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I attended the hustings at the University of Central Lancashire. The candidates were asked a question about the plans for the new Preston hospital to be located in South Ribble. The answers suggested that none of the candidates was fully aware of what the New Hospitals Programme (NHP) actually proposes for Preston and, in particular, Mark Hendrick’s comments seemed ill-informed. The NHP plan is for a replacement hospital.
Preston is to be in the final cohort (cohort 4) of the 40 new hospitals. Early cohorts had a big say in the design and location of their new hospital. That involvement will be denied for the new Preston hospital. The intention of cohort 4 is to have a single standardised design determined by central government. Hence the imperative to find undeveloped sites on which to construct them.
One of the founding principles of the NHS is that it is free at the point of delivery. Why on earth would anyone make that point of delivery more difficult to access for the overwhelming majority of users?
Read more: Preston woman slapped with fine after driving 92-year-old dad to hospital
The new hospital for Preston doesn’t need to move to a greenfield site in South Ribble. The existing site already has enough space, a transport infrastructure, and is situated near to the people who do and will use it. It is therefore perfectly positioned to accommodate the massive changes necessary to adapt to the needs of the 21st century population.
The present hospital sits on a site of 18.8 hectares (47 acres). This is a far larger site than hospitals elsewhere catering for similar numbers of users. If the hospital authorities were to do what other new hospitals are doing and build a multi-storey car park, they would free up huge amounts of land and provide the space for the much-needed new buildings, while also solving the existing parking problem.
If we are all agreed that hospitals should be near where people live (staff and users), near public transport hubs, and near existing established routes, then this is a no brainer!
Consultation. I, like thousands of others, responded to the survey carried out by ‘The Lancashire and South Cumbria New Hospitals Programme (NHP)’ from January 2021 to August 2022.
I was very impressed. The survey was thorough and wide-ranging, covering those who use the services and staff. The results were crystal clear. The title was encouraging; ‘Your Hospitals Your Say’.
The NHP analysis in September 2022 reported:
A strong preference for keeping hospital sites and services close to home (connected with a desire for the solution to be retaining hospital sites in their current locations).
Substantial interest in ensuring that transportation and access (e.g., parking) is improved as part of any refurbishment.
Positivity towards refurbishment of existing sites owing to it being perceived as a more sustainable solution.
I now ask myself why thousands of pounds were spent on asking for our views and in publishing the outcomes when the current plans for the new hospital are the complete opposite of what people asked for.
The NHP plan is for cohort 4 to use ‘an innovative standardised hospital design and modern methods of construction to reduce costs and timescales and improve the quality of new hospitals’.
This approach implies off-site prefabricated construction. It is called Hospital 2.0.
The Hospital 2.0 standard design was explained to Lancashire County Councillors in March 2022. They were told that it would require two new sites. The councillors agreed in principle to support the option of ‘Two new hospitals to replace Royal Lancaster Infirmary and Royal Preston Hospital (new sites)’.
So, from the start, the national scheme envisaged imposing hospitals on undeveloped sites for cohort 4 hospitals using an off-the -peg design. The local NHP team shared this with County Councillors but then carried out a wide-ranging survey of staff and users without making it clear that we were wasting our time if we wanted hospitals to be near where people actually live or near transport hubs or accessible by current routes.
I, and thousands of others, thought it was a genuine survey, not a massive PR exercise.
Having our local hospital design and location mandated by a faceless remote bureaucracy is unacceptable. Any financial savings in the construction, if ever delivered, must be balanced against the negative impact on people’s health.
We should be planning for an ageing population and for fewer individual car journeys. (One tip on government websites for achieving this is to ‘live locally’!)
As things stand, the same site option, favoured by the survey respondents, is not to be available to the people of Central Lancashire.
However, the same site option is currently the most common choice for hospitals which are in earlier cohorts of the programme and are free to influence design and location.
Across England the same or an adjacent site are the favoured locations for replacement hospitals. This has the advantage of the site already being in the ownership of the Trust. It enables those who work at the hospital to continue to live in locations that allow them to combine travel to work with other commitments including schooling and family.
These locations are served by established public transport hubs and networks understood by the users. These other hospital trusts have not opted for flight to a greenfield site but instead use imaginative architecture to serve the people who live in the area.
The following new hospitals are all to be developed on their current or on adjacent sites: Leicester, Hillingdon, Watford, Sutton, Leeds.
Some of the above were pressured to move out of town. They resisted. Preston should not be the poor relation.
In November 2023 the cross-party Public Accounts Committee (PAC) indicated it had no confidence in the NHP plans and warned that the standardised design posed a risk that these hospitals would be too small to meet future needs. NHS England has since invited bids for a new £600m consultancy contract for a ‘Programme Delivery Partner’. £60m has already been spent.
A new government might well reconsider whether this really delivers value for money in terms of the health of the nation. I believe this lack of progress on the NHP presents a golden opportunity to revisit and challenge the issue of a suitable site for the new hospitals.
Whichever party forms the next government there will have to be a major review of both need and affordability.
Untested plans, designed principally to save money, pose a risk to those who will use them for generations to come. RPH is a massive ground level car park with a hospital attached!
It should follow the example of others, develop on the existing site, beginning with a muti-storey car park.
Whether at national, county or local level, politicians should now be fighting for a bespoke hospital close to the bulk of the populations that need it most.
You don’t level up by making those who needs are greatest travel further for their care.
What do you think about the proposed new hospital? Let us know in the comments below
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This is a guest post from Steve Harrison. He was born and educated in Preston. He worked in Preston on the docks, on the buses and at Whittingham Hospital as a student before a career in teaching. He was later Senior Education Adviser/Inspector for Preston and South Ribble before moving into writing and
publishing. Since retiring he has been active in volunteering. He supports North End.
