HC Deb 28 June 1951 vol 489 cc1751-60

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

11.32 p.m.

Mr. Watkinson (Woking)

I make no apology for detaining the House at this late hour, because the matter which I want to raise is one which has now run for some 12 months and I have exhausted, I think, every other possible means of trying to get some satisfaction in this matter for my constituents. It is one which concerns the out-patients' accommodation at the Victoria Hospital in Woking. It is a hospital which serves a population of far more than 50,000 people. But for the war, the hospital would have been rebuilt. A complete rebuilding scheme existed, but could not be carried out because of the war. After the war, plans for extending the outpatients' accommodation were nullified by the taking over of the hospital by the South-West Metropolitan Regional Hospital Board.

The first point which I wish to make is the need for much greater out-patients' accommodation for the people of Woking in the place where it is convenient, and where it is possible for them to make proper use of it. Even as long ago as 1948, the latest year for which figures are available, nearly 6,000 out-patients used the hospital, more than 6,000 X-ray cases were dealt with, more than 12,000 casualty attendances were dealt with, and more than 21,000 physiotherapy cases, a total of more than 25,000 cases during the year.

This hospital is, therefore, meeting a large and definite need. Now let us see the kind of accommodation which is available to deal with far more than 25,000 people a year. The size of the out-patients' consulting room is 15 feet by 12 feet, not very palatial accommodation. The waiting room is 15 feet by 15 feet. The X-ray department, which is housed in the old mortuary, is in a dangerous condition, because as there are high-tension cables trailing about the place it is likely that there will be a serious accident one day. The casualty room is only 15 feet by 12 feet, and all casualty cases have to be carried through the waiting room—an unpleasant spectacle for those who happen to be there, especially as the unpleasantness is added to because the groans of the unfortunate casualties can be heard by those in the waiting room. That sort of thing is not good enough for a large and growing area which depends on this hospital for these particular services.

I think the fair thing to do is to quote a letter from one of the doctors who uses the hospital, which he wrote to me when he learned that this matter was to come up in the House. It sums it up very much better than I am able to. He writes: On most occasions, the out-patients are hopelessly overcrowded and in this one room "— that is, this one out-patients' room 15 feet by 12 feet— patients are dealt with for surgical, medical, gynaecological, ophthalmic, ear, nose and throat, dental, tuberculosis, V.D., skin and diseases of children. I think my constituents are deserving of rather better accommodation than that.

It may be said that other accommodation is gradually reducing the load on this hospital. If that should be one of the arguments of the Parliamentary Secretary, perhaps he will bear in mind that in 1950 over 2,000 T.B. refill clinics have been held, and for 1951 the latest figure I have been able to get which cover the first five months of the year, show that 700 more people have used the consulting out-patients' clinics, so that the numbers using the clinics are going up all the time. I would remind the Parliamentary Secretary that the Sheerwater estate will bring another 5,000 people into Woking and place a further load on this hospital.

May I mention again the next possible alternative that may be put forward? It may be said that in St. Peter's Hospital, which lies roughly midway between Woking and Chertsey, we have a large modern hospital, which can provide alternative facilities. In that connection may I quote a letter from another doctor—I have had a large number of letters on this question—which shows that it is a perfectly genuine case arising from the need of the inhabitants. This letter, referring to St. Peter's, Chertsey, as a possible alternative, said: St. Peter's is quite the most inaccessible place I know, whilst, on the other hand, Woking Victoria Hospital is very well situated for out-patients. I hope the solution will not be that the unfortunate people of Woking who have to have out-patients' treatment, are to have to make the difficult journey to St. Peter's, which will be a long way to go, with poor facilities for catching buses.

In that connection I should like to quote another letter from another constituent of mine, who says: From actual experience I know the value of St. Peter's Hospital to this community, but I also know the hardships entailed by outpatients and their friends having to traverse the distance either for treatments or for visitations. In the winter months, it is very hard on out-patients who, after treatment at St. Peter's, have to wait often as much as 30 minutes on the main road waiting for a bus to return to their homes. No bus shelters there, and in the wet cold weather one can vision the discomfort and the risks involved. I do not think a case can be put forward for St. Peter's, Chertsey, as an alternative to Woking Victoria Hospital.

It may be said that in these days of financial stringency and because of the financial cuts which are to be imposed on the regional boards, this is an impossible thing. The case I want to make is that for over 12 months nobody has denied that something must be done to provide greater out-patients' accommodation. If I may, I should like to give a statement by the Parliamentary Secretary himself, when he said, on 7th June last year, that he recognised the need to provide additional facilities as soon as possible. Then the former Minister of Health, the right hon. Member for Ebbw Vale (Mr. Bevan) said on 25th July last year that the regional board originally planned to increase the out-patients' department at the Woking Victoria Hospital.

