Little Lever Health Centre - Again

Well the famous public meeting is to take place tomorrow night. Bit of a hiccup though.

Apparently one concerned and campaigning member of the public in a telephone conversation with an officer of the Primary Care Trust said something along the lines of "What so we have to do to get this new Health Centre - Put a gun to your head ????"

Unbelievably the next thing that happened was that Plod turned up and threw him in the cells - prompting an article in the Bolton News. It informs us that the Primary Care Trust will not now be represented at the meeting because of fears for their safety.

You couldn't make it up. It goes to show the mentality of the people who work for these Quangos that they could take something like that as any kind of a threat as opposed to an expression of frustration at the stonewalling that is going on with this matter.

Plod has even offered to afford the poor creature 'protection' at the meeting, which she has turned down.

Personally I think it's just an excuse for them to avoid the kind of verbal mauling that they deserve and would quite likely get tomorrow.

At this point I must emphasise that in spite of the rumours sweeping around the Village, it wasn't me.

Suitably fired up I've sent the following letter to the Bolton News which I hope will be published tomorrow.

Dear Sir,

So officers from NHS Bolton are refusing to attend next weeks public meeting about the Little Lever Health Centre because of their fears for their own safety.

Perhaps therefore they would consider informing the public through your newspaper from the safety of their comfy offices. They could do this by answering the following questions.

Is the proposed Health Centre being built under a Private Finance Initiative.?

Is therefore the problem not with the capital cost but with the repayments.?

Why is it proposed to provide a building when there is no agreement with any doctor that they will occupy it (Area Forum 30th March 2009) nor any means of compelling them to do so.?

How much greater will the 'rents' be for the doctors in the new building than in the old?

Why are the views, wishes and requirements of the doctors not documented in the public domain.?

Has consideration been given to extending the existing building to the rear of the car park thus nearly doubling its size?

How many patients from outside Little Lever and from more health deprived areas are registered at the Centre?

Is it in the financial interest of the doctors to have a larger number of patients on their books thus reducing the service to each one in terms of quick appointments?

If they could answer these questions it would save their time and ours at the next Area Forum, two of which have already been clogged up this year with them telling us nothing that was useful or re-assuring.
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Since writing this letter on 2nd October I've been digging in the archives of the PCT and have come up with the following dated June 2008
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A Strategic Service Development Plan
Developing Health Services and Buildings in Bolton

(Extracts from the above)


This section of the plan outlines some of the mechanisms and approaches we will use to deliver the plan.
It includes explanations of:

1. The Bolton Rochdale and Heywood and Middleton Local Improvement Finance Trust (BRAHM LIFT),

2. The affordability of our plan,

3. How we will monitor implementation.
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1. The Bolton, Rochdale and Heywood and Middleton Local Improvement Finance Trust

The NHS Local Improvement Finance Trust (LIFT) is a procurement mechanism for development of community health premises. It is a means by which PCTs can enter into a public private partnership that brings advantages of:

Access to capital funding for buildings,
Access to expert experience and skills in property development through the private sector partner,
A long-term public private partnership.
This allows for the development of mature relationships and shared understanding to develop and implement property solutions that enable delivery of strategic aims.
......................................................................................................................................

In May 2007 the Bolton, Rochdale and Heywood and Middleton (BRAHM) LIFT company was established. The Eric Wright Group was selected as the private sector partner (in accordance with NHS LIFT procurement guidelines). The Eric Wright Group has a strong track record with other NHS organisations in the North West.

The BRAHM LIFT Company will design, build and manage the new centres identified in section 4.4 of this plan. Capital funding for the new centres will be provided by the BRAHM LIFT company. Bolton PCT will lease the premises from BRAHM LIFT Company over a 25 year term and will be responsible for the revenue costs of these new centres.
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Membership of the BRAHM LIFT Company and
shareholding is shown below:

% Shareholder shareholding
Eric Wright Group ..................................60 %
Partnerships for Health* .........................20 %
Bolton PCT ............................................10 %
Heywood Middleton and Rochdale PCT 10 %
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The BRAHM LIFT Company is held to account by the BRAHM LIFT Strategic Partnering Board. This Board comprises membership of:

The Eric Wright Group
Bolton Metropolitan Borough Council
Bolton PCT
Bolton Hospitals NHS Trust
Bolton, Salford and Trafford Mental Health Trust
Heywood Middleton and Rochdale PCT
Rochdale Metropolitan Borough Council
Pennine Care NHS Trust
Pennine Acute Hospitals NHS Trust
Northwest Ambulance Service

The Strategic Partnering Board is responsible for identifying the building developments to be commissioned from the LIFT Company and the timeframe for delivery. The Strategic Service Development Plan provides the framework for this.
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2. Affordability

Bolton PCT has seen a significant increase in its funding since April 2003, in line with the increase in investment in the NHS as a whole. Our income in 2007/08 is £390 million. This increase in resources together with the BRAHM LIFT Company, allows the PCT to invest in our estate infrastructure.

