MATERNITY HOME, SOLIHULL (CLOSING) (Hansard, 2 March 1954)

§ Mr. Martin Lindsay (Solihull)
Brook House in Solihull is the only maternity home in my constituency, and, indeed, in the surrounding district, in which mothers can have their babies at reasonable expense and be attended by their own doctors. Eleven months ago it was closed owing to an outbreak of an infectious disease, and great inconvenience has been caused to patients and doctors owing to the prolonged delay in reopening it.
The home was founded by the Solihull District Nursing Association many years ago, and run by it until 1948, when it was taken over by the Ministry of Health, administration passing to Solihull Hospital. At this time an assurance was given that maternity beds would always be available for general practitioners. The local doctors continued to attend their own cases, and so it became a general practitioner maternity unit, and, as I have said, the only one in the district. There are 18 beds, and on an average 360 cases are delivered each year.
In 1953, owing to an outbreak of an infectious disease, Brook House had to be closed for disinfecting. It was decided to take the opportunity of redecorating it, and, at the same time, to install some modern equipment. I was informed by the Minister in July last year that the regional hospital board had authorised maintenance works at a cost not exceeding £3,020, and that this was to be proceeded with at once, and at the same time it had been decided to do further work amounting to another £3,000 at a later date.
On 10th November last year I asked my right hon. Friend if he could expedite matters, and he informed me in a written reply that he hoped Brook House would be ready for occupation later the same month. That indeed was the position then, and the work was almost completed. But before the proposed date of opening, the medical sub-committee of the hospital management committee inspected Brook 1147 House and recommended further alterations. This, believe it or not, was seven months after the home had been closed and just when a great deal of work had almost been completed. One wonders why these experts were not called in at the very beginning, which would obviously have saved a great deal of time and money. I do not think that anybody can dispute that this is clearly a sad story of muddle and mismanagement.
We were also at that time told that no financial resources could be allocated for this work until the following spring. It therefore seemed that Brook House would remain closed until next autumn or later. However, I now understand that the regional board have since reconsidered the matter and found the necessary expenditure during the current year. I am also told that equipment is arriving on the site, that the work is being put in hand at once, and that Brook House will be opened in about two months.
Of course we are grateful for this change of heart on the part of those responsible, and if my right hon. Friend has to some extent been responsible, I should like to thank him too.
I hope that the Parliamentary Secretary will be able to assure me that there are likely to be no further delays. Subject to this assurance which I should be very glad to have, I do not think there is anything further to say about the delay in reopening Brook House. There is, however, one other aspect to this matter.
Unfortunately, we know that the hospital management committee has several times suggested closing down this home altogether, though each time this has been brought up local opinion has prevailed. There is a feeling that the regional hospital board would like to see Brook House closed down, perhaps in the interest of tidy planning or administrative convenience.
When the National Health Service was introduced it was always clearly understood, and indeed we were told so in the most categorical terms, that nothing would be done to disturb the traditional relationship between doctor and patient. I suggest that nowhere is this relationship more important than in a confinement. A woman who wishes to have the attention of her own doctor on this special occasion should, as far as possible, not be prevented from doing so.
1148 As I have said, this is the only general practitioner maternity home in the district; 360 births in the year is not a negligible number. I earnestly hope that the Minister will give us the assurance that at no time will it be closed down by administrative action.