I could go on quoting from the file of 70 letters which I have had from various people, from the Minister down to the Chairman of the South-West Metropolitan Regional Board, and so on. The Chairman has written several letters to me; on 7th November last year, he said that the case would be considered oil the 22nd of that month. After that, he said it was still being considered and, on 16th January last, and 22nd January, he stated that a decision would be reached on 9th February this year. Then the present Minister of Health wrote to him and said that the Board—that is, the Hospital Board—agreed that the scheme should be given priority over other work in the group

After all these promises, what can the people of Woking do to get the necessary accommodation for reasonable out-patient treatment? I do not think that the Parliamentary Secretary will deny that the need is there. The accommodation is greatly overcrowded; and at this point, let me say that I am in no way reflecting on the standard of the medical treatment given. One of my own children has been treated there, and from my experience I can say that the doctors there do their utmost to give the very best possible facilities. But they are greatly hampered by this very serious lack of accommodation

Let us presuppose that the need is not going to be questioned, and that St. Peter's is not the possible alternative. Are there others? I say quite plainly that if it is suggested that the easiest and cheapest way out is to do away with some of the present bed accommodation in order to take additional out-patients. then that is an unacceptable solution. The bed accommodation is extremely limited and, incidentally, both the ex-Minister of Health and the present Parliamentary Secretary—probably very rightly—declined to come to Woking to look at the hospital. But, none the less. they doubtlessly have all the facts to hand.

The layout is that there is the old hospital on the one side, and Riverside House on the other; and if the suggestion is made that Riverside House should be used for a sort of out-patients' accommodation, then that is entirely unacceptable; and that is the view, not only of myself, but of those intimately associated with the problem. We are desperately short of bed accommodation, and it would be a completely wrong thing if the number of beds was cut down. The land is there; the gardens of Riverside House are levelled, and ready for some sort of temporary accommodation which, I suggest to the House, would be all that one could expect in these hard times.

Nobody, so far as I know, asks for any elaborate scheme; even that kind of scheme considered if the hospital had continued under private ownership. We merely ask for increased accommodation to deal with this desperate and pressing problem, and I do hope that, after 12 months' delay, and the passing of some 70 letters on this subject between myself and various people, something can be done to meet this need.

I hope that something can be done to provide the people of Woking with out-patient accommodation where they can be treated by their own doctors, thereby keeping that continuity between doctor and patient which I believe to be so important. Woking has given up hope of a large general hospital, which its size and position in Surrey warrants; but it would be denied a very elementary right if it were denied greater out-patient accommodation to meet this very urgent need.

11.45 p.m.

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

Let me commence by saying that no one would contest for a moment the need for a new out-patients' department at Woking, which the hon. Member for Woking (Mr. Watkinson) has very persuasively argued tonight.

Mr. Watkinson

Persuasively enough. I hope.

Mr. Blenkinsop

There is, however, no need for him to do so, because we are agreed, and the South-West Metropolitan Regional Hospital Board are agreed, not only that it is desirable but that there is a need that must be met. The whole question raised here is really one of priorities; and it is an illustration of the very many individual cases where difficult decisions must be come to at the present time when priorities have to be decided upon by a regional board, which possibly has a wider view over a wider area than can be expected from more local opinion.

I find it a little difficult at one and same moment to meet the argument of many hon. Members in the House who say that the Ministry itself should not interfere with the decisions that are taken by our agents in the hospital field in determining priorities or, indeed, in the general conduct of the hospital work, and this type of complaint in which it is argued that a regional board has made a wrong decision on priorities, and that we should step in to alter the order of priorities in favour of a particular locality.

Mr. Watkinson

Let me remind the Parliamentary Secretary that as long ago as 6th July, 1950, the then Minister of Health told me that regional boards allocated capital expenditure according to the relative urgency of local needs. My point is that this is a case of great urgency.

Mr. Blenkinsop

They have to take account, as I say, of the needs over the whole of their regions in allocating their limited resources. We should all be very happy indeed—and I am sure the regional boards would be very happy—if, instead of having to make this choice, they were able to go ahead with the whole of the list that I have here of the schemes that they are anxious to develop at the earliest possible moment; but they must make selections because of the limitations that we have to accept responsibility for, and which we have to impose on regional hospital boards for reasons we all understand, and which I think are accepted in the House. Having accepted that limitation upon the resources that are available, the duty falls upon the regional hospital boards to determine the priorities for themselves, in the long and important list of projects, as to which they feel ought to go forward within the sums of money available.

Sir Hugh Lucas-Tooth (Hendon, South)

Is it not a fact that all capital projects have to be referred to the Minister for approval? Will the hon. Gentleman say whether this particular project has been referred to him or not?

Mr. Blenkinsop

There is no doubt that these schemes are all approved in the sense that they are agreed with the Ministry; but it is, nevertheless, true that because of the limitations of the resources that are available, and because of the extra limitations that have had to be imposed, and which we had hoped would not have been necessary, they have to make revisions of this list as to what are their priorities at any particular time. I want to ask the hon. Member for Woking, if he had the unpleasant duty to perform of deciding between these priorities, which of the urgent schemes would he have preferred?

