MATERNITY CASES (ACCOMMODATION. NEWCASTLE - UNDERLYME) (Hansard, 30 March 1944)

§ Mr. Mack (Newcastle-under-Lyme)
The question which I have to bring before the House is one which has aroused very considerable concern in the borough of Newcastle-under-Lyme, and this concern is shared by every section of the community there. It is now nearly to years since the first overtures were made by the borough council for the purpose of establishing in Newcastle-under-Lyme a maternity home. When one takes into consideration the fact that the borough has a population approaching 70,000 and that there are no actual maternity facilities in the borough, and they are dependent upon outside boroughs, such as Stoke-on-Trent, that some cases have to go as far as Lichfield, about 3o miles away, and to Stone, and various other outlying districts, it will be appreciated that a great deal of hardship is being meted out to expectant mothers in my constituency. On 12th December, 1934, the town clerk wrote to the Ministry of Health and suggested that Brampton Tree House could readily be converted into a 12-bed hospital at a cost of £18,000. It was a matter of extreme urgency, and on 20th December of the same year the Ministry replied, turning down the proposal on the grounds that separate small maternity homes were uneconomical from the working point of view and suggesting that the new maternity accommodation should be in connection with the general hospital.
The Ministry then sent on the correspondence to the county council. There was a gap until 11th March, 1935, when the Ministry wrote stating that there was great difficulty in sanctioning a loan for separate maternity accommodation apart from that of the county council. Then followed a rather amazing statement. They said: It is definitely the intention of the county council to proceed with new hospital provision at St. John's Institution, Newcastle, at an early date and develop this institution into a public health hospital. The Ministry urged agreement between the two councils,, and contact was established between the borough council and the county council and certain proposals were made by the county council which were thoroughly unacceptable to the Corporation of Newcastle. For example the prices proposed were too high and they were also quite dissatisfied with the treatment of the inmates of that hospital, which is a poor law hospital in the 1699 borough comprising 400 beds. The Corporation of Newcastle-under-Lyme rightly desired the active participation by the management of this maternity home, but that again was unacceptable to the county council. In 1937 this St. John's Institution was pulled down. The patients were removed. A strong protest followed from the Newcastle-under-Lyme rural council and also the Kidsgrove Urban District Council. Public meetings were held, strong dissension was expressed, and a deputation attended the Ministry and asked that new blocks should be built before the old ones were destroyed. In spite of this, the whole institution was demolished, no alternative accommodation was put up, and the county council had no intention of buildinc, a general hospital at Newcastle. I want to say to my right hon. and learned Friend who, I believe, has come into the Ministry with a fresh and vigorous mind, that the Ministry of Health in the past has done everything it can by sins of omission, rather than by sins of commission, to frustrate the possibility of achieving this desired aim in Newcastle-under-Lyme, and no steps have been taken to put the necessary pressure upon the county council to erect a hospital inside the borough.
This, I ask the House to bear in mind, was at a time just before the war, when temporary hospital accommodation was being put up all over the country. On 20th May, 1939, the town clerk wrote to the Ministry and proposed as an alternative, that the Victoria Nursing Home, at a cost of between £11,000 and £12,000, would make a very good maternity home for the borough. Plans were prepared by Dr. White, the medical officer of health, and were sent to the Ministry but again, a little later, on. 25th July, 1939, the Ministry turned down those plans. Then followed a gap of nearly four years when the question was again pressed with the Ministry, owing to the insistent clamour and demand. But the Ministry replied in May, 1943, that they could not do much about it. They blamed the outbreak