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An eye-catching image reveals for the first time what a new 'super' hospital in Canterbury could look like.
Plans are on the table to build the state-of-the-art facility on farmland next to the rundown Kent & Canterbury site as part of a bold vision to revolutionise healthcare in east Kent.
It is one of two options on the table, but with the pandemic stalling the drawn-out selection process, health campaigners are stepping up their calls for NHS chiefs to back the 'super' hospital bid.
The five-storey brick building would host a major emergency unit for the whole of east Kent, with all specialist services such as heart and stroke care centralised in the city.
Developers Quinn Estates would build the shell of the hospital for free as part of a wider housing development of 2,000 homes on surrounding land, with the NHS having to find the money to equip it.
A&E departments at Ashford's William Harvey and the QEQM in Margate would be downgraded to urgent treatment centres, but locals would still use the hospitals for the majority of their care.
The alternative would see all major services centralised at the William Harvey in Ashford, with Margate's A&E unit expanded and the K&C downgraded to a hospital specialising in diagnostics and routine planned surgery.
Both projects would cost the NHS about £400 million, with funding yet to be secured.
Health campaigner Alex Lister - a public governor at East Kent Hospitals - says it is clear which of the options is best.
"Canterbury is a no-brainer because it is the centre of east Kent," he said, speaking in a personal capacity.
"It's equidistant between all the areas it serves. If the infrastructure went to Ashford, then people in Margate would be more than an hour away from a hospital.
"Thanet is one of the most deprived areas in the country and it's not fair to put their hospital so far away from them.
"It seems obvious it should come to Canterbury, but that will be down to the powers that be.
"You roughly need one major hospital per one million of the population. East Kent has more than three-quarters of a million and is growing so we need a major hospital in Canterbury.
"It doesn't make sense for that not to happen."
The new hospital would be built on council-owned land at Ridlands Farm, once earmarked for a new 1,000-seater stadium for Canterbury City Football Club.
Quinn Estates would fund construction of the shell of the hospital - at a cost of about £150 million - ahead of 2,000 homes being built on land stretching round to Canterbury Rugby Club.
There would be multiple access routes into the site of the new hospital, the main one being via a new roundabout off Nackington Road.
A new distributor road - built as part of the Mountfield Park development - would connect this roundabout on one side with a new junction on the A2 at the top of New Dover Road, and on the other side to Hollow Lane in Wincheap.
The new hospital building would be owned by the NHS, with the current K&C site forming no part of the development plans.
Former nurse Peggy Pryer has been a key voice in championing the city's 'super' hospital bid, and is now secretary of the Option24U group, campaigning for the Canterbury vision.
"The existing K&C site is well past its sell-by-date and long-overdue a rebuild," she said. "The neglect over the years has been terrible.
"I couldn't believe it when Mark Quinn told me he'd build us a hospital, but now look where we are.
"The offer is there so of course it needs to be taken up.
"It's much more economical to build a new hospital which goes up in height, rather than being a sprawling mess with corridors everywhere.
"People need to realise what these options mean. We've got nurses and even doctors who don't understand it all - they need to realise Canterbury is the best way forward."
The 'super' hospital bid has met resistance in Thanet and Ashford, with Damian Green - the MP for the latter - branding it a "mad proposal".
But former Canterbury City Council leader Simon Cook believes there is an acceptance behind closed doors that the scheme is the best option for centralised health services in east Kent.
"Obviously if you were at Ashford council or whatever, you'd be hung, drawn and quartered if you said anything other than 'the hospital should be in Ashford'," he said.
"But I think you'll probably find behind closed doors that people would admit that there is a logic to having it in Canterbury. Nobody is going to say that in public because they all want to be re-elected.
"But there's a difference to what people say politically, and what they say pragmatically behind closed doors.
"Canterbury is the hub for public transport in east Kent. For example, it's much more difficult than you'd think to get a bus from Folkestone to Ashford, than it is to get one from Folkestone to Canterbury.
"If you look at the road network, all roads lead to Canterbury.
"And it makes particular sense because of the universities and medical school here. It all ticks so many boxes.
"A hospital is no good without people to run it, and having a split site has not been helpful in terms of having doctors two days in Thanet and two days in Ashford. People just prefer to work in one place.
"It simply makes sense for that to be in Canterbury."
With East Kent Hospitals hit by a series of scandals and poor performance in recent years, the region's MPs together wrote to the health secretary in December urging him to consider the transformation programme as a "matter of urgency".
Current Canterbury City Council leader Ben Fitter-Harding (Con) says the authority is doing all it can to throw its support behind the super hospital bid.
