HC Deb 30 January 1951 vol 483 cc858-68

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

10.3 p.m.

Mr. Black (Wimbledon)

I desire to raise on the Adjournment tonight the case of the Kingston and Malden Victoria Hospital. May I say how pleased I am to see the Minister of Health here in person this evening, and to express the hope that on this first intervention on his part in this matter he may be able to give some satisfaction over a question which deeply concerns the people in the neighbourhood surrounding the hospital.

I do not want to spend a great deal of time in dealing with events before 1st November last, because the case of this hospital has been before this House on more than one previous occasion, but since our earlier discussions a new situation has arisen since 1st November. I wish to say a word or two about events prior to that time, but to concentrate the main part of what I desire to bring to the notice of the House on events subsequent to 1st November. The Kingston and Malden Victoria Hospital is about 50 years old. During the whole of that period it has been a small general hospital of the cottage hospital type with beds available to general practitioners practising in the neighbourhood, and I think I can safely say, without fear of contradiction, that the hospital has enjoyed very high esteem in the district which it has served.

Some considerable time ago a proposal emanated from the regional hospital board whereby this small hospital would lose its independence as a separate hospital and, under a reorganisation of the hospital service in the district, become a gynaecological unit attached to the larger Kingston Hospital nearby. This proposal was accompanied by an offer to the general practitioners using the hospital of the use of the old Surbiton Cottage Hospital in place of the accommodation they were enjoying at the Kingston and Malden Victoria Hospital.

I am not competent to express an opinion on the suitability or otherwise of the alternative accommodation offered, but it is regarded as quite inadequate by the doctors concerned and there is other eminent medical opinion to support the view that it is not an alternative that could be seriously considered. After this matter had been under discussion for a long period, notice was given to the hospital authorities that no more patients were to be received after 1st November last, with a view to the hospital being closed not later than the end of November last. That order was not complied with by the doctors or the hospital authorities.

I am not here to argue the legal niceties of the issues involved, except to say that there are many cases in history in which the instructions of superior officers have been ignored, sometimes with very beneficial results, to mention only the case of Nelson placing his telescope to his blind eye. Whatever the legal niceties of the position may be, the action of the doctors and the hospital staffs has been condoned by the regional hospital board, which has continued to pay the salaries and the running expenses connected with the hospital.

The proposal whereby this much esteemed local hospital would lose its independence has been the subject of the most intense indignation by all kinds and conditions of people. I want to mention quite briefly, under three heads, the strength of the opposition to this proposal. Under the medical head, the proposal has been criticised strongly by the British Medical Association, by the Surrey branch, of the British Medical Association in all its five divisions, and by a unanimous expression of condemnation by the medical board of the hospital. The Surrey Executive Council for the General Practitioners' Service has expressed its objection and has asked to have the opportunity to be heard by the regional hospital board, but has received no reply to that request. There has been condemnation also by the General Medical Services Committee, representing all general practitioners in the National Health Service.

Under the heading of objection by hospital authorities, I would mention that the proposal was originally objected to by the Group Management Committee, and the subsequent acquiescence of that Committee was only obtained by the failure to reappoint to the committee four members who were among those most strongly opposed to this proposal, including the Chairman, and the substitution for them of four other persons who, apparently, were willing to acquiesce in the proposal of the regional hospital board. The proposal is also opposed by the House Committee of the hospital and by the Consultants and Specialists Committee, representing hospital staffs in the National Health Service.

Under what I would describe as the head of objections by the general public, there is an equally impressive catalogue of objections to which to draw attention. The borough councils of the two local authority areas served by this hospital have expressed their objection, not on one occasion but on several occasions, and that objection has been sustained by the various shades of political opinion represented on those borough councils. Not long ago a public meeting of protest was held which must surely have been one of the very largest public meetings ever held in the locality, because the largest hall available was crowded to suffocation and a number of people endeavoured to listen to the speeches in the street outside, there being no room for them within the confines of the building.

A petition has been organised locally dealing with this matter and is to be presented to the House at a very early date. That petition indicates a most impressive and almost overwhelming support on the part of the general public in the area in its objection to the proposals. The Press, both local and national, has shown the greatest possible interest in the fate of this hospital and has been almost unanimously opposed to the proposal to which I am objecting tonight. In fact, we have here almost the position of the South-West Metropolitan Regional Hospital Board versus the rest of the world, so strong, so unanimous and so complete is the objection on the part of all other sections of the public.

