HC Deb 21 June 1950 vol 476 cc1431-40

Motion made, and Question proposed, "That this House do now adjourn."—[Mr. Popplewells]

10.20 p.m.

Mr. Boyd-Carpenter (Kingston-upon-Thames)

I desire to bring the House back from the contentious, if comparatively smoke-free, environs of Wolverhampton to the more agreeable surroundings of the Thames Valley. I desire to pursue one stage further with the Parliamentary Secretary to the Ministry of Health, whom I am glad to see on the Government Front Bench, a longstanding matter affecting a small hospital located in my constituency. Being near the boundary of that constituency and the constituency of my hon. Friend the Member for Wimbledon (Mr. Black), it is also of considerable interest to him and to his constituents.

The hospital is the Kingston Victoria Hospital, which is one of those small hospitals of the cottage hospital type having about 50 beds. The issue which I desire to raise with the Parliamentary Secretary is whether or not that hospital is to be permitted to continue as a separate entity in the future or whether it is to be merged, perhaps I should say submerged, as the maternity wing of a larger hospital.

I appreciate that there are types of complaints for which specialist treatment is necessary, and specialist treatment on the whole predicates a large hospital; but there are also other types of complaints in respect of which the patient desires, and is right to desire, treatment in a small hospital into which it is administratively possible for the general practitioner, who has had general care of him for years past, to follow him and treat him there. This hospital is a hospital of that kind which has acquired a considerable reputation, perhaps I may be allowed to say affection, in the neighbourhood for the excellent work it has done.

The story begins last year, when the South-West Metropolitan Regional Hospital Board, with the intention of dealing with the real need to increase maternity hospital accommodation, prepared a scheme in which the Kingston Victoria Hospital would become simply a maternity wing of the county hospital and its separate existence as a cottage hospital of the general practitioner type would end. The Group Management Committee who, as the House is aware, are the body immediately charged with local administration of the hospitals under the Metropolitan Board, opposed that, and there was a considerable—and I regret to say acrimonious—dispute on that subject.

That dispute was resolved by the somewhat Draconian method of the Regional Board using, or in my view abusing, its power of appointment and removing from the Group Management Committee the chairman and three members of that committee who had taken a view different from that of the Regional Board on the subject of this hospital. I raised that matter in this House, as the Parliamentary Secretary will recall, some little time ago, and although it would be a gross exaggeration to say that I was satisfied on that occasion with the Parliamentary Secretary's reply, if I may so describe it, I do not propose to go into that issue now. It will have to be resolved at another time and perhaps by other means.

The issue now is whether the object of the Regional Board of eliminating this small cottage hospital, is or is not to be achieved. The matter is a little bit complicated, and I do not desire to bother the House with undue details; but after considerable discussions, of which the Minister was courteous enough to notify me, the Minister, by letter dated 10th May, 1950, wrote to me as follows: The Regional Board now propose, and the Kingston Hospital Management Committee have agreed, that the Surbiton hospital annex"— which is a totally different institution, which comes into the picture now for the first time— would provide a reasonable general practitioner unit, and all general practitioners who have previously had access to the Kingston Victoria Hospital will be allowed facilities … and so. On the face of it, that looked like a compromise; but I am afraid that, on analysis, it turned out to be no compromise, but rather a proposal to turn the immediate and sudden death of the Kingston Victoria Hospital into a lingering departure, because unfortunately—and I am supported here by all the medical opinion concerned—that annex has neither room nor medical facilities to provide adequate cottage hospital treatment.

Now, the issue has aroused great public interest, as my hon. Friend the Member for Wimbledon will bear out. The Mayor of the Royal Borough of Kingston-upon-Thames and, I understand, the Mayor of the adjacent Borough of Maiden and Coombe, have both, on behalf of their respective boroughs, protested in public. Public opinion is all but unanimous, and medical opinion entirely unanimous, on the issue that the Kingston Victoria Hospital should continue as a small general practitioner unit. In those circumstances I put a Question a little time ago to the Minister of Health, asking him whether he would take steps to secure the continued existence of this hospital. The right hon. Gentleman, with no waste of words, answered that Question with the monosyllabic answer, "No," and that left no option but to seek this as the last possible opportunity of attempting to save a hospital which has a well-merited reputation for fine work, and whose extinction would be nothing less than a catastrophe for a certain part of the Thames Valley.

Those who oppose the extinction of the Kingston Victoria Hospital have not indulged in simple blank opposition. They have sought to meet the legitimate concern of the Regional Board, and have themselves suggested another compromise proposal under which the annex of the Victoria itself would be used as the maternity wing. That has been inspected by all the competent people, and, perhaps what is most significant, I am told that the very distinguished gynaecologist who would be in charge of the maternity unit has indicated that, in his view, those premises would be satisfactory.

In view of that, it is surely right to press for a solution which would provide what the gynaecologist in charge regards as a suitable alternative, while fully preserving, in its present premises, this much loved hospital, and I do not think it is unreasonable, all other methods having failed, to seek to elicit the action of the Minister to overrule the Regional Board in this respect. I do not want to bandy personalities, but in view of the way the Regional Board have sought to bulldoze this particular project through during these last few months, one cannot have an excessive confidence in their fair consideration of this alternative scheme, and that is why it seems to me right to ask the Minister to exercise his supreme and reserve authority, and to preserve this hospital.

