(This report was delayed due to a technical issue.)
On Monday 22nd January a public meeting was organised by Derbyshire Save Our NHS to discuss the closure of Babington Hospital and the proposed plans for replacement services with representatives of Southern Derbyshire Clinical Commissioning Group (SDCCG) and Derbyshire Community Health Services (DCHS). The representatives in attendance were Dr Paul Wood (SDCCG) and William Jones (DCHS). Keith Venables of Save Our NHS chaired the meeting. All members of the public in attendance received a handout on the purpose and structure of the meeting (including a statement from Derbyshire Save Our NHS (see below) and a booklet from SDCCG on “Joined Up Care in Belper” which attempts to explain what is happening and neuter opposition. It does not, however, answer all of the questions and concerns that Belper people have.
Statement from Derbyshire Save Our NHS:
“1) This is not just a local issue. It’s an example of the bad things happening across England. The closure of Babington, as well as Newholme, Bolsover, a ward at Whitworth, possibly Shire Hill, will have an impact on the whole district and put more pressure on Royal Derby and Chesterfield Royal.
Every year since 1948 Our NHS has received the necessary additional 4%. Since 2010, this has been reduced to 1%, so there is now a £22 billion shortfall. The pressure is on and staff are leaving.
2) The managers of Derbyshire’s Health Plan (called the STP) estimate that it is £280 million in deficit. Equal to 535 beds (see our petition). They haven’t said how they intend to deal with this.
Closing Derbyshire’s Babington (and other community hospitals) and offering less health provision on Derwent Street, is clearly part of cutting Our NHS.
3) Derbyshire County Council have signed off a special memorandum that means anyone – such as Richard Branson of Virgin – can bid to make profit out of our NHS. More for him, less health care for us. (Questions asked – 7th Feb)
4) In Belper, the Babington Hospital site is said to be worth £7 million. Selling off Babington will NOT bring money to our District, nor even to Our NHS. The money will go to the London Treasury.
5) The significant reduction of full nurse-led health care provision in Babington to much less care at Derwent Street will mean that fewer people can be looked after closer to home. They will have to travel further (to Ripley, Ashbourne and Ilkeston) and there is no evidence that care at home is better. it will lead to invisible deaths.”
The meeting was held in the main hall at Strutts Community Centre (formerly Strutts School) and the room was only half full, despite the meeting being scheduled for the evening, allowing most Belper residents to be able to attend. Several Labour councillors were in attendance including Maurice Neville and Ben Bellamy.
The meeting was structured into three parts. Keith Venables gave an introduction, then the SDCCG and DCSH representatives spoke, these were followed by a public question and answer session.
Keith Venables asked for Belper people to raise their hands if they were a patient, NHS staff or the partner of, a carer, living within 10 miles of Belper, and then asked who expects to get old. Everyone raised their hands for one or more of these investments in the NHS. “We are all in the room for the same reason – we care about health!”
Keith gave examples of how we had all been looked after all our lives by the NHS. He then went on to list the services and hospitals under threat in Derbyshire (listed in the statement above).
Keith highlighted the £22 billion of money that is currently “missing” from the NHS. With £229 million “missing” from Derbyshire.
Keith went on to explain how the Winter Crisis was exacerbated by this, due to a lack of funding and a removal of beds, in addition to the extreme stress and overwork pushed onto current NHS staff.
Keith stated that he believed that the changes are partly inspired by good health ideas and partly by financial issues.
He also stated that ACOs introduce private profit and that there has been a “memorandum understanding” which Derbyshire County Council have signed but local councils have not.
The risk of Richard Branson/Virgin was mentioned, as was the risk of the NHS becoming “disorganised by fragmentation, and underfunded”.
The next issue that Keith addressed was the value of the Grade II listed buildings of Babington Hospital itself and the proclaimed ownership. Babington has been estimated to be worth approximately £7 million. Ownership is currently claimed by Propco, who would receive all funds from its sale.
Keith mentioned that the literature provided by Southern Derbyshire Clinical Commissioning Group argues that we need less nurse led care, and that this would lead to less care closer to home and travel costs being put onto relatives (many of whom would be elderly and unable to drive).
Keith asked if everyone agreed that the NHS is a treasure, a very important institution, and we would have to fight for it …everyone did agree.