There are one or two general points which I would desire to clear up with a view to removing any possible misapprehension which may exist. I want to make it perfectly clear that the objection to the proposal whereby this hospital would lose the status it has enjoyed for about 50 years is not an objection confined to the members of any one political party, nor is it actuated in the slightest possible degree by political motives.

This objection is not one held and advanced by people who are opposed to the National Health Service and who are desirous of seeing that service inconvenienced or brought into a condition of failure, but is an objection sustained by people of all shades of political opinion and urged upon the attention of this House and of the Minister by people who are genuine and sincere friends of the National Health Service—people who are most anxious that the efficiency of the service and the public regard for the service should not be impaired by the carrying further into effect of the proposal against which I am speaking here tonight.

It is only right that this point should be made quite clear—that this is not a political matter and that the objection is brought forward not by those who do not favour the National Health Service but by those who genuinely desire to see its well-being preserved and extended. I should have thought that since this matter was last debated in the House the case for the retention of this hospital on its present status had been greatly strengthened by developments in recent months.

I do not profess to be an expert on medical and on hospital matters but, if I understand the present position correctly, the strongest possible pressure is being placed upon maternity cases not to occupy hospital beds, unless there is an overwhelming reason why they should do so, because of the very great and grave shortage of beds available for the more serious cases of a general kind. I should have thought that the recent outbreak of influenza and ill-health generally, and the resulting difficult situation in the hospital service, would tremendously have reinforced the argument which has been advanced in the House that this hospital should be maintained as a general hospital and should not become a gynaecological unit attached to a larger hospital outside.

Now I come to my final point, and it is this: what it is that I am asking the Minister to do at this particular juncture regarding this grave problem. Let me make it plain that I am not asking him now to over-ride the decision of the regional hospital board. In my view it would be unfair to the regional hospital board at this stage for me to ask him to do that; and I think that it would probably be agreed that, if he were to act in that way at this stage, on the basis of any ex parte statement made by me tonight, it would be regarded as though he were coming to a judgment on this matter without having given due weight to all opinions. What I am most strongly urging upon the Minister is that he should agree to set up an independent and an impartial inquiry into the whole matter; and that the person conducting that inquiry should give an opportunity to all shades of opinion to be represented and to be heard.

I think I can go so far as to say that if such an independent and impartial inquiry were held under satisfactory conditions those who are at present defying the orders of the regional hospital board, and the great mass of bodies, local and national, who are opposed to this proposal, would be prepared to agree in advance to accept and abide by the findings of such an independent and impartial inquiry. In making that suggestion I do not think that I am asking for anything which is unreasonable, or anything which the Minister ought not to be willing readily to grant.

I beg of the Minister not to determine this matter out of hand on what I would describe as mere prestige considerations. I beg of him not to take the point of view that this matter has gone so far already that, right or wrong, the regional hospital board must be supported. It would be a tragedy if a serious mistake were to be made, to the indignation of public opinion, and to the disquiet of those who are genuinely concerned in the future of the National Health Service, just because the Minister was unwilling to appear to withhold his support from the regional hospital board.

An independent and an impartial inquiry would, I suggest to the Minister, be a suitable step to take. It would give satisfaction to all the parties who feel keenly and intensely on this matter, and it would have a good prospect of resolving the impasse which at present exists between the hospital authorities on the one hand and the regional hospital board on the other.

I, therefore, make two alternative requests to the new Minister tonight. First, I hope that he will say that he will agree to set up the independent and impartial inquiry for which I have asked; but if I have failed to carry him completely to that length with me, then I would beg of him not finally to close his mind on this issue until, in a few days' time, the Petition is presented in the House by my hon. Friend the Member for Kingston-upon-Thames (Mr. Boyd-Carpenter).

It would be wrong, I suggest, that this matter should be decided in a manner unfavourable to the petitioners before the Petition has been presented, and has received the consideration which is its due. So I ask the Minister to do tonight the big thing, the reasonable thing, the generous thing—to accede to the proposal that an independent and an impartial inquiry should be set up without further delay.

Sir Ian Fraser (Morecambe and Lonsdale)

I only want to say that this situation is parallel to that in Morecambe where the Victoria Hospital and all who are associated are in exactly the position described by my hon. Friend. There are also 20 or 30 other towns in which this situation exists. Will the Minister therefore answer, not merely the local plea that has been made but the wider issues involved?

