgets. The standard business case process is required to demonstrate that the scheme represents value for money, is affordable and, importantly, is deliverable. In April this year, NHSPS was therefore asked to commence work with the integrated care board to put an indicative business case together. As my hon. Friend points out, good progress has been made in the design, development and pre-application town planning work. Much of the essential detailed preparatory work is therefore well under way, as he rightly states.
In parallel, the ICB is engaging with key stakeholders and providers to confirm the scope of services to be delivered from a new health campus, and the plans broadly reflect the services previously provided, but with the addition of a mental health hub. The plan also includes a primary care network base, providing a wide range of clinical services to reduce the need to travel to an acute hospital site. As my hon. Friend rightly points out, vitally for local residents it includes a same-day urgent care access hub, replacing the very popular previous walk-in centre. I understand that the ICB will be holding a further public engagement event in January to provide an update on its plans.
With respect to funding the new facility, my hon. Friend has raised the self-insurance model. Self-insurance is the model in place for all NHS buildings, as it is considered the lowest overall cost, since the Government can pool and spread its own risk, therefore making it cheaper. As he rightly points out, though, that does mean that when there is a significant loss, such as at Weybridge, the replacement must be funded from current Government spending budgets. Due to the local service requirements, the capital ask from central budgets is larger than comparators for other new community hospitals. Accordingly, it is necessary for the local system and NHSPS to work together to identify additional sources of funding to deliver the scheme. I am assured that good progress is being made on that.
When my Department wrote to my hon. Friend on 16 August, important meetings were taking place involving all the relevant parties to discuss the current ICB proposals and to agree how the new facility will be funded. The Government’s recent autumn statement on 17 November has maintained our level of capital budgets. However, there are a number of pressures on future capital funding, such as the high levels of construction inflation. As a result, the scheme will need to be considered alongside other local and national investment priorities.
I hope that my hon. Friend will accept that there are good reasons why it has taken the local health system some time to agree the commissioning requirements for services in Weybridge. The ICB, local providers and NHSPS are now working collaboratively to deliver a new community hospital in Weybridge and, importantly, the preparatory work is well under way. As I said, the ICB will be holding a public engagement event on the very latest plans in January next year. Subject to the budget position, the ICB aim is to submit a business case early next year for approval and following that, 18 to 24 months are normally required to finalise designs and agree contracts before building works can commence.
To conclude, I thank my hon. Friend for highlighting this hugely important issue this evening. I know it is one that he will campaign on and champion on behalf of his constituents over the coming weeks and months. The new community hospital at Weybridge matters to his Runnymede and Weybridge constituents, it matters to him and therefore it matters to me. I look forward to working with him to deliver this new community hospital at Weybridge.
Question put and agreed to.
My hon. Friend referred to the terrible fire in July 2017, which resulted in the immediate closure and demolition of the site on safety grounds. Following the fire, the local health system and NHSPS acted quickly to provide alternative accommodation for the provision of services. As the landlord, NHSPS installed temporary portakabins on the site, enabling the two GP practices, community services and a pharmacy to continue operating. I know that my hon. Friend and his constituents have been frustrated by the apparent lack of progress in producing a plan for the site. I am aware that re-providing for the services currently housed in portakabins, with all the difficulties that he so well described, is an absolute priority for him and his constituents.
As my hon. Friend appreciates, it was important for all the local stakeholders to consider the long-term commissioning requirements and the associated property needs. That included exploring the potential for configuring services differently across the centre of Weybridge. As he pointed out, the previous hospital did not reflect modern healthcare needs—for example, it contained bedded wards that were no longer in use. That work was led by Surrey County Council, working in collaboration with the other public bodies. I echo my hon. Friend’s thanks for the work of council leaders and the WeyBetter Weybridge team on this project.
The decision was rightly taken that the hospital rebuild should progress first as a stand-alone project to be delivered by NHSPS, with a capital contribution provided from central budgets. The standard business case process is required to demonstrate that the scheme represents value for money, is affordable and, importantly, is deliverable. In April this year, NHSPS was therefore asked to commence work with the integrated care board to put an indicative business case together. As my hon. Friend points out, good progress has been made in the design, development and pre-application town planning work. Much of the essential detailed preparatory work is therefore well under way, as he rightly states.
In parallel, the ICB is engaging with key stakeholders and providers to confirm the scope of services to be delivered from a new health campus, and the plans broadly reflect the services previously provided, but with the addition of a mental health hub. The plan also includes a primary care network base, providing a wide range of clinical services to reduce the need to travel to an acute hospital site. As my hon. Friend rightly points out, vitally for local residents it includes a same-day urgent care access hub, replacing the very popular previous walk-in centre. I understand that the ICB will be holding a further public engagement event in January to provide an update on its plans.
With respect to funding the new facility, my hon. Friend has raised the self-insurance model. Self-insurance is the model in place for all NHS buildings, as it is considered the lowest overall cost, since the Government can pool and spread its own risk, therefore making it cheaper. As he rightly points out, though, that does mean that when there is a significant loss, such as at Weybridge, the replacement must be funded from current Government spending budgets. Due to the local service requirements, the capital ask from central budgets is larger than comparators for other new community hospitals. Accordingly, it is necessary for the local system and NHSPS to work together to identify additional sources of funding to deliver the scheme. I am assured that good progress is being made on that.
When my Department wrote to my hon. Friend on 16 August, important meetings were taking place involving all the relevant parties to discuss the current ICB proposals and to agree how the new facility will be funded. The Government’s recent autumn statement on 17 November has maintained our level of capital budgets. However, there are a number of pressures on future capital funding, such as the high levels of construction inflation. As a result, the scheme will need to be considered alongside other local and national investment priorities.
I hope that my hon. Friend will accept that there are good reasons why it has taken the local health system some time to agree the commissioning requirements for services in Weybridge. The ICB, local providers and NHSPS are now working collaboratively to deliver a new community hospital in Weybridge and, importantly, the preparatory work is well under way. As I said, the ICB will be holding a public engagement event on the very latest plans in January next year. Subject to the budget position, the ICB aim is to submit a business case early next year for approval and following that, 18 to 24 months are normally required to finalise designs and agree contracts before building works can commence.
To conclude, I thank my hon. Friend for highlighting this hugely important issue this evening. I know it is one that he will campaign on and champion on behalf of his constituents over the coming weeks and months. The new community hospital at Weybridge matters to his Runnymede and Weybridge constituents, it matters to him and therefore it matters to me. I look forward to working with him to deliver this new community hospital at Weybridge.
Question put and agreed to.
Sitting adjourned.
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