“Missing” money and ACOs:
This figure is the amount of the cuts which the Conservative Party are making under the guise of “productivity improvements and cost savings”, which in reality requires restructuring the NHS, and may well be an excuse to do so. As that restructuring (ACOs – Accountable Care Organisations) allows for private companies (including insurance companies) to buy up NHS services and control what care is available, what is not, and what can be charged for, the allegation stands that this lack of security in the establishment of ACOs is actually the entire aim of the defunding and restructuring, to allow the privatisation of the NHS and charging for healthcare whilst pretending that it is an improvement of services by cutting unnecessary costs.
Ownership of Babington Hospital:
Babington was built and paid for by the parish authorities of Derbyshire: Alderwasley, Allestree, Ashley Hay, Belper (6), Crich (2), Denby (2), Dethwick Lea and Holloway, Duffield (2), Hazlewood, Headge (2), Holbrooke, Horseley, Horseley Woodhouse, Ideridgehay and Alton, Ireton Wood, Kedlaston, Kilburn, Kirk Langley and Meynell Langley, Mackworth, Mapperley Markeaton, Morley, Pentrich, Quorndon, Ripley (2), Shuttle and Postern, Smalley, South Wingfield (2), Turnditch, Weston Underwood (2), Windley, Wirksworth (4).
The parishes of Alfreton, Mugginton and Ravensdale park were added on 30th September, 1837.
Later Additions: Milford (1897), Rowditch (1890). With 6 parishes in Belper outweighing all other parishes, the workhouse that it originally functioned as was built here after buying the land from George Strutt (£750). Meetings took place at the Lion Hotel.
Babington became Babington House Public Assistance Institution with a change of government ideology and the end of workhouses in 1930. Massive modernisation was paid for by the local councils, and local people. It only became a hospital out of necessity during WW2 but despite the emergency nature of this repurposing, the building was automatically transferred to the ownership of the NHS when the NHS was first established (1948) and began its current functions, which have remained largely unchanged. In 2013, the Conservative government transferred ownership to PropCo (which manage NHS Property Services), which means that the CCG get to decide what happens. The legality of this ownership transferral, without any local remuneration for a historic landmark building, is a serious issue for local people. Belper people view the property as theirs, as it was until 1948 post-war mismanagement led to it being handed away. This is an issue which local people cannot afford to either ignore or pay for, but perhaps a willing legally trained volunteer would step up and look into the matter. No-one seemed to have minded about ownership being with the NHS, however dodgy the transfer was, because the NHS is valued. The government reassigning ownership to a group which is privatising our NHS by stealth tactics and choosing to sell off a local asset for Treasury benefit is not locally approved of.
Dr. Paul Wood and William Jones speak for the SDCCG and DCHS respectively.
A booklet titled “Joined Up Care in Belper” was available to anyone attending the meeting.
Paul Wood started by saying that as he is a doctor, seeing people and trying to do the best for them, is important to him. He then introduced the phrase “Joined Up Care” and claimed that it is trying to address changes in the population such as ageing, trying to support the population as there is not sufficient support in communities (it should be noted that additional support facilities are not being offered to Belper), and that a disproportionate amount of funding is currently spent on the most expensive features of the NHS.
He alleged that Babington is struggling as a facility. He continued his criticisms of the current NHS by saying that people are living longer in poor health and this is increasing the requirement for health and social care. He added that patients spend too long in hospital beds and claimed that this resulted in “de-conditioning” (prolonged under-use of muscles) and “loss of independence”.
Using slides of the contents of the Joined Up Care in Belper booklet, William Jones spoke about the history of Babington Hospital and the current issues with the property identified by a Feasibility Study conducted in April 2015. He detailed the recent transfer of Babington to NHS Property Services. He explained that Derbyshire Community Health Services NHS Foundation Trust (DCHS) pays an annual lease to NHSPS because of this (one part of the NHS charging another part of the NHS to use something allegedly owned by the NHS).
Mr. Jones complained that the Grade II listed status of the building limits their ability to change it. He stated that there are significant infrastructure issues including fragile pipework, electrical, asbestos (not the really dangerous kind and present in many older buildings), high energy costs, high maintenance costs and risks of flooding of the car park.
He claimed that Babington was no longer fit for purpose and was too expensive to refurbish. No figures were offered on what a potential refurbishment would cost.
- He complained that the site is drafty and that caused higher energy costs. He claimed that Babington is failing to meet current regulations (if it did, woulda it not be shut down?). Mr. Jones said that it is not realistic to provide modern healthcare from this site.
