How do you solve a problem like FHC?

Nearly two years after our initial November 2008 meeting, over 50 people gathered at the Exmouth Market Centre last week to ponder the current situation regarding both the Finsbury Health Centre and the NHS.  With statements of support from Tony Benn, Chris Smith and Gerry Sproston of the Amwell Society, and a panel with Dr Jacky Davis from Keep Our NHS Public, Richard Stein of Leigh Day solicitors, and Usman Khan, former non-exec chair of the Camden and Islington Community NHS Trust in the late 1990s, we discussed both the current options as they seem for FHC and the proposed health reforms. The health reform discussion is summarised in the next post.

Statements from councillors

Cllr Martin Klute sent in a statement which is copied in full at the end of this post. In it he affirmed the Council’s solid support for FHC to be refurbished for community health services and outlined why referal hasn’t happened yet while they continue to gather evidence about funding and structures. He encouraged the set-up of a community trust. He is still taking evidence about the funding possibilities and structures, so the issue of referal will be deferred yet again on Oct 12 to their meeting on the 1st of November. As one supporter said, it’s staring to feel like Ground Hog Day.

Later on attending Cllr Raphael Andrews affirmed his support for both keeping services at FHC and for the idea of forming a community trust to push forward refurbishment.

Options for FHC

The chair laid out both the immediately past and current options for both funding and managing the refurbishment of FHC. To summarize:
LIFT: the one the PCT claimed it was ‘tied’ to, with same bank/building contractor/architect applied to each project, regardless of expertise. Lack of expertise responsible for the great inflation of costs in terms of risk. Part NHS/mostly privately owned. NHS pays no money up front, but is tied into a lease for 25 years, paying off a mortgage at commercial rates. Thus the £1 million yearly rent figure = £25milion for what they estimate will be a £9.1 mil project.

NHS direct funding: Well. Islington PCT has been running an average £5 million capital surplus over last ten years, which is around the amount the Council’s experts claimed is needed for full refurbishment. Now they’re saying that across the five boroughs of the secretive North Central London Sector Trust, only £14 mil is available, and £2 million – or £1.8 million, or ca.£2.7 million, depending on which meeting you go to, is now dedicated to the unwanted Urgent Care Centre at the Whittington. These figures are also close to the cost of repairs needed after 15 years of  NHS neglect of the building. Many supporters have made a strong case that really the NHS should pay for refurbishment. On the other hand there has been such a great deal of bureaucratic obstruction over the years it seemed sensible to look at other ways of getting the actual refurbishment done.

Heritage of London Trust Operations (HOLT): Not-for-profit conservation trust, takes on both fundraising and project management of the refurbishment of historic buildings. HOLT Ops have a great deal of expertise, and have refurbished a building for another NHS trust in Walthamstow, Thorpe Coombe House. If they took it on, they would own the building, and with access to interest-free loans from the Architectural Foundation to make up any grant short-fall would be able to charge a rent far lower than under LIFT, undertaking also to maintain the building. HOLT has been eager to begin the project for over a year, and has suggested a £20k Options Appraisal. Not much more than Rachel Tyndall’s last pay rise.

Community Trust: This doesn’t rule out working with HOLT, could oversee the redevelopment of Pine St and give a stronger voice to the community whatever happens. Grant funding is much easier to get as a not-for-profit, but if it were instead of working with HOLT, we would lose their experience and expertise. Has the support of Council. (The chair was told later that HOLT often turned properties over to community trusts after refurbishment, after the discussion.) Many FHC supporters have said they would donate to a refurbishment fund. (Lord) Chris Smith has offered to be a patron, as has Lubetkin’s daughter Sasha. Both this and the HOLT options, however are still awaiting co-operation from the PCT, and although there have been noises from them in the press about using this option, there has been no official turn-around. The chair expressed SaveFHC’s determination that any Trust will be to get full refurbishment and modernisation done.

