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West Wales News Review — analysis with a sustainability slant

Archive for the category “Public health”

Loss-Making Private Hospital Link to Llanelli’s Planned Wellness Centre

Carmarthenshire enters exclusive agreement with Kent Neurosciences

A chain of companies and directors link the proposed Wellness Centre in Llanelli to a private hospital in Maidstone and to the tax haven of the British Virgin Islands.

The chain includes Kent Neurosciences Ltd, potentially a partner for Carmarthenshire County Council in the Wellness Centre planned for Delta Lakes.

The council’s Executive Board unanimously resolved, on May 23rd, to enter into an exclusivity agreement with Kent Neurosciences Ltd “with a view to ensuring the aspirations of the Wellness and Science Village within Carmarthenshire”.

Kent Neurosciences Ltd is one of a clutch of companies with various directors in common, now or in the recent past. Kent Neurosciences Property Ltd, KIMS Hospital Ltd, KIMS Property Co Ltd, and KIMS Property Holdings Ltd, have been variously concerned with the development, construction and operation of a private hospital in Maidstone, Kent – the KIMS Hospital, KIMS standing for Kent Institute of Medicine and Surgery.

KIMS Property Company Ltd owns the hospital, which is leased to and operated by KIMS Hospital Ltd. KIMS Property Holdings Ltd is the parent company of KIMS Property Company Ltd, and the ultimate parent of KIMS Property Holdings Ltd is Mercury Management Enterprises Corp, a company registered in the tax haven territory of the British Virgin Islands.

Here we enter the world of the leaked Panama Papers, which show that Mercury Management Enterprises Corp is a shareholder of Petrel Investing Ltd, also in the British Virgin Islands, and Petrel is a shareholder of Mercury. Petrel Investing has connections with other offshore companies – OMNI Capital Assets Ltd, OMNI Management Consultancy FZE, ONTARIO Inc, Sarama Beta Ltd – and an individual, Alexander Timofeev of Toronto, Canada, in linkages that are visible to the public only because of data breaches.

Private hospital required £20 million refinancing deal

The private hospital, which opened in 2014, has been struggling. Original estimates of income from the NHS and self-paying patients were over-optimistic. The initial management team – Franz Dickmann and James Dickmann, solicitor Steven Bernstein, and chief executive Jayne Cassidy – departed from the hospital operating company and new personnel took over. In March 2016 the Kent Messenger newspaper reported[i] that in its first-year, to April 2015, the hospital’s losses were over £15.2 million, nearly twice as great as the revenues, and so a refinancing was urgently sought from its major investors, Realta Investments Ireland Ltd and Regional Healthcare Ltd. Realta Investments Ireland had negative net worth of nearly €5 million in 2014. Regional Healthcare Ltd in the UK was dissolved in April 2015 (but a Cyprus company of the same name remains active).

The hospital refinancing, worth around £20 million in total, included a rent holiday until April 2019, so the intended rent recipient, KIMS Property Company Ltd, will itself have a big income hole to try and fill.

KIMS hospital pioneer Franz Dickmann, and Phyllis Holt (who is also consultant cardiologist Dr Phyllis Holt Dickmann) are the major shareholders in Kent Neurosciences Ltd, according to Companies House on June 1st, with 8,535 and 9,040 shares respectively. Consultant neurologist Dr Mun Seng (Sam) Chong and ASB Law each owned 2,500 shares, and Richard Gullan, consultant neurosurgeon, and Alan Day, retired professor, owned 1,000 apiece.  ASB Law, a legal firm operating in Sussex and Kent, is the company secretary, and Dr Sam Chong, Richard Gullan and Alan Day are all current directors of Kent Neurosciences Ltd.

Head of Swansea’s Business School was on board of Kent Neurosciences

Why should Kent Neurosciences be interested in a start-up venture in Llanelli? There is a link in the accomplished person of Professor Marc Clement, Head of the Business School at Swansea University’s School of Management. Llanelli-born Professor Clement was a director of Kent Neurosciences between December 16th 2014 and August 21st 2015.

Currently Professor Clement, holder of patents relating to medical devices, is a director of nine companies, including four based at Technium 2 in Swansea – Cyden Ltd, Ipulse Direct Ltd, Ipulse Ltd, and MC500 Ltd, concerned with the supply of medical and dental instruments. The other five companies are Life Sciences Hub Wales Ltd, Arthurian Life Sciences Ltd, Swansea Innovations Ltd, WWII Ltd and Calon Cardio-Technology Ltd.

Swansea University is part of ARCH – A Regional Collaboration for Health – alongside Hywel Dda University Health Board and Abertawe Bro Morgannwg University Health Board. ARCH is behind the plan for a Wellness Centre at Llanelli, a venture for which Carmarthenshire County Council would provide the land. The ball-park cost of the project is £60 million, money which has to be raised. Abertawe Bro Morgannwg (ABM) University Health Board reckoned, in a press release dated December 2nd 2015, that “funding could come from the EU but also from private investment and match funding in various forms”.