It does raise an issue, which, as I say, has aroused opinion in the division which I have the honour to represent, but it also raises a general issue of not a little importance. Throughout the country these cottage hospitals exist, most of them, I think the Parliamentary Secretary will agree, doing excellent work. In the nature of things, perhaps, their present existence does not appeal unduly to the planners of the Regional Boards. They mar a little the perfect symmetry of the system. I am afraid that many of us have found that since the National Health Service came into being the separate life and existence of these hospitals has been menaced. From this example and from others of which I have heard, it looks as if there is an unfortunate tendency for the Regional Boards to eliminate from their schemes, and from existence, cottage hospitals of this kind. That is a matter which, when fully understood, I think will be resented by large sections of public opinion. I think it does the National Health Service no good if, in the process of much-needed extension of the service, there is perpetrated the destruction of one of the more useful and valuable parts of the old system.

It is in the light of that, not only as an individual case—though it is naturally as an individual case that I and my constituents are most concerned about it—but also very much from the point of view of the general issues involved, that I beg the right hon. Gentleman, through his representative the Parliamentary Secretary, at least to consider fairly on their own the facts of this case, and to consider the proposal put forward by the Victoria Hospital itself. The head of this hospital's medical advisory board is a physician of great distinction; he is well known in the counsels of the British Medical Association, and on occasion has enjoyed the dangerous honour of personal negotiations with the Minister. If responsible people of that sort put forward such a scheme, it is at least the duty of the Minister fully and fairly to consider it on the highest level and to see that action is taken accordingly, without consideration of anything else.

10.32 p.m.

Mr. Black (Wimbledon)

My hon. Friend the Member for Kingston-upon-Thames (Mr. Boyd-Carpenter) has outlined this matter with the admirable clarity which one always expects from him, and I have no desire to occupy the time of the House by dealing further with those aspects of the matter which he has explained; but he has told the House of the indignation which is felt in the constituency which he represents about the proposal to change the character and the status of this hospital, and I should like to make it quite clear that that indignation is equally felt by a substantial part of the constituency which I have the honour to represent.

As my hon. Friend has made clear to the House, this hospital, although situated just inside the boundary of the Royal Borough of Kingston-upon-Thames, is within a very short distance of the Borough of Maiden and Coombe, which forms part of my constituency. For rather more than 50 years, this cottage hospital has served the needs of the people of the Royal Borough of Kingston-upon-Thames and the people of the Borough of Maiden and Coombe with, I believe, complete satisfaction to the two districts concerned. Indeed, I would like to make clear that the full title of the hospital is "The Kingston and Maiden Victoria Hospital." That, I think, will make quite clear the point which I seek to bring to the notice of the House, namely, that historically and at present this hospital does serve equally the two boroughs.

I should like to say a word or two before concluding about the position within the Borough of Maiden. This proposed change in the character and status of this hospital has been considered on at least two occasions at meetings of the Borough Council of Maiden. On 17th October and on 23rd November, 1949, these meetings were held, and on both occasions the members of the Borough Council of Maiden, of whatever shade of political opinion they might be, were united in recording their opposition to this proposal; and they have consistently, and throughout, done everything possible to dissuade those responsible from proceeding with the proposed change in the character and status of this hospital.

I have taken some trouble to ascertain what is the view of medical opinion in the Borough of Maiden, and I do not believe that I shall be over-stating the case if I say that medical opinion is almost, if not quite, unanimous against the change. Many local organisations have also expressed their opposition, and I think that if a poll were taken of the Borough of Maiden, it would reveal a literally overwhelming volume of opinion against any change in the character and status of this greatly esteemed cottage hospital. It is also the fact, so I am informed, that the British Medical Association itself has expressed its opposition to the Board's proposal.

If the future destiny of this hospital were in the hands of any board or council or body which consisted of popularly-elected members, it is quite certain that the proposal would not have reached even the point which it has reached now. That the proposal has been carried so far is solely due to the fact that the controlling body is an appointed body and not one which has been elected, and it is not, therefore, responsible to public opinion as an elected body would be.

I associate myself most strongly with the appeal which my hon. Friend has made that even at this comparatively late hour regard should be had to the feelings and opinions which have been made so manifestly clear and which are also so strongly held by people in the neighbourhood, and that this proposal should not be proceeded with any further.

10.39 p.m.

Dr. Hill (Luton)

If I may detain the House for one minute, I shall not, of course, cover the detailed ground, which has in any case been so admirably covered. I want to stress the underlying principle. Everyone realises the Minister's responsibility for specialist services, but it is in the public interest that there should be an ample provision of general practitioner beds—not places where specialist work is undertaken by general practitioners, but places where general practitioners can, in the interests of those patients whose domestic and housing conditions make it necessary, treat their own patients within their proper scope in hospital surroundings. I ask the Parliamentary Secretary to express his approval of that principle of general practitioner provision and to try equally to apply that principle in this case as in other cases.

