HC Deb 09 October 1941 vol 374 cc1116-20
23. Sir F. Fremantle

asked the Minister of Health whether he is in a position to indicate the general lines of the Government's post-war hospital policy?

Mr. E. Brown

I will, with the hon. Member's permission, answer this Question at the end of Questions.

Later—

Mr. Brown

The question of post-war hospital policy and reorganisation, more particularly in relation to the Emergency Hospital Scheme, has for some time been engaging the attention of the Government. While any immediate reorganisation must be regarded as impracticable in present circumstances, certain broad principles can be laid down as the basis of Government policy. It is the objective of the Government as soon as may be after the war to ensure that by means of a comprehensive hospital service appropriate treatment shall be readily available to every person in need of it. It is accordingly proposed to lay on the major local authorities the duty of securing, in close co-operation with the voluntary agencies engaged in the same field, the provision of such a service by placing on a more regular footing the partnership between the local authorities and voluntary hospitals on which the present hospital services depend. The Government recognise that to achieve the best results and to avoid a wasteful multiplication of accommodation and equipment it will be necessary to design such a service by reference to areas substantially larger than those of individual local authorities. It will be the aim of the Government also to avoid overlapping and uneconomical expenditure by securing the provision of the more highly specialised services at teaching hospitals and other centres selected to serve these wider areas, and by arranging for a proper division of function between hospitals in these areas.

With regard to the financial aspects of the Government's proposals, it is their intention to maintain the principle that in general patients should be called on to make a reasonable payment towards the cost whether through contributory schemes or otherwise. In so far as any new burden may be thrown upon local authorities in providing or maintaining hospital accommodation, or in contributing towards the expenditure of voluntary hospitals, a financial contribution, the extent of which will be a matter for further consideration, will be made available from the Exchequer. Special arrangements for dealing with the teaching hospitals by way of increased educational grants are in contemplation. In present circumstances the arrangements for hospital services must be determined by war-time requirements, but the Government are anxious to take every step to avoid any unnecessary delay. I have already had preliminary discussions with the bodies representing the municipal hospital authorities and the voluntary hospital movement, and I am hopeful that these discussions will be continued. With their concurrence I am instituting a survey of hospitals in London and the surrounding area, to provide the information needed as a basis for future plans. As regards the remainder of the country, valuable preliminary work has already been done in some areas by bodies representing both the municipal and voluntary hospital authorities, in particular, by an organisation formed under the auspices of the Nuffield Provincial Hospitals Trust. In any surveys which it may be found necessary to institute in the provinces I shall have full regard to the information already available in this way, which I am glad to know will be at my disposal for the purpose. I am asked by the Secretary of State for Scotland to take this opportunity of stating that the aims of future policy in Scotland are generally similar, but that certain important differences in the Emergency Hospital Service and in the methods of financing voluntary hospitals in Scotland are being given special consideration.

Sir F. Fremantle

May I ask the right hon. Gentleman what kind of personnel will be engaged on this survey? Is it to be carried out simply by the officials of the Department concerned, or will officials of the local authorities be consulted, along with professional or other outside persons who are interested?

Mr. Brown

I shall do my best to see that the most competent persons are consulted in this most important survey.

Sir F. Fremantle

Will local bodies be consulted?

Mr. Brown

Undoubtedly.

Earl Winterton

Speaking as a hospital chairman, may I ask whether, in this matter, the right hon. Gentleman will keep in close touch with the British Hospitals Association?

Mr. Brown

We have been so doing, and shall continue so to do.

Dr. Haden Guest

Will the light hon. Gentleman also consider hospital policy in relation to the future of the medical profession as a whole, with a view to bringing forward a scheme for a general national health service in the country?

Mr. Brown

That is, of course, a wider question, and the hospital service must be considered first.

Lieutenant Butcher

Is my right hon. Friend satisfied that in the scheme that he has announced proper use will be made of voluntary hospitals?

Mr. Brown

Yes. I contemplate that the general control to be exercised by my Department will secure that in the design of the scheme for the future hospital service full opportunity will be given to the voluntary hospitals to play their part.

Mr. Rhys Davies

Will the right hon. Gentleman also bear in mind the recommendations of the inter-departmental committee, of which several Members of this House were members and which inquired into the problem of the proper staffing of hospitals, which found that one of the chief problems of hospitals was that of proper staffing by well-paid and well-treated nurses?

Mr. Brown

I shall have an announcement to make on the question of nursing in the near future.

Mr. Sorensen

Is the right hon. Gentleman bearing well in mind the principle that, if increased public financial aid is to be given to these voluntary hospitals, it should carry with it a relative amount of control and responsibility on the part of the local authorities?

Mr. Brown

My hon. Friend will see that the arrangements provide first for consultation between all concerned, then for the survey, and afterwards for the working-out of the scheme, of course with the approval of the Ministry. These are the wise stages by which a comprehensive scheme of this kind should proceed.

Mr. A. Bevan

Is it not a fact that the maintenance of voluntary hospitals and their subvention by public funds and flag-days is becoming increasingly repugnant to the conscience of the public, and has not the time arrived when we should have a hospitals' scheme more in accord with civilised notions of organised society?

Mr. Brown

First, public response to the appeals does not seem to bear out my hon. Friend's suggestion, neither, secondly, do the welcome and increased contributions, made in factories and workshops by workmen themselves, to their local contributory schemes.

Mr. Bevan

Has the right hon. Gentleman obtained the views in this matter of the present Home Secretary, has he considered the consequences of the London hospitals' scheme, and does he realise that his present policy is repugnant to every Labour Minister on the bench—or ought to be?

Mr. Brown

If my hon. Friend will read my statement carefully, he will see that we have had consultations with all bodies concerned.

Mr. Sorensen

Will not the right hon. Gentleman reply to the particular point of my question dealing with the relationship between increased financial aid from public sources and proportionate representation and control?

Mr. Brown

I cannot add anything regarding the financial aspect of the scheme to what I have said in my statement. The House will appreciate that I cannot go into details in advance of the consultation, survey, preparation and settlement of the scheme.