KOHIN

Keep Our Hospital in Norwich

Planning Background

The Planning Background

The 1988 Planning Application

1.1 In 1986 the Norwich Health Authority recommended to the Regional Health Authority that they apply to the Minister for approval in principle for the building of the second district general hospital at a site in existing use as a psychiatric hospital at Hellesdon, Norwich. The site at Hellesdon, inside the built up area, was supported by the public and Norwich City Council.

1.2 The Consultant Staff Committee favoured a site on or adjacent to the University of East Anglia campus. The Committee sought a meeting with the Minister for Health to press their case. The meeting took place in London in March 1987 and resulted in a letter from the Department in July 1987 requesting the RHA to appraise a site at Colney. In December 1987, the RHA published a report recommending use of a site at Colney.

1.3 The first Notice of Development was served on South Norfolk District Council (planning authority for the Colney site) by the East Anglian Regional Health Authority on 10 August 1987 and related to some 30 ha of land to the south-west of Colney Lane, Norwich, to provide a Second District General Hospital (2 DGH) to be built in 3 phases and to be opened between 1991 and 2000.

1.4 The second Notice of Proposed Development was served on South Norfolk DC by the East Anglian Regional Health Authority on 25 February 1988 and related to some 26 ha of land (within a larger area of 51 ha) to the southwest of Colney Lane, Norwich to provide a Second District General Hospital to be built in 3 phases to be opened between 1991 and 2000.

1.5 The Planning and Environment Committee of South Norfolk DC resolved on 10 February 1988 to support in principle the proposed development of the district general hospital on the (first) notification site and that the proposal be referred to the Secretary of State as a departure from the development plan which the authority would wish to support, subject to conditions and to request that a local public inquiry be held.

1.6 In a letter dated 3 March 1988, the Secretary of State referred to the Second Notice of Proposed Development and directed that it be referred to him instead of being dealt with by the Local Planning Authority. On the information available at that date, he considered that the following points appeared to be relevant to his consideration of the proposed development:

a) the relationship between the proposed development and the provisions of the Norfolk Structure Plan;
b) the suitability of the site for the proposed development;
c) the effects which the proposed development might have upon the surrounding area;
d) the road safety aspects of the proposal;
e) any other material considerations.

1.7 A non-statutory public local inquiry was held between 12 April and 9 May 1988 into the Notification site off Colney Lane. Norwich City Council and Broadland District Council appeared as objectors.

1.8 The Secretary of State issued his decision letter on 5 December 1988 accepting the Inspector's recommendation that the proposal for a Second District General Hospital on the notification site at Colney Lane, Norwich, should be allowed to proceed on the basis that there were no compelling planning reasons why the development should not take place. In his letter the Secretary of State accepted 'that accessibility by other transport modes than car is unsatisfactory and, although this is not a convincing planning objection in itself, this is an issue that will require further attention by the relevant authorities, there will clearly be problems for patients, visitors, nursing and ancillary staff unless proper and effective public transport facilities are provided. (see attached letter)

Note. It is now government policy to retain major facilities in town centres, including hospitals and to ensure that development is located where it will: ref. Planning Policy Guidance Note 13 on Transport, 1994; Revised Planning Policy Guidance Note 6 on Town Centres and Retail Developments, 1996.

1992 Public Consultation on a Single Site Hospital at Colney

2.1 In February 1990, the Secretary of State for Health gave Approval in Principle" to build a second new district general hospital of 920 beds at a site at Colney Lane. It was envisaged that after the new Hospital was opened, there would be 1,650 beds for acutely ill general and mentally ill patients, split between the two sites at the Norfolk and Norwich and Colney Lane.

2.2 Before moving onto the detailed design stage, the Department of Health requires Authorities to reaffirm that the original basis of the Secretary of State's Approval in Principle still holds good and that there have not been significant changes in the interim.

2.3 As part of the AIP process, the Norwich Health Authority embarked upon a review of the size and nature of the Hospital which culminated in an examination of five options:
2.4 The five options were judged against a number of financial and nonfinancial criteria. The health authority opted for a single site option at Colney. It presented the Colney site as the only feasible option in its public consultation exercise in 1992. (1992 public consultation document issued by the Norwich Health Authority)

2.5 In the consultation document, Norwich Health Authority stated that concerns about the long-term future of the Norfolk and Norwich had caused the Authority to reassess the investment necessary to retain it as part of any of the five options. Povall Worthington, hospital architects had been brought in, in 1990/91, to undertake a detailed appraisal of the Norfolk and Norwich Hospital. The architects' findings were never published. It was assumed the Authority had relied on the advice of Povall Worthington in reaching the conclusion that:
"The scale of investment and reorganisation involved at the Norfolk and Norwich to maintain it as a viable unit for the long term, coupled with the importance of integrating district general services and the logistical difficulty of achieving the work on a congested site, suggested that the single site solution was the most practical and economic proposition". (section 7.2 of the 1992 public consultation paper)
2.6 Norwich City Council wrote to the Norwich Health Authority in a letter of May 1992 stating:
"Reluctantly it is accepted that no suitable location is available within the City which combines the required elements of size and accessibility and which could be developed in a low rise form within the financial parameters set by the Health Authority".
2.7 Recently, there has been some insight into Povall Worthington's involvement. Eastern Evening News sought the views of Povall Worthington on the proposal by the Keep our Hospital in Norwich campaign for building a new hospital on the Norfolk and Norwich site. Comments by Povall Worthington as published in the Eastern Evening News on 24/4/97 read:
"And a spokesman for the architects said they had concluded the site could be redeveloped. Povall Worthington did not make any decisions in 1992, that was left to managers in the regional and district health authorities.

