Progress is slowly being made towards establishing a new hospital. There was a joint meeting of the Dulwich Project Board and the Community Involvement and Communications Group in the Board Room at King's College Hospital on 19 March. This meeting, described as 'not a public meeting but one which the public is invited to attend', was to enable the Southwark Primary Care Trust (PCT) to present its 'Local Improvement Finance Trust (LIFT) Stage 1 Business Case' to the Dulwich Project Board and Community Involvement and Communications Group, following approval by the Southwark PCT on 8 March at a meeting at Guy's Hospital.
The approval process now follows a number of stages during this spring and summer, after which it is hoped that firm NHS approval will be given for the hospital project to proceed. Provided these are successful it is envisaged that final financial consent would be obtained by August 2008, after which there would be a construction period of two years. This means that a new hospital building would be operational by October 2010, at the earliest. Already a further delay, perhaps of three months, has occurred because NHS London has requested further clarification of some aspects of the Business Case.
Planning application to Southwark Council for a new building will be made only during spring 2008, after the above processes have taken place. The plan is that the new hospital will occupy only 45 per cent of the whole site. The rest of the site will remain occupied by the old buildings, which will continue to provide existing hospital services until the new building is ready. There will be further appraisal of options, followed by public consultation, about this part of the site which will then become redundant. So uncertainties about this are likely to persist so several years.
A number of people, including local councillors, expressed dismay that the eastern wing of the old hospital (that part designated for the new building) has already been demolished. This followed two unsuccessful appeals to English Heritage to list Dulwich Hospital and to the PCT at least to preserve the front façade of the old building. It judged that the shape of the old hospital made its design unsuitable for new hospital purposes, and that to preserve old features would add unjustifiably to its expense. So the symmetry of the old hospital building has already been irretrievably lost. Any worthwhile retention of its character will now be limited to the central 'chateau' part, and depend entirely on a viable use being found for it.
The freehold of the whole site was transferred from King's College Hospital to the Primary Care Trust in 2005. At the time when Southwark Council's Planning Committee gave outline planning consent for the new hospital, it was hoped that a detailed planning application would relate to the site as a whole. Meanwhile there remains apprehension in some quarters that it will become an increasingly attractive option to sell the redundant part of the site for development, especially if land values continue to rise. The PCT's accountants are also recommending a 'sale and leaseback' of the freehold, to reduce its financial liability to capital charges. We are assured that this proposal applies only to the land on which the new hospital will be built, because this will then have a higher taxable value.
In the present uncertain state of NHS finances, the project is vulnerable at every stage, but the PCT is hopeful that it will continue. NHS policy remains that primary care services should be improved and modernised, and that community hospitals should increasingly take the pressure off larger hospitals with their greater specialised capacity to deal with more serious problems. Unfortunately, delay is a potent government weapon to control the flow of public expenditure and regrets have been expressed at the complexities of Private Finance Initiatives (PFIs). With the Government's determination to reduce the burden of public finance there is, for the present, little realistic option that a Dulwich Community Hospital will be built at all.
If you want to find out more about plans for Dulwich Community Hospital, the next meetings of the Dulwich Project Board and Community Involvement and Communications Group will be held in public on Thursday 12 July 2007 at King's College Hospital from 2pm-4pm. For further information about Dulwich Community Hospital please visit www.dulwichcommunityhospital.nhs.uk