"The council is emphatically backing a new hospital for Canterbury and we've enshrined that into how we're operating the council," he said.
"The calls for the hospital were all part of our individual campaigns in 2019 - there wouldn't have been a leaflet without that being on there.
"We've been making sure that our policies are supportive of making that happen - we haven't taken any decisions that might block us from that.
"Everything is geared around trying to make it happen."
NHS leaders in east Kent have put together a wide-ranging business case for the two options, which has been assessed by independent clinicians.
It is being reviewed by NHS England, which will need to approve it given how much capital investment is needed from central NHS budgets for both projects.
It will then be put out to a 12-week public consultation, which officials stress is not a referendum between the two options.
Following this there would be a meeting of the East Kent Joint Committee of Clinical Commissioning Groups (EKJCCCG) to consider all the feedback gathered.
It would then confirm a single preferred option to progress to the final stage.
A full business case would be developed - looking exclusively at the preferred option - and submitted to NHS England, with a request for the capital investment needed.
If approved, the EKJCCCG would take a final decision to progress with implementing the preferred option.
It is expected both projects would take between five and seven years to implement from the start of the consultation.
But it was confirmed last week that the consultation has again been stalled as the NHS focuses on the Covid vaccine roll-out.
A spokesperson for the East Kent Transformation Programme said: “We are, quite rightly, focused on our response to the pandemic and the vaccination programme at this time.
“However, we are continuing to work with colleagues at NHS England and NHS Improvement on finalising the pre-consultation business case and securing a commitment of capital funding.
'The process has been repeatedly kicked into the long grass, which has put our local healthcare into a unenviable predicament...'
"It would not seem wise or appropriate to launch a public consultation when the Covid-19 pandemic continues to be the key priority for the NHS and when our local communities are unlikely to be able to engage in a meaningful way.”
The spokesperson said the pandemic, local elections and feedback from county councillors would influence when the consultation starts.
Mr Lister says the delay is a “matter of considerable disappointment”.
“The process has been repeatedly kicked into the long grass, which has put our local healthcare into a unenviable predicament,” he said.
“The dithering and delay is causing a lot of harm because no one knows how to plan. We don’t know if or when the money is coming in, or where services may be relocated to.
"The trust struggles to recruit or retain staff as it has a bad reputation, but 30 or 40 years ago training at the K&C was one of the most sought-after places to train at, and that could happen again.
“We just need a decision to be made. The trust is strapped for cash and can’t invest in the estate which means they can’t attract the best staff, meaning more has to be spent on getting agency staff."
While Canterbury MP Rosie Duffield backs a new hospital in Canterbury, the Labour politician believes it should be funded by the government and not Quinn Estates.
"Investment in the NHS is long overdue and should come from central government rather than private developers offering to build hospitals in return for building houses in the area," she said.
"Our old facilities, including the 1937 K&C building, which even pre-dates the NHS, were never built to accommodate the number of patients we see today, and for too long have been overwhelmed and ill-equipped to deliver the required services and care.
"The trust trains the next generation of healthcare workers, and in order to keep that wealth of knowledge and experience, we must make our hospitals an attractive prospect to work in.
"We need the best long-term decision for east Kent, based on what the medical experts say would result in the best health outcomes, with care delivered as close to people’s homes as possible.
"I believe Canterbury is the best location for a large new hospital. We cannot afford to get this opportunity wrong."
Retired consultant surgeon Bob Heddle has long-been a supporter of the campaign group Chek and fought against the downgrading of the K&C.
He worked at the hospital from 1981 to 2005, when he resigned over the "absolute mayhem" of growing waiting lists and services being cut.
He remains convinced that the offer of a centrally-placed new hospital in Canterbury is too big an opportunity to miss.
"It makes sense logically, practically and clinically, but you're obviously not going to please everyone," he said.
"Clinically, having all the acute services and specialists under one roof clearly has advantages for patient care, which will be easily accessible.
"It's perfectly possible for patients to be transported from Margate or Ashford to Canterbury.
"But I also know many doctors, like those working in gynaecology and obstetrics, don't mind where they are as long as they are together in a system that works.
"Having the offer of a new hospital is a huge opportunity for east Kent and brings advantages for staff and patients.
'It's perfectly possible for patients to be transported from Margate or Ashford to Canterbury...'
"And again, clinically, with the new medical school in Canterbury, it will be a draw to retaining those young doctors.
"And there are problems with Margate, which is cut off by the sea and suffers with poor recruitment.
"I believe having the hospital in the middle of east Kent just makes sense."
