It is little wonder that temperatures are rising in North Norfolk over the decision by health bosses to sell off Benjamin Court in Cromer – a reablement centre that helped patients recover after being discharged from an acute hospital.

The NHS Norfolk and Waveney Integrated Care Board (ICB) claims it is not financially viable to keep the facility open as it “no longer fits its model of care” and instead has adopted a “home first” policy.

This is despite the fact there is a huge demand for what used to be called “step down” care, where patients who no longer needed treatment in an acute hospital could be safely discharged to a “cottage hospital” setting (remember those?) until they were well enough to go home.

This also gave time for their homes to be adapted for a safe return.

The ICB decision is more baffling because recent statistics reveal about 20pc of hospital beds are being occupied by people who no longer need to be in an acute hospital bed.

It is not as though Benjamin Court is an outdated facility.

It is a modern building that only closed in June last year and could readily be brought back into service as the annual winter pressures build on an already-stretched NHS.

Selling off the facility would conveniently suffocate the upsurge in calls for it to reopen.

Its closure was strongly fought last year but fell on deaf ears at the ICB.

It was a kick in the teeth for North Norfolk, and since its closure a survey by Healthwatch found 79pc of respondents wanted it to reopen, while the remaining 21pc wanted the property still to be used in a healthcare capacity.

Tim Adams, leader of the Liberal Democrat-controlled North Norfolk District Council (NNDC), branded the ICB decision “ridiculous” and added: “We have a modern facility sat there that could be helping patients.”

He intends to challenge the ICB decision and claims the cost of keeping a patient in a hospital bed is three times the cost of a reablement bed.

But who or what is the ICB, you might well ask.

Well, its chair and figurehead is the Rt Hon Patricia Hewitt, former Labour MP who was Secretary of State for Health (2005-2007).

The board comprises a cross-section of health professionals and independent non-executive directors.

The ICB for Norfolk and Waveney replaced the five Clinical Commissioning Groups (CCGs) that had in turn replaced the Norfolk Health Authority. Unlike the old health authority, the CCGs and ICBs do not comprise any elected members.

Instead, ICBs are a commissioning vassal of NHS England, that has a Government mandate to lead the NHS in England to deliver high-quality services for all. Importantly, NHS England holds the purse strings, and sets the budgets and targets for the ICBs.

Norfolk and Waveney’s mission statement reads: “We have been working together closely over the past few years to improve services and provide more joined up care for local people.”

And it goes on to say: “Integrated care is about removing traditional divisions between services so people and communities get the support and care that they need.”

But despite the fine words, the ICB is not accountable to electors or its elected representatives.

Yes, it holds public consultations about some of the decisions it plans to take, but it rarely listens and changes course.

The problem is that targets and budgets set by NHS England are the trump card and, if the NHS is to be reformed, someone (among many other issues) should take a long, hard look at the way the money flows down to the front line and how costs are apportioned.

And please don’t get me started about the Government’s latest daft idea about hospital league tables that will give more money to the top performers, and less to those at the foot of the table.

It’s robbing the poor to pay the rich.

Currently, while a patient is in a hospital bed, it is the hospital that foots the bill.

Once they leave that bed and transfer to another healthcare setting, the cost of care transfers to that provider.

So, a cynic might say that while the patient stays in hospital it does not hit the ICB coffers.

To counter this scenario, NHS England has boosted by a further £200m a national discharge fund to support ICBs. The fund is designed to increase capacity in post-discharge care and support.

Through use of this fund, ICBs are expected to deliver reductions in the number of patients who are stuck in an acute hospital bed but are not well enough to go home.

I quote: “This funding should be used to purchase bedded step-down capacity plus associated clinical support for patients with no criteria to reside (in hospital) but who cannot be discharged with the capacity available through existing funding routes or the Adult Social Care £500m Discharge Fund announced previously.”

This statement sounds like a good financial incentive to reopen Benjamin Court, and a string to the bow of North Norfolk’s council leader Tim Adams in his meeting with the ICB over its “ridiculous” decision to dispose of this asset.

After all, the efficacy of the ICB’s “home first” initiative is still leaving far too many patients marooned in hospital, but perhaps it would be unkind to suggest it is more about the money than the patient.

*Peter Franzen OBE is former EDP editor.