When it comes to picture postcard Cornwall nowhere sums up the cosy coastal idyll of a harbour village better than Polruan.
Surrounded on three sides by water, it has the unique feel of a mainland island, and its steep hill up from the River Fowey is like something out of a Hovis advert if you swapped loaves for fishes, which is fitting as there’s something quietly spiritual about the place.
For many, Polruan is the dream location – a beautiful, friendly village which is the perfect place to bring up children and grow old.
However, there is trouble in paradise and the residents are really worried. So worried that they’ll tell you they feel abandoned and are genuinely concerned that their way of life is now under threat.
Dig under the surface and Polruan has its problems like many coastal villages around Cornwall – it’s a second homes nirvana with a layer of deprivation and hardship underneath. It’s also out on a limb.
Which is why a great deal of the village’s 700 residents are fearful of a proposal by Fowey River Practice to possibly close Polruan GP branch surgery in a bid to “maintain and enhance services for our whole patient population”.
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A public consultation ends on Friday (April 17) but Lanteglos by Fowey Parish Council is pushing for an extension, so strong are locals’ views on the matter.
I visited Polruan on one of the rare sunny days we had enjoyed so far this year before the current spell and walked down that steep narrow hill to the village’s reading room to meet some of those who believe closing the surgery next to the Lugger Hotel will have a huge detrimental impact on the community.
It would mean people having to travel by ferry to Fowey on the other side of the river and then walking up yet another steep hill to that town’s surgery. Imagine doing that if you’re feeling ill and the water’s choppy, they say.
Gini Ainley, vice-chair of the council, told me: “Obviously the parish council is extremely concerned about what’s going on. You probably don’t realise this, looking out at that beautiful view, but we are a very high area of deprivation for services and housing. About a third of our permanent houses – nearly 100 – are social housing.
“So having a local surgery here is absolutely key to the healthcare of people, but also our prosperity and prospects.
“If we don’t have a surgery here then what’s going to happen is that people that are most in need and the most vulnerable aren’t going to be able to access healthcare services.
“The health service is pushing prevention yet those are the least likely people to be able to afford to go over to another surgery or to sort out how they get there as transport is so difficult.”
Half the housing in Polruan is second homes and a lot of the social housing in the village has been lost over the years to ‘right to buy’ and some of them have even been turned into second homes themselves.
As well as those living in social housing, there is a significant percentage of elderly people in the village. Living in Polruan must have its restorative powers as a lot of them are in their 90s, but losing the GP surgery is obviously a matter of concern to them.
There are young families too, with around 20 children attending Polruan Academy primary school.
Jane Wills, head of the school, said: “The loss of this essential service would have a profound impact on the wellbeing, stability and long-term sustainability of our community.
“For families already facing financial pressures, being required to travel across the river to access GP services would create unnecessary hardship. This could create a situation in which healthcare becomes inaccessible to exactly those who need it most.
“The proposed closure would also have a direct impact on schools, including increased disruption to children’s learning.
“When families are forced to travel longer distances for healthcare, pupils are more likely to miss significant portions of the school day for appointments that would otherwise have taken minutes. This disrupts not only their academic progress but also their sense of security and routine.
“In the longer term, the absence of a local GP surgery risks reducing the number of families who are willing or able to remain in or move to Polruan and might also impact negatively on social housing placements.
“This has implications for school roll numbers, community stability and the overall vibrancy and sustainability of the village. Schools and surgeries are cornerstones of rural life; when one is threatened, the entire structure of the community becomes less secure.”
A return ferry trip to visit the surgery in Fowey would cost £6.40.
“We have food banks and people on very low incomes – to say to them, you have to pay £6.40 let alone anything else is a lot to ask,” added Gini.
“One of the issues is the accessibility of this surgery, but to go over there you have to go down a hill, clamber on to a ferry, go up a hill to get to the surgery to get your blood pressure taken, which then turns out to be high and then you have to do it all the way back. So people who are in any way infirm will find that impossible.
“In the longer term, if we don’t have a surgery, we’re going to become less attractive as a place to live permanently and we will potentially lose people who already live permanently, and that’s a nail in the coffin to our community, to our local businesses, to our school and undoubtedly turns us more and more into a ghost town – and at the moment we’re not, we’re a thriving community.”
She added: “While having consultations with the practice, all the staff are wonderful, it does really feel that there is something going on with a one-size-fits-all national policy which isn’t working for rural communities.
“I don’t think our local integrated care board (Cornwall and Isles of Scilly ICB) has quite worked through how it can adapt policies, but we’d like to work with them.”
As Gini says, it really is a thriving community – more so than in many coastal villages which have been hollowed out in recent years for the sake of gentrification and tourism.
Considering the size of the village, there are a lot of community groups, including a Coffee, Cakes & Chat group, an arts hub, indoor bowling, table tennis group, film club, kids’ club, book clubs, an allotment society, darts team and a community shed association to name just some.
Tammy Skinner, village representative on the patient participation group, said: “I’ve lived here for 20 years and I’ve seen the village go through a real trough pre-Covid, but a lot of people moved in during Covid as they could work from home, so it’s an attractive place and there is now loads of energy and people are prepared to get stuck in.”
“It’s buzzing,” she added, “absolutely buzzing here, but if we lost the GP surgery I think it would be inevitable that some people would consider their future in the village.”
One of those is Louise Kidd who I met while she was taking a painting class at the Quay Arts Hub near the harbour. She told me that the possibility of losing the surgery “makes getting older here very difficult, so I’m thinking ahead whether I need to move out of the village and go somewhere else.