10.21 p.m.

Mr. Messer (Tottenham)

There is not time to argue this case. I regret very much that the hon. Member for Wimbledon (Mr. Black) used up so much time that he prevented any real reply even by the Minister. I rise so that the Minister shall know that if he concedes what is requested he will have trouble from one end of the country to the other. The hospital regional boards have been set up for the purpose of planning the Health Service. I can understand that in this particular part of the country emotion has been aroused. What does not strike the hon. Member and his colleagues, and indeed the local people, is that as a result of planning there is an addition to the available beds. They can only see this hospital.

Anybody at a town meeting can point to his little cottage hospital and describe it in terms that would wring tears from the eyes of the stone statues in the ground: "This is not a thing of bricks and mortar. This is the embodiment of years, of generations of the spirit." One knows just how emotion can be aroused. I plead with the Minister to let the regional boards get on with their job. If he does not there is no justification for their existence. If they cannot plan the Service, believe me the Ministry of Health cannot: they are not in a position to do so.

10.22 p.m.

The Minister of Health (Mr. Marquand)

The hon. Member for Wimbledon (Mr. Black) said there was intense indignation about this matter in the district he represents, but fortunately he did not show any tonight, and I was glad to receive his assurance that there was no political bias involved. He told us that there were people of all shades of political opinion who were disturbed by what they heard at public meetings at Kingston and in the neighbourhood, and shared his views. I dare say there are.

Equally, on the other hand, I am sure it is perfectly clear to him that the proposals of the regional board have not been drafted by the Labour Party. No doubt if we troubled to inquire—which we never do—we should find that on the regional board among those who have drawn up the scheme there are also people of varying political views. We must therefore discuss this matter tonight in a completely dispassionate manner as far as party politics are concerned.

There have been, I believe, two debates before on this subject and a great number of Parliamentary Questions, and I therefore thought it right that I should myself take a hand in the matter as soon as possible, particularly because it seemed to me that there was a general problem involved as well as the particular problem of this hospital. That there is a general problem involved has been made abundantly clear in very succinct speeches from the hon. Member for Morecambe and Lonsdale (Sir I. Fraser) and my hon. Friend the Member for Tottenham (Mr. Messer).

I take it we are all agreed that we are in favour of a National Health Service. We may have different views as to the way in which it ought to have been developed, and so on, but we are in favour of a National Health Service. The hon. Member for Wimbledon certainly said that he was. If we are in favour of a National Health Service, I presume we are also all in favour of a regional organisation for the hospital service. That was proposed by every commission and body which, before the National Health Service was started, inquired into the hospital service as such. Everybody thought that it should be regionalised, and it was for this purpose that regional boards were established under the National Health Service Act—to advise the Minister and to plan the hospital services in every region so that within any given region all the various specialties which might be expected there in the different hospitals might be co-ordinated and provided in the most suitable way for the good of the whole of the people in that region.

I think we are agreed that that was the job of the regional boards. To set up a regional board to ensure that the specialties in every given part of the region shall be available to all the citizens in that region inevitably means some re-organisation. Re-organisation of that kind is bound to affect some of the smaller hospitals which cover the wider range of specialties and yet have very few beds and perhaps lack other facilities. Such hospitals in every one of these schemes had to give up some of these specialties or become a unit for one speciality only in order that one adequate unit might be available in every committee group. That is the essence of the planning of the regional boards. The regional boards have done that and consequently the functions of this particular hospital have had to be changed.

I think that we ought to realise that any regional board undertaking this job must inevitably here and there encounter local susceptibilities. We must realise that in any region a change of this kind is part of the general plan for the better service of the public. I am sure that the board is not doing it in any spirit of feeling that a general practitioner hospital in itself is an undesirable thing. The regional board does not think that, the Minister of Health does not think it, and his advisers do not think that. There is no bias or animus against a general practitioner hospital as such.

What has happened in Kingston is that it has been found by the regional board that there is an outstanding need there for a first-class gynaecological unit. There are, I am told, nearly 300 women on the gynaecological waiting list, and this list cannot be cut down until the scattered gynaecological facilities are centralised and improved. It is not a fair argument to introduce into this general question of how best to provide gynaecological treatment in this area the particular effect of the influenza epidemic of today. When there is an influenza epidemic and certain people are in danger of life they should, of course, be taken into hospital as quickly as possible, and that is being done. But we are planning now not for an influenza epidemic. This plan is drawn up to meet the long-term normal situation.

