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Burnham residents took their questions and concerns directly to their local representatives, NHS officials, and developers last Friday (August 18), during a public debate about the town's surgery.

It was attended by 450 people and was described by local MP Sir John Whittingdale as "the biggest public meeting" he had ever witnessed in his constituency.

Panellists included Carol Banham and Dr Rahman from Burnham Surgery, Dan Doherty from the local NHS Health Authority, Burnham Waters Project Director Ian Holloway, and Burnham Waters Planning Consultant Stewart Rowe. Samantha Glover, CEO of NHS watchdog Healthwatch Essex, chaired the meeting.

Questions covered a range of areas. The main themes included the Burnham Waters development, transport and accessibility, finance and funding, current surgery capacity, and the ICB's (Integrated Care Board) process.

Here are the 10 main public questions and answers from the night, summarised:

1) Resident David Kennedy: "This is about the 'Waters-Gate' email: the email from the NHS to Maldon District Council (MDC) that had what appeared to be a series of 'done deal statements' in it. The mid Essex and South Essex health authority, the ICB, have a statutory and constitutional obligation to consult with the public. That email led the public to believe that statutory and constitutional consultation had not been carried out. When do you believe that this consultation that was spoken about in that email started?"

Dan Doherty, Alliance Director at NHS Integrated Care Board: "In terms of when did that consultation start, it hasn't. And the reason it hasn't is that the ICB have not been in receipt of a proposal on a surgery moving. If the ICB does get to the point of receiving a proposal for the surgery to move, it will have to see that there has been a statutory consultation." 

Mr Kennedy: "What criteria was chosen for the assessment that was called out in the Waters-gate email and what experience do those consulting on the options appraisal have?"

Mr Doherty: "The options appraisal looked at a whole raft of options, but it only looks from a very estate's driven lens. So it is only looking at the practicality of land ownership, planning permission, the state of buildings, those sorts of things. That document went to the surgery to give them different options that they could look at and that could potentially give them the space that they are seeking to get. I think the 'Waters-gate email' appraisal did suggest that new developments, Burnham Waters, is what Burnham surgery is looking for and is the most viable."

2) Resident: "Do the GPs want to move the surgery? What about the Crouch Clinic?"

Dr Rahman: "We have to move - we need a bigger space at the moment."

Carol Banham: "We have used crouch clinic for physio, however the charges for that site are exponential, and the charges has gone up by about 15 per cent from the year before. The building isn't up to scratch, is outdated, it is older than where we are and infection control… it costs a lot of money to upgrade."

Many residents stood in the school grounds outside the assembly hall for two hours to listen to the meeting. (Photo: Ben Shahrabi)

3) David Kennedy: "How much can the health authority be trusted to abide by public opinion? And how much can a developer be trusted to deliver the commitments they make to get us to move to their site?"

Mr Doherty: "If we don't refer to the statutory requirements for public engagement that you referred to, you guys can rightly overturn one of our decisions and take us to judicial review."

Samantha Glover, CEO of Healthwatch Essex: "I understand the NHS process and how I can hold to account the NHS process and we can share that process with you, how to refute a decision, what the public channels are, how to go to a public consultation, and so forth"

Stewart Rowe, Burnham Waters Planning Consultant: "Commitments made or requirements that MDC as planning authority have that may relate to transport, accessibility, or anything else, can be enshrined in a planning legal agreement, what is called a section 106 agreement. This is an agreement between the developer and MDC. That is a legal document which is an agreement under the planning act. That's enforceable through breach of contract through the courts, it is a civil matter. The short answer is that matters which matter to your community are presented through your councillors, your elected members and your planning officers - who will take that into account and provide your members, your councillors with advice. Important matters can be enshrined in a Planning Legal Agreement which can be enforced by the council. It is under the Town and Country Planning Act 1990. It is a legal agreement, an act of Parliament. That is how you can ensure that things are delivered."

4) Councillor Nick Skeens: "You say you have done an appraisal and it seems evident that you like the idea of moving the surgery out of Burnham. You can see how that is a deeply unpopular opinion here and that is because there is such a sense of community here and most of the people here live south of the railway line. But there are other locations and we want to know whether you have considered those, like Station Approach or Burnham clinic."