§ The Parliamentary Secretary to the Ministry of Health (Miss Patricia Hornsby-Smith)
I thank my hon. Friend the Member for Solihull (Mr. M. Lindsay) for the manner in which he has raised this matter. I recognise that there is a great deal of local feeling about this maternity home, but it is fair to say that the obligations placed upon the hospital management committee to provide adequate accommodation for cases which require institutional maternity care have been fully met.
I recognise that the local people are particularly interested in this small unit of what I thought was 17 beds—although my hon. Friend said that there are now 18 beds—at Brook House, which has been maintained as a general practitioner unit. Brook House is a moderate size Victorian building which has for many years been a general practitioner maternity unit, but has not in the past been considered satisfactory according to the standards of the National Health Service.
Brook House did not conform to the standards which are believed to be necessary in a properly run obstetric unit. It was very soon found that it would require considerable expenditure to bring this comparatively small unit up to the standards which we feel are necessary for any unit which provides for confinements under the National Health Service.
In 1947, the regional hospital board and the hospital management committee considered that the best plan would be to close this unit but, as my hon. Friend has said, there were considerable local protests, and the suggestion that it should be closed was postponed. In view of the unsatisfactory nature of the unit it was then suggested that alternative accommodation for a general practitioner service should be found. That was not practicable. It was not possible to find alternative accommodation, and the situation was worsened by the fact that, as my hon. Friend knows, there was an outbreak of pamphigus neonatorum among 1149 the children in 1953, which resulted in the closing of the unit on 1st April, 1953. AM the patients in it at that time were finally discharged on 17th April. This made more urgent the question whether tile unit could economically be brought up to date for the National Health Service.
It was emphatically clear that if it was to be continued in occupation as a general practitioner unit it must have very substantial improvements on both the maintenance and capital expenditure sides. It required not only to be decorated and adapted but also that there should be modern equipment for the control of cross-infection.
For that purpose there were visits by officials of the regional hospital board who advised improvements, and the board estimated that the maintenance works alone would cost £3,020 and that further there would be required capital works of £3,000 before the standard of: efficiency of this maternity home could be raised to that considered adequate for a unit operating under the National Health Service.
Efforts were made to find alternative accommodation. Because of the financial stringency at the time it was felt that to spend some £6,000 on a unit of 17 beds, when there were other urgent priorities in the region, not only for mothers and their children but for the population generally under the Health Service, was a very large expenditure for a comparatively small unit, particularly when it is borne in mind that, according to the terms laid down by the Ministry, the area as a whole provides very well and adequately for institutional maternity care.
The average number of confinements provided for in institutional accommodation under the National Health Service is well above that of the country as a whole. Even with the closing of this unit 77.3 per cent. of all the babies born in Solihull have been born in hospital or maternity home accommodation.
Therefore, there is no question but that the hospital management committee met its obligation not only to provide for all those maternity cases which on medical grounds required institutional treatment but for those which on social grounds required treatment in a hospital 1150 or maternity home. It has been able to take in virtually all those requiring to go into hospital for confinements. So that there is no question but that the hospital management committee has fully met its obligations towards confinement cases in this area.
I realise the interest of my hon. Friend in maintaining this unit as a general practitioner one. I know the local and very strong feeling that there is in this matter, and that strong feeling has certainly prevailed upon the regional board to the extent that it has undertaken to see that this unit is reopened. Quite rightly, in my opinion, they have insisted that it should be brought up to the standards we demand in maternity units under the National Health Service.
I admit that there has been what would appear to be some delay in regard to the undertakings given, and I know from the file of correspondence we have had with my hon. Friend that he was told last July that the board hoped to be able to reopen the unit as soon as possible. The maintenance work was carried out last year, but on reinspection the board still felt that additional money would have to be spent on the equipment and plant necessary to prevent cross-infection, and to bring this unit up to the required efficiency before it could sanction the reopening of the unit.
After pruning the capital estimate the board decided early this year that some further £2,000, on top of the money already spent in the maintenance work, for additional adaptations and equipment must be spent. In fairness to the regional hospital board, I must point out that it has had to go very closely into its priority programme and to cut out other items of the programme to provide the £2,000 for the necessary adaptations to Brook House.
I understand from the regional board that that allocation of money is to be provided in the 1954–55 estimates and that it expects completion in May. It will then be possible to reopen the home. The Ministry fully supports the regional board's determination to see that this unit maintains the standards we believe to be necessary for confinements carried out in maternity homes or hospitals under the National Health Service.
Knowing the many priority calls upon the board, while I appreciate my hon. Friend's regret that there has been this 1151 apparent delay, it is fair to say that the regional board has not been unduly long in finding the additional capital expenditure for a comparatively small unit, particularly when, in the area generally, the board has provided an adequate service for all those mothers requiring hospital treatment. No cases of social or medical need have been refused, I understand, and the cases seeking admission to Brook House have been transferred and taken into Netherwood Hospital and—

§ Mr. Lindsay
My hon. Friend will appreciate that although they have been taken into. Solihull Hospital, it has not been possible for their own doctors to attend them. That is the whole point at issue.

§ Miss Hornsby-Smith
If my hon. Friend is asking me to accept for the whole country that maternity cases should automatically be dealt with in general practitioner units, that I cannot accept. It is the exception rather than the rule in this country that maternity cases are 1152 dealt with in general practitioner maternity homes rather than in the hospitals where they come under the supervision of obstetric specialists. If he is asking me for a general assurance that these units will be customarily provided in the country, that I cannot give him.
On the other hand, I think he should, and I believe will, be satisfied by the assurance of the regional board that it is prepared to reopen this unit, that it has already provided the money for maintenance work, that it has already budgeted in the next year's financial programme for the additional £2,000 which will bring this unit up to the required standard, and that it has given an undertaking that it hopes to see the home open in May. Beyond that, I do not think my hon. Friend can expect me to go.