HC Deb 04 March 1954 vol 524 cc1638-48

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

6.54 a.m.

Mr. H. Hynd (Accrington)

It is unfortunate that I have to raise this matter at 7 o'clock in the morning, but as I have sat here with all the patience that I could muster for many hours, I can hardly be blamed.

This is an important subject which may have repercussions in other parts of the country as well as in my own district. I think that the background of the matter has been illustrated by the petition that was presented at the beginning of this sitting by my hon. Friend the Member for Eton and Slough (Mr. Fenner Brock-way), by last Tuesday's Adjournment debate opened by the hon. Member for Solihull (Mr. M. Lindsay), and by various Questions that have been asked recently.

It is quite obvious that there is a general move to close maternity homes throughout the country. I cannot understand why, because I have before me an extract from a speech made by the Minister of Health at the Fifth Annual Meeting of the Executive Councils' Association in October, 1952, in which he says: Another thing that I think we can do to increase and help the status of general practitioners, particularly, of course, in the smaller towns and in the rural areas but not necessarily confined only to them, is to see that they have charge of their own patients in hospital who do not need specialist care but who do need admission. In any mind this applies not only to general cases but also to maternity patients where the confinement is expected to be normal. We will do everything we can to encourage hospitals to make beds available in that way. Despite that, the Blackburn Hospital Management Committee were faced with a cut of over £25,000 in their estimates last November, although at that time more than 2,000 people were awaiting admission to hospitals within their jurisdiction, including 84 gynaecological cases.

The maternity home to which I refer is called Springfield, and is a 20-bed general practitioner maternity home. It was opened by the Blackburn Corporation some 30 years ago and it was the only one in the town, which has a population of 110,000. In view of what was said at Question time today, I should explain that the catchment area for this home extends not only to the Division of my hon. Friend the Member for Blackburn, East (Mrs. Castle) but to my constituency. I am raising the matter for that reason, and with the full co-operation of my hon. Friend.

In October last, without consultation with the Blackburn Executive Council, the Lancashire Executive Council or the general practitioners concerned, the hospital management committee recommended the closing of this maternity home. That was admitted by the Minister in a letter to me, dated 31st December, in which he said: Your constituents are right in saying that they were not consulted about the proposal to close Springfield itself. The closing led to many protests, and I should like to quote one letter which was sent to my hon. Friend the Member for Blackburn, East, by a lady who said: I am 26 years of age and have one child aged three years. My husband is a sheet metal worker.…. My mother is a sick woman and is awaiting admission to hospital for an operation. I have two sisters, both married, the elder being a full-time cotton operative and the younger who is aged 21 has a baby of eight months herself. Unless I am able to secure a bed in hospital or nursing home I will be obliged to remain at home for my confinement. As I can call on no one else I shall have to depend on my younger sister. This will necessitate her husband and child living with us also until such time that I am able to look after myself and family. It is very difficult to see how they could live in her house, which is a typical small Lancashire house. That case has been refused a bed in any hospital. There was a deputation of local doctors to the Ministry on the general question of closing this hospital, but I do not want to dwell on that, because, whatever the rights or wrongs of the decision to close this home, I am more concerned with how it was closed than with why it was closed. The facts, which I have taken a great deal of trouble to verify, are very bad, and I hope that the Parliamentary Secretary will be able to give some explanation of them.

On 7th January, at about 8 o'clock in the evening, the patients and staff in this hospital were told that, starting from 10 o'clock next morning, patients would be transferred, with their babies, either to their homes or to another maternity hospital called Bull Hill, eight miles away, on the other side of the neighbouring town of Darwen. The doctors in charge of these women were told nothing about this until the next morning, with the exception of one who heard accidentally the same evening. The mothers and babies were moved without medical inspection by laymen, some to their homes and some to Bull Hill Hospital. Some members of the Hospital Management Committee learned of this only from the newspapers.

I raised this matter with the Minister by Question in the House on 21st January, when he told me that the doctors of the seven patients who were sent home accepted the proposal. The doctors informed me that they did not accept the proposal in that sense. They were told on the telephone the following morning that removals had already started, and when the right hon. Gentleman said that the doctors were consulted and accepted it, I can only assume that he had been misinformed. It so happens that the date of the transfer was the coldest day of the winter, and I am told that one of the ambulances could not travel up the icy road to one of the patients' homes. She had to walk with her new baby about 300 yards over icy pavements from the main road. The other five mothers and their babies went to Bull Hill Hospital.