Mr. Watkinson

The hon. Gentleman accepts, does he not, that as long ago as 12 months the Minister of Health took the view that this should have had very high priority?

Mr. Blenkinsop

Yes. We still do, but the regional board felt that there are schemes that have to be given even higher priority than this out-patients' scheme at Woking. Nearly all of them are schemes for increasing tuberculosis accommodation, which, I am sure, the hon. Member would agree, as would we all, is what we regard nationally as one of our greatest priorities. We have asked, in line with the pressure in the House, that the regional boards should give the most urgent consideration to these needs in any extension of accommodation that they can provide within our limited capital resources.

I have details here of schemes for adaptations designed to provide 25 additional T.B. beds at one centre, the improvement of equipment for T.B. at another centre, equipment to provide an additional 25 beds within this actual hospital group, two schemes for chest clinics—again for T.B.—and, finally, further improvements at Godalming to provide for 40 extra beds, the first stage of a larger scheme of accommodation which will provide, altogether, 100 extra T.B. beds. All these are schemes which have been given additional priority by the regional board. Outside that, there is only one scheme of very great priority and that is for the adaptation of two observation wards for mental cases, which is certainly regarded by everyone in that area as being of the very first priority.

I do not think that the hon. Member himself, if he were asked to carry out this rather distasteful job of settling priorities, would say that this particular scheme—which he and all of us are anxious to see proceed—could take precedence over these others. Yet that is the sort of problem that faces the regional board, and it is made more acute by the limitations placed upon development in the hospital field through the capital restrictions that we are having to face.

Therefore, I have to say that I cannot regard the decision of the regional board on this scheme as being in any way unreasonable; but that does not mean that this scheme has been lost. The regional board, with our approval, do still regard it as an essential need for that hospital, and whatever temporary arrangements may be made to meet the problems of this immediate year, that need is still existing. We would all hope—although I still cannot give any pledge—that this will be regarded as one of the first priorities to be fulfilled next year. I am not pledging the board—it would be wrong for me to do so—but the board did very much hope that it would have been possible to bring the scheme into operation this year. Because of the stark realities of the position they have to defer it, but they hope, and I hope, that there will be a deferment only till next year.

In the meantime, we must take action for the immediate intervening period until the full scheme can go forward next year. The proposal for that temporary period only is one which the hon. Member for Woking said he regarded as unacceptable. I hope he will not regard it as unacceptable—on the understanding that it is not a permanent proposal in place of the new out-patients' department, but one to meet the need in the intervening period until that department comes along.

For that purpose alone I think the proposal is a reasonable one—that Riverside House should be used for extending outpatient facilities, and that the consequent temporary loss of eight beds should be made up in other hospitals. I accept that that will not be so convenient, but, nevertheless, the arrangement seems a reasonable alternative for a temporary period, and undoubtedly, at the end of this time, it will be possible to go forward with the new out-patients' unit, which we all agree is so necessary.

I would like to emphasize the very great difficulty that we are in with this type of case. It is perfectly natural and right for hon. Gentlemen to make sure that the needs of their constituents are brought to our attention, but I think they will accept, at the same time, that the regional board have the duty to try and sort out from among a whole host of very desirable plans those which, on a regional basis, they regard as most urgent. We must, as the Ministry, accept the responsibility of placing that duty on them. I am sorry that we have had to do so, but they certainly cannot escape it.

Mr. Watkinson

May I get one thing clear? If the temporary extra accommodation for out-patients is based on Riverside House for 12 months or to the end of this year, is it really hoped, after these long delays and postponements, that the new accommodation, even of a temporary nature, can be tackled in next year's building programme.

Mr. Blenkinsop

That is certainly the common desire of the board and ourselves. There may be more serious events, which would, naturally, put an end to our hopes and expectations, but I hope they will not arise, and that it will be possible to go forward as suggested.

It may appear from the timetable given by the hon. Gentleman, relating to the consideration that the board have given these proposals, that they have not adopted a particularly sympathetic attitude. I do not think the board can be blamed in any way for the position they have taken up. They have all along wanted the scheme to go forward, and they have tried to find less costly alternatives. All these schemes have had to be discussed with the management committee, who, I think, would agree that the board, during these past four or five months, have tried to agree on some means of meeting the difficulties. It would be fair to say that the management committee themselves, faced with the regional position as I see it, would have accepted the unhappy but necessary step of going forward on the basis I suggest.

On behalf of the regional board I can say that they have no wish to offend local opinion. They recognise the anxiety of people locally, but they also have to carry out their own duties. I hope with that assurance on the way in which the scheme will work out the hon. Gentleman will agree, not merely that the Ministry have taken the closest interest in it, but that the regional board have adopted, on the whole, a sympathetic attitude, even although they have not been able to meet all the desires of the local people.

Mr. Watkinson

I hope that it will be possible for the plan as now announced to be carried out. If these things could have been made plainer to the people of Woking I am sure there would not have been these difficulties.

Adjourned accordingly at One Minute to Twelve o'Clock.