KOHIN

Quotes from Eastern Daily Press 3/5/06 about the PFI
"It is hard to escape the conclusion that the public sector staff managing the project were not up to the rough and tumble of negotiating refinancing proposals with the private sector." "The unacceptable face of capitalism" - Edward Leigh MP, Chairman of the Public Accounts Committee.
"What is shocking and unacceptable is that the Department of Health allowed a contract like this to be signed, which put the public sector in such a weak position." - Richard Bacon MP, Member of Parliament for South Norfolk and member of the Public Accounts Committee. The Hospital is within his constituency.

More quotes from Eastern Daily Press 21/4/06 about the PFI
"The private sector took massive profits from the refinancing of early PFI deals like the N&N, while the public sector took on increased risks, including huge extra financial liabilities" - Richard Bacon, South Norfolk MP and member of the Public Accounts Committee.
"There had been a history of the public sector taking the risk and the private sector coining the cash" - Ditto.
"Recent deals, including the refinancing of the N&N, showed that private sector companies were still making 'astronomical' profits while passing added risk to public authorities" - Edward Leigh, Chairman of the Public Accounts Committee.
"The simple fact is that the scale of the refinancing demonstrates how expensive this particular early contract was." - Patricia Hewitt, Minister of Health.
"The Public Account Committee chairman Edward Leigh sounded off about 'the unacceptable face of capitalism in the public sector' - re Octagon and the PFI.

Our £3.9m bill just to park at the N&N
Headline, front page Eastern Evening News 20/8/2005
Patients, visitors and staff have paid out almost £4 million in parking fees since the Norfolk and Norwich University Hospital opened at Colney in 2001. The huge sum has been condemned as a "tax on ill health".

Flagship N&N: the real cost. Concern at PFI deal "secrecy"
Mark Nicholls, Eastern Daily Press 23/11/2004
Experts at the Association of Chartered Accountants put a price tag of £1.16 billion - this is five times the initial cost of £229 million. N&N Trust pays Octagon consortium £37.1 million a year out of its budget of £37.1 million.

PM Faces Challenge Over Hospital Crisis
Martin Barsby, Eastern Daily Press 26/9/2003 p14
Urgent Questions about the financial "mess" at Norfolk's main hospital are to be raised at the highest levels - 10 Downing Street.
Yesterday, the EDP revealed the cash-strapped Norfolk & Norwich University Hospital had imposed a raft of cuts to stop it plunging £7m into debt.
These even included cutting out biscuits in the boardroom.
Hundreds of stand-in doctors and nurses are being axed and all overtime is to end as the hospital trust tries to save cash.
The trust is already struggling to find its £4m share of a multi-million shortfall within the central Norfolk health system - mostly caused by the running costs of the N&N.
On Wednesday, director of resources Anna Dugdale told the N&N trust board that if current levels of spending by hospital directorates continued, the trust would end the financial year £7m in debt.
Last night two Norfolk MPs vowed to raise the question of how Norfolk's flagship hospital had got into such a financial state in Westminster and Whitehall.
Norwich North MP Ian Gibson, who described the finances as an "utter mess", said it was time to quiz Prime Minister Tony Blair on the issue.
"I will not only raise the matter at Prime Minister's Questions but also raise it at Downing Street. This hospital was supposed to be part of a brave new world, but things keep going wrong and just get worse and worse. There is not a lot of public confidence left in the way it's been managed, but a great deal of praise for the staff, who deliver a world-class standard of care. As for no more biscuits in the board room, I'd have thought on the kind of money the board are earning they might be able to afford a packet of rich tea themselves."
The £229m hospital was built under a controversial Private Finance Initiative (PFI), which means the trust rents the building from private consortium Octagon Healthcare over 60 years.
The annual pay-back over the full term averages out at £29.3m a year, for which the hospital gets the building and its full maintenance and added extras, including security and catering.
Mr Gibson said the question of whether the PFI was draining Norfolk's health system had to be asked and if the answer was "yes", then that had to be faced.
Specific concerns over the PFI at the N&N are to be raised with the Treasury Select Committee by North Norfolk MP Norman Lamb. "I plan to ask the committee about how the PFI is operating and how it seems to be an extremely expensive way to run a hospital. I am not totally opposed to the use of private finance, but the cost of the N&N project and the way it is draining the local health economy is well worth looking at. The Treasury has recently taken responsibility for PFI and it is now under their control. In the light of that, the fact it is a continuing cause for concern and with the N&N in mind. PFI is something that needs looking at again."