Yes to a community trust

After a short question and answer session about these options, Richard Stein spoke about FHC’s important place in the NHS, and his work representing people who question the drive towards privatisation. Usman Khan spoke about how he and Chris Smith had tried to see how FHC could be refurbished in the late 1990s, but how these plans failed through lack of money and because FHC never quite seemed as pressing as other issues at the time, like the Northern Hospital. Our campaign has finally brought it to the fore and he hopes it will succeed.

The discussion afterwards ranged widely,  from the particulars of ownership under HOLT or a community trust to moving testaments to the building’s enduring place in the community’s heart. One experienced local trustee said setting up a trust is actually a fairly straightforward process once people are gathered for it; several people offered to help with a working party to look into the practicalities and set one up.

At any rate the current ad hoc organisation of this campaign has to change. A meeting to pursue a community trust will be called in the next few weeks, watch out for it. There will also be video from the meeting up on our website soon.

Cllr Klute’s statment

Hello, Cllr Martin Klute here.  I’m really sorry I am not able to be present this evening, but unfortunately this meeting clashes with a Planning sub-Committee, which, since the elections, I have been appointed to chair.

The Battle to save Finsbury Health Centre seems to have developed into two halves:  The battle to establish the principle that the building should be retained in public ownership and continue to provide the multiple health services that it already delivers, and the battle to get the building restored to its original glory as an icon of public service for ordinary people.

I believe we have won the psychological battle to save the building.  The combined efforts of the campaign (including the tireless energy of Barb Jacobson), and the Council’s scrutiny of the PCT’s proposal to abandon the building, have demonstrated beyond doubt that it is in the best healthcare interests of local patients and the population to retain the building and restore.

However, the financial climate has changed dramatically since the campaign began, and even since the Health Scrutiny Committee completed its investigations. And whereas we previously demonstrated that properly costed restoration by the PCT would in itself offer better value for money than moving to new premises, the PCT have now been stripped almost entirely of any capital funding, and face imminent abolition.  The reserve option of funding the restoration via a charitable trust would now appear to be the only possible option, since the PCT simply don’t have the funds.

The Committee heard further evidence last month from Dr Richard Sykes, who Chaired the Trust that restored the De La Warr pavilion in Bexhill using a very similar funding model, and we were heartened to hear him suggest that the chances of sourcing heritage funding for the project are still quite high, because the buildings proposed use on completion of the restoration is known and certain.  We are also aware that the building is a highly respected architectural icon, being held to be one of the most important 20th Century modernist buildings throughout the world, and I suspect that a number of philanthropists with an architectural interest could be persuaded to help.

We had a robust discussion at the last Health Scrutiny committee about whether the closure decision should be referred to the minister immediately, or whether it should be delayed whilst we look more carefully into the charitable funding options.  In the end my view that we should resolve to refer but delay pending further information on funding was supported.  Since then I have been made aware of legal correspondence between solicitors representing certain aggrieved patients of the Health centre and the PCT. And in the PCT’s response,  was the statement, that at the time of their Board meeting which considered the Scrutiny Committee’s recommendations, and I quote, “there were no proposals on the table which the PCT could accept to enable third party charitable ownership to be developed”. Clearly, if this view were to be put to the minister without the benefit of robust evidence that charitable ownership is an option, any referral could fall at the last fence.  The scrutiny committee, with the help of John Allan and Barb Jacobson are currently engaged in obtaining evidence of firm and potential interest in the project, and also in setting up a Community Trust with the potential to engage in delivering the project.

Evidence sessions relating to funding are scheduled to take place shortly after the next Health Scrutiny Committee meeting, so there will be little progress to report on that date.  In the mean time however, if anyone present has an interest in and/or experience of membership of a building restoration trust, and thinks they might be interested in getting involved, can you please speak to Barb Jacobson, or contact me via email at the Town Hall.

Thank you for listening, and have a good evening.

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