I am quite sure that the regional board has considered this very carefully, and I do not see why I should reject their opinion that the scheme could not be worked without making use of the exceptional facilities of the Kingston Victoria Hospital to create there this gynecological unit. It is needed and that is the place to have it because it is close to the general Kingston Hospital with its equipment, specialised skill and so on. It is unfortunate that that plan should mean that particular patients will no longer be able to use this hospital, but there is no doubt that its facilities and 44 beds will be better used for this purpose than in an attempt to deal in such a small compass with all aspects of medical and research work. That is the expert opinion, and it seems to be the proper one. That seems to me to be right.

Proper safeguards for the general practitioners using the hospital at present are preserved under this scheme; they are not to be cut off from hospital work altogether and the Surbiton Annexe, as it is called, and it is perhaps an unfortunate name—

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

An unfortunate building!

Mr. Marquand

Perhaps it is an unfortunate building; but the name given to it and the fact that it has been a pour building in the past must not lead us to suppose it must always be like that.[An HON. MEMBER: "It ought to be a gynecological unit."] It is obviously not suitable for that; it is a mile away from the general hospital where all the facilities are available, but cottage hospitals all over the country are miles away from the general hospital, and this Surbiton building could be a satisfactory building for a cottage hospital.

If the general practitioners in Kingston who have been making use of the Kingston Victoria Hospital will lend their assistance and give us their co-operation and suggest what are their requirements in the Surbiton Annexe, we shall be very pleased to have their views and observations. I hope that I am wrong but I think they have appeared to refuse to offer their advice but I hope they will come forward and co-operate in the provision of a satisfactory building there. If they will co-operate I can assure them that in addition to providing this building in which we hope to give all reasonable assistance for the general practitioner, facilities for general surgical work in Kingston will be offered so that all the patients who would have gone to the Kingston Hospital will be properly catered for in the Annexe or in other hospitals in the group.

I have examined a little chart which has been prepared for me—and I wish sometimes that one could do in the House what one did in the university and have a blackboard to give demonstrations—and I think this chart will show the hon. Member for Wimbledon and his hon. Friends that among the six or seven hospitals in the area of the Kingston group, there will be 226 beds under the new scheme as compared with 203 at the moment. At present there are 81 maternity beds, compared with 102 under the scheme, and whereas there were 37 gynaecological beds there will be 41.

Apart from the increase in beds there will be the increase in facilities. This [...] not a large number of beds to assign for gynaecological work and I am sure nobody in the House is ever going to suggest that gynaecological work is unimportant or that there should be here and there a number of beds without expert care and the necessary facilities. Let hon. Members remember the discussions we had in this House about analgesia and let us see that all facilities are provided for gynaecological and special types of maternity work which require the services of a specialist.

I have been asked to set up an inquiry but I really do think that hon. Members will agree there has been ample inquiry. Full attention has been drawn by the hon. Member for Kingston-upon-Thames (Mr. Boyd-Carpenter) in Adjournment debates in this House to the whole subject, and questions have been answered. The Minister of Health and his Department, and the regional board have gone into the whole matter. There is here a conflict of opinion, no doubt, but there could be no advantage in further inquiry. We know all the facts, and have to take action on the basis of those facts.

If there are people in Kingston, and there evidently are, who do not know all the facts which I have available here, I shall be only too glad to make more information available about the scheme than I can do in the short space of time at my command to-night. I have only about half a minute left, and I would say that if hon. Members would like to bring a deputation to meet me, and allow me to explain the scheme in greater fullness, and show how it will work to the benefit of the people, I will gladly do that.

Mr. Boyd-Carpenter

Will the right hon. Gentleman hold up action until that is done?

Mr. Marquand

I am not talking about a general deputation on the work of the regional hospital boards, Certainly not. We are dealing only with this particular hospital and locality.

Mr. Boyd-Carpenter

Will the right hon. Gentleman hold up action until he has received that deputation? Otherwise the offer is valueless.

Mr. Marquand

The only action going on is work on the Annexe to make it into a general practitioners hospital. But we are not prepared to hold that up. However, if any hon. Member is not satisfied with the information which I have been able to give in a matter of 10 minutes, I am perfectly willing to receive a deputation.

Adjourned accordingly at Twenty-three Minutes to Eleven o'Clock.