The spokesman said: What happened was that, to a degree we felt the existing site was scuppered. High infrastructure figures were brought in and the mood "was let's build a new hospital ..."

We came to the conclusion that we could build the hospital on the same site (the N and N), with all the latest technology. It was completely practical and realistic. But they wanted 1600 beds and the more we went into it the more we were horrified.

We said they needed 600 to 800 beds. We never recommended anything, we said "There's the results, it's your decision. There was a big driving force for Colney because the Consultants wanted it next to the university".
2.8 According to the 1992 consultation document, it appears that all tiers of the NHS relied on the recommendations of the Norwich Health Authority. Section 10 of the consultation paper described the decision making process:
"By the end of June 1992 - Norwich Health Authority will submit its proposals to the East Anglian Regional Health Authority (EARHA). Subsequently, EARHA will submit its proposal to the Department of Health (DoH) for the Secretary of State's approval".
2.9 In other words, there was no independent assessment of the decision; instead all tiers of the NHS relied on partial advice from Norwich Health Authority.

Note 1 "The possibility of a one-site DGH on the existing N&N Hospital had been excluded from previous discussions because it could not accommodate 1,650 beds but if fewer beds were now necessary it could again enter the reckoning." (1992 discussion document 5.1)

Note 2The methodology used for scoring the five options included only one pertinent to interests other than those strictly internal to the NHS. This was accessibility. There was no score to reflect any effect upon the city, the county or the environment. On the question of accessibility St Stephens came out top with a score of 48 against Colney of 36. (Consultation Document 1992 page 28)

1996 Planning Application for a 701 bed Single District Hospital at Colney

3.1 January 1996 - Local people formed the Keep our Hospital in Norwich campaign (KoHiN) to oppose the anticipated planning application for a single site hospital at Colney on locational and access grounds. There was a very strong groundswell of public opinion, supported by Norwich City Council, against relocation and in favour of rebuilding the N&N on its existing site. Over the past year, serious public disquiet has been expressed at five major public meetings and in numerous letters in the press, objections to the planning application and letters to MPs. An 18,000 signature petition was collected very quickly.

3.2 April 1996 - KoHiN commissioned a national architect to develop a strategy for building a new hospital on the existing site. The strategy demonstrated rebuilding to be a feasible, practicable and cheaper alternative, Contrary to the impression given by Norwich Health Authority.

3.3 April 1996 - Octagon Healthcare submitted a planning application to South Norfolk District Council for a 701 bed district general hospital at Colney.

3.4 There was widespread public mistrust of the South Norfolk Chief Planning Officer, Michael Haslam, who had written a private letter to the South Norfolk MP, John MacGregor, dated 7 December 1995, stating:
"My brief is to do everything possible to secure the approval of the hospital proposal on the Colney site."
i.e. four months before the planning application was submitted in April 1996.

3.5 Mr Haslam made a number of misleading statements on the correct approach to determining the planning application, at three public meetings and in written material. KoHiN sought a legal opinion from a planning barrister who stated:
"The approach promulgated by Mr Haslam in the above extracts evidences a misunderstanding of the correct approach which the Council, as a matter of law, is required to adopt when considering the application. If the Council were to adapt this approach in reaching its determination of the application then their decision would, in my view, be unlawful and open to challenge by way of judicial review."
3.6 Objectors, including Norwich City Council, requested the Secretary of State to call in the planning application and hold a local planning inquiry on grounds that the application conflicted with government policy. John Gummer refused, saying that since the adopted local plan made provision for a hospital, the local planning authority was best placed determine the application.

3.7 The hospital allocation had been included in the local plan (the Norwich Area Local Plan) prepared by South Norfolk in 1992. Objectors had been unable to speak at the Local Plan inquiry on this issue because the site had at that time planning permission for hospital use which ruled out discussion. Planning permission lapsed in December 1993.

3.8 Technically, the Secretary of State for the Environment had the power to call in the application, because the policy in the local plan conflicted with updated government policy. But the Colney project was more than a planning issue. As the Tory flagship PFI NHS project, it had achieved a political dimension. In a telephone call, DoE officials told Norwich City Council that John Gummer had had his arm twisted not to call in the planning application.

3.9 On 18 June 1996, South Norfolk District Council granted planning permission for a 701 bed hospital at Colney. At the planning meeting, Norwich City Council was given three minutes in which to state its case.

3.10 Norwich City Council sought a legal opinion for a judicial review on grounds that the applicants had failed to follow the sequential test required by PPG6. The City Council was advised that a legal challenge was unlikely to succeed.

Revised application for 809 bed hospital

4.1 On 2 September 1996, Octagon Healthcare submitted amended plans for an additional 108 beds, having argued the adequacy of 701 beds ten weeks earlier. Norwich City Council objected to the amended plans.

4.2 On 16 October 1997, South Norfolk District Council met to consider the revised plans. The briefing notes for the meeting stated that 63 letters of objection had been received, but stated incorrectly that: "These letters have raised no new issues other than those reported in the original Committee report". Following representations by a member of the public who had read the letters and noted many new issues, the planning officer publicly read out one of the letters of new objections. The revised plans were passed.

4.3 Notwithstanding the increase in bed numbers, there remains a shortfall of provision for 6,000 annual cases treated by the hospital trust. East Norfolk Health has agreed to purchase an annual 81,700 cases from the Norfolk and Norwich Health Care NHS Trust. Provisional outturn figures for 1996/97 are at a level of 87,602 cases.
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"It is the people's national health service and we should never forget that."

(Alan Milburn MP, Minister of State for Health, Hansard 15th May 1997)

"City centres are the places for hospitals."

(John Gummer, recently Minister for the Environment, Bristol 22nd March 1996)