§ Motion made and Question proposed, "That this House do now adjourn."—[Mr. T. G. D. Galbraith.]
§ 12.1 a.m.
§ Major Sir Frank Markham (Buckingham)
After the major debates we have had during these last few days, it may appear somewhat of an anti-climax to invite the House to consider a matter of almost purely local importance to North Buckinghamshire and the immediate neighbourhood, namely, the provision of adequate hospital facilities for the Bletchley area. But one of the great virtues of this House is that we can switch from subjects of world-wide importance to subjects affecting a small number of individuals. In such a way we get the fresh air of democratic criticism blowing through every Government Department in turn. It is, therefore, with no apology or hesitation that I raise this question of the lack of adequate hospital facilities in the area which I have the honour to represent in this House.
The Bletchley area has no general hospital provision at all, nearer than about 17 or 18 miles. It is true that there are large hospitals at Luton, Bedford, Oxford, Aylesbury and Northampton, but to get to any one of those centres from Bletchley means often a very difficult journey, and in many cases it may mean as much as eight hours travelling and waiting time for a 10-minute or a 15-minute interview by the doctor or the specialist concerned.
This area of nearly 1,000 square miles, embracing over 60,000 people, is an area which is developing very fast, since Bletchley is an enlarged town under the recent regulations and is expanding at the rate of 1,000 persons per year by immigrants from other areas in addition to the normal expansion. This expansion has been helped in every conceivable way by the Minister of Housing and Local Government, as I think everyone in the Bletchley area would agree, but on the hospital side there has not been a parallel approach. The urban district council have done everything they can to secure hospital provision for Bletchley. They have earmarked an area of nearly an 1526 acre for a new general hospital—and excellent site—and apparently they are faced with a situation which I find difficult to understand. They have been informed by the Oxford Regional Hospital by letter dated March 10th this year that:I cannot give you any very helpful indication as to the likelihood of the Board being able at any early date to proceed with the construction of hospital premises at Bletchley following upon the decision to ask for a site to be reserved in the Development Plan.The fact is that our capital allocation over the next two years at last is already overcommitted and we are quite unlikely in that time to include provision for Bletchley in the programme. Unfortunately, in making allocations to the regions it would seem that the Ministry do not take account of the needs of the new towns in the developing areas, but simply leave it to the Boards to do what they can with the small amount of capital available.Frankly, that letter gives one the impression that the board would be happy and willing to do their part by Bletchley if the Ministry in turn would do their part by the board. I should be very grateful if the Parliamentary Secretary could enlighten me on this situation. Is it the Ministry holding up this development, or is it the regional hospital board? Whoever it is, what steps can be taken to ease this situation?
Bletchley itself in the pre-war days was better off in hospital provision than it is now. In those days there was the Woburn Clinic, sometimes known as the Duchess of Bedford's Hospital, an admirable small hospital. It has been closed down for several years. The buildings are still empty, while at the same time Bletchley and the area has inadequate hospital facilities.
As another alternative, the Ministry might care to look at the R.A.F. Hospital at Bletchley, which contains about 30 beds. At the moment, it has only three or four R.A.F. patients, and I understand that the R.A.F. are thinking of giving it up next year. Would it not be feasible, pending the proper development of hospital facilities, to take over the R.A.F. Hospital as it stands in the near future? I put these suggestions forward purely as temporary palliatives for a difficult situation.
The main thing I want to ask the Parliamentary Secretary for is every help and support towards getting an adequate modern general hospital built at Bletchley. The urban district council have 1527 done their part, and done it well. In view of the growing population of the area, the ever-growing importance of the A.5 route which goes right through the area, with the possibility of road accidents developing with higher speeds, the growing industrial development of Bletchley itself, I think this matter of hospital accommodation is urgent and becomes more urgent with every day that passes.
I hope that the Parliamentary Secretary will give us some ground for hope that the hospital provision in Bletchley will be provided within a reasonably measurable time.
§ 12.18 a.m.
§ The Parliamentary Secretary to the Ministry of Health (Miss Patricia Hornsby-Smith)
The hon. and gallant Member for Buckingham (Sir F. Markham) has raised a question which I know gives rise to some considerable concern in the Bletchley area of his constituency. It is true that Bletchley was selected as one of the towns under the Town Development Act, 1952, for certain industrial and residential expansion. The estimate is that in the course of 10 years Bletchley will increase in population by some 10,000. So far it has been able to induce industry to go there, and in housing it has done a great deal to meet the additional call for residences.
It is true that within its own area it has no hospital. It has a chest clinic, and the nearest hospital is a small one of 21 beds in Buckingham. There are within range—within longer range but certainly serving the patient-need of the area—large hospital groups and units at Aylesbury, where there are 700 beds, Northampton where there are 1,100 beds, and Bedford where there are 700 beds, covering all the various specialties.
With regard to expansion, I would like to make clear the differentiation between a new town where there is in prospect the transfer of 100,000 or 200,000 people, and an area like Bletchley and the surrounding district which has a population of 60,000 or 70,000 and a probable increase of 10,000. The two cannot be dealt with on the same basis, and there is a very clear difference in Ministry responsibility.
1528 In the case of a new town, such as the Welwyn-Hatfield area, hundreds of thousands of people are being moved. Obviously, the scale of that makes it necessary for direct allocation to be made in any consideration of entirely new hospital services where none exist, and that direct allocation over and above the general board allocation will have to be considered by the Ministry.