The Wellness Centre would probably include a new leisure centre, a “wellness education centre”, hub for out-of-hours GP services and various therapies, a hotel and conference centre, and a Hywel Dda branch of Swansea University’s Institute of Life Science, which is based in the College of Medicine. The Institute of Life Science is a partnership between the university, the Welsh Government and ABM University Health Board.

ARCH itself “breaks free from an outdated healthcare system designed over 50 years ago and replaces it with an accessible one specifically planned for today’s needs”, according to ABM University Health Board’s December press release.

The practical benefits for the people of Carmarthenshire are not yet clear.

Echoes of Technium?

A millennial plan for entrepreneurship centres – called Techniums — throughout Wales did not live up to the original aspirations. Wales used to have 10 Technium centres, modelled upon the first, which was set up by the now-defunct Welsh Development Agency (WDA) and by Swansea University in 2001. They were small science parks, intended to foster local innovation and entrepreneurship in a programme which cost around £111 million, but the majority were not a success and in November 2010 the Welsh Government decided to close six of them, including one for performance engineering based in Llanelli, which Carmarthenshire County Council took over and renamed the Beacon Centre. It is now a conference and meeting centre.

Four Techniums remained, two in Swansea, including Technium 2 (the address for four of the companies on which Professor Clement sits as a director), and one each in St Asaph and Cwmbran.

An evaluation by property consultants DTZ indicated that each job created under the Technium programme cost, on average, £190,000 from public funds.[ii]

The inspiration for the Technium project came from a small group of people including Swansea’s Professor Clement and Professor Ken Board, and the WDA’s Gareth Hall (who was the Agency’s final chief executive, between 2004 and closure in 2006).

Professor Clement’s own role in higher education finance expanded in 2007, when he became pro vice chancellor – the chief executive — of the University of Wales, which at the time represented nine higher education centres in Wales. The University of Wales was raking in £ millions from accrediting degrees overseas, in a much-criticised programme which prompted half a dozen leading vice-chancellors to call for the University of Wales to be abolished. In 2011 the University of Wales was subsumed within the colleges of Saint David, Lampeter, and Trinity, Carmarthen, and Swansea Metropolitan University, in a sort of reverse takeover. Professor Clement returned to Swansea University, to be Executive Chair in the Institute of Life Science.

Now, his jobs include board membership of the ARCH programme.

The concept of a medical research centre in Llanelli, raising the profile of Wales as a country of scientific excellence and innovation, has a definite allure. Even so, and allowing for  Professor Clement’s recent involvement with Kent Neurosciences, is this company – full of medical expertise but light on proven business success in the ‘wellness’ arena – the most appropriate partner for Carmarthenshire County Council in the Wellness Centre project?

And, perish the thought, could the Wellness Centre be a conduit for public money to flow through networks of companies into far-away entities registered in the British Virgin Islands and other tax havens?

 

PDR

 

 

 

 

 

 

 

 

[i] ‘KIMS Hospital in Maidstone sought £20m hand-out after making huge loss’. by Chris Price, March 11th 2016.

[ii] ‘What we can learn from £100m and 10 years wasted on the Technium programme’ by Dylan Jones-Evans, Wales Online, June 1st 2013.

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‘Wellness Centre’ to Worsen Financial Starvation?

Part 1

Talk of a £60 million ‘Wellness Centre’ in Llanelli is not unalloyed good news because such a major complex would bring with it major running costs – when public authorities of all kinds are having to axe services because they have no money.

Cllr Meryl Gravell (Independent, Trimsaran),  Carmarthenshire County Council’s board member in charge of regeneration and leisure, spoke in quite rapturous terms in praise of this flagship/iconic project during Wednesday’s council meeting.

The Wellness Centre would be linked to ARCH, ‘A Regional Collaboration for Health’ between the health boards Abertawe Bro Morgannwg and Hywel Dda, and Swansea University. The £600 million ARCH plans include expansion of services at Morriston and Singleton hospitals, a medical science park at Swansea University, and the Wales Centre for Rural Health on sites across the Hywel Dda area of Carmarthenshire, Ceredigion and Pembrokeshire.

The Wellness Centre would be funded with the help of grants from the European Union, and built in the Llanelli area, possibly the Old Castle Works ex-tinplate factory site, which Carmarthenshire County Council bought in 2005 intending to build a leisure village for which funding never materialised, or at the Delta Lakes industrial park.

The Wellness Centre would incorporate a replacement for Llanelli’s leisure centre, and probably a day centre, health and social services and occupational therapy. The town’s existing leisure centre in Park Crescent, which had expensive repairs last year after storm damage, appears more conveniently sited for townspeople, though.

But of course everyone visiting a Wellness Centre for occupational therapy, or to see their social worker, would both own a car and be able to drive it, wouldn’t they? Well, no – there would be big public transport implications. Centralisation of services shifts transport costs (and time) onto the ‘clients’ or ‘customers’, often to the detriment of their ‘wellness’.