The Minister admitted to me in the House that one doctor strongly objected. He did so because the baby had been born only on the 6th, that is, the day before they were told of the move. That objection was of no avail and the mother and her baby were moved. Other doctors could not be reached by telephone because they had started on their morning rounds. One doctor did object to the moving of a dying baby. The mother had gone home, and the doctor simply dug his heels in and said. "You are not to move that dying baby." The baby was left behind with a skeleton staff, and died about 36 hours afterwards.

The Minister also told me on 21st January that no ill effects had followed the transfer. I am sorry, but that information also is not correct. As a matter of fact, about 10 days before he told me that, an outbreak of strepto-coccal throat, which I am told is the most dangerous type of infection in a maternity home, had broken out at Bull Hill Hospital to which the women were transferred. One of the mothers was found to have a throat infection., and I have a statement signed by two doctors who examined her in which they say, In our opinion the patient caught cold through being transferred to Bull Hill Hospital. Within three days six patients and one ward maid were affected.

Here is a curious feature. This resulted in the hospital being closed, and there were efforts to keep it quiet, quite understandably. Doctors who asked about the admission of women in labour were told that the hospital was full. But it was not; it was closed because of infection. It was three days before the medical officer of health, the doctor who should have been first notified of the infection, was informed. Another doctor was called in, and this irregular procedure was evidently taken to try to covet the fact that infection had taken place. It seems to me as a layman that the proper way to close a hospital of that kind would be to stop admissions at a certain date, and then automatically within about 10 days the place would be empty. Why it should be suddenly closed at such short notice, I cannot understand.

Here is a letter that one of the fathers wrote to the "Northern Daily Telegraph" on 12th January: I personally never thought it was humanly possible for authorities to take such a step against wives and newly-borns, causing such anxiety and domestic disorder. The Lancashire local medical committee, quite properly, I believe, asked for a public inquiry about this, but it was refused. The British Medical Association have become interested in it. They printed a critical article in their Journal, and, I am told, they are sending a deputation to the Ministry. In a letter which they wrote to a local doctor on 18th January, they said There does seem to have been an appalling mishandling of affairs, both locally and centrally. The British Medical Association are, of course, very properly concerned, mainly about the doctors being ignored and being overridden by laymen. I feel sure that this House will not only support the doctors in their attitude but will be even more concerned about the effect on the patients and anxious to ensure that this kind of thing is not allowed to occur elsewhere.

The Minister must know in his heart that the facts in this case are shocking. I feel sorry for him, because constitutionally he has to accept responsibility for what occurred. Indeed, at a recent public meeting in Darwen, when the Minister was challenged by some of the doctors concerned, he went so far as to admit—I quote from a report in the local newspaper: It might be that the decision to close was taken too hurriedly. He went on to say: It may be that it was not handled with as much tact as it might have been at all levels. That is going fairly far, and no doubt the Parliamentary Secretary will give some kind of repetition of those admissions in the House. But what the House would be entitled to ask from the Parliamentary Secretary is an assurance that, whatever may have happened in this case—though it is very regrettable and cannot be put right—and whatever has transpired since, steps will be taken by the Ministry, through the National Health Service, to ensure at any rate that this kind of thing will not occur again elsewhere.

7.8 a.m.

The Parliamentary Secretary to the Ministry of Health (Miss Patricia Hornsby-Smith)

I know that this case has given rise to considerable local feeling and that there have been representations from the hon. Member for Accrington (Mr. H. Hynd) and also from my right hon. Friend the Member for Blackburn, West (Mr. Assheton), in whose constituency the home is situated; it is not in the constituency of the hon. Member for Blackburn, East (Mrs. Castle). Therefore, I know that hon. Members are very closely concerned, and I am grateful to both the hon. Member and my right hon. Friend for having stayed through the long hours to hear the case on this problem.