of war, they said there was a restriction on all works which involved capital expenditure, there was the difficulty of the use of materials and labour, and they argued as an excuse, that a scheme for post-war hospital planning may—note this—include alternative accommodation on a regional basis. The Minister wrote further on 26th 1700 May last year stating that he was prepared to consider a proposal for temporary accommodation and asking for further details as to cost and so on. Again, on 27th July it was stated that the Haywood War Memorial Hospital at Stoke-on-Trent was building a new maternity block, and it was asked that the Newcastle council should apply for some accommodation at this hospital. This statement was made in spite of the fact that the Ministry of Health were well aware that the Haywood Hospital was overcrowded and that a new block could not be completed for some considerable time. The report of the medical officer of health for Newcastle-under-Lyme shows that infant mortality in the borough was 54.1 per 1,000, which is rather higher than the average rate for the whole country. To a large extent—and I know that the hon. Member for Stone (Sir J. Lamb), who has been closely associated with the borough for a long time, will bear me out—slums have been largely eradicated and tenants have been re-housed. Having regard to all these circumstances this relatively high death rate has been exacerbated, in good part, by lack of accommodation.
There was a further proposal that "The Limes," Porthill, might make another alternative home, but here again the borough council were faced with the difficulty that it had been taken over by authorities, who were not prepared to release it. It is almost impossible, at the present moment, to get any suitable homes for that purpose in Newcastle. A stormy interview took place at the Ministry of Health on 25th November, at which the hon. Member for Stone and myself were present. The outcome of that interview was that the Ministry said they were prepared to consider the adaptation of a private house, if a suitable one could be obtained. As I have said, it is not possible to obtain a suitable one, and we find that a progressive non-county borough is subservient to a county council. I wish to make it clear to the right hon. and learned Gentleman that the dilatory action of the county council and their lack of consideration, and the fact that they have not put forward a progressive policy in this matter, has caused the strongest indignation in Newcastle. In my opinion, every civilian community should ensure that there should be a bed available for every expectant 1701 mother. If one is breeding chicks I think more regard is paid to the installation of incubators for them, than is often paid to human life. I am not indicting the Minister personally, because I know he is a new entrant to his position, but I say very emphatically that it is ignominious for a borough of the size and importance of Newcastle-under-Lyme to be placed in this position and to be asked, in view of transport difficulties and other considerations which must spring to the mind, to send pregnant women to a neighbouring hospital where, be it noted, they cannot be assured admission owing to overcrowding.
Having regard to the overtures, which have been protracted over a period of 10 years, it is an indictment of the inefficiency of the Ministry of Health as well as the county council. The borough council has shown great patience and I can understand the indignation of the town clerk, and other officials who have been working hard, at the dilatory manner in which this matter has been handled. While we recognise the many difficulties of war-time we want from the Minister an assurance that the specific and special needs of Newcastle will be attended to; it is no satisfaction for us to have to go to a small town and find there no beds for expectant mothers, whose cases have thus to be neglected. If I had the time I could give examples concerning many women who have suffered great pain and mental and economic stress as a consequence of this treatment. I trust the right hon. and learned Gentleman will take this matter seriously in hand, and will see not only that closer liaison is established between the borough council and his Ministry but himself take immediate steps to see that provision is made for whatever alternative accommodation can be provided.

