Local Updates

Chris sends out regular updates on issues within the constituency. If you would like to receive these newsletters please subscribe by clicking the button below.

SUBSCRIBE HERE

Dear constituent

It has taken far far more time than I would have wanted, but I am writing to let you know that the promise made by Southern Rail at the start of its franchise to introduce Oyster and Contactless Cards to Epsom and a group of stations in Hertfordshire is finally going to happen.

For passengers from Epsom, Oyster and Contactless will be introduced at Epsom by the end of March 2019. I will confirm the exact date nearer the time. Epsom will not be in a designated zone and fares will be broadly in line with what they are now (sorry, there isn’t money for a fare cut), but I hope this will make Epsom easier to access and use, and will end the situation where people arriving at Epsom expecting to be able to use Oyster face a penalty fare.

Many commuters (including me) are continuing to face problems on South Western Railway. Although SWR usually gets the blame, in reality most of the problems are with the infrastructure, which is managed by Network Rail.

There are some inbuilt problems with the way the SWR network is working at the moment, and earlier this summer I commissioned a senior rail figure, Sir Michael Holden, to review the way in which SWR and Network Rail operate together on this network, and he has identified a number of improvements to the way the railway should work. These are now starting to be implemented.

However as many of you will be aware, there have been particular problems in the last few weeks, and I have been putting pressure on the new boss of Network Rail to tackle these. As a result, there have been major changes to the management of the local Network Rail route, with a new Route Director brought in this week to try to fix the immediate issues. I saw the Chief Executive of Network Rail earlier this week, and also asked him to make sure that our local route gets access to additional investment to tackle the current problems.

All of this won’t mean easy solutions. One of the biggest issues is about the capacity of the network to cope. At peak times there are 19 trains an hour going through Wimbledon on our suburban line into London, which makes it as busy a railway as any in the world. That makes the timetable is so tight that a late running train can throw the whole timetable out of kilter. That is why sometimes trains run fast to try to keep the timetable reasonably in shape, though that only happens if there is an alternative close behind. I am encouraging SWR to keep these to an absolute minimum.

But there are also deeper problems with the way the railway is working, and you may have seen that in my national role I have started a process that will lead to a comprehensive reform of the way that rail works in this country. More on that in due course.

On a more positive note, Waterloo International Station will reopen as a permanent extension of the main station in about ten days time. I hope this will help ease some of the pressures there.

Best wishes

Chris Grayling

Dear constituent

You may be aware that there is a mounting effort to stop the ill-judged plan by the Epsom and St Helier Trust to sell off a part of the Epsom Hospital site for development as housing.

The Trust Board has decided that a part of the land, including Rowan House, the red-brick building at the back of the site, and a section of the site adjoining it, are no longer needed.

However last year the Chief Executive Daniel Elkeles gave a written promise not to sell off any of the site until the long term future of the hospital is resolved. That promise is now being broken.

Last year, with the future of local hospitals starting to be discussed again, I sought an assurance from him that he would not pursue a sale while that discussion was going on. This was his reply to me.

I can confirm that I agree with your condition that we can’t sell land on the Epsom hospital site until we have arrived at a consensus on the range of clinical services that will be provided at Epsom for the future and so know how much space we will need.  So we will not put any land up for sale in 17/18 at Epsom and will only do so in 18/19 if we have arrived at the long term answer. 

Yet he is continuing to push for a new build acute hospital to serve the whole Trust area, and no long term decisions about this have been taken. I find this hugely frustrating, and it means once again that community pressure will have to be brought to bear against the wrong decision by local hospital management.

The Trust claims that it needs the money to balance its books. But the Government has just announced a big increase in funding for the NHS in the next few years, and our local Trust is in fact in a better financial position than many others elsewhere.

It is certainly true that money needs to be spent on improving Epsom, and the Trust claims that the proceeds of the sale will help do that. But with extra money on the way, and no firm decisions about the future, the danger is that a sale will take place, will remove options for the future, and cannot be reversed if it proves to be wrong.

I would be happy to see the site used to improve the availability of social care beds locally. I think there would be a logic in having a new facility aimed at supporting the frail elderly next to the hospital, to provide better all-round care for them. I would also support the building of another block for staff accommodation on the site.

But the current plan is to build 195 new houses and flats on the site, with more than 170 parking spaces, some of which would have to be built on “parking podiums”. I struggle to see how this could possibly fit with the surrounding area.

We do need to build more houses locally, but we will also need space for the NHS services that the occupants of those houses will need.

The Trust is an independent body, and so neither I nor any local politician can force it to change its mind, but it made a promise and I am pressing the directors very hard to keep that promise.

The next meeting of the Trust Board is in Conference Room 1 at Epsom Hospital on Friday August 10th at 9.30 am. I would encourage everyone who can to attend that meeting and make their views known in the strongest possible terms.

Best wishes

Chris Grayling

Dear constituent

I am writing to you with an update on the local NHS. You may have seen this week that the local NHS has launched another local consultation about the way it runs services in future. Like many of you, I suspect, I think it would be better if they got on with the day job rather than carrying out yet more consultations.

This latest exercise is bound to be seen in the context of future decision making about Epsom and St Helier hospitals. In fact I have been told by the local Clinical Commissioning Group, which oversees our local services, that this is not an exercise that is purely about hospitals. They want to discuss how services should be run for patients in both the community and hospital environments in the future.

All of this is yet another distraction for the team at Epsom Hospital who continue to do a really good job for patients. The hospital is meeting its targets better than most others in the NHS and it has a first rate team of people working there. There have also been some very good improvements on the site, which I saw when I was there last week.

You will hear all kinds of rumours in the coming months, particularly with the Trust continuing to argue that there should be a new hospital in Sutton, but my view is this. It remains the case that no senior person in the NHS has told me that there is money available to build a new hospital locally. There is undoubtedly a problem with a number of the buildings at Epsom and St Helier, but it is performing too well as a hospital trust to be seen as in urgent need compared to some others. If and when this changes, I will tell you, and I will also carry out a proper consultation exercise with my constituents to see whether you all support the idea of a new hospital, or whether we should defend the status quo. Clearly if a new, single hospital is ever seriously proposed, I would argue for it to be at Epsom – but the reality is that the push in the NHS would be to locate it alongside the Royal Marsden hospital in Sutton. For now, though, any such development remains a distant prospect.

In the meantime, you will be aware that the Trust continues to want to sell off part of the Epsom site which it says is not needed. I am strongly opposed to any sale which does not keep the land for use for health and social care purposes. I am now working with the Borough Councillors on a cross-party effort to makes sure that this is what happens. I will keep you posted.

Best wishes

Chris Grayling

I am writing to you with an update on a number of local issues.

You may have seen reports that the Chief Executive of the Epsom and St Helier Trust has announced a plan to sell a significant part of the land at the rear of the Epsom Hospital site. His argument is that the sale will allow him to balance his books and spend the proceeds on improvements to the Epsom site. I have been clear to him that I am very unhappy about his plan and could only support it if the land is used for more health or social care facilities.

Last year he promised me that there would be no sale of Epsom land unless and until there was a clear resolution about the long term future of the Epsom site. That is not yet the case, and so I regard this decision as premature as well.

Over the next few days I will be having discussions with senior people in the NHS in an attempt to either get the current process halted or to secure an absolute guarantee that the sale will only be used to bring another health or social care organisation to Epsom. I will let you know how I get on and whether or how we need to talk about further action as a local community.

Many of you will share my unhappiness about the recent performance of South Western Railway on the line into Waterloo. Much of the problem has been caused by track and signal failures, controlled by Network Rail, rather than by the train company. However the situation has still not been good enough and so in my national role I have insisted that the situation is sorted out. The two companies have now set up an operational review of what is going wrong and I hope this will lead to rapid improvement.

Like many of you I am hugely frustrated by the much too slow progress towards pay as you go ticketing at Epsom. This has proved much more technically and operationally complex than anyone had realised because of fare structures and systems issues. This really matters because if we can’t get the promise for Epsom finally fulfilled, and for the stations in Hertfordshire that were also expecting integration into the Oyster system, then we cannot deliver a proper smart ticketing system across the South East either. I hope to provide you with positive news shortly, but it is very firmly on my agenda to sort things out.

I have been asked for assistance by two local charities who need volunteer support. Cruse Bereavement Support is looking for a new local Chair to head their trustee board. The Epsom Hospital Medical Equipment Fund are also looking for new volunteer help. Please let me know if you would like me to put you in touch with either of them.

You may have seen that I have volunteered to be Parliamentary Species Champion for the hedgehog. The species champion scheme is a worthwhile one run by several conservation charities and has individual MPs who raise issues with Ministers or in Parliament about threats to their species – and who help them in their conservation efforts.

Hedgehog numbers have been in rapid decline, though they have started to rise again in urban areas. I haven’t found any where I live in Ashtead, but I am always interested to hear of sightings locally (thanks to everyone who has already been in touch) and please do let me know if you see any in and around our area. You might also want to make sure that you have a small hole in your fence as garden fences make it very difficult for them to move around.

Next week is in fact hedgehog awareness week. Expect to hear more about them and how you can help in the media.

Best wishes

Chris Grayling

Dear constituent

Part-time work in constituency office

I am currently looking to recruit a temporary assistant to work in my constituency office in Ashtead. The role would involve responding to enquiries from constituents in a sensitive and confidential manner, helping arrange constituency surgeries and some event management. Ideally the role would be combined with administrative support for the Epsom and Ewell Conservative Association as well. It would be on a part-time basis, with flexible hours to fit in with other commitments, and initially for a period of three months. If you would like to find out more, please send a CV to [email protected]

166 Bus Route

There are doubts about the future of the 166 bus service which is operated by Transport for London and runs between West Croydon and Epsom Town Centre. I won’t have a direct say over what happens (local bus services like this fall under the remit of Surrey County Council rather than the Department for Transport) but I am very concerned about possible changes to the route and the loss of the link to Epsom Hospital and Epsom town centre. I am pressing London Buses and the county council to find a sensible solution and will let you know as soon as I have some news.

Charity of the Year

I am delighted to announce that I will be supporting Love Me Love My Mind as my chosen charity for this year. Love Me Love My Mind is a small charity based in Epsom Surrey which aims to promote better understanding of mental health and to support the wellbeing of everyone in the community. They organise the well-established Epsom Mental Health Week in addition to supporting the community on a weekly basis with drop in sessions and self-help groups. I will keep you updated about events and activities I will be doing to support them throughout the year. www.lovemelovemymind.org.uk

Warm Home Discount

British Gas have reminded me that applications for the Warm Home Discount are still open. The Warm Home Discount is a scheme which allows some constituents a rebate of £140 off their electricity bill. You may be eligible if you get the Guarantee Credit element of Pension Credit or if you are on a low income and meet British Gas’s criteria for the scheme. You can qualify if you use a pre-pay or pay-as-you-go electricity meter. Further details at http://po.st/W_H_D

With best wishes,

Chris Grayling

Dear constituent

I am writing to you ahead of Christmas with an update on some local issues.

There is good news about Epsom Post Office. After months of uncertainty, the Post Office has now secured a permanent location for the office. It will open early in the New Year in a new card and gift shop at 59, High Street. I wish the new team all the best for the new shop and Post Office and hope this will secure its long term future.

The Planning Inspectorate have rejected Aldi’s appeal to build a new supermarket on the old dairy site in the Upper High Street. I am very pleased about this, as Epsom needs to use sites like this for flats and not to build yet another supermarket.

Some of you will be aware that there is a question mark over the future of the 166 bus from Banstead to Epsom Hospital. The bus is specified by Transport for London and I have spoken to both Surrey and the Transport Commissioner to try to secure the future of the route. Its future is in doubt because it crosses the London boundary. I am working hard to try to sort this out so that the route continues for the future.

Those who are commuters will know that the services to London have been pretty shambolic recently, particularly into Waterloo. Most of the problems lie with Network Rail, which is the public company which reports to my Government department. There were problems after the works in the summer because of a signalling glitch – but this was resolved in later engineering works in November. I am profoundly unhappy that things do not seem to have improved, and have summoned both Network Rail and the new train operator, South Western Railway, to an urgent meeting this week to identify how we solve the problem.

In slightly better news, you may have seen that the extended 10 coach trains are now being introduced fairly rapidly, which at least means more space in the rush hour.

On a different subject, you may remember that I chose to support Age Concern in Epsom this year. I am very grateful to the Soundbytes choir who agreed to hold a concert for Age Concern last week, raising more than £1200.