He then introduced the topic of the Derwent Street site, which will hold the replacement facility. Final approval and transfer of actual funds to purchase the site are still awaited. The cost of the new site is £5.9million (Babington is valued at £7million – meaning that Belper loses £1.1million due to this enforced change).
Then a cheap video of one member of Babington staff played. There was some tinny emotive music followed by lots of shots of the same four warning signs, and the one staff member saying the same things that Mr. Jones had said, in the same words. It is assumed that DCHS commissioned this specifically for the purpose of showing our community that staff at Babington agree with them.
Other issues mentioned were basement flooding and a problematic lift, which apparently inspired moving physio to the rational location of the ground floor. The phrase “not fit for purpose” was repeated frequently. It was conceded that there is nothing wrong with Belper clinic but that they are “not allowed to separate it”. Who doesn’t allow it and the reasons for this prohibition were not explained.
It was said that the wards ARE “fit for purpose” but are not up to current standards. No quotes/costs were mentioned in relation to any of the issues claimed, so it is unclear whether any quotes were sought and rejected as too expensive or whether this possibility was skipped entirely in favour of the ACO plan which allows for private profit.
New site containing outpatient and existing clinic services, a base for community teams and offering flexibility for future service usage (what that flexibility might plan for was not mentioned).
New facility on Derwent Street (library and old age care) adjacent to the Babington replacement site.
No bed facilities. This will be replaced with “community bedded care” through “discharge to assess” (see diagram in booklet PDF) – this means that patients will discharged as soon as possible, will be visited in their own bed for assessment and won’t have access to nursing outside those visits.
Babington Hospital had approximately 200 admissions in 2017. Under the proposed model, throughout the year, 100 will be discharged and sent home, 60 will be sent home with visits (this is what they are describing as “community support beds”), 30 will go to intensive rehab and 10 will go to “End of Life beds” in hospitals outside the area; Ilkeston and Ashbourne were mentioned as possibilities.
Currently there is 1 ward at Babington, which provides 10 beds throughout the summer and 15 over the winter. The proposal is that everyone except the dying be sent home.
In conclusion we were told that “it is important in the NHS that when you are offered money you grab hold of it.” We were also promised that they intend to continue “public engagement” until March. Any member of the public can contact Engagement Manager Claire Haynes on 01332 868 677 to discuss the issues. Alternatively she can be contacted by email: email@example.com
Part 3: Questions from the public:
Questions were taken in clumps and answered en masse, making it easier to avoid answering specific questions.
Q1) Why was Babington and Newholme transferred to Property Services?
A1) It failed criteria
Q2) Why don’t we get any money back (from the sale of Babington)?
A2) We do, we get £6million (£5.9 million for the new centre on Derwent Street, £1.1 million less than the value of Babington)
Q3) Why has it been allowed to become “unfit for purpose”?
A3) All old buildings get to the stage where they would need gutting or demolishing. Grade listing stops that from being possible.
Q4) Why can’t we have beds in the new facility? Why do we have to go to Ashbourne?
A4) If you have a small number of beds, staff sustainability is an issue. There are limited resources. We prefer community care and aggregated care.
Questioner) That didn’t answer my question.
Maurice Neville spoke between clumps of questions to say: We haven’t been told the criteria which Babington Hospital failed. NHS staff are not all in agreement and no-one has consulted them. We haven’t been told the cost of refurbishment. Seven options were considered and this is the seventh – we were not informed of this before now. We were promised consultations. October 2017 was the last time we were promised that. This has now been retracted.
Q5)Why are Belper people not going to get equity of provision? It’s a long way to Ashbourne. This is letting us down and palming us off.
A5) Avoided and not answered.
Q6) Questioner listed problems that the NHS is currently facing. How does it work to move people into already full to capacity hospitals?
A6) Avoided and not answered.
Q7) Why with all the problems the NHS has at the moment can’t you keep it open until you sort yourselves out?
A7) We believe that the right thing to do for Belper is to build a new building for integrated care. There is no better option than to use the money we are being offered to provide services that will last longer.
Q8) Change exacerbates dementia. How does this plan consider their needs?
A8) Answerer used the word “demented” to describe dementia patients and claimed that 10 days in a hospital bed causes 10% of muscle loss and 10 years of ageing.
This claim was disputed by numerous people in attendance including members of the Derbyshire Save Our NHS panel, who cited research which disproves the assertion and debunks the research that it was based on, and pointed out that “It is not true” and that in acute cases where it does happen, it will also happen at home.
