Over the last 25 years we have had politicians queuing up to ‘Save St Helier’ but precious few coming forward with a realistic plan to do so. I believe that this needs to change which is why I invited Jeremy Hunt, Secretary of State for Health, to come to St Helier Hospital and meet me and the chief executive to discuss how we can secure St Helier’s future. Wouldn’t it be great if at the next general election, the future of healthcare in Sutton had been transformed permanently for the better? The chief executive kindly showed us around the best of St Helier and the worst.
The best included ‘board rounds’, an initiative in the hospital’s acute care centre where a group of doctors considered each patient on the ward in a multi-disciplinary approach, looking at everything together. This has led to mortality rates being at their lowest ever, despite treating ever more patients and recovery being so much better. We saw a new CT scanner adding much more capacity, enough to take in patients from right across South London. We also dropped in on the new restaurant which opened yesterday and which will free up space for a new renal unit.
The conditions of the existing renal unit was less satisfactory. As with everywhere on site, the staff do amazing things in the most challenging of conditions. Beds for dialysis are too closely packed in. The single lift is not big enough for a trolley bed, leading to the incredible situation of the Trust having to spend £10,000 a week on an ambulance shuttle service to take patients from the back of the hospital to the front.
We then went to the boiler room, which contains huge steam-powered boilers from the 1950s. If this is the heart of the hospital, it’s suffering from acute angina. Clearly hugely inefficient in its running, if anything went wrong, the hospital would struggle to stay open for any length of time. Two members of the maintenance staff go around the hospital every day, testing water for legionella and flushing through systems if and when it is found.
The back of the building is largely blocked off by hoarding. Not because of maintenance work but to protect passers-by from crumbling masonry. The trust has to find an estimated £5m of its budget to go to extra maintenance every year simply down to the state of the building. Despite these risks, the staff work so hard to achieve patient outcomes that are among the best in London.
Finally we had a chance to talk to Jeremy Hunt about creating a vision for the future. The NHS cannot start a public debate during the election ‘purdah’ period but I can. The views here are mine, I don’t speak for the trust, nor the government and I am open to change my mind through meaningful discussion with residents. To my mind there are three options for a new hospital. St Helier, Epsom or the Sutton Hospital site co-located with the Royal Marsden. If we went for the latter, the Marsden would benefit from extra intensive care and acute facilities to support its work. The vast majority of services at both Epsom and St Helier would remain where they are but the trust could remove some duplication thus releasing more money to spend on front-line treatment. To be clear, I do not want St Helier to close, neither does anyone in the trust. The reported one-for-one replacement with a super-hospital in Belmont is a non-starter. The key thing is to get residents involved and focus on care, outcomes for patients and the best locations for services here in Sutton, rather than just buildings. Each site should be able to retain their full urgent care centre with the A&E placed in the best location on clinical grounds, but we should remove the matter as a party political matter, instead discussing this in a pragmatic way that brings everyone behind a solution that we can secure from the NHS and the Treasury.
Once we have agreed on how we configure services over the three sites, we need to look at the difficult issue of funding. Building a new hospital now will cost in the region of £300m. Delaying this for five years will increase the cost to £400m, purely through the effect of construction inflation. One way of securing this funding is to work across London to realise the value of NHS-owned land that is surplus to requirements. It is estimated that there are a small number of trusts in London with around £1bn worth of surplus land. However, the challenge is to release this and then to see that money shared across other trusts, when they will want to keep it for themselves. Another possibility is prudential borrowing via Sutton Council or through pension funds. Sutton Council has borrowed money to buy Oxfam’s head office in Oxford and an office block in Wallington. When I was on the pensions committee for the council, we used to review Sutton Council’s pension investment in a number of shopping centres across the country. I can see no reason why this investment could not be better used to invest in our infrastructure. Either way, pension fund managers are on the lookout for low-risk, long-term investments like hospitals. As a loan, ownership would remain with the NHS, not in private hands. The challenge in this case is how to account for the debt which would sit on the government’s books at a time when they are trying to get to a point that they can reduce debt, not increase it.
If we can secure alternative funding for the largest part of investment, we would then need to secure funding for ensuring that the existing buildings are up to the job for the next 20 years. I have talked about £75m for this as an estimate. However, this figure is bound to increase as time moves on and the buildings continue to degrade. The trust has secured £12m, the biggest investment into the building at St Helier for years, to refurbish B and C blocks. They won’t look that different to the eye but that money will allow the windows at the back to be replaced and to firm up more of the crumbling structure. They have bid for £10m of energy efficiency grant funding to sort out the boiler but more will be required.
St Helier needs the brightest and the best to continue the great work there. As long as some politicians talk down the future prospects of the hospital, staff may be put off going there, instead looking to other hospitals like St George’s. Well, St Helier is not closing and the training and systems there work incredibly well, giving great opportunities to staff. It is therefore sad to see the continuing tales of woe from politicians with a campaign to fight, dragging down morale. It would be easier for me to take the default position of joining others in making supportive noises without any clue of what to do next. But I am a local resident first; one who wants to help to shape a solution. Whilst others petition, I have been trying to engage with decision makers to get answers. They won’t necessarily listen to political sloganeering but they just might to a reasoned, well-evidenced solution that is affordable, practical and deliverable.
Jeremy Hunt said after the meeting: “St Helier has made huge strides in recent years and I was delighted to hear more on my visit about progress and plans for the future. There is no question that St Helier hospital is here to stay, but we do need a plan for improving the facilities and the services on which local people rely. So it was great to see how Theresa May’s local Conservative candidates are working with the local NHS leadership to deliver a vision for St Helier.” I am pleased that he took the time to come, to listen carefully and really take on our thoughts as to how best to keep St Helier performing at its best for Sutton residents.