Finally my Christmas Card competition this year was won by eight year old Ana Fialho, who goes to St Martin’s Junior School. Well done to Ana.

I have attached a copy of the card for you, and would like to wish you and your family a very enjoyable Christmas, and a happy New Year.

With best wishes

Chris Grayling

Dear constituent

I wanted to update you on a number of local issues.

Firstly, the latest on the future of the Hospital. The Epsom and St Helier Trust has now completed its informal engagement programme with the public. They have now said that they believe they have public support to ask the NHS to move ahead with the construction of a new hospital. But they have been careful not to express a preference between Epsom, St Helier and Sutton – though it is clear that the preferred option of the leadership is for a new build on the Sutton site.

However as I indicated to you in my last email about this, I have spoken to many senior people in the NHS and it is clear that whilst the Trust leadership wants to build a new hospital, this doesn’t appear to have much support elsewhere in the NHS. The Government is providing additional capital funding for the NHS, but this is almost certain to be spent on smaller projects. As I have said before, if the prospect of a new hospital locally becomes a real one, then we will need to have a serious debate about the plans. Right now, though, there is no immediate threat to the future of services at Epsom, and if anything I am frustrated that this exercise has raised both concerns and expectations without the Trust having secured wider support in the NHS for what it wants to do.

In the meantime, Epsom Hospital continues to perform pretty well, and the Trust is one of the best performing in the country in its current form.

I will be keeping a careful eye on all of this, and will update you if anything looks like changing.

The latest news on Epsom Post Office is more positive. After several months of either no post office, or a temporary one in the Town Hall, a new Town Centre site has been located for a permanent post office. I am hoping that the new office will open early in the New Year.

The new 10 coach trains have started to arrive on the line to Waterloo. Over the coming months we will see the steady introduction of the longer trains, meaning 20% more seats in the peak. I was checking the timetables a few days ago, and there will be 12 ten coach trains from Epsom to London between 7 and 8 am next year. Ten years ago there were only eight, and they were only eight coaches long. It’s a step in the right direction.

Congratulations to the winners of this year’s Epsom and Ewell Business Awards. There was a really strong field of entries, and some really deserving winners, ranging from small one person operations to well-known local companies.

The winners were Dastaan, a recently opened Indian restaurant in Ewell, run by award winning chefs Sanjay Gour and Nand Kishor. http://dastaan.co.uk/

Finally, the charity I have been supporting this year is Age Concern Epsom. Soundbytes Choir have kindly agreed to hold a concert to raise funds for the charity. The concert is being held at Christchurch United Reform Church, Epsom Road, Leatherhead KT22 8ST on Friday 8th December 8pm, everyone is very welcome.

I want to thank all the members of the choir for their support.

With best wishes,

Chris Grayling

Dear constituent

Firstly can I thank all of those who supported me in the recent election campaign. It is a great honour to represent this constituency, and I will continue to do so to the best of my endeavours.

There has been a significant development over the future of Epsom Hospital. The Chief Executive of the Epsom and St Helier Trust has today launched a public discussion about the future of the two hospitals, arguing that emergency and high end services, like maternity, need to be merged into a new building on one site. As I indicated in previous emails, he has been arguing that there should be a new hospital next to the Royal Marsden in Sutton for some time. But this discussion leaves open the option of building a new hospital at Sutton, Epsom or St Helier – a debate we have had many times before. I do not believe it is helpful to have that debate again now.

In particular, I do not believe it is helpful to our local community to keep getting caught up in a debate about how the NHS in London will operate in future. Some months ago, the regional leadership of the NHS in the South agreed in principle to Epsom being separated from St Helier, and for it to become part of a network of Surrey hospitals. I think this is a much better option for its future.

Decisions about the operational structure of the NHS are no longer taken by politicians, even at a senior level. They are left to the professional leadership of the NHS. But that will not stop me making a strong case for the future of Epsom, and I intend now to push for that divorce to finally happen. I will also involve people locally, across the community and across the political spectrum, as has always been the case when we have resisted pressure on Epsom Hospital in the past.

I will come back to your shortly with suggestions about how you can make your voice heard in this new process.

In the meantime, I have included below a copy of the letter I have sent to Daniel Elkeles, the Chief Executive of the Trust.

With best wishes

Chris Grayling

Daniel Elkeles
Chief Executive
Epsom and St Helier NHS Trust

By email.

9th July 2017

Dear Daniel

Thank you for briefing me about your plans for a public debate about replacing the acute services at Epsom and St Helier hospitals with a single, new hospital for the future.

As I indicated to you when we spoke, I have profound concerns about what you are doing. When I wrote to you about the issue earlier in the year, I was clear that I did not agree with your plan to go forward with yet another discussion about this issue with no clear indication from NHS England that funds would even be available for the construction of a new hospital. You have not been able to provide me with any such indication. This has happened several times before, and it is simply not right to start yet another debate about local hospitals without this.

In addition, I said that given your preference for building a new hospital alongside the Royal Marsden, you would need to demonstrate the clear support of the Marsden board before you could engage in such a discussion. I talked to the Chief Executive of the Marsden on Friday, and it is clear that no such support had been provided by the time you briefed me, and the issue was not due to be discussed until a board meeting later this month.

I therefore strongly disagree with your decision to reopen this discussion at this moment in time. Since you have done so, though, it is my clear view that Epsom should now be separated from the debate about the future of hospital services in South West London and that Epsom and St Helier hospitals should separate.

Epsom is a Surrey hospital, and as you will know, there have been extensive discussions in recent months in NHS England about splitting Epsom away from the Trust and putting it into a network of Surrey hospitals, where medical staff can gain experience by working flexibly in different hospitals at different times. Epsom has also been a pathfinder in shaping a new partnership between primary, community and secondary care, and its performance has remained very good through a difficult period in the NHS. I am confident that it has a bright future.

I discussed this issue with the regional leadership of NHS England in the spring and they indicated to me that they were supportive of this option.

So may I now formally request that you start a process of separation of the two parts of the Trust, and that you engage in discussions with NHS London and NHS South to make this happen. This will enable the discussions about the future of hospital services within London to take place without the complications around the future of a Surrey hospital.

Given the interest in the issue, I am releasing this letter to the local media. I will also be making the case that now is the time for “divorce” between Epsom and St Helier in the local community. I am copying this letter to the Regional Directors of NHS England, to my local CCG, and to Simon Stevens.

Yours sincerely

Chris Grayling

Your Content Goes Here

Epsom Post Office

The closure of Epsom Post Office is bad news, and has sadly come about as the result of a private legal dispute over the premises in which it was situated.  The closure is not intended to be permanent, and I am working with Epsom and Ewell Borough Council and the Post Office to try to identify new premises so a new branch can reopen elsewhere in the town as soon as possible.

Roadworks in Epsom Town Centre 

Major gas works are planned for East Street to allow the replacement of the old metal gas mains with new plastic pipe. At the moment the work is due to start in early February but Chris is pressing for a rethink given the other works now taking place in Epsom town centre.

Dear constituent

You may have seen yesterday’s press reports about the future of our local hospitals. The articles suggest that Epsom is one of a group of South London hospitals, of which one is expected to be closed completely. This appears to be based on a report by the independent think tank, the Kings Fund, about its impression of discussions in the NHS in London and relates to the current review of services in many parts of the country.

I have been aware of these discussions for some time. I have had a number of conversations with those involved both locally and in NHS England in thinking about the future of the NHS in our area in the past few weeks, and wanted to reassure you that I have heard no suggestion that the future of Epsom Hospital is in doubt as part of the current review of services.

As you will probably recall, the Epsom and St Helier Trust has been exploring for some time the possibility of a new hospital at Sutton which would absorb acute services from both Epsom and St Helier whilst leaving elective services at Epsom. I have always been sceptical about the viability of this plan because of the cost of building a new hospital, and my most recent information suggests that it seems unlikely to go ahead. If such a plan were to properly materialise, then we would need to have a discussion locally about it – there would be pros and cons for our area. But I don’t think this is likely to happen.

In the absence of such a plan, there is no threat to the future of Epsom that I am aware of. Our local GPs here in Surrey, who hold the budgets for our local NHS remain very committed to the future of Epsom, and if there are changes in London, I am not expecting Epsom to be affected. Indeed Epsom is currently a pathfinder in the development of a new approach to working that links together hospital services, social care and GP services, and is meeting its key national targets.

I will keep you posted if anything changes.

With best wishes

Chris Grayling

Dear constituent

I am writing with an update on a number of local issues:

Future of Epsom Hospital
The Chief Executive continues to argue for a new build hospital on the Sutton Hospital site, with a lot of services integrated with the Royal Marsden next door. His plans would leave outpatient services and planned care, like that provided by the Orthopaedic Centre at Epsom, but would transfer emergency services to Sutton.

As I have indicated before, I remain sceptical about the viability of the idea and the concept is still very much on the drawing board. If the NHS centrally does decide that this is something that it does want to pursue, I will take soundings locally about what people think before deciding how to respond. But I don’t want to waste everyone’s time, or to raise the ante on the issue, unless and until this becomes a genuinely serious proposal.

In the meantime, Epsom is not one of the hospitals highlighted recently as facing possible service reductions, and the Epsom and St Helier Trust is seen by the NHS as doing a decent job in tackling its financial issues.

Oyster and Southern Rail
As you will probably know, I was appointed Transport Secretary when Theresa May became Prime Minister in July. Sadly this doesn’t mean that I can automatically order Oyster cards for Epsom and rezone the station – there are strict rules (rightly) to stop Ministers doing pet projects in their own constituency. However the issue is now firmly on the agenda given the promises made in 2014.

In addition, there is a firm requirement in the South West Trains franchise renewal process for the introduction of Oyster or a similar system as part of that new franchise as well. But that’s a couple of years away – and I don’t want us to wait that long.

So whilst things are happening much too slowly, I am pushing to get this sorted as quickly as possible.

I am, though, working as hard as I can to ensure that the problems on the Southern routes are dealt with as quickly as possible. The industrial dispute remains an ongoing issue. But it is not the only problem.

At the moment GTR, the train operating company, runs the trains, and Network Rail runs the tracks and the signals. But if things go wrong, the tendency is for those involved to blame each other and not work together to sort them out quickly. That must change now. So I am establishing a Project Board, which will be led by one of the most senior figures in the rail industry, to fix this, and to create one single team that works together to run this railway better.

In addition, there are too many little breakdowns which cause chaos on the network. So I’ve put in place a £20m scheme to tackle some of the causes of these breakdowns.

Southern have also started to put back some of the services that were withdrawn temporarily in the summer, and I hope the rest will return shortly. I can’t promise overnight improvement, but I am determined that we will sort things out and believe that things will start to get better.

Epsom and Ewell Business Awards
The closing date for nominations for this year’s Epsom & Ewell Business Awards is at the end of this month. This is the sixth year that we have organised the awards, which are designed to give local people and businesses the chance to nominate firms or businesses that have done a particularly good job for them over the past year. Please do go to the website, www.epsombusinessawards.co.uk, and nominate someone who has done a great job for you. Last year’s outright winner was Home Instead Senior Care. Congratulations again to them. Who will win the various awards this year? That’s down to you – they can only win if you nominate them!

7th Epsom Scout Group
On a different matter, I have been asked by the 7th Epsom (Methodist) Scout Group for help in finding someone who might take over as its new leader. The incumbent Neil Dallen is retiring, and I am grateful to him for all the work he has done for the scouts locally.

The local Scout organization tell me that the Group is “a significant contributor to the Borough of Epsom and Ewell and its young people. It is one of the largest scout groups in the UK, is financially sound and has its own purpose built Head-Quarters.”

If you are interested, please email Kevin Mead, via [email protected]net.com.

Dinner with Lord Dobbs (author of House of Cards)
Finally, as you know, I normally keep Conservative matters out of these more general emails. But for those of you with an interest in politics, on October 14th the Epsom and Ewell Conservative Association is holding an Autumn Dinner with Michael Dobbs, the author of the original House of Cards, and co-producer of the US version, starring Kevin Spacey. If you are interested in a ticket please clickhere for further information or order tickets online following this link 

I hope you had a good summer.

You may know that Epsom and Ewell is part of a group of four twinned towns, Chantilly in France, Watermael-Boitsfort in Belgium and Ueberlingen in Germany. This summer choirs from the four towns are meeting in Epsom for a three day choral festival. There will be events in different venues across the Borough, which will be publicised nearer the time. But I have been asked to pass round a request from the organisers to any music lovers (or others) who would be willing to host one of the members of the visiting choirs during their visit. They are here from the 30th June to the 3rd July. If you are willing to help, please let me know and I will pass your details to the organisers.