PFI is Ineffective
Allyson Pollock on the Lothian Hospitals PFI. Implementation led to capacity restraints across all acute specialties and downsizing of hospital community provision. PFI did not reach its targets. Further downsizing may be required due to its high costs.
Dunnigan MG, Polock AM, BMJ 2003; 326: 905-8

Hospital staff quit jobs over 'poor bus service'
Car park too small and public transport unreliable, say N&N workers
Eastern Daily Press, January 31st 2003, page 18.

Why Blair's gleaming new hospitals are really making the NHS worse
Nicola Graydon & Allyson Pollock: The Mail on Sunday Review, 26/1/03, page 60-61.

Why this link is absolutely vital
I note the Liberal Democrat administration at City Hall has chosen to demonstrate its full support for a direct access from the southern bypass to the new hospital, by rejecting the alternative, second-rate routes and insisting that the direct option is revisited.
It is a pity that the ruling Conservative group at the county council doesn't have similar conviction; instead, however, it chose to drop direct access from further consideration, without even giving a proper opportunity to express their views.
Let us not forget the absolute necessity of a direct road from the A47. The gravity of the situation was alarmingly brought home to me just last week as I attempted to travel in the area.
It took me 25 minutes to journey from the junction with the Southern bypass to the entrance to the university. There were no roadworks, obstacles or accidents to contend with and the distance I covered could have been no more than a mile.
The sheer volume of traffic, however, made my trip a complete nightmare. I dread to think of the repercussions should an emergency vehicle have been trying to use the route. The congestion was impenetrable.
The one positive outcome of this episode is that it served as further reassurance that justification for a direct route to the hospital is as important as ever. The campaign must continue and I applaud the city council for whole-heartedly lending it their support.
Tim East, County Councillor and Liberal Democrat spokesman for Planning and Transport
Eastern Evening News 7th October 2002.
(Tim East was a leading member of the ruling Lib Dems at South Norfolk District Council when they approved the planning application without proper consideration of access.)

Hospital site criticised
A government architecture group has claimed that the new Norfolk & Norwich University Hospital was built in too remote a location to serve the city.
Watcdog group the Commission for Architecture and the Built Environment (Cabe) praises the hospital as a fine example of design, but says it is in the wrong place and does not serve its community.
The claims are contained in a report into public sector projects built using the controversial Public Finance Initiative (PFI) method, where private companies build schools and hospitals and rent them back to the state.
The report says the PFI process could usher in public facilities that are badly designed, lack innovation and fail to embrace advances in medicine and technology.
Eastern Evening News 7th October 2002.

Let down over new hospital
City MPs have failed
Labour are failing. Charles Clarke MP (see,or see), the Labour Party Chairman, finally has admitted it. He has also warned the Government that if they carry on failing to deliver decent public services they will be booted out of office.
The Norfolk and Norwich University Hospital is a case in point. Where our MPs and Labour have failed, the Tories have also a share in the blame as they started PFIs.
The hospital is built on a greenfiels site, it has poor access, it is remote and has too few beds.
Six years ago the Keep Our Hospital in Norwich campaign highlighted these major points as a cause for concern and reasons not to build the hospital at Colney.
Charles Clarke MP wrote to the Evening News on July 3rd 1997, and stated: "I have started assembling evidence and campaigning on four aspects of the new hospital where I believe we can make a difference.
(1) To keep 24-hour accident and emergency facilities located in the city centre, along with some outpatient services if possible.
(2) To test the assumptions about bed numbers and campaign for an adequately sized hospital.
(3) For significantly upgraded and cheap public and private transport facilities.
(4) To ensure proper use of the city centre sites."
Well now we know taht on all four points, Charles Clarke has:
(1) Failed.
(2) Failed
(3) Failed.
(4) Questionable.
Just wrote to the EDP and EEN on April 19th 1999 stating: "I would bet my salary that the road is going to come off the southern bypass."
It was also reported that he thought the announcement was likely within three weeks. "I think the questions we have asked show that they can indeed build a road within two kilometres of another road off a bypass. There is no excuse for not doing it."
Dr Gibson MP (see, or see, or see, or see) has also failed to highlight the NNUH problems in Parliament like his constituents would like him to.
He has accepted "cash for no questions" - £200,000 is handy especially for a private hospital, but won't help the waiting lists very much. The sum is a drop in the ocean as far as the NHS spending is concerned.
I am disappointed in a way that Dr Gibson hasn't paid up. My mother would have loved her long overdue hip operation done, as no doubt others would. I said in a way, because I suspect that Charles Clarke and Ian Gibson when faced with another general election will pull a direct access link out of the bag.
But will the Government have made waiting lists, funding for the NNUH, transport to the hospital and residents on the route in University and Henderson Ward any better?
Cllr Ian Williams
Norwich
Eastern Daily Press 18th January 2002