First, let me deal with the major point which the hon. Member for Accrington mentioned in opening the debate. It was a suggestion that there had been a change of policy and that deliberate cuts were being made by my right hon. Friend in the available maternity accommodation. I say straight away that the basic policy upon which maternity accommodation is provided still rests on the Circular issued in August, 1951, by the previous Government, which said: It is not possible to lay down a proportion of births for which hospital or maternity home beds should be provided in all areas. But in general, hospital provision is required on medical or social grounds for about half the confinements. This proportion, however, may be exceeded in areas where social conditions require it or where the proportion of abnormal midwifery is high. The advice of the local health authority should always be obtained as to the increase in the number of beds, especially on social grounds, in any particular case. My right hon. Friend has made no alteration whatever of that provision. What has happened is that the percentage of intake into maternity accommodation has in some areas been very high. Cases have been adequately provided for, not only on medical grounds but on social grounds, on top of which it has been virtually possible in this area to provide accommodation for anyone, regardless of any particular need, who wanted to go into a home.

Responsibility for allocating the accommodation in the regional hospital board's area devolves on the board, in consultation with the hospital management committee. There are often conflicting priorities. In this area, without question, there was a considerable number of beds available for maternity purposes. In fact, in the last returns we were told that the available beds had been used only to the extent of 69 per cent. On the other hand, there is a waiting list and a severe shortage of accommodation for the chronic sick and old people; and this unit has not 'been lost or put out of use in the health service. It has been transferred from a service in which there was adequate provision to one in which there is a vital priority need, namely, to look after the chronic sick and old people. The home is already in full occupation, and there are 30 patients there at present.

Regarding the criticism of the hospital management committee, I cannot accept the glib statement that no doctor was consulted at any time. There are five doctors on the Blackburn and District Hospital Management Committee—three consultants, a medical officer of health and the chairman of the Lancashire Local Medical Committee. They knew all along of the policy in regard to the Springfield Maternity Home. Before reaching its decision, the hospital management committee considered a report from a special sub-committee appointed to review maternity provision. That subcommittee was assisted by the medical officer of health, a Lancashire County Council divisional medical officer of health and a representative of the Blackburn Local Medical Committee.

This sub-committee recommended that the beds should be cut to 85, but the full hospital management committee, after considering the report, suggested that they should be cut to 100. Recognising the general practitioner interest, the hospital management committee appointed a representative of the Blackburn Local Medical Committee to the subcommittee, and invited the Blackburn and Lancashire Local Medical Committees to send representatives to the full meeting on 4th May and to submit in writing a statement of their views. Neither medical committee took the opportunity to do so. I feel that had they raised objections, then there might have been more co-operation on all sides regarding this particular removal.

The hon. Member asked why we could not stop reservations at Springfield and increase them at Bull Hill. It was due to the fact that we had a limited specialist staff for maternity work, and it was not possible fully to staff both units at once. There was a period when Bull Hill had to close because of an outbreak of infection; but, again, the hospital management committee took special pains to consider the matter, and the regional hospital board insisted on the special consideration of whether Springfield or Bull Hill should be a maternity unit. As the hon. Member knows, Bull Hill has newly-built wings, it is well equipped with better labour wards and has new sterilising and much more modern sanitary fitments than Springfield for the purpose of maternity work.

The proposals were put to the regional hospital board, which deliberately held over its decision to a meeting on 12th October because it understood that the matter was to be considered between the hospital management committee representatives, the local health authority and the executive council. Here I must confess that the hospital management committee took too much for granted. It did not issue formal invitations to those bodies to send representatives but relied on dual representation on the part of some of its members on that committee. The chairman of the local health committee and the chairman of the Blackburn Executive Council had in fact, dual membership of both bodies and were aware of what was going on. It did not—and I think that here it made a mistake—issue formal invitations to the various bodies to send specific representatives.

The hospital management committee knew that Dr. Campbell was on the committee, and was the chairman of the Lancashire Local Medical Committee. He knew that the committee had agreed to reduce from 124 to 104 the beds available for maternity cases in this district.

If I may, I will now deal with the question of the removal of the Springfield residents to Bull Hill. It was not possible to do as the hon. Member suggested and merely let the reservations run down in one hospital as they were built up in the other, because there was not an adequate rota of staff to look after the two sets of patients. The chairman of the hospital management committee, when it was found there was the smallest number of inmates that there had been in Springfield for a very long time, called together the senior consultant obstetrician, a consultant surgeon member of the hospital management committee and the group secretary. The position was explained to the patients when their husbands were present, and there were 11 of the husbands present among the 12 patients when the position was explained to them on the evening of 7th January. No objection was raised by either patients or husbands.