I have also been asked by the organisers of the Surrey Hills cow parade to let people know about their plans for later this year. From May onwards, you will see brightly coloured full-sized fibreglass cows start to spring up around the County. It’s meant to be a fun event for families to spot the cows around the area, but there is a serious end to it – the cows will be auctioned for charity at the inaugural Surrey Hills festival in September. You can find out more at http://www.cowparadesurreyhills.com

I promised to let you know about plans for a local debate as part of the EU referendum campaign. There will be a churches debate at St Mary’s Cuddington at 5pm on Saturday 11th June. I will be setting out the case for Leave and Tom Brake, the MP for Carshalton and Wallington will speak for Remain. For those of you who don’t know St Mary’s, it’s in The Avenue in Worcester Park, at the top end of Epsom and Ewell borough.

I will be holding the latest of my Business Breakfasts on Friday 29th of April at 8am at Epsom Golf Club. We will be discussing issues affecting local businesses. If you would like to come, please ring my constituency office on 01372 271036 or drop me an email.

I am writing to you concerning the EU Referendum. As you will know, the referendum is to be held on the 23rd June. For anyone who is likely to be away that day, you can apply for a postal vote via Epsom and Ewell Borough Council. Details can be found on their website, www.epsom-ewell.gov.uk. The ballot paper will ask you whether you want to remain in the EU or to leave.

There will be two officially sanctioned campaigns. These will be approved by the Electoral Commission in April. There is only one candidate for the Remain campaign – Britain Stronger in Europe. There are two different organisations applying for the designation as the official Leave Campaign, Vote Leave and Grassroots Out. The Commission will designate one of the two in time for the main ten week campaign. However the two are working together locally, holding a number of campaign events.

As you may know, I have decided to campaign to leave the European Union. A detailed explanation of my reasons is set out on my website, www.chrisgrayling.net.

If you are interested in joining the campaign to leave the EU, I am holding a drop-in meeting at the Epsom Conservative Club in Church Street from 1pm until 2.30pm this Saturday March 12th. The venue has not been chosen for political reasons – it is near the town centre, has an open bar, and a meeting room that is free! Everyone, regardless of political persuasion, is welcome.

Of course my job is to represent everyone in the constituency. I am not as yet aware of any locally organised Remain activities, but if anyone approaches me with an interest in that campaign, I will try to steer you in the right direction.

I want this campaign to be as constructive and sensible as possible – with a proper debate between the two sides. I am expecting to participate in at least one local debate about the issues, and I will let you know when that is happening.

Dear constituent

I am writing to you with an update on a couple of issues.

Firstly, the latest news on Oyster cards for Epsom. I had a letter from the Minister just before Christmas confirming that this is being worked on now, and whilst she did not this time give me a timetable for the change, she did promise me that officials are on the case and that it was her intention that it would happen and that she is “looking forward to its implementation”. I met her again last week, and she confirmed to me that work is progressing on when and how the introduction will happen. They are apparently trying to sort out some technical problems, as well as to work out how the Oyster fare system will interact with the current fare system at Epsom.

Secondly, the latest news about Epsom Hospital. You may have read that there are discussions taking place about the future of the stroke unit. The NHS has taken a national decision to have a smaller number of “hyper” stroke units to deal with the immediate impact of stroke. In London there has been a reduction in the number of stroke deaths after a similar change. There are now discussions in Surrey about how to approach this. There is strong pressure being put on those involved that even if Epsom is not chosen as one of these new units, it must retain a proper stroke unit to provide ongoing support for those affected.

The Epsom and St Helier Trust has also just published the outcome of the review of its estates. Among other things they are continuing to explore the option of a new hospital at Sutton, as a way of improving facilities. This is at the very early stages, and there is no evidence yet that this is a viable project. I will keep you posted.

As always, if you need to contact me for a surgery appointment, please ring the office on 01372 271036 or email [email protected].

I am writing to update you on a number of local issues.

Firstly, the hospital. You are probably aware, thanks to the hapless management consultant who explained loudly on a train what he was working on, that the Epsom and St Helier trust has started once again looking at the possibility of building a new hospital in Sutton to take most, but not all of the services currently carried out at Epsom and St Helier. Coming only weeks after the new Chief Executive announced that there would be no changes for at least five years this was, to say the least, very surprising.

I am not opposed in principle to a smart new hospital to serve our area, but I have seen all of this many times before, and am wholly unconvinced that this project is viable. When the news first emerged, the Health Secretary Jeremy Hunt made it clear that it was extremely unlikely that there would be money to build a large new hospital, and although the management believes it can raise the money elsewhere, I will take some persuading that a project on this scale can be funded in the coming years. I would prefer to see the financial problems in our local NHS – which never seem to go away – solved by the hospital, the mental health trust, and the GP and community services pooling resources to save money. And I do not support yet another consultation about hospital services locally, particularly when I have seen no evidence that this latest effort to take services away from Epsom is either affordable or realistic.

I will keep you posted, but would be interested to hear your views.

Like many of you I had been expecting Oyster cards to arrive in Epsom this month. It seems that this isn’t going to happen – and I am not best pleased. I am trying to get to the bottom of what has gone wrong, and it appears to be nothing to do with our line, but problems introducing the cards on a number of other routes outside London. It was all supposed to happen as one package, but there have been complications elsewhere, particularly on the Brighton line. I am in discussions with Southern and the Department for Transport about trying to sort things out quickly.  I am sorry about this delay, and will do everything I can to get things moving. I am assured that Oyster is definitely still on the way – it’s just a question of how long it will take.

The closing date for nominations for this year’s Epsom & Ewell Business Awards is at the end of this month. This is the fifth year that we have organised the awards, which are designed to give local people and businesses the chance to nominate firms or businesses that have done a particularly good job for them over the past year. Please do go to the website, www.epsombusinessawards.co.uk, and nominate someone who has done a great job for you. Last year’s outright winners were Spring Electrical of Ewell. Congratulations again to them. Who will win the various awards this year? That’s down to you – they can only win if you nominate them!

Meanwhile for those involved in local businesses, I am holding the latest of our Business Breakfasts on October 8th. The guest speaker will be Peter Martin,

Deputy Leader of Surrey County Council & Cabinet Lead for Economic Prosperity.  If you would like more details please email: [email protected] or ring 01372 277066.

I hope you were able to enjoy at least some of the summer (in between the rain).

Dear constituent

As you will know, we are now less than two months away from the General Election campaign, as well as local council elections across most of the constituency. We will also be providing campaign support from Epsom and Ewell to the Conservative campaigns in Sutton and Cheam and Kingston and Surbiton.

These are crucial elections for our area. The General Election will determine who is our Prime Minister after May, whether it is David Cameron or Ed Miliband. The local elections will determine who shapes our area for the next four years. Our particular focus will be on ensuring that the Council works to protect the character of our area.

We are keen to find additional people locally who would like to play some part in the campaign. If you are interested in taking part, whether as someone who is willing to deliver a few leaflets, help canvassing, provide support in the office, or to play any other part in the campaign, please do let us know.

We will be holding a campaign drop in session at our offices at 212 Barnett Wood Lane in Ashtead at 7.30pm on Monday 30th of March if you are free to come along and meet the team and get involved. Alternatively please email me via [email protected]

With best wishes

Chris Grayling

Dear constituent

I am writing to give you an update on a number of local issues.

Firstly, you may have seen just before Christmas that the local NHS Clinical Commissioning Group has run into financial difficulties because of work pressures in the NHS. In total it expects to have a deficit this year which amounts to about 3% of its total budget.

This situation probably sounds pretty familiar – we have seen similar problems at the Epsom and St Helier Trust in recent years and no sooner does one organisation seem to sort out its problems than the other starts to experience them.

My first concern was that this would lead to another discussion about the future of acute services at Epsom. But in fact the different organisations involved in our local NHS services seem to be taking a very welcome and rather different approach.

They have launched a project to find ways of joining up what they do and sharing resources rather than simply making cutbacks to make the numbers  add up. This involves a closer working partnership between the bits of the NHS that provide hospital, GP, community and mental health services.

It’s early days yet, but I am hopeful that this will lead to what I have argued for many years that Epsom should become more of a local health campus  providing a wider range of services to the area. I will keep you updated in due course as their work continues.

**********************************************************

I have had a meeting with Reigate and Banstead Council about the issue of backland development in Nork. I am concerned that the scale of development in some streets is still changing the character of the area inappropriately.

The new national planning framework should give local councils much greater autonomy over local development, as long as they have a credible plan that can support essential development. The detailed part of that work is currently under way in Reigate and Banstead.

The Council are planning detailed discussions with local residents over the coming months about how to find a better balance for the area in the next    iteration of the local Plan. I will keep a careful watch on this as I do think that development of many parts of the area continues to go much too far.

**********************************************************

David Baker has sent me a message saying that the Ashtead level crossing refurbishment timetable has now been confirmed. Work is due to start in August and will be completed over four or five weekends over the following six months. That’s the good news. The bad news is that the work  will involve a number of closures of the crossing.

The provisional dates are:
27th and 28th of August 17 hours
26th and 27th of September 12 hours
28th to 30th of November 28 hours
12th to 14th of December 28 hours
Plus possibly 17th and 18th January 12 hours

It will be a pain while the work is done, but hopefully when it is finished the breakdowns of the last few years will be a thing of the past. Residents will be getting more details nearer the time.

**********************************************************

For those involved in local businesses, I am holding the latest Business Breakfast on February 13th. The purpose is to share and discuss local business issues and network at the same time. If you would like more details please email [email protected]

**********************************************************

Finally, if you have a few hours to volunteer each month, the Friends of Bourne Hall Museum are looking for extra helpers in their shop. I said I would put the word around for them. If you are interested, do drop in to the museum. They would love to talk to you.

Dear constituent,

I am writing to you with a couple of local updates.

  • Firstly, I wanted to let you know that we have just launched the 2014 Epsom and Ewell Business Excellence Awards. I launched the awards three years ago to recognise great local businesses and business people, in what were difficult times economically. Happily things have improved since then, but the awards will continue, as they have proved a great way to celebrate local firms and local entrepreneurship, and they are a way for everyone locally to say thank you to someone who has provided good service locally.

The awards have now been established as a local trust, and will hopefully continue as a regular annual fixture locally. So I am writing to invite you to submit nominations for the awards. It might be that you want to say thank you to the local corner shop, the solicitors who have just done the conveyancing on your new house, or the nursery that looks after your children or grandchildren. The winners all get a trophy, extensive coverage in    the Epsom Guardian, and often other prizes.

You can nominate a business by going to the website www.epsombusinessawards.co.uk and filling in the form. Do go for it.

These are the categories and how we define what the best looks like.

Best Business for Commitment to the Community sponsored by TWM Solicitors

You are a business with focus on community issues. This award recognises companies that are investing in the community in which they operate and those in greatest need, achieving sustainable impact on key social issues in these areas.

Best Business for Customer Service – sponsored by National Counties

How do you WOW your customers? Do you go that extra mile to attract and keep them? Tell us what great customer service should look like and how it has benefited your business.

Best Business Personality – sponsored by Toyota (GB) PLC

A leading business person who can demonstrate outstanding achievement within their business or the community. The business leader should have passion, vision and the drive to succeed.  They should be a compelling leader who embodies entrepreneurial spirit and isn’t afraid to take risks and drive their business forward.

Best New Business sponsored thebestof Epsom and Ewell

Best business that has been trading for less than one year and demonstates potential for future significent growth. We are looking for innovative business ideas. Did you identify a gap in the market for something new or perhaps you are offering an established product service with a special twist? The judges will be more focused on future potential rather than an entrant’s ability to show turnover and profit growth at this early stage.

Best Business in Epsom & Epsom Downs – sponsored by The Ashley Centre

Any business that has shown exceptional performance across every aspect of its business from financial return, strong growth, innovative strategies and good customer service.

Best Business in Ewell & Stoneleigh – sponsored by Metro Bank

Any business that has shown exceptional performance across every aspect of its business from financial return, strong growth, innovative strategies and good customer service.

Best Business in Ashtead sponsored by Milners

Any business that has shown exceptional performance across every aspect of its business from financial return, strong growth, innovative strategies and good customer service.

Best Website of Use of Social Media – sponsored by 143 The Canopy

The company that can demonstrate great use of social media to promote or build it’s business or the use of a creative website to showcase it’s business.

Best Young Entrepreneur – sponsored by Ashtead Hospital

Someone who is under 30 years old and shows real initiative and and has made a dramatic impact on their business or in the community. We are looking for businesses to nominate that special employee, who has made a significant contribution during the year to your business. This award recognises the input an individual makes to their company’s success. 

