Please note that the time allotted for Opposition Business is 30 minutes (Constitution Chapter 2, Section 3.7(d))
The following item of Opposition Business has been proposed by Cllr Dr V Holliday, seconded by Cllr E Vardy:
Closure of Blakeney Surgery
Blakeney Surgery, which is a branch surgery of Holt Medical Practice, serves the parishes of Blakeney, Cley, Kelling, Langham, Morston, Wiveton, Salthouse, Stiffkey & Cockthorpe, in all a population of 1954.
Holt Medical Practice proposes to close this surgery. Currently, it serves as a reception hub and a prescription drop off and medication pick up. Face to face appointments were withdrawn prior to Covid and never reinstated despite requests from parishioners.
The local and wider community strongly objects to the proposed closure. For example, a public meeting with the practice was hugely oversubscribed, almost 900 have signed a petition at time of writing, and an online survey by Duncan Baker MP had 434 responses of which 99% were opposed to the closure, The major reason for objection is the difficulty patients will face in accessing health care.
If the Surgery closes, for residents of Blakeney and surrounding villages the nearest health care is at High Kelling (a 14 mile round trip), or Melton Constable (a 20 mile round trip). Those without a car, 20% in Blakeney from 2011 census data, face a 3 ½ hour round trip by bus to High Kelling (including a half mile walk) or a 5 ½ hour round trip to Melton. The local volunteer car service is at capacity and there is no local taxi firm.
Over 40% of Blakeney residents are over 65 and over a quarter of these live alone. Over a tenth of residents say their day-to-day activities are limited a lot, and 6% say they are in bad health (all from 2011 census data). How will these residents cope with a three, four- or five-hour bus journey with multiple changes? It is not just older residents. How could a young mother manage with two children in a pushchair?
Travel is similar or worse for residents in nearby villages. For Morston, which is 3 minutes by bus from Blakeney, it would be more than a 2 ½ hr round trip with four changes to High Kelling and it is not even possible to get to Melton.
Closure will have an impact on health inequalities. Section 149 (Public Sector Equality Duty) of the Equality Act 2010 states that a public authority must, in the exercise of its functions, have due regard to the need to eliminate discrimination, advance equality of opportunity, remove or minimise disadvantages and take steps to meet the needs of persons who share a relevant protected characteristic, such as age and disability.
The National Health Service Act of 2006 states in Section 13G that “The Board must, in the exercise of its functions, have regard to the need to reduce inequalities between patients with respect to their ability to access health services.”
Closure of Blakeney Surgery would also go against four of the key principles of the NHS Constitution for England, namely:
1. The NHS provides a comprehensive service, available to all;
2. The patient will be at the heart of everything the NHS does;
3. It is committed to providing the most effective, fair and sustainable use of finite resources; and
4. The NHS is accountable to the public, communities and patients that it serves.
The NHS Constitution also pledges to ‘provide convenient, easy access to services.’
Finally, but equally importantly, closure of this branch surgery has a negative impact on North Norfolk District Council’s ambition of net zero. The carbon footprint of patients travelling from Blakeney and surrounding villages to High Kelling or Melton is calculated to be almost 55 tonnes of carbon dioxide a year, equivalent to almost 11 return trips from London to Sydney. This carbon footprint would need to be offset by planting more than 2000 trees annually, which would require more than 2 ½ acres of land per year.
We propose Council resolves to
Minutes:
The following item of Opposition Business has been proposed by Cllr Dr V Holliday, seconded by Cllr E Vardy:
Closure of Blakeney Surgery
Blakeney Surgery, which is a branch surgery of Holt Medical Practice, serves the parishes of Blakeney, Cley, Kelling, Langham, Morston, Wiveton, Salthouse, Stiffkey & Cockthorpe, in all a population of 1954.
Holt Medical Practice proposes to close this surgery. Currently, it serves as a reception hub and a prescription drop off and medication pick up. Face to face appointments were withdrawn prior to Covid and never reinstated despite requests from parishioners.
The local and wider community strongly objects to the proposed closure. For example, a public meeting with the practice was hugely oversubscribed, almost 900 have signed a petition at time of writing, and an online survey by Duncan Baker MP had 434 responses of which 99% were opposed to the closure, The major reason for objection is the difficulty patients will face in accessing health care.
If the Surgery closes, for residents of Blakeney and surrounding villages the nearest health care is at High Kelling (a 14 mile round trip), or Melton Constable (a 20 mile round trip). Those without a car, 20% in Blakeney from 2011 census data, face a 3 ½ hour round trip by bus to High Kelling (including a half mile walk) or a 5 ½ hour round trip to Melton. The local volunteer car service is at capacity and there is no local taxi firm.
Over 40% of Blakeney residents are over 65 and over a quarter of these live alone. Over a tenth of residents say their day-to-day activities are limited a lot, and 6% say they are in bad health (all from 2011 census data). How will these residents cope with a three, four- or five-hour bus journey with multiple changes? It is not just older residents. How could a young mother manage with two children in a pushchair?
Travel is similar or worse for residents in nearby villages. For Morston, which is 3 minutes by bus from Blakeney, it would be more than a 2 ½ hr round trip with four changes to High Kelling and it is not even possible to get to Melton.