The patients were asked to inform the matron next morning whether they wished to go home or be transferred to Bull Hill. Here my information is in conflict with the hon. Member's, because I am informed that the group secretary spoke to seven of the general practitioners, none of whom raised objection to their going home. If the hon. Gentleman still challenges it, it must be a matter of division between us.

Mr. H. Hynd

Not raising an objection is a different thing from agreeing to it. They were informed that this move had taken place, but that is not the same thing as saying that they were consulted and agreed.

Miss Hornsby-Smith

If the group secretary rang up and said that he proposed to move a patient, if the doctor had any objection and thought that it would be dangerous on health grounds he would obviously raise some objection. But the hon. Member and I do not agree, and so we will agree to differ.

Of the five patients going to Bull Hill, it is a matter for regret that it was possible to contact only one of the five general practitioners concerned with those five patients. There have been one or two widely publicised allegations made against the hospital management committee, which I think it fair to answer. There was wide publicity for a story that one of the patients had given birth to a child on a stretcher in transit from Springfield to Bull Hill. That is quite untrue. An emergency case coming direct from the patient's home, in fact, arrived at Bull Hill Hospital and the baby was born on the ambulance stretcher in the labour ward, but it had no connection with any patients being moved from Springfield and I am sure that the hon. Member wishes to refute that widely publicised and false story.

Mr. Hynd

Hear, hear.

Miss Hornsby-Smith

It was alleged that the whole ambulance service was put out of operation. In fact, it took one Blackburn ambulance one journey and one Darwen ambulance two journeys to convey patients from Springfield to Bull Hill, and I have said already that to suggest it was only a move by laymen ignores the fact that there are five qualified and experienced doctors on the Blackburn and District Hospital Management Committee.

In conclusion, therefore, may I say that my right hon. Friend feels that there might have been more co-operation over the actual removal but, on the other hand, an opportunity to co-operate was offered to the local medical committee in the early days of the plans to change this hospital. I can appreciate that feeling ran high, as it always does when a general practitioner unit is being transferred to other uses, and that co-operation was not forthcoming. It is to be regretted but, in principle, my right hon. Friend feels that the decision made by the hospital management committee to transfer this unit was correct, in view of the fact that the maternity bed accommodation was used only up to 69 per cent, of its availability and that there is an urgent waiting list of 172 chronic sick, even having used the 30 units in Springfield, whom we urgently require to get into accommodation.

We feel that, in general principle, the regional hospital board acted wisely and rightly in transferring this accommodation to its other priority use. I hope that now that the move has been made, the unfortunate circumstances and the feeling which has run so high in Blackburn will be mitigated, and that all sides of the Health Service, whether lay or otherwise, will work together under the programme of the local hospital management committee.

7.22 a.m.

Mr. Ralph Assheton (Blackburn, West)

As the Parliamentary Secretary has told the House, this hospital at Springfield is in my constituency and, therefore, naturally I have been extremely interested from the beginning in all that has been going on. As the hon. Lady knows, I communicated with the Minister the first moment I heard of what was proposed.

There is one thing which I am sure the people in Blackburn and the district surrounding it who were served by this hospital management committee will be glad of, and that is to know that these matters can be raised and discussed on the Floor of the House of Commons when occasion arises. That will be a satisfaction not only to them but to people in other parts of the country, because there are certain affairs which many hon. Members would like to raise in connection, for instance, with the nationalised industries which cannot be raised on the Floor of this House. Therefore, it is a satisfaction that in the case of the Health Service every matter can be fully discussed here.

It is now 24 minutes past 7 o'Clock in the morning, and the Parliamentary Secretary has been here all night waiting to reply to the Motion. There is no time for me to add anything more to the debate, but I am sure it will be a matter of satisfaction to my constituents to know that it has been possible to debate the matter in the House of Commons.

Question put, and agreed to.

Adjourned accordingly at Twenty-four Minutes past Seven o'Clock a.m.