Think again
Why can we not keep the old Norfolk & Norwich Hospital? Cannot someone make the voice of the public heard?
A city the size of Norwich without a central hospital is unthinkable. Cannot something be done before it is too late?
Mrs L Vera Wyatt
Norwich
Eastern Daily Press 18th January 2002
Where has she been all these years? Ed.

Parish Councils should be heeded
The senior vice-president of the Royal Town Planning Institute, Michael Haslam, rightly observes (letter, December 11) that "parish councils are frequently able to influence the decisions of planning committees where public speaking rights exist". However, until the power to implement many of these decisions devolves from Whitehall, planning committees will continue to waste time and public money.
In his capacity as chief planning officer for South Norfolk District Council, Mr Haslam is well aware of the utter frustration of local parish councils, the county council, MPs, the local police and health authorities and many more who unaminously endorsed plans for access to the newly opened Norfolk and Norwich University Hospital. These have been consistently rejected by the Highways Agency at Whitehall.
As a result of this five year planning debacle, Norfolk now boasts one of the most advanced medical facilities in northern Europe, with access only from a single-track country lane or by helicopter.
Oliver Chastney
Cringleford
The Times 18th December 2001

Travel fears of hospital staff
With reference to parking problems facing the new hospital, I would like to add to the ever-increasing comments being voiced on what is now becoming a very serious issue for both staff and future patients alike. The letter by Mrs J. Harvey, who is also employed in nursing, quotes travel to the new hospital by public transport from Hethersett as another valid example.
On the eastern side of the city, staff without parking permits will need to board a No 21 bus at Sprowston by 5.49am at the latest,or, if living closer to the city, a No 25 at Riverside by 6.05am in order to "scrape in" for 6.45am to relieve colleagues by 7am for the morning ward handover.
For late shift staff, the very earliest return possible - when able to leave their shift on time at 9.32pm, followed by a frantic dash across to the hospital bus park - will now be 10.26pm (arrival time at Riverside) and 10.52pm (arrival time at Sprowston).
On a shift rotation pattern nursing staff can on occasions expect a maximum time of four and a half hours spent at home before repeating the process. The hospital will expect to function 24 hours a day, seven days a week regardless of variations in bus times.
Your leader comment on November 14, stating that "staff seem reluctant to give up the comfort of their cars", would seem a little inappropriate. The issue is one of survival rather than comfort.
To drive up to six miles in the opposite direction to one's place of employment in order to find a park and ride and then be penalised as Mrs Harvey has stated is absurd.
The many thousands of staff required to operate a city hospital have in the past based their domestic location within reach of their employment in order to attain the required standards of punctuality.
The well publicised daily gridlock within the city and which is already spreading towards the "dreaded" B1108 is now placing a serious doubt on reliability which will be outside the control of many conscientious members of staff about to transfer to the new site and who cannot obtain a parking space.
The quiet exodus taking place of nursing staff not prepared to accept the risk and who are considering prematurely surrendering their contracts rather than having to relocate their homes is now being seriously addressed by Unison, which may be able to help towards achieving some solution to a very real problem.
Sadly, the problems of traffic movement should have received positive action years ago. If a sink is already blocked then adding more fluid can only result in a flooded kitchen.
GD Roberts (NHS Trust employee)
Norwich
Eastern Daily Press 23rd November 2001

