Community Forum on the Provision of Health Services



The Community Forum took place on 26th September 2023 under the chairmanship of Cllr Elaine Best, Chairman of WHPC. The event followed a ‘Question Time’ format, and the panellists were:

  • Dr Rishi Barai, Partner, Horsley Medical Practice
  • Joss Bigmore, Chairman, Royal Surrey NHS Foundation Trust
  • Caroline Camp, Practice Manager, Horsley Medical Practice
  • Jo Cogswell, Place Based Leader for Guildford & Waverley, NHS Surrey Heartlands ICB
  • Graham Wareham, CEO, Surrey & Borders NHS Foundation Trust

The purpose was to inform the audience, which filled West Horsley Village Hall, what effect the increase in numbers of new houses in our two villages, and perhaps on Wisley Airfield, may have upon Health Services in the Horsleys and their surrounding area. This was not a protest meeting, rather, it was an opportunity to receive information from the panelists and to ask them questions. The hope was that by the end of the evening, we would all be better informed, and perhaps, even reassured.

Dr Barai spoke first. He told us that the Medical Centre is successfully catering for 10,600 patients, and they are going to be expected to deal with thousands more from the developments in East and West Horsley. If Wisley is developed, as is planned by Taylor Wimpey (TW), the impact could be far bigger or, possibly, negligible depending on whether funds for an on-site Medical Centre or annex will be provided by TW. Dr Barai believes that the changes to the population can be met by the addition of two extra consulting rooms for which £70,000 has been allocated by the ICB. The balance will be funded by the Practice Partnership. As he explained, each development is expected to make a financial contribution to the community in which they are building. This is known as an S106 payment. The £70,000 has come from S106, and it may be that further sums will be available in the future. He believes that while the Practice can cope there will be an additional need for administrative assistance and also increased use of Nurse Practitioners and other Health Professionals. He is concerned about the possible impact of Wisley, but there are early talks in progress, and they will continue. It is right to say that the reception his comments were given was demonstrated by enthusiastic applause from the audience.

Jo Cogswell, from the Integrated Care Board (ICB) explained that their job is to identify and prioritise the needs of the population and to assess the nature and capacity of existing NHS services in the area. She made the point that the total spend on Health Care encompasses matters such as Social Services, Mental Health, Education, and other areas of Social Care. Only 20% of spending on social wellbeing is achieved by medical intervention. Jo told us that some S106 money has already been provided to fund some developments in health care and there are ongoing discussions to ensure that if Wisley goes ahead provisions will be made, but, as to exactly what they will be, she could not yet say. She made the important points that “regular” annual increases in population are met by increased spending, providing of course that government can provide that, and that the increasing age of our population inevitably has an impact upon the spending required.

Graham Wareham, CEO, Surrey & Borders NHS Foundation Trust, dispelled any idea that our Medical Centre funds Mental Health Services. This service is provided on a county wide basis and the service that is provided to children is integrated with Surry County Council education services. They also work with 200 voluntary bodies and assist schools in the help they provide for mental health problems. any local rise in population will have no immediate impact upon the service they provide.

Joss Bigmore, Chairman, Royal Surrey NHS Foundation Trust, provided a similar message. The Trust provides a service for a large part of the county and his view was that the Foundation gets more than most but still not enough. In answer to questions from the audience he agreed that he would like more outpatient clinics but outlined the difficulties in providing those. These were largely due to efficient use of Consultants’ time. He also acknowledged the need for better dementia services, accident and emergency services and preventative clinics. Again, his comments were of interest and were reassuring, but did not suggest that our imminent local expansion in numbers would have a significant effect on the service for which he is responsible.

Caroline Camp, our Practice Manager, was able to deal with some questions about the possible provision of other services at the surgery. She explained that while additional services may be welcome it could well be that other services would suffer financially as a result.


The Parish Council set up the Forum with the object of receiving information and to seek answers. By the end of the evening the hope was that we would be better informed and perhaps even reassured. We believe that we achieved this aim.

We were informed as to the reality of how our Health Services work and in particular the explanation of the 80/20 approach was highly significant. The Medical Centre is of course important to our villages, but it only provides a portion of the Health Services that we all rely upon. We are only a part of the population that the Hospitals and the Mental Health services provide for the county, and thus any increase in our population, although of significance locally, is unlikely to be significant to their overall strategies.

Going to our local interest, our Medical Centre, we were greatly reassured by Dr Barai’s confidence both in the services that are being provided and those that he anticipates being able to continue to provide with the burden of the extra population including face to face consultations. There is money to build new accommodation in the centre, but more may be required from S106 payments and other possible sources to cover extra costs such as the expense of employing more staff.

As regards the possible development at Wisley the future there is uncertain but there is hope. Talks are ongoing with Taylor Wimpy and clearly if the development occurs there will be some S106 money available and it would seem, if not inevitable but extremely likely, that some, if not all of that, would be allocated to providing proper medical provision for that development and would not result in an undue strain being placed upon the resources available to our villages.

Summary prepared by Cllr Paul Dodgson, 30 Sept 2023

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