“It would be sad, but you’ve got to be sensible – the thought of breaking my hip and falling downstairs, which is easily done around here with the steps and the hills… we feel very cut off.”
“Abandoned,” added Sarah Manners, who was also at the art class. “They’re abandoning the community – they’re isolating and totally cutting off the community here.
“How do they expect people from the older generation or young mums with babies who are ill with other children to get on a ferry when they’re poorly and then go up the hill to the Fowey surgery?”
A recurring comment from people as I walked around Polruan is that it’s like an island, with many residents comparing the village to the Isles of Scilly in terms of inaccessibility and a lack of services.
A bus service to Polperro and Looe runs four times a day, but only on weekdays, and there’s a Wednesday service to Bodmin. Apart from the ferry to Fowey, that’s it. There is also a community bus, but that depends on volunteers.
Tammy said: “There has been a suggestion from the surgery that we run the community bus and take people to appointments in Fowey or Par, but any service like that has to be sustainable and it can’t rely on volunteers – that’s not appropriate. Getting volunteer drivers is difficult too.”
Tony Cottrell pointed out the irony that “we have to be ill on the day that the community bus goes”. Others responded that it would mean putting ill people on a bus together, which could lead to the spread of diseases.
Martin Quinn told me: “You look across to the Fowey surgery on a day like today and it looks like a pleasant journey, but when you get a swell, the ferry goes up and down and it can be difficult and unpleasant to get over there.”
Kathryn Hill lives halfway up the hill and relies on a mobility scooter to get around. “I’d be virtually housebound without that, but you can’t take it on the ferry.”
Another Polruan resident, who lives with multiple health conditions which limit her mobility, told me: “Nearby in-person healthcare is not just a convenience for me, it is vital.”
The villagers say there is talk of a medical hub in Bodmin for blood tests and similar procedures but one of them told me “that’s a frightening prospect” as it would be so difficult to get to.
If by chance both the Fowey ferry and the nearby Bodinnick car ferry were out of use, it would take around 50 minutes to drive to Fowey “just to hand in a urine sample”, as one resident pointed out.
It’s obvious that the prospect of losing their surgery is putting a burden of stress on a lot of the locals.
“Very much so,” said Tony. “I use the image of the Sword of Damocles looming over our head, waiting to drop.”
The very real fear among people is that if the surgery does close and Polruan folk are forced to go elsewhere for treatment, they simply won’t bother.
Halfway up the hill on Fore Street is one of the area’s major hubs – Polruan Village Store.
Rose Edney, who works in the shop, said of the surgery proposals: “It can’t shut, it really can’t. Our access to healthcare is really minimal, we’ve got to be right down at the bottom of the pile and to lose that…”
Graham Morris, who runs Polruan Stores, added: “It will have huge detrimental effects on the people who are here and how the village grows and its sustainability.
“Polruan’s a fantastic village to be part of – the community is amazing. As soon as that starts to fracture, it eventually folds and that’s not what any of us want.”
He believes Cornwall Council could use the extra money it is now receiving from the council tax premium on second homes as a way of helping situations like the one Polruan is now facing.
He added: “Where does that money go? It goes in a central pot. Perhaps, somehow, it could be looked after by a local committee to retain village life so, for example, we could give our local surgery £10,000 a year so that they stay.”
Tammy – who raised the village’s concerns at a Cornwall Council health meeting last month – said she has great fears about the proposal “to remove a service like this without any kind of plan, any kind of vision for how you’re going to provide services to this community”, but she stressed that the GP surgery is willing to listen.
Indeed everyone I spoke to was very complimentary about the medical staff at Polruan surgery and the level of care, but it’s all of that they are worried about losing on their doorstep.
In a letter to a group campaigning to save the surgery, the Fowey River Practice partners said: “The partnership has been thinking about how we provide quality care to Polruan and the particular challenges that it’s geography affords to the patients we have served there for very many years.
“We have noticed the decline in numbers of patients using Polruan Surgery, the controversies around dispensing and the marked increase in our total patient population and individual consultation rates.
“We understand that the announcement of our consultation and engagement process has led to upset, anger and concern. The decision to formalise this conversation has been many years in the making and has not been taken without careful thought about how any possible changes might affect individual patients, particular cohorts of patients and our whole registered population.
“Unfortunately, when we are talking about funding squeezes, financial sustainability, workforce issues and workload pressures, the conversations can seem very negative and gloomy.
“However, we do have a positive vision for the practice, confidence in the partnership and an aspiration for a different service. This would be local clinician led and prioritise continuity from cradle to grave” as part of a ten-year plan.
The letter added: “This consultation is not a fait accompli. Once we have collated all responses we will decide whether to formally request a closure of Polruan branch surgery. If this were approved we could plan on making the changes over a period of a year as our notice to relinquish the lease runs out. This period of time should allow us to manage many of the difficulties that ensue.”
You can read the full letter here, which explains many of the reasons for the consultation, including the age of the surgery building which is not designed for healthcare use and a lack of parking.
A spokesperson for Fowey River Practice told us: “We encourage as many local patients and stakeholders as possible to have their say and thank those who have already participated.
“No decisions have been made and hearing from our valued patients will help us shape our services to meet their needs. Those who haven’t had their say yet are still able to in writing to: Fowey River Practice, Rawlings Lane, Fowey, PL23 1DT or in e-mail to fowey.engagement@nhs.net.”
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