  • Meanwhile for those involved in local businesses, I am holding the latest of our Business Breakfasts on September 25th. The guest speaker will be Matthew Hancock MP, Minister of State for Business, Energy and Enterprise. If you would like more details please email [email protected].
  • I have written to Lidl to complain about their action in demolishing the old Organ and Dragon pub on the Ewell by-pass. As you may have seen, they have lodged an application to build a supermarket on the site. Following the decision by planning inspectors to block plans for a KFC on the site, it seems strange that any company would think that it was an appropriate site for a supermarket, given the fact that the last application was blocked because it would generate too much traffic.
  • Finally it’s been a vintage year for local fetes and fairs. I have been to a number of school events, as well as bigger local occasions like Ashtead Village Day, Nork Music in the Park and Ewell Village Fair. I just wanted to congratulate everyone who has been involved in organising them this year.

With best wishes

Chris Grayling

Dear Constituent
I am writing to update you on a couple of local developments.

  • The first relates to Langley Bottom Farm, the land in and around the valley below Langley Vale and the racecourse. It has been mostly sold to the Woodland Trust, a charitable organisation which specialises in protecting and creating woodlands around the country. Their plan is to use the land to create a memorial woodland to mark the centenary of the outbreak of the First World War in 1914.

The plan involves planting trees on the majority of the site, with some open spaces, and walking areas throughout the farm. The trees will be traditional English deciduous ones, and not evergreens. There will be a car park and a visitor centre at the top of the site near the junction at the top of the hill on the way to Headley and Ashtead.

On the whole I think this is very good news. Whilst it will mean a change to the character of the land, it should also preserve most of it from other pressures in perpetuity.

  • However there is a sting in the tail. The sale of land does not include either the farm itself or the field immediately adjoining Langley Vale. Another field at the other end of the farm, adjoining Tadworth, has also been excluded from the sale, and is now being offered by a Middle Eastern firm as a development opportunity. I am concerned that the retention of the field next to Langley Vale means that there will be an attempt to extend the village by a street. I will be keeping a close watch on this, and will do everything I can to prevent this from happening.
  • Elsewhere, you may have seen reports that the Borough Council is examining the future need for Traveller sites in the area. As you may know Epsom and Ewell is a small borough and already has two sites for the traveller community, in Cox Lane and Kiln Lane. Whilst there is an identified need for sites in some parts of the country, I am wholly unpersuaded that there is any reason for this Borough to have more than two sites.

The Borough has not yet brought forward any detailed plans, and may in the end decide not to do so. But I wanted to let you know that I will strongly oppose any new development. I am keeping a careful eye on this, and will keep you updated if there is any further news.

With best wishes

Chris Grayling

Dear constituent

I am writing to update you on a number of the things that I have been doing recently and about some local developments.

• Firstly, you may have seen that the Better Services Better Value programme, which was the programme planning to reconfigure local hospital services, and was proposing the downgrade of Epsom Hospital, has been wound up.

I expect there to be continuing debates about the structure of hospital services in London, but there is now no reason for Epsom to be caught up in these discussions. Locally there are now interesting discussions taking place about bringing some additional services to Epsom, including some currently carried out on the Sutton Hospital site. The financial position of the Epsom and St Helier Trust has also improved and so I am more optimistic about the future of Epsom than I have been for some time.

• In Ashtead, I have been consulting residents who live beyond the level crossing on what they would like to see done to tackle the growing problem of blockages and breakdowns at the crossing. Thank you to everyone who replied.

• I have picked Home Start locally as the charity I am supporting this year. The charity is based near Tattenham Corner, and it provides mentoring and support to young families going through difficult times, or to young parents who need to build their parenting skills. https://chrisgrayling.net/charities/

It’s an important task, and it has a really good team of volunteers who do the work locally. We will be holding a fund raising dinner for the charity in September. I will send out details nearer the time for anyone who would like to come.

• Nationally, in my role as Justice Secretary, I have just published a new Bill which will, I hope, close a number of loopholes in the criminal justice system. In particular, it will end automatic early release for child rapists, terrorists, and a range of the rest of the most serious offenders. it will also extend the maximum sentence for people who play a small part in terror plots to life imprisonment if the court thinks they are a real threat to society. It also paves the way for a big expansion in the provision of education to young offenders when they are sent to prison to try to stop them reoffending,

• Finally, I was asked by a local businessman if I could organise periodic breakfast meetings so that people in the local business community can discuss current political and regulatory issues that affect them. The first one is being held at Field to Fork in Epsom on 28th March at 8am, please see the attached information. If you are interested in coming, please email [email protected]

With best wishes

Chris Grayling

I am writing following my email last week to let you know the result of the GPs ballot on the future of Epsom Hospital. I am very pleased to be able to report that our local doctors voted overwhelmingly to oppose the plans and as a result Surrey has now withdrawn from the Better Services Better Value programme, which was recommending the removal of A&E and maternity services from Epsom.

This is very good news and a tribute to everyone who has been involved in campaigning against the plans. I am grateful to everyone who came to the mass meeting at the racecourse and has helped in what we have been doing.

I am now expecting serious discussions locally about how to create stronger links between the hospital and community services, and I hope that our local doctors can find a better approach for the future than these seemingly endless attempts to downgrade Epsom.

There has been a little bit of confusion locally about what Southern and South West Trains are planning for the new electronic ticketing system that will be introduced locally in the next few weeks.

I spoke to Southern again on Friday and they have confirmed that our area will be one of the first to have the new system. Initially the new smart cards will just contain season ticket information, but over the next few months they will be converted to be able to contain credits in the way an Oyster Card does.

By the middle of next year they expect the cards to be useable across the London transport system.

I am still working to get the Department for Transport to include Epsom in zone 6 at the next franchise renewal in 2015 at the latest.

Dear Constituent,

I am writing to let you know that there has been a further development in the debate over the future of Epsom Hospital.

You will remember that my Surrey MP colleagues and I carried out a ballot of local GPs in the summer which showed a majority opposed to the proposal by NHS doctors in London to downgrade Epsom Hospital. After a lot of pressure, the local Clinical Commissioning Group, which is the local GP committee that decides which services will be provided locally, has decided to hold its own ballot. This will happen in the next few days.

Perhaps more significant still, the Governing body of the Clinical Commissioning Group is making it clear that it is not convinced that the proposals for reorganising hospital services, called Better Services Better Value, will actually mean better services in Surrey. In its letter it says The Governing Body fully acknowledges that BSBV proposes the highest standards of care for London services. However, that shared ambition must be balanced with the needs of Surrey and the current BSBV proposals may not offer the only or best solution for local patients.”

So I am quite hopeful that the GPs will again vote against the proposals for Epsom. If that happens, the Better Services Better Value programme will be dead, and these proposals will have to be scrapped.

So apart from keeping your fingers crossed, can I urge you that if you have the chance, you ask your local GP to vote against the plan to downgrade Epsom.

Along with this, the financial position at Epsom Hospital has improved significantly, and there is chance now that the Epsom and St Helier Trust might be able to get what is called foundation status, which would mean that it would be in a much stronger position to resist proposals to downgrade the services it provides in future.

I have been asked by Mohamed Rasool, who lives in Epsom, if any of you would be willing to get involved in setting up a local branch of the Diabetes UK Volunteer network as there is not one in Epsom and the immediate vicinity. Could anyone who is interested get in touch with Mohamed on 07788615858, or via email. His address is [email protected].

Hello there. I am writing with a couple of updates.

Firstly, there have been no further significant developments on the Epsom hospital front. There is no doubt that the Better Services Better Value team, the team of GPs from London which has been promoting the reconfiguration of local hospitals, is struggling somewhat, and it is clear that there is now a strong sentiment in the health community in Surrey in favour of a Surrey solution for the future of Epsom. There may yet be a public consultation on the way forward, but at the moment the project for major change looks like it is going nowhere.

On the Zone 6 front, I am still in discussions with South West Trains and Southern. They are in the process of introducing a new system of smart card tickets across the rail network – in the next few years this will be available across the whole country. You may have seen the new card readers at Epsom and Ashtead stations. But the issue I am pursuing is to make sure that Oyster comes to Epsom as well. I am expecting a further response in the next few days and will keep you posted.

You may remember that I told you the Epsom and Ewell Conservative Association’s main autumn fundraising event, the Late Summer Ball, will also be raising money for the Sunnybank Trust, an Epsom charity which looks after people with learning disabilities.

Firstly, there are still some tickets left for the event which is on the evening of Friday 20th September at Denbies. If you’d like to come to what should be a good evening, please email me and let me know. I will be moving round the tables so will hope to see some of you on the evening.

But in addition to that, we are also going to be auctioning a rather special item, a rare lithogram signed by the Russian artist Marc Chagall, it comes with a certificate of guarantee and authenticity. All the money raised from that sale will go to the Sunnybank Trust. Because this is such a special item, I wanted to give anyone locally who is interested a chance to bid for it. If you would like more details and a picture sent to you and if you’d like to lodge a bid, please email me at this address. I will let you know if you have been successful. We will keep all bids private until the appropriate point in the auction is reached, and we will then let the audience know that there is a private bid for the additional amount. Who knows, you might end up with a piece of art history, and it’s all for a very good charitable cause.

I am also looking for some part time help in the Conservative Office, if you have some spare time and would like to earn some extra cash, please email [email protected]

I hope you have all had a good summer.

Best wishes

Chris Grayling

Dear constituent

I wanted to let you know about this year’s Business Awards, and a couple of more political things I am pursuing locally, and which you might be interested in participating in.

Next year is the centenary of the outbreak of the First World War, and as part of the Conservative Party’s social action work, I am looking to get our local team involved in identifying and restoring or cleaning up any local war memorials which have become overgrown or scruffy. Most of our main memorials are well known and well looked after – but I have often found smaller memorials which are partially forgotten when travelling round the country. Are there any in our area that you have spotted which have been forgotten or neglected? If there are, could you please let me know.

We are currently taking nominations for this year’s Epsom and Ewell Business Excellence Awards. I started the awards two years ago to celebrate local success stories. The first year’s winner was Jelly Bugs Ltd, a smart new local company providing a range of party services for kids and operating fun cafe facilities for kids in both Kingston and Epsom. Last year’s winner was Ladysafe & Sons, which is one of our best known local taxi firms. This year’s awards have more of a local focus for individual areas of the constituency, with specific local awards for Epsom and Epsom Downs, Ewell and Stoneleigh, and Ashtead. This is designed to give you a change to vote for your favourite business in the area where you live. All the details are on the website, www.epsombusinessawards.co.uk. Please do get involved and nominate a local business that has done a good job for you.

Finally, you may remember that I picked the Sunnbank Trust as my charity to support for this year. It is a local charity which provides help, support, and friendship for people with learning disabilities. As part of this, we are giving a share of the ticket sales from the main Conservative autumn fundraiser to the charity. The event is a Ball on the evening of Friday September 20th. There should be good food and music, and if you are interested in coming and also doing something to support the Sunnybank Trust, please can you ring Sarah on 01372 277066, or email [email protected]

Hope you have a good summer.

Best wishes

Chris

GPs in Epsom and Ewell, Mole Valley, Reigate and Banstead and Elmbridge have voted overwhelmingly against the Better Services Better Value proposals to remove acute services from Epsom Hospital.  An even larger proportion said they wanted the future of Epsom Hospital decided in a Surrey context and not part of a London review.

The secret ballot, instigated by local MPs Chris Grayling, Sir Paul Beresford, Dominic Raab and Crispin Blunt, was sent to all GPs practicing in the new Surrey Downs commissioning area, and the result was independently counted and verified by the Returning Officer at Mole Valley District Council.

The new Surrey Downs Clinical Commissioning Group and the Better Services Better Value review team had previously said that local GPs were behind the scheme. But doctors voted by two to one against the plans for Epsom hospital to be downgraded and by more than four to one in favour of decisions about Epsom being taken in a Surrey context.

Chris Grayling said:

“We organised this ballot because we did not believe that local doctors really agreed with what is going on, and the result clearly shows that we were right. This vote was carried out in secret, was independently verified, and it shows that the controversial plans for Epsom are not just opposed by the public but by the doctors as well. I think this result marks the death knell of Better Services Better Value, and I hope that all involved will now call a halt and stop wasting public money on a review that, in the context of Epsom and Surrey, has never added up.”

The questions to the GP’s and voting results were:

Are you in favour of the BSBV proposals to remove A & E and Maternity Services from Epsom Hospital?