§ Sir Joseph Lamb (Stone)
I can thoroughly substantiate what the hon. Member has said about the needs of Newcastle-under-Lyme, but I must question his statement that those needs are the responsibility of the county council. It is not so. They are willing, and will be at any time, to help in any way possible and, if it is possible for the Minister or anyone else to tell them of any way in which this difficulty can be overcome, they have offered to do all they possibly can. I will not say any more, though I could say a lot, but I do not wish to encroach 1702 on the time the Minister has left for his reply.

§ Mr. Mack
I cannot accept the hon. Gentleman's statement, though I know he is speaking with great sincerity. My information is that the county council has not been at all helpful in the matter.

§ The Minister of Health (Mr. Willink)
I make no sort of complaint that this matter has been raised. I am advised that at the interview in November last, to which the hon. Member has referred, both he and my hon. Friend the Member for Stone (Sir J. Lamb) were most helpful. I entirely accept that North Staffordshire, which includes Newcastle-under-Lyme, has been unfortunate in this matter in recent years, but I hope to satisfy the hon. Member that we are doing our best and that we are making progress. May I mention one or two matters which are, and were in November, common ground. The first is that it is recognised nowadays that small independent maternity homes are not the best, or indeed proper, provision for this very important service. There should always be association with a big hospital for cases of difficulty and complication. I do not remember a single word of criticism in the two days' Debate on the National Health Service in respect of the proposal that such homes as these should be the concern of the new joint authorities, which means that neither county nor non-county boroughs under that scheme will have such homes. Consequently, except as an emergency measure, one would not contemplate the bringing into existence of a small, local, entirely independent maternity home.
I do not think I can usefully go back to 1934–35—I would rather deal with the present and the future—except to say that it is true that for some years before the war the borough had been pressing for this sort of home and the position was this: There were well-advanced plans for replacing the public assistance institution in Newcastle-under-Lyme by a new general hospital, which was going to contain 22 maternity beds. The unfortunate thing is that that institution is no more, and the outbreak of the war prevented the building of a new hospital on that scale. That position was accepted by Newcastle-under-Lyme from September, 1939, to April, 1943, and no further approach was made to my Department during that period. The new approach was 1703 made at a time when everything was very much more difficult. It is not only that those difficulties have arisen, but it should be appreciated by all concerned that these war years have given rise to a very greatly increased demand for lying-in accommodation in a hospital or maternity home. I suppose there are various causes for that. One is crowded home conditions, another is the absence of neighbours and home help. I rather think that the absence of the husband means that the wife is more inclined to seek such accommodation. It is not quite fair to describe my Department as supine in this matter. In 1938 there were in England and Wales 11,500 maternity beds; to-day there are 15,500, including 2,500 emergency maternity beds.

§ Mr. Mack
I do not dispute that at all, and I recognise that progress has been made, but my case is that there has been no apparent progress in Newcastle.

§ Mr. Willink
I am coming to that. In addition, 500 more beds have been approved. That can be put in another way. The beds that were available before the war took approximately one-third of the births. The beds at present available take one-half of the births. That is, roughly, what we believe to be the increase in demand taking it all over. Whether the demand on that scale will continue after the war one does not know. On that basis of demand, Newcastle-under-Lyme ought to have access to something like 30 beds. I think that what I have said was common ground at the interview on 29th November last year. On that occasion one or other of my hon. Friends made the suggestion that, as a temporary expedient, Newcastle-under-Lyme, contrary to our principles, which are against independent small maternity homes, should be allowed to establish a small maternity home of their own. That proposition was approved, and we said that if the borough could find suitable premises, to which we felt a hut should be added, we would approve it, subject only to Ministry of Works sanction. Unfortunately, from then to now we have heard of no such premises, and one knows how difficult it is to find them. During that period we have not been stagnating. There is a hospital to which my hon. Friend referred, the Burslem, Haywood and Tunstall Voluntary Hospital, which 1704 is nearer to Stoke, but which has in recent times been taking more Newcastle patients than Stoke patients. In the scheme we envisage everybody will not have a maternity home just round the corner. That will not be possible with the larger units. The Burslem Hospital is adding 18 more maternity beds with our approval and our assistance in getting priorities. We hope that they will be ready by June.

§ Mr. Mack
Is my right hon. and learned Friend able to say what proportion of these 18 additional beds will be allocated to Newcastle?

§ Mr. Willink
The hospital does not allocate its beds in that way, but it has been taking more Newcastle patients than Stoke patients. In addition to that substantial extension of the Burslem Hospital, the county borough of Stoke-on-Trent owns a hospital known as The Limes Maternity Hospital, and a hutted extension has been approved with 16 new maternity beds. I am glad to tell my hon. Friend that we received a letter on Monday last from the town clerk of the Stoke-on-Trent Council saying that that council is prepared to co-operate by setting aside not fewer than four of these additional beds for Newcastle patients, subject to the satisfactory settlement of details between the two parties. There should, therefore, be available within a few months 34 additional maternity beds. These numbers sound small, but I can assure the House that 34 additional beds are and should be sufficient to meet the needs of a population of just on 100,000.
That is the way it works out. There is one birth per 70 of the population. One bed takes 20 confinements in a year, and the hon. Member will find—anybody can work it out from that—in fact, that the provision needed to meet the demand of half the expectant mothers who we understand desire lying-in accommodation, is one bed to about 3,000 of the population, so therefore 34 beds is a very substantial addition indeed. The hope I would express is that Newcastle-under-Lyme will not be too insistent in its demand that it must have its own specific maternity home. That is not what is envisaged in our new health service. I hope that the borough of Newcastle-under-Lyme, and the hon. Member himself, will be as grateful for this co-operative effort on the part of Stoke as I am at the Ministry of Health.