Work has been undertaken to review the money needed to support the development of the PCT's Estate and initial calculations on the assumptions confirm that the Estates Strategy review recommendations described in section 4.4 of this plan are deliverable.

The PCT needs to ensure that an investment in building is consistent with meeting the other priorities for health in Bolton. A five year financial plan demonstrates that we can afford the estimated increase in costs driven by the Estates Strategy after taking account of income changes, and service developments (including those in the Manifesto) and after cost pressures.
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3. Monitoring Arrangements

Better Health for Bolton - A Manifesto for Improving Health Services includes 71 quantified promises of the developments and improvements in health services which we will implement by 2009.

These promises have been translated into individual service plans, each with detailed milestones and costs, and each with an assessment of the space required to accommodate them.

The development of the PCT estate will enable delivery of the Manifesto. It is also one of the promises being monitored. Progress on implementing the Manifesto developments is regularly reported at Board meetings held in public.
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Building Plans and schedule for the remaining new Health Centres

Farnworth:-
Completion year was to be 2011
Increase in size from existing 1,200 sq metres to 2,500 sq metres

Great Lever:-
Completion year was to be 2011
Increase in size from existing 1,323 sq metres to 2,500 sq metres

Avondale:-
Completion year was to be 2011
Increase in size from existing 1,047 sq metres to 2,500 sq metres

Horwich:-
Completion year was to be 2012
Increase in size from existing 419 sq metres to 1,000 sq metres

Westhoughton:-
Completion year was to be 2012
Increase in size from existing 303 sq metres to 1,000 sq metres

Little Lever:-
Completion year was to be 2012
Increase in size from existing 700 sq metres to 1,500 sq metres

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Now Westhoughton Councillors are kicking off about the delay in their new Health centre as per this article in the Bolton News which also provides some further info.

Westhoughton health centre delay angers town's councillors

Plans to delay the building of a new health centre in Westhoughton have angered the town’s councillors.
NHS Bolton has admitted plans for six super surgeries have been put back by six years.
And it was revealed Westhoughton was at the bottom of its priority list, behind Avondale, Farnworth, Great Lever, Little Lever and Horwich.
The town’s current health centre is in a Victorian terrace property in Market Street. There are also three GP surgeries in the town, two of which are very small practices.
Now councillors in Westhoughton claim it is another example of the town being overlooked by Bolton....................................................
Westhoughton, Horwich and Little Lever were due to have new health centres built in 2011/12, after Avondale, Farnworth and Great Lever in 2010/11.
NHS Bolton said in May it was unlikely to keep to the schedule because, although the centres were being built by a third party at an average cost of £7 million, the NHS Bolton must pay £1 million a year per centre in rent.
A spokesman for NHS Bolton said: “NHS Bolton remains committed to replacing Westhoughton Health Centre but, as previously reported due to financial constraints, the timetable is being reviewed.
“All the six areas which had previously been identified for new health centres went through a prioritisation exercise.
“Out of a possible score of 99, Westhoughton scored 27.5, which is sixth on the list. The new Westhoughton Health Centre was originally due to open in 2012. The new timetable reflecting financial planning will be approved at the October board.”
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This confirms that since the middle of this year the order of build has been reviewed and prioritised on the basis of Health Deprivation of the individual areas. It would appear that Little Lever is now fourth on the list.
It also reveals that the average cost of build would be £7m and each centre would be leased back for 25 years at a cost to the PCT of £1m per year

So- putting it crudely - Eric Wright would build Little Lever Health Centre for £7m and over £25 yrs would receive £25m for his efforts. Not a bad little earner.
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Run out of time before the 'Meeting'
Next Blog More about 'Health Deprivation' and what happened at the meeting

Paul