Yes 32%

No  68%

Would you support a separate process to consider the future of Epsom Hospital as part of the Surrey and not SW London health economy?

Yes 82%

No  18%

I am writing to let you know that there has been an unexpected development in the review of the future of local hospital services, including the future of Epsom. The so-called Better Services Better Value team was due to go to public consultation this month on whether to remove A&E and maternity from Epsom and St Helier hospitals. However following intensive pressure from campaigners locally here in Epsom and Ewell, and Mole Valley, and similar pressure in Sutton over the future of St Helier, the process has been delayed until at least the autumn.

Although the review team say that they are still planning to go ahead in the autumn, the delay means that it is much less likely that the process will continue as they had planned. This means at the very least that the threat to A&E and maternity at Epsom has been pushed back, and might be lifted altogether.

As you know from my previous emails, there have been a wide range of concerns raised about the failings of the process. I have written to the Chief Executive of the NHS in England asking for a full investigation of the process so far, which has been riddled with problems. The latest to emerge is that information about travel times obtained under the Freedom of Information Act from the South Coast Ambulance Trust shows that the actual blue light transfer times from the Epsom area to other hospitals apart from Epsom are much longer than the Better Services Better Value team had suggested.

I am now going to push for a proper, separate discussion about how best to organise health services in Surrey. I think that combining community and hospital services locally is a much better way of making sure that we keep costs down so that money can be spent on new treatments and drugs. This already happens with paediatric services in our area, and it could happen in other parts of the health system too. The delay provides a breathing space to look for alternatives for healthcare locally.

Because of the delay, we will not now be pushing ahead with campaign activity this summer. But detailed plans had been prepared for when the consultation went ahead, and we will simply deploy these in the autumn if necessary.

However I am hopeful that there will now be a real attempt to find a better future for Epsom Hospital than the rather clumsy London-focused review that we have seen in the last few months.

With best wishes

Chris Grayling

Dear constituent,

I am writing to update you on the outcome of the meeting at the racecourse yesterday on the future of Epsom Hospital. Unfortunately, but not surprisingly, the representatives of local GPs agreed to move to the next stage of the process. They agreed to the principle of the plans and to move ahead with a meeting of the different GP groups involved in this process in two weeks time, which will almost certainly confirm that there will be a public consultation on downgrading Epsom Hospital.

What was most disappointing was that the GP representatives made part of the  case for change on the basis of factually incorrect evidence, despite being challenged on the accuracy of what was being said. I have written to them following the meeting to raise concerns about what took place, and also to seek answers to key questions which remain unaddressed.

The one bright spot is that Dr Claire Fuller, who chairs the GP group, has in her reply to my recent open letter left open the possibility of retaining more than a midwife led maternity unit at Epsom. However we are still a long way away from securing agreement to that.

I have included below a copy of the response that she sent me, as well as a copy of the one I have just sent.

The Epsom Hospital Campaign steering group will meet this week to discuss the next steps in this battle. I am then planning to hold a meeting for those who are willing to become local organisers in the campaign on Tuesday 28th May, at 7.30pm.

Please can you let me know in advance if you are willing to offer practical help to the campaign and so want to attend the meeting, as this is not meant to be a big public meeting.  I will be sorting out the venue this week based on how many people are coming. After that I will send out a further email bulletin giving you details of planned campaign activities.

Thank you to everyone who came on Friday for the support they gave. There were around 700 people present, which should at the very least be an indicator of how strongly people feel about this.

With best wishes

Chris Grayling

*********************************************************************

Dear Chris,

Thank you for your previous correspondence on Better Services Better Value and you’re your continued interest in the programme. I have separated the concerns you have raised into broad themes and will respond to each issue in turn.

Possibility of developing a local solution for Epsom Hospital

I was also pleased with the level of interest at Surrey County Council meeting in developing viable solutions for our local health economy, and would welcome further discussions about how local services should be configured. I believe that there is a vision for Epsom Hospital emerging as a campus site containing services from a number of providers. Subject to consultation, this could see the retention of an expanded world class elective centre, perhaps augmented with surgery provided by specialist London trusts. There could be community in-patient beds, with a full suite of rehabilitation and reablement services provided by both the NHS and social care to ensure that people are cared for close to their family and friends and swiftly supported to return home. The site would retain full outpatient services but again specialist providers would be invited to provide services from the site to increase access. Rather than provide full emergency and full maternity services, Epsom would concentrate on continuing to provide the bulk of services to the local population, with specialist care moving to the major acute hospitals (as it already does in a number of clinical areas). We would wish to agree a model for urgent care on the site that ensured that the majority of people could continue to safely access services at Epsom. We also want a model that provides convenient on-site access to paediatric services and community paediatric support outside the grounds of the campus. Subject to demand and viability, we would also wish to have a model that continued to allow low-risk births to take place on the site.

Will BSBV proposals improve the quality of care for residents?

The proposals have been developed by senior clinicians from Surrey Downs and South West London and are based on best practice nationally as defined by the Royal Colleges. Not all of the clinical working groups had 100% unanimity, which is to be expected, and in some instances it was clinicians from Epsom and St Helier who were in the dissenting minority. We believe that centralising services has produced significant benefit in London in the treatment of stroke and major trauma and believe there is an opportunity to get similar improvements from centralising emergency care, higher risk maternity and in-patient paediatric services. With regard to maternity services, you rightly point out that that neonatal and perinatal mortality rates at Epsom are significantly lower than other BSBV trusts. The case mix at Epsom is significantly skewed towards “low risk” partially because of the demographics of the surrounding area, but also because complex cases during the antenatal period and pre-term babies are already transferred to St Georges in recognition of the requirement for more specialist care. Therefore the mortality rates do not indicate higher quality but the lower risk births seen at Epsom. For moderate or high risk pregnancies there needs to be a solution in place that has a high level of consultant cover and access to more specialist services, but lower risk pregnancies services could be offered at Epsom, either via a stand-alone midwife led unit or other service.

Financial concerns

The proposals will require significant capital investment as you rightly point out, but keeping services in their current configuration are also likely to incur capital costs, given some of the issues with infrastructure at hospitals like St Helier. As you are aware there is no guarantee of availability of capital, particularly before any strategic case is agreed, and this does present a risk. The Business Case does reflect the expected cost of capital in line with Treasury guidance. We have considered in detail the possibility of expanding Epsom to become a major acute hospital that meets the London clinical standards, but in the scenarios modelled the hospital has a recurrent deficit of £4.5 – £6.5m which would render it both financially unsustainable and unattractive to potential providers both public and private. In our view, regardless of BSBV, there would need to be significant changes in the services offered at the Epsom site. As local commissioners we would be joining any consultation process prepared to consider a range of alternative scenarios that could be capable of delivering the improved quality that we seek. It is true that Epsom and St Helier’s financial position has improved but they are not anticipated to reach break-even this financial year. Their Board are considering whether they have viable plans to get to Foundation Trust status which may require reconfiguration of services across the two sites irrespective of BSBV. The NHS Trust Development Authority has not publicly changed its view that Epsom and St Helier is not capable of achieving Foundation Trust status in its current organisational form, and I am aware that the Transaction process with Ashford and St Peter’s was halted because a break-even position was not attainable with the restraint on reconfiguring services at the Epsom site. The movement of activity from one provider to another as envisaged in BSBV is intended to increase quality, it would not per se, save any money for a CCG, however it would reduce operating costs for the overall health system and under the preferred options, ensure Epsom’s long-term financial viability. It would also provide the opportunity to maximise the site for other services, either for specialist providers to allow local access to high quality services or for community led services to ensure the need for acute care is minimised.

Conflict of Interest

I understand that you have received concerns from constituents regarding GP’s referring patients to private organisations that they control. These arrangements clearly have the ability to potentially inhibit patient choice and restrict the competition that they were designed to encourage. The CCG is working with its local clinicians, to ensure that none of our providers or practices are (intentionally or not) breaching guidelines. In discussion with our localities and practices we are considering whether to centralise referral and patient choice processes to remove any suggestion of conflicts of interest. I would be keen that you raise any concerns that you come across directly with me to ensure that they are addressed.

Impact on Surrey providers

The changes proposed in the Business Case have an impact on other Surrey providers, principally St Peter’s, East Surrey and the Royal Surrey hospitals. The travel impacts have assumed that if services move from Epsom, patients will chose their next nearest hospital. More patients may choose to travel to Kingston, St George’s or Croydon because of the enhanced standards, or more may prefer Surrey as you suggest, so our assumptions appear to reflect a medium position. The CCG’s in Surrey are committed to driving up standards at all Surrey hospitals over the same timeframe as the potential BSBV timeframe, although given that there has been far less preparatory work to date in Surrey, it is unlikely that they will be able to meet the same standards as London. The impacts are unlikely to create a large capital requirement for Surrey hospitals. Most hospitals are planning to reduce beds over the next few years as lengths of stay in hospitals continue to reduce and more community services support people, without the need for admission. If there is a greater flow of admissions into these hospitals then less beds will be redundant, meaning these could be maintained without capital cost.

Out of Hospital services

In your letter you raise a number of concerns related to the need for increased provision of services within primary rather than secondary care. The CCG has already developed services that are working in partnership with all providers to reduce or shorten acute hospital admissions, such as virtual wards, the Community Assessment Unit and community hospitals. This work will need to continue at an increased pace, and the BSBV proposals are predicated on further investment in primary care and community care to ensure that we have the necessary capacity to enable people to access the services they need. Surrey Downs CCG is currently developing a comprehensive Out of Hospital Strategy, led by clinicians within our four localities, to support this work.

Elective centre

We believe that the preferred option offers a great opportunity to not only preserve a nationally recognised elective orthopaedic centre, but to increase its scope to include the majority of elective surgery in Surrey and South West London. If this option is agreed following consultation and elective surgery therefore decommissioned at the major acute sites, the activity will either flow to the elective centre or commissioners will not pay for the activity. Other NHS providers are also interested in providing services at an elective centre at Epsom, recognising the economies of scale of having a critical mass of elective theatre capacity.

Movement of clinicians to London hospitals

As you note there will be a movement of senior clinicians to London trusts in order to drive up the quality and safety at the major acute sites. There will be a requirement that services are delivered in a networked fashion to ensure the continuity of high quality local services. Whilst in-patient paediatrics beds are proposed to be concentrated on major acute sites, we will retain paediatricians supporting out-patient services and community facilities such as those supporting disabled children on the Epsom site. The models are based on not changing the point of delivery of care for most people. Currently there is a big difference between what can be treated at St George’s and what can be treated at Epsom. The public already accept that if they have major trauma or require emergency surgery they will not be seen at Epsom, but the majority of people who currently attend Epsom A&E will continue to, under the new model. Only the sickest will need to attend the major acute hospitals where they will be met with the best standards of care 24 hours a day, seven days a week. I fully understand the concerns you have raised on behalf of your constituents and it is important that these are considered by us as local clinicians and by the Better Services Better Value programme to ensure any proposals are fully developed and will deliver improved clinical outcomes for our patients.

We understand local people are worried about any proposed changes at Epsom, however as an organisation we are committed to delivering better care for our local population. We believe there is an opportunity to drive up standards of care for our patients and it would be wrong for us to ignore this. As you are aware, safety and staffing issues mean we cannot continue to safely provide every service on every site and that means difficult decisions will need to be made. We will not shy away from these and we will continue to ensure patients, and their clinical needs are at the heart of any decisions we make, both in relation to Better Services Better Value and the healthcare we commission for local people. As you will be aware, each of the seven CCGs involved in the review are currently considering the proposals that have been developed at their Governing body meetings. If every CCG agrees, the proposals would then be subject to a three month public consultation. We will of course continue to involve you as the programme progresses.

Yours sincerely

Dr Claire Fuller Clinical Chair

Cc Surrey Downs CCG Governing Board members, Surrey Downs GP practices

*******************************************************************************

Dear Claire,

Thank you for your letter setting out your response to the issues I raised with you last week. I will make your answers available to my constituents.

However I am afraid that I am also writing to express my enormous disappointment at the way in which the CCG handled Friday’s meeting, and at the way in which inaccuracies in the presentation to the Governing Body were left unaddressed.

I had hoped and expected that there would be a serious discussion of the issues around the table, in order to give the public confidence that at least their local GPs are aware of the concerns and are debating them properly. Instead what we had was little more than a rehash of what has already been presented by the Better Services Better Value team, and serious issues raised from the floor were mostly left unaddressed. I am writing to you therefore to seek from your Governing Body clear answers to those questions that have been raised with you, and which remain unanswered.