To expand an area by 10,000 is very common indeed. Dozens of areas in the country have expanded their populations by similar figures within the last few years. In the last few years my constituency has absorbed 25,000 people. It would be quite impracticable for the Ministry to deal with all such areas by direct ministerial grant because it could only do so by first withdrawing that aggregation of money from the total sum which it had at its disposal for the regional hospital boards, and it would deprive the regional board with one hand of what it would otherwise allocate with the other. We should rapidly find that we were deciding on most projects from Whitehall and removing from regional boards the authority which they were given under the Act to decide the priorities in their own areas.
Bletchley's development is a normal programme which comes within the purview and priorities of the Oxford Regional Hospital Board. It is for that board to decide from the capital allocated to it the priorities within its own region. I have repeatedly said in the House that my right hon. Friend does not think it right to interfere, except in very extreme circumstances, with the priorities fixed by the people on the spot and responsible for their own areas. We know very well that if a priority is changed we have no additional money which we can provide for it. It means that some other priority which was given first place by the board has to be held up while the new one uses the capital which the board allocated elsewhere.
With regard to Bletchley, the board would certainly like more hospital provision there, but it has given first priority for new hospital capital expenditure to Swindon. It is for the board to decide in what order of priority further development in Bletchley should be made.
My hon. and gallant Friend raised a question concerning two units, with which I will now deal. First, there is the ques 1529 tion of the R.A.F. station at Bletchley. The board is well aware of the need for additional beds in Bletchley, and it tried to make interim arrangements with the R.A.F. camp some time ago, but those negotiations fell through. The camp is still in use, although it is mooted that the R.A.F. may be moving out fairly soon. It is primarily a residential camp, with a hospital or sick bay, and in its present form that would not be wholly suitable to provide the requirements which would be demanded of a unit serving general patients for the Bletchley area. But should the R.A.F. vacate the camp, the regional hospital board would certainly investigate the possibility of using the premises. It must, however, take into account the capital cost—and the capital cost of adaptations is generally very high—and also the maintenance cost of what might be a comparatively small unit.
The Duchess of Bedford Clinic, known as the Woburn Clinic, at one time served Bletchley but it now comes within not the Oxford Region but the North-West Metropolitan Hospital Board. The North-West Metropolitan Board considered whether it was a practical proposition to re-open and to run this unit, but in its negotiations it was considering the unit for chronic sick, and even for that purpose, which does not involve so high a capital expenditure on clinical necessities, it would have cost £8,300 for building and engineering works, repairs and equipment, to bring it up to a standard at which it could be used. Maintenance costs even as a unit for the chronic sick would be £13,000 a year. In view of the heavy cost of maintaining so small a unit, the board did not pursue those negotiations as it did not consider it a practical, economic proposition.
The Oxford Regional Hospital Board, as stated in its letter, has earmarked its capital resources for 1954–55 and 1955–56. It is fully aware of the need to provide additional accommodation at Bletchley. I cannot wholly accept the criticism in the letter which my hon. Friend read to the House, because the Oxford Regional Board knows, as do all regional boards, that the sum of money allocated for capital expenditure, and the amount which the Government feel that it is possible to allocate in any 1530 one year to the health service and from that to the hospital service, is divided among the regional boards.
In that allocation we take into consideration all such aspects as change or migration of population. Population is one of the factors considered when the allocation is made. We also take into account the existing hospitals and the need for maintenance of buildings and for new buildings.
All those factors are very fully considered in the allocation of money to the regional boards, but once the total allocation has been made it is for the regional board to make its own priorities within its area. I am sure my hon. Friend will agree with that policy. To do otherwise would be to take away from those who live and work in the area, and who have given great service in the area, responsibility for decisions on matters within their own knowledge. It would be directing everything from an office in Whitehall, which I am sure is neither the desire of the board nor the intention of my hon. Friend.
It is true that if a board is unable to make a local scheme its top priority, it always blames the Ministry for not finding enough money. If, on the other hand, the board finds the money for a particular priority, it always takes the credit for its prescience in doing it. Nevertheless, I assure my hon. Friend that we are conscious of the difficulties in Bletchley. There is no question but that it is a matter and a priority that must be decided within the capital allocation of the Oxford Board. It does not come into the category of a new town, nor will it increase by such a vast amount that it would justify direct and special treatment from the Ministry, as is anticipated in the case of the real new towns as opposed to extended existing towns.
I am sorry not to be able to give my hon. and gallant Friend greater hope in this matter beyond assuring him that we know that the board has it on its list of priorities. We know that the board will do all in its power to consider the possible alternative of the use of accommodation in the R.A.F. camp when the Royal Air Force moves out of it, and we know that the board has it well to the fore that so far as is possible it should 1531 do its best to provide nearer accommodation and some additional accommodation for the Bletchley area.
§ Sir F. Markham
I thank my hon. Friend for her sympathetic and extremely frank reply, and I shall discuss this with my friends in Bletchley. I must, in the most ungentlemanly way, threaten her 1532 with raising another Adjournment debate on the subject before the Session ends if I do not get what I am after.
§ Adjourned accordingly at Twenty-two Minutes past Twelve o'clock a.m.