The representatives then repeated what they want to happen and offered excuses for not consulting Belper people which were, “”there was a national election” and “there were local elections”.
Another catchphrase was introduced, “Buildings don’t provide care; people do.” A member of the public interjected that, “It doesn’t work.” They continued to talk about “getting people home”.
Q9) What is the demand for the area around Belper and are the projections? (from NHS staff member)
A9) Not answered.
From this point on questions became statements and arguments. This seemed in part to be out of frustration about questions not being answered or being answered with sanctioned responses instead of honest dialogue.
Ben Bellamy, Labour Councillor, asked people to raise their hands if they agree with the following:
1) Do you want 24 hour nursing care?
All hands were raised.
2) Who doesn’t want it?
No hands were raised.
Belper resident: All of this depends on social care. There isn’t any. Budgets are being cut. Time with patients has been reduced to minutes. They pretend money is going in but it isn’t realised. Take a message back to this CCG of yours: The people of Belper want a full proper bedded service. The NHS belongs to the people of this country and should not be privatised.
A10) No response from CCG and DCHS but huge applause from the public.
Derbyshire Save Our NHS: If Babington Hospital was refurbished then the rent would go up. One part of the NHS ripping off another part just for political accountability and justification of self. Questions are still not answered. People are angry about elderly patients being sent to Ashbourne, Ripley and Ilkeston. You are breaking up communities. The Accountable Care System is just a stealth privatisation geared towards insurance sale.
Paul Wood said that there is no point in public consultation because there is only one viable route forwards, There is no room for discussion on anything except the beds.
Maurice Neville pointed out that legally there has to be a full public consultation.
Paul Wood said they had taken advice from NHS England, who they are accountable to. He repeated the previously listed problems with the building and complained that he thought that the meeting was just for them to explain what they are doing.
Maurice Neville corrected him, that this was part of the meeting remit, which he had been informed about.
Mike Jones asked, “What is the point of relocating from a site with excellent access for emergency vehicles and parking to one with terrible access, which is an accident spot?
The answer to this was: It’s not our problem. It’s Highways’, and they are happy.
A Belper resident interjected: Can I just remind you that the NHS belongs to us? If we want a consultation then you will hold one. It does not belong to you.
The response to this was : It will be a very significant building, a minimum of three floors. Physio, Rehab, Children’s Services.
Another member of the public said, “Publish the plans so that we can assess whether what you tell us about space is true.”
The Vice Chair of Belper Neighbourhood Planning added, “It would have helped if you had come with a few more specifics. That would have been useful. What has NOT been talked about is what is NOT included in the new proposals. The timescale and derelict sites.
It was pointed out that they still hadn’t answered about dementia patients and pathways. There was no answer this time either.
William Jones said that plans will be publicly provided, that all services will be replaced except beds, that the front facade of Thorntons will be kept and the rest has already been demolished and the historic aspect of that site will be retained (because of the facade). And that they were having a 15 week public consultation now (which they thought was just to explain what they had decided without input).
The public response to this was, “this is not acceptable to us in Belper.”
By this point the meeting felt all pitch and no progress.
William Jones continued trying to repeat and summarise what had already been said in what seemed to be an attempt to get the last word. Paul Wood then repeated the entire pitch again with emphasis on the money.
Maurice Neville summed up Belper’s side of the issues, reiterated consultation demands and criticised Accountable Care Systems and pointed out that there is nothing in the contracts and legislation to stop private companies taking over NHS services. He also pointed out that many of the statements made by the representatives of the CCG and DCHS are questionable and not certain. “We will have further meetings about consultations to ensure that happens.”
Keith Venables pointed out that the new site is equally liable to flooding. He questioned what has happened to Babington Hospital because it was given to the community. He repeated that we still have the issue of bedded care to deal with, and reiterated that both locally and nationally we need to address the “missing” money (cuts to NHS funding).
The meeting ended here.
The next meeting about Babington Hospital:
Derbyshire Save Our NHS
Organising and Planning meeting:
Monday 5th February @ 7pm
Strutts Community Centre
Monday 5th February is also a day of action for Belper’s branch of Save Our NHS. You can help at these times and location:
10.30-11.30 – Leafleting and petition outside Poundland
12noon – conducting a traffic survey on Bridge Street to assess the access to the Derwent Street development and the possible impact on Bridge Street itself.
1pm – Protest/Vigil outside Babington Hospital