Most particularly, why was factually incorrect information presented to the meeting as part of the justification for change?  On two occasions during the presentation, material arguments presented to the Governing Body as part of the justification for change were based on inaccuracies. The first was the claim that the move to a 24/7 consultant presence on maternity wards was now a Royal College requirement. As you will know, when the RCOG published the current guidelines, it acknowledged that the 24/7 aspiration was unlikely to be achievable in the near future because of cost pressures. At present Epsom hospital is fully compliant with RCOG guidelines, and no changes are due which could alter this. When you were challenged on this, no formal attempt was made to correct the record.

The second issue is that the meeting was told that other Surrey Trusts are all working towards the same 24/7 objectives.  Letters from the Royal Surrey County Hospital and from Surrey and Sussex Healthcare Trust to Surrey County Council in the last few days make it clear that this is not the case. Your letter to me confirms that they will not be able to meet the same standard as London. Again no formal attempt was made to correct the record.

I was to be frank astonished that representatives of the local General Practitioners could feel it appropriate to act in this way.  I wait your confirmation about how you will deal with this.

In addition, I believe that you now need to take legal advice before taking any further action in relation to the BSBV programme. I am not a lawyer, but I believe that in using inaccurate information in this way at a decision making forum, and failing to correct the record when challenged, the CCG has opened itself to a serious risk of Judicial Review. I believe that you would be in danger of acting outside your fiduciary responsibilities if you were to proceed without taking further clear legal advice. I was disappointed that you did not agree to do so on Friday afternoon.

In addition, I would be grateful if you could explain why it appears that members of the Governing Body were not provided with prior notification about the nature of the decision they were being asked to take. When Cliff Bush raised concerns about this, you then registered his vote as an abstention without offering a chance for a negative vote. Why was this?

Separate from the issues of legal propriety, I know that the 700 or so people who came to the meeting will have gone away with a real sense of frustration that they saw no evidence of a more serious discussion between members of the Governing Body. In a nutshell, the impression left was one of a simple stitch up, without even a clear indication, as I had hoped, that serious consideration would be given to other options in the months ahead.

There are a number of basic questions that remain unaddressed, and to which I would now publicly invite you to give answers.

  • What guarantee can you provide that patients from the London CCG areas will use Epsom as an elective centre? If patients in those areas choose to exercise patient choice, and the three Foundation Trusts choose to offer elective services, what is to prevent all of the work remaining in London?
  • Who will control and have responsibility for the administration of Epsom Hospital following if St Helier Hospital loses all of its inpatient services, and the Epsom and St Helier Trust becomes unviable as a result? This question appears to have been ignored by all involved.
  • BSBV’s pre-consultation documentation claims that the hospitals being covered by the review are not meeting Royal College guidelines for patient safety. Please will you confirm which Royal College guidelines Epsom Hospital is not currently meeting? In particular will you please confirm that Epsom’s maternity unit currently meets those guidelines.
  • Please can you explain how paediatric services will operate in the Surrey Downs area in future if consultant-led care is not available at Epsom Hospital. Epsom is unusual in that hospital and community paediatrics are integrated. This was clearly a concern even among your governing body. Please can you explain what the successor arrangements will be?
  • Epsom currently has a 24/7 A&E department, but does not offer emergency surgery. Please will you confirm that the new Urgent Treatment Centre will only be open twelve hours a day? Please can you confirm whether or not local GPs will operate an out of hours service for the remaining twelve hours, and where that service will operate from? You will be aware that concerns have been raised over the years about the existing arrangements. Please can you tell me how these will be changed, and who will provide the service? Will the CCG and its members take back delivery of this service?
  • Please can you indicate whether or not South Coast Ambulance Trust has agreed that it will routinely transfer patients into hospitals in London, and what the extra resource requirements will be? Who will meet the cost of the additional ambulance capacity?
  • It was clear from the meeting that even your Governing Body has serious doubts about the issue of travel times. Are you in a position to give a clear categorical assurance on behalf of the Governing Body that you are satisfied that no patient safety issues will arise as a result of increased travel times? Please can you publish the information you have been provided by the ambulance trust about the worst case estimates of travel times to the nearest acute centres.
  • You have estimated that an additional £51m will need to be spent at other Surrey hospitals to support the changes resulting from BSBV. In addition, I assume that the Surrey health economy will have to bear some of the cost of supporting the £2-300m capital spend required within the BSBV area. You will also be aware that additional out of area funding is likely to be required in London. This is likely to lead to a bill of well above £300m of capital, as well as the annual cost of depreciating that capital. Can you give a categorical assurance as you seek to enter a consultation process that will inevitably destabilise services in the coming months that you have been given a clear undertaking by NHS England that capital funds will be available to pay for all of this?
  • Why is the secondary care representative on your board a consultant from one of the London hospitals that stand to gain from these changes, and not one who is locally based? Can you provide an assurance that he has played no part publicly or privately in the discussions about these proposals.

I do not believe that you need accept change on this scale. You have a projected balanced budget for the coming year. The deficit of the Epsom and St Helier Trust has fallen rapidly and the Trust is off the Department of Health’s list of top concerns. There are clearly substantial savings to be made in Surrey by integrating primary and secondary care facilities and treatment. Epsom is currently a safe centre by national standards.

I believe that the local medical community is less and less convinced of the argument for change, and it is a matter of great disappointment to me (and I know of surprise to many of them) that unlike in Sutton, they were not asked to vote on the proposals.

At the very least, I had hoped on Friday that there would be a clear statement from your Governing Body that you would begin a Surrey based review alongside the BSBV consultation, and that you would publicly state that you would not automatically accept the end findings of the BSBV process. This would have played a major role in alleviating local concerns, and I thought that this is what you were planning to do. The fact that you were not able to do so means, inevitably and disappointingly, that you and your participating practices will face a summer of intense public pressure.

Yours sincerely

Chris Grayling

I am writing to let you know that the options for the future of local hospitals have now been published by the Better Services Better Value team, the people who are leading the drive to reorganise services in SW London.

As expected they are bad news for Epsom.

All three options involve Epsom losing its A&E and maternity departments. In two of the three scenarios St Helier does as well. In a third option, Croydon loses its acute services and St Helier keeps them. I do not believe that this is a likely option, though.

The preferred option published by the BSBV team would see Epsom remaining as an elective centre, doing planned operations, while St Helier loses all of its inpatient services.

The most important thing to say is that this is a long way from being a done deal. First the local GP Commissioning Groups have to agree that these are options that they want to consult on. As I said last week, this is what our local doctors are meeting on the 17th to decide. It is a board meeting in public, not a meeting where everyone can chip in, but a packed room at the racecourse from 1.30 pm onwards would be a helpful message if you can get there.

After that there will be a lengthy period of consultation, before detailed planning can take place. Any agreement also has to be ratified at the top of the NHS. No final decisions will be taken until next year, and changes won’t happen for another four to five years.

Needless to say, I am strongly opposed to this, and we will campaign vigorously against the plans. There is a long established Epsom Hospital campaign group which will wheel into cation again.

Do bear in mind that this is the fourth time we have faced plans to downgrade Epsom since 2000, and there is no certainty that it will happen. This is the most serious to date though, as it is the doctors rather than the managers or the politicians who are driving this. Please do take advantage of any opportunity you have to tell your GP what you think.

If the meeting on the 17th decides to go along with the consultation, we will organise a whole series of protests and other activities over the coming weeks. I will provide you with an update on this shortly.

In the meantime I am working behind the scenes to get us back to a Surrey option for Epsom. There is sympathy for this at senior levels in the NHS centrally, and so I am hopeful we may be able to find a different option.

I will keep you posted.

***

I met both Southern and South West Trains on Friday to discuss the Zone 6 for Epsom option. Both are sympathetic to the idea, though there are some significant barriers – not least the cost of a change. They have agreed to go away and do some joint work on the issue and to come back to me shortly. Fingers crossed!

***

Finally I am providing support this year to a local charity called the Sunnybank Trust. It helps local people with learning disabilities, and does some really worthwhile work. They are doing local fund raising collections in the next few weeks, and if you are one of the people they contact, they come with my highest recommendation.

With best wishes

Chris Grayling

Since I contacted you last week it has become clear that the Better Services Better Value team reviewing the future of local hospital services is planning to publish its recommendations sooner than I had expected. They are due out on Friday 3rd May.

I have very real misgivings about what they are set to propose, and I have set these out in an open letter to Dr Claire Fuller, who chairs the new local Commissioning Group of GPs who are taking the decisions locally. I have attached this letter below so you can see more about what is really happening and the issues.

Most importantly, the Commissioning Group’s Governing Board is meeting in public at 1.30pm on Friday May 17th at Epsom Downs Racecourse. This is not a meeting where there are many opportunities for public views to be aired, but it is really important that as many people as possible come along. Those who attended the board meeting at Epsom Hospital a few years ago when maternity was under threat will know that a large audience provides real food for thought for the decision makers. So please do come. The meeting is due to last for much of the afternoon, so even if you can’t come at the start come later.

Once we have seen the consultation document in full, I will provide you with more details about planned campaign activities.

Best wishes

Chris

Open letter to Dr Claire Fuller

Surrey Downs Clinical Commissioning Group.

Dear Claire,

I am writing to you, and copying this open letter to your management board, all the GPs in my constituency and all local councillors, in anticipation of the publication next week of the recommendations to be made by the Better Services Better Value review. 

I have long argued that our local GPs should be at the centre of decision making about the future of health services in the constituency that I represent and the surrounding area. It is a matter of enormous disappointment to me that so soon after that power has been granted, our local GPs have chosen to acquiesce in a programme that in my view involves cannibalising Epsom and St Helier hospitals to bolster three other London hospitals, leaving our area denuded of services and putting unfinanced pressure on other Surrey hospitals. I would always have hoped that there would have been a proper local discussion, an evaluation of the savings to be generated for the local health economy by consolidating a range of community and other services on the Epsom site, and local decision making. I would also have hoped to see a real attempt being made to see if an innovative approach to the provision of acute services at Epsom can make them sustainable. Instead we have seen clinical working groups where the views of local consultants have been railroaded by their London counterparts. We have seen decisions taken by meetings where there were six people present from St George’s alone, and two from Surrey, and each individual got a vote.

I have always said that, over all the years that I have campaigned for Epsom Hospital, that I would treat seriously any proposals that genuinely enhance the quality of healthcare for the people I represent. I have always intended to support difficult decisions if I truly believed that they were the best options for patients. I am utterly unpersuaded that such improvements are on the table.

My expectation is that later this week BSBV will announce either that Epsom will lose all of its inpatient services, or that it will become a purely elective centre. It has seemed clear to me all the way through that you and your colleagues have believed that in this latter case, a large amount of additional work will flow from London to Epsom and as a result will sustain it as a local centre.

What this assumption fails to recognise is that there is absolutely no obligation on any London hospital or CCG to transfer work to Epsom. All the hospitals will shortly be Foundation Trusts, they have the right to take their own decisions, and patient choice will, in my view, dictate a reality that they carry on doing most if not all of their current work themselves. I do not believe that the proposed elective work will come to Epsom.

I also believe that no thought has actually gone into what happens to the ownership and control of Epsom after all of this. If both hospitals lose their acute services, and one loses all inpatient services, it is hard to see the Epsom and St Helier Trust surviving in its current form. Who then controls the remaining services at Epsom? Who is responsible for its finances? This is a basic question that it is clear no one has thought about at all. It’s quite obvious that the thinking so far about the consequences generally of BSBV has been woefully inadequate.

The doctrine behind the BSBV review also involves a significant transfer of provision from the secondary to the primary care sector. I have yet to see any evidence that the primary care sector in our area has developed a clear strategy to do this. There is no local GP capacity available – indeed I receive complaints about the difficulty in obtaining an appointment with a GP in some practices, such has been the increase in demand for routine GP appointments. Out of hours services are not well regarded. Those practices that offer additional services tend to make use of roving consultants – but those same consultants will be required to relocate to London hospitals and focus more clearly on their needs if the overall levels of consultant cover envisaged in BSBV are to be met. The primary care sector will need to cover a lot of the work currently being done in A&E at Epsom – either on site or in their own facilities. But who is actually going to do the work?

Most fundamentally, you are signing up to a process of change that is unfunded and where deliverability is completely uncertain. Together with all the local authorities affected and the local MPs, Surrey County Council is currently seeking detailed information from all the hospitals involved, both inside and as neighbours to the BSBV process, to establish the cost and availability of funding to do all of this.