Ms Banham: "We have employed someone to do an assessment for us to find us options, not choices, not what is down on the table, our options. Considering all the bills… Crouch Road etc, are going to have to come to infection control standards and it's going to cost an awful lot of public money to do that"

Maldon District Councillor Wendy Stamp said, 'I will do everything I can to stop that surgery moving out of the town centre.' (Photo: Ben Shahrabi)

5) Resident: "It is rumoured you cannot build any more until you supply a surgery, is this true?"

Mr Rowe: "Let me be clear about this, the surgery at Burnham Waters will be proposed as a private surgery and that is what will be delivered, unless the NHS come to us and say 'we want to take your private surgery'. For us we will proceed, it has been worked out and costed, despite all the rumours, and believe me we monitor social media and most of it is nonsense. Frankly most of it is unfounded, misinformed and frankly untrue, the information is out there if you go looking for it it's on the council website and the legal docs are there, or we will provide you with that or ask your councillors or planning officers for that. We will provide ourselves a private surgery that was always the intention and it remains that"

6) Resident Gary Murray: "How will people get to an out of town surgery? Will there be a bus route? If there is a bus route, how long will we have to wait?"

Ian Holloway: "As you have heard from the NHS, this conversation is in its very early stages. We have made representations to the surgery about what we think we can do and that includes an extensive review of transportation, under Section 106 we will provide a minibus service. The minibus service is a legal obligation we have to meet, we have also had conversations with Andy Ambrose of Essex and Suffolk DaRT with the view to bring in the D4, D5 and the 99 to create extensive transportation into our site. The DaRT service is in a good place to serve the whole Dengie".

At the end of the meeting, the panel was presented with a petition signed by 1,300 Burnham residents. (Photo: Ben Shahrabi)

7) Resident Susan Brewer: "What access provision would there be for the most vulnerable patients, such as Dementia sufferers?"

Dr Rahman: "We have home visits, a dedicated paramedic, and nurse home visits for vaccinations"

Mr Doherty: "The process that the NHS has would need any proposal to demonstrate the impact it may have on particular groups. This is called an equality impact assessment. This particularly looks and groups including those with learning difficulties or those with dementia are looked at within that. That acts as an assurance that should the ICB be forthcoming with any proposal it will have to assess whether it will affect particular groups."

8) Resident Susan Brewer: "In what way would the proposed new site give better services? Would the new surgery offer minor surgical procedures, diagnostic tests, secondary care provided by hospitals are miles away from Burnham"

Dr Rahman: "That is our plan. Provided the NHS funds those facilities, we can provide those services."

Burnham Town Mayor Duncan Rawlinson told the panellists to 'keep the town council in the loop' during further discussions. (Photo: Ben Shahrabi)

9) Councillor Mary Ann Mumford: "Who would pay for a new surgery on Burnham Waters?"

Mr Doherty: "The NHS doesn't build GP surgery's, we don't own any, the vast majority of GP surgery's are owned by partners, then the NHS pays those partners a rent to use those buildings for the public. Who owns it will be whoever builds it. In the case of a developer it would be a developer, in the case of the council it would be the council, in the case of any other party, it would be them. The GPs enter into a 20 year lease and the NHS fund that lease. That is true of any surgery."

10) Resident: "How much funding nationally is being given to the NHS?"

Rt Hon Sir John Whittingdale: "The amount of money going into the NHS goes up every single year. You must take into account the ever increasing demands in terms of the ageing population, the social care budget, medical technology advancing, people living longer, all of those things are increasing demands on the NHS and therefore the pressure rises at the same time. That is a national issue and it is one that every government is having to grapple with."

"Crouch Vale Medical Centre in South Woodham Ferrers came about with the construction of the Sainsbury's. This is because part of the agreement with the development of Sainsbury's was that they should build a medical centre. This is similar to the medical centre in Southminster, and a proposed one in Heybridge. There are surgeries across Essex, across the country, that are in buildings that are not appropriate the population they are serving, so we must look at the options and developments is one of the way in which you can acquire new buildings for the NHS."

Access to the full transcript is available here.

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