Hospital access dangers continue
Our new Norfolk & Norwich University Hospital at Colney is on the brink of opening to patients and the police chiefs question the convenience of reaching it! The public has been demanding better access since its conception but to no avail.
A great deal of money has been spent widening a small section of one access, the B1108. The second access - Colney Lane, Cringleford - has already been closed to public transport.
The evening of November 3rd was a foretaste of what can happen when the UEA has a popular musical event combined with the Earlham Park firework display. All roads in that area were snarled up approaching and on the B1108.
Taxis refused to take fares to the UEA..
Come on people of Norfolk & Norwich, show your displeasure and disgust by contacting your MP and the EDP before it is too late. It could be a matter of life or death
Loreena Bartram
Eaton
Eastern Daily Press 14th November 2001.

What on earth were Messers Bartram, King and Gunson doing during the planning of this "Brightest star in the local NHS"?

New N&N faces crisis on staffing
Front page news in Eastern Daily Press 14th November 2001.
Frustrated staff at the N&N Hospital are threatening to give up their jobs and contracts because of the lack of parking spaces at the new £229 million facility at Colney.
Norfolk County Council leader Alison King said there was now a flurry of activity regarding the need for an access road, but it should have been planned well in advance.
Adrian Gunson, cabinet member for planning & transportation said "The whole issue of accessibilty is a nightmare".

PFI a disaster?
Hospitals built under the Private Finance Initiative could be a disaster, says the head of the government's own advisory board Sir Stuart Lipton. He has warned that many of the mistakes made with tower blocks of the 1960s are being repeated.
read all about it....
http://news.bbc.co.uk/hi/english/health/newsid_1615000/1615004.stm

Crass idiocy
Leaving aside the crass idiocy of building a hospital without first deciding and providing adequate access, I am just wondering how patients without their own transport are to get to it. Vague mention has been made of buses running from the city centre, but it may surprise those who are making these arrangements that not everyone can or is able to travel in buses.. So what are they to do?
More information on this matter would perhaps be a little more helpful to some, rather than reading about the number of lifts, doors,windows and other interesting features which have been supplied in the construction of the hospital.
WJ Peck
Norwich
Eastern Daily Press 19th October 2001

Ridiculous access
I read with some interest the article (October 13) about the traffic disruption caused by a chemical spill at the Thickthorn roundabout.
What could have happened if the new hospital was in use at the time of the incident? What possible headlines could we have expected "Patient dies stuck in traffic trying to access the hospital"?
Is it really going to take a situation like this to get the people in power to do something about the ridiculous road access issue?
I have first hand knowledge of the chaos that has already occurred since the closure of Colney Lane access - and this all before the opening of the hospital.
Noreen Farrel
Norwich
Eastern Evening News 18/10/2001

We told you so!
Please don't deny us one small opportunity to say "We told you so!" The spectacle of our rulers squabbling over access to the hospital at Colney would be ludicrous if it were not so sad.
You are right when you say that the hospital at Colney is unstoppable. You are wrong when you say that there is little to be gained from revisiting the issues. They concern the manner in which we are governed.
South Norfolk Council granted planning permission for a hospital with inadequate access, too few beds and no accommodation for resident staff. They now have to yield to every demand. "Let us get the hospital built and sort out the problems later". What sort of planning is that?
The Povall Worthington report is crucial. It has been "mislaid". The proposition that the St Stephen's site is too small is based upon it. Where is it? Have you seen it? Has the South Norfolk Council seen it? Has anyone seen it? Does it exist? There is evidence (Eastern Evening News 24 April 1997) that it recommended that the St Stephen's site could be redevoloped for a hospital of Colney dimensions. Can we see it now please?
Who briefed the Chief Planning Officer of South Norfolk Council "to do everything possible to secure approval of the hospital proposal on the Colney site"?
Did the Minister for the Environment mean it when he said "The proper place for hospitals is in city centres"? Why did he not act upon his convictions?
What steps did the Community Health Council take to ascertain their public's views before throwing in its hand for Colney? For that matter did anyone respect public opinion when it was expressed? Did anyone take any serious steps to discover what it was?
What of the dithering of the Norwich City Council and the Planning and Transportation Committee at Norfolk County Council?
And then there is the question of the PFI........
There is plenty to talk about and much to be gained by talking in the interests of "Open Government". Sweeping it under the carpet is not an option.
Dr Geoff Clayton
Eastern Evening News 14th January 1999