The changes will involve a need to invest in extra capacity not just at St George’s, Croydon and Kingston, but also at East Surrey, St Peter’s and Guildford. It is likely that a large proportion of emergency cases that currently use Epsom will go south and not north, and all of the evidence from past changes is that Epsom patients choose Surrey options and not London ones. In maternity alone, the decision to close the units at Epsom and St Helier require capital investment capable of providing for 6,000 births, the equivalent of a large maternity unit at a major hospital. As far as I can ascertain so far, the expectation is that realising the ambitions of BSBV is likely to cost several hundred million pounds – possibly as high as £300m. Supporting this level of investment will probably impose an additional annual cost of capital burden of  perhaps £25-£30 million on the health economy in SW London and Surrey. Where is this money to come from? What evidence is there that it will be provided by NHS England over the course of the next few years? Some of it will need to come from Surrey in the form of additional capital for the other Surrey hospitals. Whose budgets will that money and the ongoing cost of capital come from? What happens if you take decisions now which start to impact on the viability of Epsom and St Helier, services start to really struggle, and then the investment funding is not available?

You will know now that the projected deficit for Epsom and St Helier has fallen sharply, to the point that the Department of Health now regards it as one of its lesser financial problems. There is a strong likelihood of the Trust achieving break even within the next financial year, according to its current forecasts.

More importantly, though, wherever the work currently done at Epsom is carried out in the future, you will still have to pay for it. Unless you can deliver cheaper treatment models in the primary care sector very quickly, then you will end up paying the same amount to other acute trusts, whilst the local health economy also has to find a way of paying for its share of the capital spend on BSBV.

So I really do not understand how this will save any money for our area. And the financial problems that seemed to be making a Surrey option for Epsom unrealistic are clearly easing. I recognise that there is a degree of passing of deficit between secondary and primary care – but the way to solve that is to maximise the utilisation of the spend we have got by consolidation of provision onto the Epsom site, and transforming the way the hospital works.

Of course you and your colleagues have rightly argued that patient safety and patient outcomes should be the most important factor in this. But it is far from clear that we will see improvements for local people.

The most obvious area of concern in this respect is maternity. Epsom’s maternity unit, for example, is currently compliant with Royal College Workforce guidelines, and has mortality figures that are well below the national average and crucially well below the levels at Kingston, Croydon and St George’s. In 2010 it had no neonatal deaths and its perinatal death rate was well below Kingston.

Part of the justification for change is to secure 24/7 consultant cover. But the other Surrey trusts are nowhere near achieving this, and so local people are being asked to accept the disappearance of a local service to secure an outcome that might become available in London, depending on staff retention, but will not be available to them in their own county.

Finally, the plans from BSBV are only workable if the London hospitals take on most if not all of the key medical staff at Epsom. Otherwise it is not possible to achieve the kind of consultant cover they are talking about. But at the same time the primary care sector is operating at close to capacity. So where will the staff come from to do the work at Epsom? How can we be sure that what is left will be able to offer any kind of quality staffed service? You will be aware that clinical staff at Epsom have warned that the BSBV proposals in maternity and paediatrics represent a safety threat to patients in their current form.

In short, I remain completely unconvinced that this rushed process has provided any sensible answers for local health issues. The quality of analysis provided by the BSBV team has been poor, and the understanding of healthcare in Surrey limited.  

By contrast there is a real willingness, as you saw at the meeting we held at Surrey County Council, for the Surrey community to engage in real discussions about how to make the local health economy work more efficiently and cost-effectively and to find a Surrey option for Epsom – possibly by integrating health and social care on the site.

What we have on the table right now is either an option which removes all Epsom’s inpatient services, or another which simply removes its acute services. Neither appears to offer either obviously better value for money or a guarantee of improved care for the patients who are currently using Epsom Hospital. There is no guaranteed funding for change, and the cost of provision is, if anything, likely to rise not fall because of the cost of capital. Primary care locally does not seem to be ready to take on significant extra responsibilities, and it is far from clear how the future configuration of services locally would be staffed. It looks like an attempt to cannibalise Epsom to help SW London, and will certainly be seen as such by the local community. And I’m not sure that the NHS is remotely capable of handling yet another major reconfiguration in London when there is already so much happening elsewhere.

I can see no benefit to anyone locally in the months of protest and confrontation that will undoubtedly lie ahead if Surrey Downs simply decides to go ahead with the BSBV proposals. It will embroil local GPs across the area in controversy and will distract everyone from delivering healthcare. By contrast an agreement to set aside the BSBV process, or at least to work alongside it and establish a Surrey based working group with a clear brief and a clear timetable to bring forward a viable plan for the future of Epsom would seem a far more sensible approach. This would enable us to explore again partnerships with other Surrey Trusts, the integration of primary and secondary care on one site, alternative business models for the existing acute services, and possible partnerships with the private sector. I am absolutely of the view that such an alternative is deliverable and would provide better security for our local services in future.

I’m really not sure your governing body has fully thought through the consequences of the current process. I don’t doubt the sincerity of the clinicians involved, but the practicalities look rather different. And they are walking into a maelstrom if things continue as they are.

I can only urge you to take a step back.

With best wishes,

Chris Grayling

I am writing to give you an update on what has been happening with Epsom Hospital.

As you may remember, the Better Services Better Value team delayed its decision until the summer after all the challenges to their work that we generated a couple of months ago.

Since then there has been a concerted effort by the different local authorities and MPs involved in the issue in our part of Surrey to keep them under pressure. This has involved both continuing to challenge some of the assumptions in the BSBV programme, and also to look for alternatives. At my request the County Council hosted a meeting for all the health organisations in Surrey and the local authorities involved, plus Sir Paul Beresford and myself, to talk about alternative options for Epsom – and there are now a number of follow-up conversations taking place.

A joint letter was sent on our behalf by Surrey County Council last week putting a whole series of questions to the Chief Executives of the major hospitals included in the BSBV review as well as those in other adjoining areas. In particular we are trying to establish clearly what the cost of the proposals would be. It looks as if it would be several hundred million pounds, with no clear guarantee that funding would be available to pay for this. There are also likely to be knock-on costs at other Surrey hospitals, and we don’t know if they could cope.

It would be unfortunate to say the least if the medical profession took decisions about the future structure of services, with all the potential impact on the short term stability of the hospitals affected, without certainty that there is money available to pay for the relocation of services.

I have also challenged the BSBV team over their assertions about patient safety and quality.  I have now obtained copies of the figures for safety at Epsom’s maternity department, and it is clear that it is currently way above the national average on most safety measures, and well above the main London hospitals included in their review – although to be fair they do handle more complex cases. One of the key arguments for change is patient safety, but clearly if Epsom is already one of the safer maternity units, the case for change seems  much weaker to a non-doctor like me.

In the meantime, the financial crisis in the Epsom and St Helier Trust which prompted the inclusion of Epsom in the BSBV process seems to have eased. The forecast for the deficit this year, is that it will be substantially down, and that the Trust is on a path back to balance.

So if we have a hospital which is delivering a generally high quality and safe service, and which is sorting out its financial problems, it’s not really clear why change is so urgent.

The new Surrey Downs Commissioning Group is to hold a meeting in May at which it will decide whether to commit further funding to the BSBV process, and whether to go along with its likely conclusions. This will be a meeting held in public, and I will let you know time and venue a bit nearer the time so that people who want to attend are able to do so.

In the meantime, the Epsom Hospital campaign team is preparing plans for a public campaign if a decision to downgrade Epsom is put to a public consultation. Here you can be of help.

I want to expand the number of people I am in contact with as part of the campaign as far as possible so that if we need to get together a mass petition or letter writing campaign or another major campaign activity, I am in contact with as many people as possible. Please could you ask friends or neighbours locally if they want to receive these bulletins, and let me know their contact details if they do.

One other update. I am due to meet Southern and South West Trains in the next few days to discuss the issue of Epsom and Zone 6. More on that shortly.

With best wishes

Chris Grayling

BSBV Future of Epsom Hospital Decision Delayed until March. “I’m glad that the NHS has pulled back from making an instant decision based on a flawed process. I think there now needs to be a proper discusssion of different options for our area and sensible decisions need to be taken with the interests of the people of Surrey in mind.” Chris Grayling

A big thank you to all of the people who attended the public meeting at Blenheim High School about the future of Epsom Hospital on February 7th. More than 500 people attended, and we had so many that not everyone could get in. My apologies to those who could not, but at the very least you contributed to a strong message about views in the local community.
A whole range of concerns were raised at the meeting, and it was absolutely clear that the proposals for local NHS services do not command the universal support of local doctors.
I have written again to the Better Services Better Value team to ask them to publish a whole range of detailed documents about their work, including giving us details of the capital spending and work that would be needed to transfer services from five hospitals to three, about the impact on Surrey hospitals and Surrey ambulance services, and about travel times from the local area to potential sites for future acute services. I am far from convinced that this work has been done to anything like the level that would be needed to justify the proposals. No announcement should be made about the future location of services unless there is clear evidence that this work has been done properly.
I will continue to keep everyone locally posted about developments.

Dear constituent,

I am writing to you again so soon after my last message because there have been unexpected and unwelcome developments on the hospital front.

During the week the team running the hospital review held their project board meeting, and the London based group of doctors and nurses who have been advising the project submitted a recommendation that two of the five A&E and maternity units at St George’s, Kingston, Croydon, St Helier and Epsom should be closed. Although the project team is stressing that these are only recommendations and not a final decision, it seems pretty clear that the main candidates for closure would be at St Helier and Epsom.

This is an extraordinary development, given the fact that the discussion involving Surrey has barely started, and the project team are due to hold their first meeting next week with local interest groups to explain how the review will work. It is bound to lead people locally to the view that the review process is not a serious one.

It is also a very risky step to take legally, as I know from my own experience that public bodies need to be very careful to ensure that any process is genuine – or there is a high risk that it can be challenged in the courts.

I have already made my strong concerns known to the NHS team leading the process. They have a lot of ground to recover if the Better Services Better Value project is to have any credibility at all in Surrey.

The big difficulty I have is that this is not a political process. It is the medical profession who are driving the change. In some respects they are right. There are examples of where the consolidation of services has been good for patients. For example, the decision to treat stroke patients in a smaller number of specialist centres in London has lead to a significant improvement in the likelihood of recovering from a stroke. That’s obviously a good thing.

But I have three arguments with the approach that seems to be being taken.

Firstly, the idea of closing acute services at both Epsom and St Helier seems completely unrealistic. It would leave a gap in provision running from St George’s to Guildford, and in the case of maternity, where there are 4,500 births across the two hospitals, it would require other hospitals to absorb the equivalent of a large maternity unit in a major hospital.

Secondly, I want the future of Epsom to be decided in a Surrey context, and not a London one. Since we now know that the financial position at Epsom is not nearly as bad as was suggested a couple of months ago, I think the process of splitting Epsom from St Helier and looking at Epsom’s future in that context should restart.

Thirdly, it is very obvious that our own local doctors should have the main input in what happens. And yet the provisional recommendations have been put forward without them even having the chance to have their say.

I have therefore written to all of our local GPs to ask them their views on the future of Epsom, so we can put those to the Better Services Better Value team.

If a good majority of our local doctors say they want to see changes, we will have to listen to them. But at the moment things seem to be moving ahead without them even having the chance to express their views.

I am planning to hold a public meeting to discuss what is happening on Thursday 7th February at 7.00. It will be held in the main hall at Blenheim High School in Longmead Road, Epsom at 7.00pm. All are welcome.

I will continue to keep you posted.

With best wishes

Chris Grayling

Dear constituent
First of all, can I wish you and your family a very happy new year.
I am writing to you with a further update about the future of Epsom Hospital.
The Better Services Better Value process, which is the review of services across South West London, has now extended to Epsom and the assessment work is beginning.

I have to say that the whole process is unsatisfactory, and will be unacceptable to residents in our area. I am now planning to step up campaigning against what is happening.

The most fundamental problem that we face is that this is no longer a political process, but one that is being driven by GPs across South West London. I believe that it is right that doctors should take decisions about local services, but the problem is that doctors in Surrey are getting virtually no say in what is happening. The future of

Epsom is being decided by GPs in five London boroughs, something I believe is not acceptable.

Epsom is being subjected to a review that was designed to meet the needs of SW London, and where the final decision making will be subject to a vote of NHS doctors groups in five London boroughs, plus Mid Surrey – in other words we only have one vote out of 6. The intention of the review team is to reach a decision by March, and then go to public consultation in April.