And what happens when the council’s share of the running costs starts to appear in the accounts? The portents are not good, as if there is no interest from the private sector, projects which turn the revenue accounts red are either closed or passed to community councils or voluntary groups, for them to contemplate the gaps between expenditure and income. Currently Carmarthenshire is trying to offload 96 parks and playgrounds, and this week confirmed a decision not to prioritise saving the meals on wheels service (now costing £3.70 a time). A hot meal delivered to the door, and a local park in which to take the air, both contribute to ‘wellness’. If the county council can’t guarantee these basic services, what chance is there of contributing to keep a Wellness Centre, somewhere outside Llanelli, operating as comprehensively as its founders would wish?

Grants for the capital costs of new projects can turn into fool’s gold if there are scant prospects of the projects operating at a profit, and there are insufficient subsidies towards the running costs.

Despite our ageing population, Carmarthenshire County Council plans to cut spending on social care, health, housing and leisure by a net 6.4%, £5.8 million, between 2015-16 and 2017-18, which can hardly be done without also cutting ‘wellness’. A huge cut in home care services run directly by the council will reduce net expenditure from £5.568 million this year to £530,000 in 2017-18. The work will go to the private sector, who will get £3.561 million-worth of extra work – but this still means an overall budget cut of almost £1.5 million.  How this will assist ‘wellness’ is, as yet, a mystery.

More coming in Part 2  

PDR

Toilets Flushed Away to Detriment of Public’s Convenience

UPDATE September 6th: Pembrokeshire Tops the Toilets Table 

Pembrokeshire’s ‘Public Toilets’ page may be blank, but my attention has been drawn to another page on their website, headed ‘Public Convenience Cleansing‘. This page reports that since August 1st 2014 the maintenance and cleaning of the county’s 73 public toilets has been outsourced to Danfo UK Ltd. Seventy-three is a good number — certainly compared with Carmarthenshire’s 28 — and 52 of them cater for disabled persons. No less than 26 are open 24 hours in summer, and 16 have 24-hour opening throughout the year, again far better than in Carmarthenshire — also a centre for tourism — where only one place, Whitland, is listed as having 24-hour toilets. Whitland is close to the county boundary, so maybe the Pembrokeshire influence has crept over.

Llansawel's convenient toilets, handily signposted

Llansawel’s convenient toilets, handily signposted

Local authorities do not have to provide public toilets. No one has to supply toilets for the public, except I think the operators of motorway services, although businesses need to do so for their employees. Numbers of public toilets are in steep decline: a House of Commons Library note* in 2010 recorded that in England alone in 2000 there were more than 6,600, but in 2005 only 5,084 in England and Wales combined.

Imagine West Wales without any public toilets. After Pont Abraham at the end of the M4 we don’t even have any motorway service areas, as there are no motorways. Elderly folk, and parents with small children, would probably have to stay home a lot more, or gamble on the chance of finding a convenient deserted wood. The Wales Government has made a gesture towards toilets in the Public Health Wales Bill 2015, which requires local authorities to publish a public toilets strategy – but a strategy is not actual provision.

Ceredigion County Council has more toilets than Carmarthenshire but fewer than Pembrokeshire. Ceredigion publishes a list of 39 locations, 14 of which are open 24 hours all year. In addition, 13 businesses in the county have joined in a Wales Government scheme — initially but not now funded by the government – for businesses to make toilets accessible to the public. They range from The Talbot in Tregaron, via Siop y Ffrydiau in Cenarth, to The Guildhall in Cardigan.

As for Pembrokeshire, until alerted to ‘Public Convenience Cleansing’ (see Update, above), I was unable to find any information about public toilets on their website. There is a public toilets page – but it is blank.

In Carmarthenshire, only one of the 28 toilets is listed as open 24 hours, in West Street, Whitland, run by the town council. The county council list says it is free, but according to the town council it costs 20p. Many of the other toilets have restricted opening, so if you are going on a trip, as well as finding out where the toilets are, you also have to investigate the opening hours. No point relying on the facilities in Ammanford’s Co-op car park after 5pm, because that’s when they shut, according to the county council’s list.

Unless you have an amazing memory, it’s probably a good idea to take the list with you. You don’t want to be in need of a toilet in Glanamman after 2pm, or any time at weekends, or in Kidwelly after 5pm, or in Llanddowror between noon on Friday and noon on Monday.

The British Toilet Association points out that a “lack of adequate toilet facilities can also impact on an individual’s physical and mental health, as well as affecting the wider environmental health of the population”, and our ageing population surely requires more toilets than in previous decades. There’s a huge disparity between the modern house with at least two, and often three toilets, and the world outside with hardly any.

I’m glad to say that here in Llansawel  — photo above — we do have public toilets, free, in the village hall car park – a boon for people visiting the play park and riverside walk and picnic area. They are signposted, too!

PDR

*House of Commons Library Note number SN/SC/976, Public Conveniences, by Louise Smith, 2010

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