Do you want the good news or the bad? Today's report is a mix of the two!

Firstly, we learn that West Cornwall Hospital is to be one of the three newly branded "Urgent Treatment Centres" for Cornwall, along with Truro and Bodmin. Hopefully this means that West Cornwall will continue to have its doors open 24/7, with access to a wide range of urgent treatments. However, if we are serious about taking the pressure off Treliske, then it needs to retain its sub-acute status rather than become a community hospital. Last month's major Nuffield Trust report, commissioned by the NHS, called for policy changes to support small sub-acute hospitals, saying that closing or downgrading these is too often a 'knee-jerk' reaction, whereas offering a financial premium for small hospitals, consultant contract changes and ending the practice of separating out services like ambulatory care, would benefit our cherished hospital in Penzance.

Secondly, we learn that St Michaels Hospital Hayle is to be Cornwall's elective centre of excellence, dealing with 95% of all planned orthopaedics, with development to include a High Dependency Unit. Such an elective centre, that doesn't have to worry about emergency admissions cancelling planned surgical lists, will always provide a more relaxed environment for patients and staff, and is much to be welcomed. We know how valued St Michaels is and, after many anxieties about its future, we hope that these plans really do come to fruition.

Thirdly, the Edward Hain Hospital debacle rumbles on. We heard last month from the Health and Social Care Secretary, Matt Hancock, that "the era of moving all activity into fewer, larger hospitals and blindly, invariably, closing community over". Perhaps partly because of this, and despite Edward Hain's beds having been closed for over two years, we now learn that there is to be a further two-year consultation process (up to April 2020) to to decide its future. This will involve producing a long list of options and potential evaluation criteria, public workshops to co-produce options, evaluation criteria and weighting, then workshops to share options, scoring of options against weighted criteria, ranked options produced with business cases, followed by public consultation as required. Does this all sound rather familiar? We recall such a process when Poltair Hospital closed, and when the preferred public option was kicked into the long grass in favour of the decision which some of us knew all along would be the result. We are doubtful that the process for Edward Hain will be any different.

At the risk of sounding boring, West Cornwall HealthWatch continues to reiterate the benefits of local community hospitals. For over two years, Penwith has not had one. Proposals to commission places in private care homes instead are no substitute for effectively used community hospital care, even if we had sufficient care home capacity in this area, which we don't. Time after time, families tell us about the benefits of community hospital rehabilitation care - infinitely better than either sending people home before they are ready, or leaving them in bustling huge hospitals when it isn't the right environment for them. We'll all need to be ready to make the case during the forthcoming consultation, whether future community hospital provision should be at Edward Hain or in a new purpose-built facility in Penwith.