I have already received complaints from some local GPs in Surrey that they believe that they have no say in what is happening, and that they are being asked to approve pre-ordained plans. But some of our local GPs are strongly in favour of change – so opinions are divided.
To compound the issue, the review team are continuing to use figures for the level of deficit at Epsom in their presentations to, for example, London councils, that we know are now not accurate. The danger is that Epsom is written off on a false prospectus, and without the chance to really see if there is an alternative for it separate to St Helier.

There are a number of things that people locally can help with.

Firstly, please email your concerns about all of this to the team doing the work.
The contact email address for them is [email protected]

You should also encourage your GP to do the same if they are worried about what is happening.
The review team is also holding a “scoring” meeting at Epsom Downs Racecourse on the evening of January 15th. Local doctors and local representative groups have been invited. This is not a public meeting. But if you are a member of any local organisation, perhaps in the voluntary sector, which has not been invited, can I suggest that you email the BSBV team and ask to attend. The more people who attend and make their point about the process the better. It is important that this exercise is not able to be presented as an endorsement by the community in Surrey about what is happening.

I will be organising at least one public meeting about what is happening shortly, at which I will invite the BSBV team to defend their actions. I will give you more detail about this shortly.

I am working hard to try to get Epsom Hospital removed from the Better Services Better Value process, and to get the process of finding it a new partner reopened. Since we now know that the financial basis for halting the proposed merger with Ashford St Peter’s was flawed, I think that the process for finding Epsom a new partner should start again. In the meantime, though, we need to put as much pressure as possible on those who are rushing through this new process, in my view to the detriment of Epsom hospital.

I don’t want to underestimate the nature of the challenge, though. There is now pretty broad consensus among doctors in this country that we should have fewer, bigger hospitals delivering better specialist care. I’m not trying to argue against that view, but I do want us to see whether we can find a proper role for smaller hospitals like Epsom without simply closing or massively downgrading them.
This email is going to several thousand local residents, but it would be very helpful if you could pass it on to friends and relatives locally in case they haven’t received it. Please can you ask them to get in touch directly with me if they would like to receive further updates, or details of future meetings.

With best wishes
Chris Grayling

Dear Constituent,

I am writing to you with further information about what is happening about Epsom Hospital. I have enclosed below the content of a letter that I have just sent to Ruth Carnall, who is the Chief Executive of NHS London, the body which is ultimately responsible for Epsom Hospital. The letter is pretty self-explanatory, and will give you an indication of the unacceptable financial confusion that now appears to surround the Epsom and St Helier Trust.

I am now reconvening the Epsom Hospital Campaign group, which has representatives of local councils, MPs, businesses, and patient groups. This was the Group that organised, with me, all of the protests across the past decade. There is no need right now to move into full campaign mode. At the moment the NHS is planning a further series of reviews to decide what happens now, and this will involve assessing the future of Epsom alongside the broader review of services that has been taking place across South London. However I will be asking people locally to make their views firmly know to that review process and I will come back to you shortly with more information.

In the meantime my frustration is that a process of eighteen months of discussion that looked to be on track to deliver a good solution for the future of Epsom has been unnecessarily abandoned on the basis of what appears now to be incorrect financial analysis. You will see from my letter that I strongly disagree with the NHS decision to halt the process that they have been going through, and that I asked them earlier this week not to disband the team that has been working on the future of Epsom. Unfortunately they have not agreed to do so, which is why I am releasing this letter generally.

I will keep you updated about what happens, and I remain as committed as ever to ensure that Epsom has a strong future. There are many different pressures and changes within healthcare at the moment generally, and it is obviously important that patients get the best possible treatment. However I do not accept that it is impossible in today’s world for a small hospital to continue to do many things for its local community.

With best wishes
Chris Grayling


Dear Ruth,

I am writing to you further to our recent discussions about the future of Epsom Hospital and the ongoing process to establish where it will fit in the NHS.

I wanted to raise with you my very great concern about the recent decisions regarding the future of the transaction process, and about the apparent lack of understanding of the financial position in which Epsom finds itself. I intend to make this letter public later this week, once the Epsom and St Helier Board Papers have been published and the information to which I will be referring is in the public domain.

I had intended to wait until then to write, but the imminent disbanding of the transaction team means that this letter cannot be delayed. Because of the new information that has emerged, I want to formally request, and urge you in the strongest possible terms to halt the disbanding of this team, and if necessary to convene emergency board meetings this week to take that decision. I hope that by the time I release this letter publicly that decision will have been taken.

At the heart of my concern is the position that the Epsom and St Helier Trust appears to find itself in financially. You will recall that at the time the proposed merger between Epsom and Ashford St Peter’s was abandoned a month ago, the transaction board was told that Epsom had an annual deficit of £13.8 million, and that it would not be possible to realise sufficient efficiencies for the merger to go ahead.

Over the past few days it has become clear that this figure was far from accurate, and that in fact the underlying deficit for Epsom for the current year is running at a rate of only half that level. I had heard several well-informed rumours to this effect, but it was confirmed to me confidentially by the Epsom and St Helier Trust on Friday. This figure may be adjusted upwards if Epsom is fined by the Commissioners over the level of infection outbreaks, but that is clearly a one-off and needs to be addressed by any future management of the hospital and need not and should not affect the transaction process.

In addition, I have now read the Deloitte report into the Trust’s finances, which clearly contained considerable amounts of subjective, rather than objective evidence about the split between Epsom and St Helier in calculating the deficit. Deloitte made clear that the management information they were given was out of date, and so their report relied on the judgement of individual managers in allocating costs between the two sites. Given the fact that most departmental managers are based at St Helier, which faces being downgraded as a result of the Better Services Better Value process, this would seem a less than satisfactory way of assessing the cost and deficit split between the two sites.

It seems now therefore that the financial information on which the decision to halt the transaction and disband the transaction team was based was flawed. You will understand how surprised I am by the way that the figures for Epsom can yo-yo in this way in a matter of weeks, and in particular in the way they are jeopardising its future.

I am aware that at the Partnership Board this week the option of a rapid move to remove acute services from both Epsom and St Helier was discussed, leaving them both as “cold” sites. I cannot stress how strongly the public in the Epsom area would react if that were to happen. It would leave a huge and unacceptable gap in provision across a wide area. But such a move would be inexplicable if it were taken on the back of a set of financial projections which already seem to have been a long way from accurate. If nothing else it would leave the NHS open to huge and unnecessary legal risks.

There is no doubt that Epsom faces major challenges to address its financial position. Above all it needs proper leadership to rebuild revenue streams – something that has been woefully lacking over the past decade. It needs to recover some of the £14m a year of activity that used to be carried out on the site, but which has been taken into the primary care sector by local GPs. That will require a smart strategy to improve services on the site, but it can certainly be done.

It also needs to attract new services and providers onto a site that is inefficiently used. And it needs to rebuild the income that it once received from private patients. That will require consultants working at Epsom Hospital to make a determined effort to bring much more of their private work to the site – something I am actively encouraging them to do.

I am therefore formally asking you to do the following:

Firstly to halt the break-up of the transaction team, and to reopen the transaction process. This time they need an unconditional mandate to find new partners to take over the management of the Epsom site on behalf of the NHS or within another NHS Trust, retaining its core of NHS hospital provision.

Secondly, there needs to be a complete open book process as regards the Trust’s finances, with potential partners given full access to the Trust’s accounts so they can prepare detailed models to understand its real underlying financial position. The current position where no one seems to have a clear idea about what the financial situation is has to stop, and no serious decisions can be taken about the future of Epsom Hospital until this situation is properly resolved.

Thirdly, because of the short term risks of Epsom losing work to the Primary Care sector, the private sector and other Surrey trusts, a small development board should be established with the specific remit of securing additional short term revenue streams to the site. I am all in favour of patient choice in the NHS, but it seems to me that far too little is being done locally to ensure that services at Epsom Hospital are part of that choice.

In addition, I will be asking the South Coast Strategic Health Authority this time to devote serious effort into helping secure the right outcome for Epsom Hospital. As you will know, many of those in the process have told me that there has been inadequate interest by their leadership team in what happens.

I cannot stress strongly enough that I will resist at all levels any attempt to subsume Epsom into the Better Services Better Value process and take instant decisions about services on the basis of a flawed or uncertain prospectus. Clearly what happens to Epsom needs to be seen against the background of what is happening in South West London, for example in terms of future patient flows. And the lack of interaction between Surrey and London in the transaction process has been unfortunate to say the least. But if there is a rapid process that simply decides that South West London can go from five acute centres to three without the processes I have described above, there will undoubtedly be a strong and hostile reaction.
Furthermore it would be mad to throw away eighteen months of expensive work by the NHS in both South West London and around the future of Epsom and St Helier in circumstances where the deficit figures are so uncertain.
I hope and trust that you will take rapid action to address the issues I have outlined, and I will hope to receive confirmation of this during the week.
I am copying this letter to Sir Paul Beresford MP, Crispin Blunt MP, Sir Ian Carruthers, Chief Executive of the South Coast Strategic Health Authority, Matthew Hopkins, Chief Executive of Epsom and St Helier, Jan Sawkins, Chair of the Transaction Board, Anne Walker, Chief Executive of NHS Surrey, and Dr Claire Fuller of the Surrey Downs Commissioning Group.
Yours sincerely

Chris Grayling


Epsom Hospital Update – October 2012

I wanted to write to let you know that Ashford St Peter’s has unexpectedly decided not to go ahead with its plans to merge with Epsom Hospital. I am extremely disappointed by this news, as I had hoped the merger would provide a long term solution for the hospital. There is still some confusion about the reasons for the decision, with both sides blaming the other. At the heart of the issue is concern about the financial challenges surrounding the merger, and the current financial position of the Epsom and St Helier Trust.

I have talked to my colleague Jeremy Hunt, who is now Health Secretary, about what has happened and he has assured me that the situation will now be reviewed carefully and nothing will be done hurriedly. The failure of the merger has big and wider implications for the health service across South West London, and may have the effect of forcing local NHS managers and commissioners to go back to the drawing board. The decision has already been taken in principle to remove acute services from St Helier, but clearly they cannot remove services like maternity from both Epsom and St Helier as the capacity does not exist to absorb elsewhere what happens at the two sites. So there is no question of Epsom losing services in the short term, though it has some financial challenges that have to be addressed.

I will be playing a very active role, as always, in the work that is done over the next few months to find a new path for Epsom. I am hugely frustrated by what has happened, and angry that those involved seem to have wasted so much time and money in a process that they were unable to see through. I will be working to make sure that the future of Epsom Hospital is properly sorted out. The key decision makers now will be local GPs, who are about to take over responsibility for commissioning local healthcare. I have always believed that the future of Epsom will be more stable if local doctors are the people who decide what happens there, and that is now what is going to take place. But we will need their commitment to making sure that the hospital has a strong future.

In the meantime, though, for the hospital and its staff and patients, it is business as usual, continuing the very important work that the team there do on all of our behalf.

Best wishes

Chris Grayling
MP for Epsom and Ewell

Dear constituent

I am writing with an update about a number of events planned locally.

You may know that Epsom and Ewell is part of a group of four twinned towns, Chantilly in France, Watermael-Boitsfort in Belgium and Ueberlingen in Germany. This summer choirs from the four towns are meeting in Epsom for a three day choral festival. There will be events in different venues across the Borough, which will be publicised nearer the time. But I have been asked to pass round a request from the organisers to any music lovers (or others) who would be willing to host one of the members of the visiting choirs during their visit.  They are here from the 30th June to the 3rd July. If you are willing to host or help out, please let me know and I will pass your details to the organisers. See further details here.

I have also been asked by the organisers of the Surrey Hills cow parade to let people know about their plans for later this year. From May onwards, you will see brightly coloured full-sized fibreglass cows start to spring up around the County. It’s meant to be a fun event for families to spot the cows around the area, but there is a serious end to it – the cows will be auctioned for charity at the inaugural Surrey Hills festival in September. You can find out more at http://www.cowparadesurreyhills.com

I promised to let you know about plans for a local debate as part of the EU referendum campaign. There will be a churches debate at St Mary’s Cuddington at 5pm on Saturday 11th June. I will be setting out the case for Leave and Tom Brake, the MP for Carshalton and Wallington will speak for Remain. For those of you who don’t know St Mary’s, it’s in The Avenue in Worcester Park, at the top end of Epsom and Ewell borough.

I will be holding the latest of my Business Breakfasts on Friday 29th April at 8am at Epsom Golf Club. We will be discussing issues affecting local businesses. If you would like to come, please ring my constituency office on 01372 271036 or drop me an email.

With best wishes

Chris Grayling