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If health centre is sold, will surgeries be built?
• ISLINGTON Primary Care Trust’s consultation over services at Finsbury Health Centre (FHC) has been fraught with errors and omissions so far.
The PCT’s consultation document, Help us to improve health services in Islington, says: “By mid-September 2008 we will have bought the land next to FHC to build a new home for the two GP practices currently based there.” But, as of September 30, the PCT states the land has not been purchased.
Demolition of the building in Pine Street, on the land on which the PCT claims it wants to build two new GP surgeries, has not been agreed with English Heritage. Under Department of Communities and Local Government planning rules, demolition in a conservation area has to have a “strategic national benefit”. The PCT’s proposal does not meet this requirement as it is for local services.
The PCT claims the refurbishment of FHC, including installation of a lift to allow full access, would cost £25million over 25 years. But the estimated cost of the refurbishment works to FHC is put at £12million, plans and planning permission for which are already said to exist.
The “£25million” figure only applies if the PCT funds the refurbishment via a private finance initiative (PFI) or Local Improvements Finance Trust (LIFT). This funding route would involve selling FHC to an entity, Camden and Islington Solutions (CICS), which is part of a joint venture between the private sector and the Department of Health called Community Health Partnerships. CICS would carry out the work, and the PCT would then rent FHC back at £1million for 25 years.
The PCT says it has “failed” to find other funding routes for the refurbishment, and that Heritage Lottery funding would not be available. But Heritage Lottery funding is available for work on important public buildings that have a “real use”, such as St Pancras Station.
The PCT says the new-build is required to provide “adequate clinical space”. But under the proposed move to polyclinics (the government has mandated all PCTs to have a coherent plan for polyclinics within the next five years), a polyclinic is not defined as services provided in a single building – it can in fact be a set of linked services across a series of buildings.
The extra space the PCT says it requires for clinical and other services (for example, a gym) at FHC could be rented or bought – property is cheap in a crashing market, and a change in planning use could be applied for as necessary – and incorporated into a polyclinic, of which the FHC’s three floors (ground floor, first floor and basement) would be the central element.
The consultation document does not once mention the “carbon cost” of the PCT’s proposal to demolish and build, or the carbon cost of extra journeys (by bus, tube, car) for FHC patients.
The government’s target for reducing UK greenhouse gas (GHG) emissions, including CO2, is now 26-32 per cent on 1990 levels by 2020 – a cut in GHG emissions of nearly a third in the next 12 years on 1990 levels.
The PCT is proposing demolition and new-build even though new construction is a major contributor to UK GHG emissions.
What are the GHG, including CO2, emissions for refurbishing FHC? What are they for demolishing an existing building, carting away the waste, and building and fitting out a new structure to house two GP surgeries?
The PCT has not indicated how it proposes to fund the new GP building.
How much will it cost and how is it to be funded? Is it to be funded via the very expensive (to the taxpayer) PFI route the PCT declines to follow for the refurbishment of FHC?
The global economic outlook for the next few years is bleak and, with proposed tax cuts in the offing, it is by no means certain that public services will not be cut too as tax revenues fall, with rising unemployment and business bankruptcies. FHC patients have been shown no firm funding commitment for a new building, and the PCT could easily scrap the proposed new GP building to save money even after FHC has been sold off.
In view of these significant errors and omissions, the PCT must withdraw its misleading consultation document and reissue it with full and accurate information, including answers to all the questions posed above, to all 22,000 patients at FHC.
S CASEY
Registered patient at FHC
Portpool Lane, EC1
• I WISH to voice my feelings about the intended sale of Finsbury Health Centre in prose verse form:
Our Treasure
They want to rip the heart out
of the Finsbury Health Centre
an organ of the people.
For seventy years it has given
health care to all of the needy.
In a quiet spot close to a main thoroughfare
this engine has worked ceaselessly.
Purpose built with flexibility in mind
it has treated many generations.
Now new custodians, Islington PCT
have in the last couple of months
opted for real estate enterprise.
They wish to sell our treasure
and claim by so doing they can
save £400,000 rent money p. a. alone
(a calculation nowhere proven).
However, could this amount be balanced
against thousands of monthly ‘carbon’ miles
to be travelled by frail patients
because they will have relocated certain
essential services such as physiotherapy etc.
Surely to save half a million pounds
it must be possible to depose
a tycoon or two.
Why is there a hurry to destroy FHC
when all the expertise available
point to the simple alternative of
good maintenance and even expansion
of the services so well employed here.
If the central government concept
of expanded central medical units
is to be implemented. Then it becomes
a nonsense to destroy an exemplar model.
ANDREW DA SILVA
Percival Street
EC1
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