10.40 p.m.

The Parliamentary Secretary to the Ministry of Health (Mr. Blenkinsop)

To deal first with the short comment of the hon. Member for Luton (Dr. Hill), as I think he knows and the British Medical Association know, my right hon. Friend has expressed quite clearly in circulars to the Regional Hospital Boards his desire that there should not be exclusion of general practitioners from small hospitals. Indeed, we are very glad that the compromise proposals that have been put forward—amended proposals by the Regional Hospital Board—do take into account that very point. As I think will be appreciated by the hon. Gentlemen who have raised this matter, the original proposals of the Board meant almost the complete exclusion of general practitioners from this hospital.

As I think is generally known, there were discussions about it lasting over a fairly considerable period of time, but in cases of this kind not only the Ministry but clearly the Board, which is the planning authority in the area, have to bear in mind above all the needs of the public, which are both specialist and general practitioner needs. There are bound to arise differences of opinion in a particular area when one has an authority like a Regional Hospital Board attempting to secure the best possible use of the accommodation available. It is inevitable that there will be some clashes of opinion about the use of specified hospitals. This is obviously not the only occasion when we have had conflicts of this sort. Regional Hospital Boards do attempt to reach reasonable conclusions.

The hon. Member for Kingston-upon-Thames (Mr. Boyd-Carpenter) was using rather unusual and inappropriate language when he talked about the death and extinction of this hospital, when in fact it is to be turned into a gynaecological unit. No one would regard that as the death of a hospital. I should regard it as new life.

Mr. Boyd-Carpenter

Would not the Parliamentary Secretary regard it as a transmigration of souls?

Mr. Blenkinsop

That brings to my mind rather unfortunate results.

Mr. Boyd-Carpenter

That is exactly what I claimed.

Mr. Blenkinsop

The proposal for this hospital is for a most vital purpose. There is no doubt that in this area there is an urgent need for additional maternity accommodation, and this proposal as a whole will affect quite a number of hospitals within the group. It is not merely a change in one or two hospitals; it involves a series of changes which will result in a total increase in the number of beds available. For maternity cases it means, for the group as a whole, an increase from 81 to 96 beds which are urgently needed. I am not saying it is sufficient, but it is a valuable step which had to be taken. It also means a small increase in gynaecological beds from 37 to 40, while chronic sick beds remain at the same figure and there is only a reduction of two beds for general patients. That is, I think, a perfectly reasonable proposal to put forward.

When the hon. Member for Kingston-upon-Thames says that the Board have bulldozed through the proposals, he should recognise, and pay a compliment to the Board for the revised proposals they have submitted. Not only have they suggested the use of the Surbiton annexe for general medical cases which will be open to general practitioners, but also the suggestion has been made that, as far as practicable, there will be posts offered as clinical assistants. This is a development we surely want to encourage for suitable general practitioners on the staff of the Kingston Victoria Hospital. We certainly would not wish to give any guarantee that every single practitioner who at present has access to the Kingston Victoria should automatically, by virtue of that, be able to secure a clinical assistantship. What is desired is that, within what is regarded as the proper clinical needs of the area, the general practitioner should not be cut off from hospital work. It seems to us that these modified proposals adequately cover that point.

I have tried to explain that we are conscious of the principle lying at the back of these, as of other, proposals, and I have stressed the fact that my right hon. Friend is concerned to see that the general guidance he gave in a circular sent to Regional Hospital Boards should be given effect to. It is for that reason that we have welcomed these new proposals. I understand that the alternative suggestion mentioned by the hon. Member has only been put forward very recently. It is a proposal that a wooden hut in the grounds of the Kingston Victoria Hospital should be used for gynaecological cases. I cannot say whether this is a useful proposal or not. I gather that it is regarded as extremely doubtful whether it would be a satisfactory alternative to the Kingston Victoria itself, but it is, I am sure, one that would be considered by the Regional Hospital Board, who are now at one with the Management Committee concerned in approving the revised proposals put forward.

Mr. Boyd-Carpenter

Can the hon. Gentleman say whether it is in fact being now considered?

Mr. Blenkinsop

I understand that this is a new proposal, and I cannot say anything about it. I know nothing of it other than that it concerns a wooden hut in the grounds. Whether that would be regarded as adequate or not, I cannot say. It seems to me on the face of it that it is highly unlikely, but whether it would be is a matter for the Regional Hospital Board and the Management Committee to decide.

Mr. Boyd-Carpenter

Can the Parliamentary Secretary assure the House that he will consider the matter, and that the matter will not be regarded as irrevocably settled?

Mr. Blenkinsop

I have no news about this proposal. It was put forward only a few days ago, and I am certainly not going to commit anyone as to their reaction to it, or say that it must hold up a decision which must be taken after the long consideration of all the proposals that have been made and the reasonable attitude now shown by the Regional Hospital Board. We are most anxious that this important accommodation for the needs of the people as a whole in the area should now be proceeded with.

Question put, and agreed to.

Adjourned accordingly at Eleven Minutes to Eleven o'Clock.