Chaos Ahead on Route to Hospital
I am sure many people share Mr McDonald’s puzzlement about the fuss about access to the new hospital (EDP, May 10). Surely you don’t build a £229 million hospital without sorting out the access issues first?
But that is exactly what has happened. Anyhow, the new hospital must have better access than the old one. Of course, access will be better for some people some of the time - but not for those using public transport.
The present Norfolk & Norwich Hospital is close to the focus of existing public transport routes. Many patients, visitors and staff come from surrounding areas of the city and everyone could easily do a bit of shopping in Norwich if they wished.
All good reasons why planning policy guidelines state that hospitals should be located close to city centres. There will, of course, be a much improved service to the new site but it is going to be more inconvenient to get to by bus than the old hospital.
However, having decided to move the hospital to the outer edge of the city it made sense to plan to link it directly to the bypass a couple of hundred yards away so at least cars could get there easily. But no, this was not part of the hospital access plan. The result is there are fewer access routes to the new hospital than the old hospital. In fact, there is just one, Watton/Earlham Road, the B1108.
At peak time this road is already congested - in the morning, peak traffic often queues back to the bypass. This before the hospital is open, but that is not all! There are several developments already with planning permission that are either incomplete or not yet started - for example, another 1200 houses at Bowthorpe, the new medical school, the new nursing and midwifery school and two science business parks. The principal or only access to these developments is the B1108.
Traffic consultants have stated that once all these developments are finished, the B1108 will be gridlocked in the morning peak, with traffic queuing on the bypass, delays of up to 25 minutes to reach the new hospital from the bypass and only slightly smaller tailbacks of traffic coming from Norwich. Hence the fuss about access.
Dr Gray (EDP, May 12) accepts “that initially access to the hospital will not be perfect”. What an admission, five years since planning permission was granted and the hospital admitting patients within a few months.
The best suggestion that South Norfolk Council has come up with is a dangerous, third-rate access from the A11 through a housing estate. This has yet to get planning permission and is years away.
If the district council had shown more resolution five years ago, we could have had a new hospital and nearly perfect access to the bypass.
No doubt the councillors at South Norfolk are full of good intentions but the road to hell is paved with those. We should settle only for a road direct from the bypass.
Graham Martin
Chairman, Colney Parish Meeting
Eastern Daily Press 18th May 2001

The full cost of PFI sinks in
"The impact on both the character of the NHS and the way its resources are distributed will be immeasurable. The full cost of PFI is just beginning to sink in" The Guardian 23rd July 2001 p8-9

Hospital access is far from safe
I was horrified to hear Martin Shaw, Norfolk County Council's director of planning and transportation, on the radio saying the access to the new hospital would be adequate for the traffic.
I wa at a public meeting in the early 1980s about the proposed new hospital when a police report was read saying that Colney Lane was totally inadequate and dangerous for the traffic movements predicted for the hospital.
The hospital is now built and, apart from work on the junction with Watton Road, a lot of words have been spoken but there is no action.
How many lives have to be lost before anything is done?
Also, expecting staff to use the park and ride will make getting to work longer and will add to travel costs with no increase in pay. Sounds like a recipe for more nurse shortages.
Staff, patients and visitors are expected to use public transport if they live in the county, with no bus station to await connections, nowhere to wait safely, in the warm, nowhere to get a cup of tea and no toilet faciities.
Another wonderful oppoprtunity lost to make this a "Fine City" once more.
Short-term thinking for a long-term problem.
Mrs APulford
Hellesdon
Eastern Daily Press 3rd August 2001