A special report by Melksham Neighbourhood Plan Steering Group in conjunction with Melksham News
Melksham Hospital on Spa Road has occupied an honourable place in the affections of residents of the town and the surrounding villages for almost 70 years, since it was formally opened by the then Marquis of Bath on 27th July 1938.
Today the hospital provides some hospital consultant clinics; podiatry, physiotherapy, specialist children’s services and X-ray services; is home to a GP surgery, which is seeking relocation elsewhere; and is the base for the successful community nursing teams who cover both Melksham, Bradford-on-Avon and their surrounding villages. Space is also used for the Great Western Hospital (GWH) Foundation Trust administrative purposes.
But it could be under threat in the future, says local campaigners, the Melksham Neighbourhood Plan Steering Group (the MNPSG).
There are three reasons for this:
1: The hospital is spread out and becoming too expensive to heat and maintain;
2: Increasing demand pressure on local healthcare services from the growing population;
3: Possible changes in future ownership of the hospital site.
The site
The hospital was built as a result of a bequest of almost £200,000 contained in the will of the late Mrs Louisa Ludlow Bruge. To commemorate this generous donation, a ward is named after her.
The single storey building covers a large area, which is becoming increasingly expensive to heat and maintain. It also means walks along long corridors for staff and patients to access the facilities. In short, it is becoming too expensive to meet the modern standards of healthcare facility that society now expects.
Over the succeeding years, other benefactors, the fundraising efforts of the Friends of Melksham Hospital, and NHS investment have enhanced the facilities that were available to local people.
These included minor injuries, physiotherapy and X-ray services – only some of which are still provided today.
Increasing Pressure
For many decades, clinical support for the hospital was provided by local GPs. Many people still do not realise that GP surgeries are private businesses, albeit delivering services under contract for the NHS. Some years ago, local GPs decided to withdraw their clinical support for the hospital.
Over the past few years hundreds of new homes have been built and the local population has increased to over 27,000. Hundreds more houses are expected to be developed over the next ten years to meet government and Wiltshire targets.
All three of the GP practices operating in the town are located in close proximity off Spa Road. Many people find these inconvenient or difficult to access by public transport.
On paper, these three surgeries have around 20 doctors, which is sufficient to meet the needs of the community. In reality many of these doctors do not work full time – some work only three days a week. Doctors have noted significant levels of deprivation in their patient groups. It has also been reported that it is becoming increasingly difficult to recruit GPs to work here – a Wiltshire and national problem.
Local GP surgeries are already struggling to cope with increasing demand from existing patients. Current pressures on local health services is bound to increase as even more houses are completed, made worse by an increasingly aging population.
Melksham GP surgeries do not provide any minor injuries services, thereby forcing people to travel to Chippenham, Trowbridge or even to the RUH in Bath. In some cases, this can place unnecessary pressure on local ambulance services if people then choose to dial 999.
Public feedback shows this is a significant inconvenience and irritant to local people.
The situation is not helped by continuing delays to the plan to relocate one practice from cramped accommodation at the hospital to the campus development; and a 40% cut in the amount of space now available at the new campus for the new surgery raises viability questions.
It is also understood that NHS funding has not yet been confirmed for any GP provision at the campus site.
No-one doubts that local clinicians are committed to provide the best possible services to their patients, but it is equally true that complaints about the long time delays in getting access to see a doctor when patients think it is needed are increasing.
And there also appears little appetite amongst local GPs to provide cover to restore the Minor Injuries Unit and assessment beds.
Changes in hospital ownership
For the early years of its existence, Melksham Hospital operated as a Trust, but this changed after the advent of the NHS in 1948.
Currently ownership of the title to the Melksham Hospital site rests with the Great Western Hospital (GWH) Foundation Trust, based in Swindon, who won the contract to provide community care services across Wiltshire.
Over recent years Melksham Hospital has lost both the provision of hospital beds and eventually the closure of the minor injuries unit. This was to meet GWH operational priorities, who argued at the time that these closures were necessary to manage the spiralling costs of community care and in the interests of patient safety.
Key questions…
We understand this community care services contract is coming up for re-tender and this begs a series of key questions…
• What happens to the Melksham Hospital site if GWH fails to win this contract?
• Can GWH hold on to the site and dispose of it as it pleases?
• Would GWH be forced to pass the site on to the winning bidder, who might have tendered on a basis that has no use for the site? And could the new operators then be able to sell the site?
• Could the site pass to some central government department to do with as it pleases?
Local people may have little say in the outcome of each of these scenarios, and the local area may not even benefit from any income generated if the site is sold.
This, we feel, is completely unacceptable.
So now is the time for local people to have their say and to play a role in the future of healthcare locally.
What are the options?
There are number of possibilities that would see an active role for the local community.
1. Use powers in the Localism Act 2011 to designate the Melksham Hospital site as a ‘community asset of public value’. This would give local people more of a say about how it might be used or redeveloped.
For instance, the community of nearby Tetbury took over their local hospital and successfully run it as a charitable Trust providing a wide range of NHS and private healthcare services – is this a model worth exploring here in Melksham?
2. Sell the hospital site and Canberra Youth Centre site next door and use the money to provide new state-of-the art health facilities on a new site in Melksham.
The Canberra Youth Centre site is now vacant and Wiltshire Council is seeking alternative land-use proposals including for new housing development. Both sites together would generate significant revenue.
3. Join forces with the Wiltshire Air Ambulance who are looking to move to a new site on the edge of Melksham. Could a new health centre become part of these plans?
4. Create a charitable Trust in Melksham to offer healthcare services: • perhaps in the current hospital buildings if they are not too expensive to maintain; • or in a new building built at the back of the present site or adjoining Canberra site; • or on a new site elsewhere in the Melksham perhaps linked to a new GP facility.
It may be necessary to safeguard land in the proximity of the existing Giffords and Spa surgeries to allow future expansion of buildings and car parking facilities.
5. Provision of an accessible GP surgery located elsewhere in the Melksham area. Public meetings have already indicated significant public support for this. This could run in conjunction with any of the above proposals.
The way forward…
Much further work will be needed to explore these options. But the Localism Act 2011 gives local communities specific rights to ‘bid’, to ‘build’, and to ‘challenge’ and could be used for the Melksham community to have a much greater say in the running of healthcare locally.
These rights give local communities a fairer chance to save private or public ‘assets of community value’ that are important to them; to undertake small-scale, community-led developments; or to run the whole service or part of a public service where they believe they can do so differently and better.
The Act also provides for the production of a Neighbourhood Plan to give local communities the statutory right to have more say in how land is developed in their towns and villages.
Work is well under way to produce such a statutory plan for the areas within Melksham Town and Melksham Without Parish Council boundaries and the surrounding villages.
Already hundreds of comments, ideas and views have been contributed about how the town and surrounding areas should be developed over the next ten years.
As part of this, the MNPSG has discussed and identified several land use options to meet the increasing demand for health services in Melksham and its surrounding villages.
Any comments or suggestions you make could become part of this process.
So what do you think?
We would love to hear your views – either on the above opportunities or other ideas of your own that we may not yet have identified.
Email news@melkshamnews.co.uk or write to Melksham News at 31 Market Place, Melksham. SN12 6ES.
You can also email your views and comments to: mnpsg@mail.com visit their website at: melkshamneighbourhoodplan.org and sign up as a friend on their Facebook page – Melksham Neighbourhood Plan Facebook page.
