Newton Abbot MP Anne Marie Morris has written to the Dr Paul Johnson, the clinical chairman of the NHS Devon CCG, regarding the new health hub in Teignmouth and the proposed closure of Teignmouth Hospital.

We published an extract in today’s Mid-Devon Advertiser. Here is the complete text.

Dear Paul

I have read the consultation document issued earlier this month which proposes the creation of a new health hub in Teignmouth in which all GP services would be consolidated and work alongside the integrated health and care team currently based in Teignmouth Hospital, and voluntary services. The intention is then also to move all other services to the new hub or to Dawlish hospital.

There is currently no intention to consult on the closure of Teignmouth hospital, yet the document makes clear that this will happen as a consequence of these changes. The document says that the sale proceeds from the hospital will be reinvested to deliver more NHS care, but it does not make clear what that will be, or whether or not it will benefit Teignmouth, which is losing its hospital.

Teignmouth Hospital is unusually owned by the Torbay Trust. To whom legally would any proceeds be paid, and therefore whose decision is it as to how any such funds should be reinvested?

Having read through the proposals thoroughly and the additional information provided in your letter of 17 September, I have a number of concerns which remain:

Any consultation must be based on up to date information and evidence to reflect the needs of the population at the time of the consultation. I do not believe this consultation achieves that. The consequences of Covid have not been fully and properly addressed. Nightingale urgent care is a small part of a much larger problem. Neither have the social care needs been fully addressed – Devon Health Scrutiny Committee find domiciliary care provision insufficient for existing need, never mind the growing demand which will increase pressure on services.

Under the NHS Act 2006 as amended by the Health & Social Care Act 2012, there is an obligation to consult should there be a service change. Even if this were just a relocation, which it isn’t, consultation would be required. If a substantial change under s244 the local authority must also be consulted. The Health Scrutiny Committee has received a presentation and asked for further information for its November meeting. What further information will you provide to them and what meaningful consultation will you undertake of their views? The Health and Wellbeing Board do not appear to have considered the proposal at all according to their website.

There is to be no consultation on the proposed closure of Teignmouth hospital. There is to be no consultation on bed closures, despite the new 2017 requirements. That the promised beds were never delivered while questionable in its own right, does not remove the obligation to consult on bed closures as you yourself have said. The requirements of the 2006 Act do not appear to have been met and you have refused to release the legal opinion you have received on this issue based on legal privilege. I would suggest public interest is more important.

That integrated care is the way forward, goes without question. Devon have been a pioneer of integrated care as the articles you provided evidence, for which you are to be congratulated. However, there are a number of assumptions and assertions made regarding the quantity and quality of care in the community, which recent evidence shows are not justified in Coastal, both as regards residential care homes and domiciliary care. Teignmouth has no nursing care homes.

Dawlish has only two remaining nursing care homes. Domiciliary care is unable to meet existing need. Saving bed occupancy days is but one half of the equation. What happens on discharge and the rate of readmission is not documented and is not addressed by the clinical senate.

The financial position and financial justification for the proposal remain unclear.

You have repeatedly confirmed that this new hub does not depend financially on the sale of Teignmouth hospital. Yet it would appear that a third-party investor is envisaged with the hospital being leased back for rent to the trust. Is this PFI by another name? Government funds, and funds from the CCG will you say meet the capital costs but there is no evidence of this.

There is an assertion but inadequate evidence that Dawlish will be able to accommodate the influx of outpatient clinics, 23 of them, making up 27 per cent of outpatient appointments at Teignmouth Hospital, alongside its existing case load with 19 outpatient clinics. The two new consulting rooms created by closing the maternity room, are not “new”. The two existing consulting rooms have been reassigned for patient prep and patient recovery in Dawlish hospital. Those patients will include not just coastal – there is nowhere else for non-coastal patients to go. Torbay and Newton Abbot do not have capacity as you have confirmed to absorb more patients.

There is an assertion but inadequate evidence that the new health hub can accommodate the high use community clinics, at the same volume levels. The physiotherapy provision will be smaller than that provided at Teignmouth hospital (funded by the League of Friends). There is no plan or layout of the new hub in the consultation evidencing how much space will be available and how it will be used.

Day case surgery is to be moved to Dawlish hospital. While 14 per cent of patients will be from coastal 51 per cent will be coming from Torbay who will have significantly further to travel. Torbay hospital itself cannot accommodate them. This is a very significant change for these patients, as will be the change for the 35 per cent coming from Newton Abbot and Moor to Sea. An announcement on 17 September 2020 indicates more provision may be made at Newton Abbot hospital but if that happens it will not be in the short term. Indeed talking to Torbay Trust, I understand all that provision will in fact be used at the main Torbay hospital site.

Travel times are important not just for those living in Coastal which is the core of the travel data provided. They are also important for residents in Newton Abbot, Moor to Sea and Torbay because they will also be travelling to Dawlish rather than Teignmouth. This has not been properly considered. Even for Coastal residents, four miles If you are elderly and fragile, is no short journey, hazardous by bus and expensive by taxi. It is self-evident that we have a disproportionately elderly and fragile patient group, but no proposal has been made as regards their transport.

I am aware that you are under time pressure to acquire the site in Brunswick Street. That development will go ahead in January 2021 with or without the hub. As you have demonstrated, it is the right place for the hub and the hub is the right way forward. It should go ahead.

What you have not demonstrated is that this new hub can accommodate everything intended both in the short and long term post Covid and that Teignmouth Hospital is redundant, whether as a hospital or an alternative centre for nursing care for which there is significant unmet need. This exercise must be undertaken before it is considered for closure.

Given the progress with the hub is not dependant on the sale of the hospital site please change your statements in the consultation which cannot be justified or sustained as regards the future of the hospital. Please confirm:

1.This consultation is not about the future of Teignmouth Hospital and any decisions based on this consultation will not be part of any decision about the future of the hospital.

2. Teignmouth Hospital will not be closed without a further consultation on its potential future use, its potential closure and on bed closures all of which require specific and separate consultation.

3. The future of Teignmouth Hospital will not be considered and determined until the new hub is up and running and can demonstrate in practice that it can meet the need assigned to it and that Dawlish Hospital can successfully meet the additional demands which are to be placed on it.

Anne Marie Morris

Member of Parliament for Newton Abbot