Closure will have an impact on health inequalities. Section 149 (Public Sector Equality Duty) of the Equality Act 2010 states that a public authority must, in the exercise of its functions, have due regard to the need to eliminate discrimination, advance equality of opportunity, remove or minimise disadvantages and take steps to meet the needs of persons who share a relevant protected characteristic, such as age and disability.
The National Health Service Act of 2006 states in Section 13G that “The Board must, in the exercise of its functions, have regard to the need to reduce inequalities between patients with respect to their ability to access health services.”
Closure of Blakeney Surgery would also go against four of the key principles of the NHS Constitution for England, namely:
1. The NHS provides a comprehensive service, available to all;
2. The patient will be at the heart of everything the NHS does;
3. It is committed to providing the most effective, fair and sustainable use of finite resources; and
4. The NHS is accountable to the public, communities and patients that it serves.
The NHS Constitution also pledges to ‘provide convenient, easy access to services.’
Finally, but equally importantly, closure of this branch surgery has a negative impact on North Norfolk District Council’s ambition of net zero. The carbon footprint of patients travelling from Blakeney and surrounding villages to High Kelling or Melton is calculated to be almost 55 tonnes of carbon dioxide a year, equivalent to almost 11 return trips from London to Sydney. This carbon footprint would need to be offset by planting more than 2000 trees annually, which would require more than 2 ½ acres of land per year.
It is proposed that Full Council resolves to
The Chairman invited Cllr Dr Holliday to introduce the motion. She explained that 2000 people currently used the surgery at Blakeney and that there was overwhelming support to keep it open, with 1300 people having signed a petition against its closure so far. She said that it was a 14 mile round trip to the surgery at High Kelling and a 20 mile round trip to the surgery at Melton Constable. There had been a doctor’s surgery in Blakeney for 180 years but face to face appointments were removed 4 years and the parish council had been pushing to have these reinstated ever since. The Practice claimed the building was not fit for purpose and didn’t fit the trend towards team-based working and that resources were limited but the ‘Save Blakeney Surgery’ campaign group disagreed, stating that it was a purpose built and had been rated as appropriate for the services it delivered. Cllr Holliday went onto explain that general practices were private businesses and there had been reporting nationally that income had risen in recent years. She said that staffing at the Holt Practice seemed adequate, with 1800 patients per GP, which was lower than the national average of 2300. In addition, it should be remembered that age and disability were protected characteristics and over 40% of Blakeney residents were over 65 with a quarter of these living alone. Over a tenth of residents said their day-to-day activities were limited a lot, and 6% say they were in bad health. The closure of the surgery would discriminate against the elderly and the disabled.
In addtion, Cllr Holiday said that achieving Net Zero was a key ambition of the District Council and the additional travel required by Blakeney residents to access GP services in Holt would have a significant carbon footprint – equivalent to 55 tonnes a year. She concluded by urging all members to support the motion, in advance of a decision being made early in 2024.
Cllr E Vardy, seconder of the motion, reserved his right to speak.
Cllr T FitzPatrick commented that North Norfolk was a rural, coastal district and satellite surgeries were vital as public transport was non-existent in many places. He used a satellite surgery and they provided easy access to both young and elderly people and as well as providing support for medical issues, they were also vital to ensure that people could access services for mental health issues. He said he would be supporting the motion.
Cllr T Adams, Leader, said that the issue was symptomatic of diminishing health provision across the District. He said that he felt there was a role for the Overview & Scrutiny to look at the impact of such closures and reduced access to health facilities as part of their work programme and he encouraged the committee to do so.
Cllr L Shires said that she valued work such as this by Opposition colleagues, particularly as it outlined where members’ values were aligned on shared issues and concerns. This was where rural communities were served inadequately by public transport and services which were diminishing over time. The provision of accessible health services was something that everyone would expect and want to see across the District. She said that the motion had her full support and she seconded Cllr Adams suggestion that the Overview & Scrutiny Committee could look at health inequality as part of their work programme.
Cllr C Cushing thanked Cllr Holliday for bringing the motion forward. He said that it was an issue that she felt very passionate about – both for her own ward and the wider community. He said he was very supportive of branch surgeries and knew from growing up in the area, how challenging it could be accessing the GP surgery in Melton Constable and anything that could reduce this would be beneficial.
Cllr C Ringer said that he was fully supportive of the motion. Coastal communities suffered from the impact of second homes and holiday lets and the closure of this surgery would exacerbate the existing vulnerabilities in small villages. He said it was important to speak as one of such issues as it was very unlikely that Blakeney would be the last satellite surgery to close.
The Chairman said that the issue seemed to have united the Chamber and she welcomed this.
Cllr E Vardy, seconder of the motion, thanked Cabinet for their positive comments and support. He said doctors were answerable to their patients and they needed to take into account the impact such a closure would have on residents. He said that the crux of the issue seemed to be about finances rather than public service. He commended the motion.
Cllr Holliday was invited to make her closing comments. She thanked everyone for their support. There was substantial evidence that there was coastal inequality regarding the burden of ill health and she was supportive of the Overview & Scrutiny Committee looking at this in more depth.
It was proposed by Cllr Dr V Holliday, seconded by Cllr E Vardy and
RESOLVED unanimously to