HC Deb 14 December 1955 vol 547 cc1351-60

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

11.2 p.m.

Mr. J. P. W. Mallalieu (Huddersfield, East)

I wish to raise a matter which directly affects my own constituency although it has a generalised importance to the country, and I am grateful that the Minister of Health is here to listen to it.

There is in my constituency a large mental hospital known as Storthes Hall, and when I went round it a few months ago I was distressed to find that in the female part of the hospital a number of old ladies, far from being accommodated in dormitories, had their beds in the corridors. That was the degree of overcrowding which was being experienced in this hospital. I can believe that as a result of the devotion of the staff these patients are well cared for, but I cannot believe that it is ideal or desirable that for a moment longer than is absolutely necessary that degrees of overcrowding should persist, and I understand that what I saw in that mental hospital applies equally to such hospitals in other parts of the country. I therefore begin by appealing to the Minister to do whatever he can to relieve this overcrowding by a hospital building programme, and one of the questions I want to ask tonight is, what building plans has the Ministry for relieving that overcrowding?

I find that in this hospital the number of male patients, which in 1939 was 993, has now risen to 1,148, and that the total number of patients, male and female, is about 25 per cent. more than it was before the war. While the number of patients is up, the staff is substantially down. Before the war a nursing staff of 87 had to look after 993 patients. Today, a staff of only 52 has to look after 1,148 male patients. I was seriously alarmed by the staffing position in some of the refractory wards. In one ward before the war there were 48 patients and a nursing staff of seven to look after them. In the same ward today there are 80 patients and a staff of only four to look after them.

Outside the nursing staff the position is just as bad. The kitchen staff is one-third below the complement, which should be 24. When one remembers that figure, the turnover is shown as being really shocking. No fewer than 37 members of the kitchen staff have left in recent years. The reason for this turnover, so I am informed, is that the hours of work and the rates of pay are not sufficient to maintain an adequate staff, and far from sufficient to provide the staff which there should be for all the duties to be carried out.

The staff is pressing for the working hours to be reduced. At present, there is a six-day week of 48 hours, but in the main industries around Huddersfield the basic hours are 44 in a five-day week; and, inevitably, with the hours fewer and substantially higher pay in industries in the town, people are drawn off the hospital staff. There are negotiations for the purpose of trying to improve the conditions of the existing staff in order to attract other people to come in, and these have been going on for the best part of two years. However, the only move which the Ministry has made is that of trying to make good the deficiencies in the staff by suggesting that nurses from West Africa and elsewhere should be invited to join. The unions concerned have objected, not because of any colour bar. Thank goodness, in the West Riding of Yorkshire we do not have ideas about a colour bar; but this objection was based on two grounds.

First, that if these nurses came in they would be bound for two years to suffer the existing conditions and terms of employment, which are considered to be bad; and, secondly, it was felt that this might provide the Ministry with an excuse for not really trying to remedy the conditions at all. The Minister seems to have shown a great interest in this, as in other hospitals, although in this specific case he is trying to compel the hospital to get rid of a farm. The hospital runs this farm at a substantial profit of about £4,500 a year, and I beg the right hon. Gentleman to leave well alone. The farm is very successful and there is, if I may say so, no need for his interest in that direction.

I would ask him to direct his interest to the provision of new hospital buildings and especially to the problem of improving the wages and conditions of the staff so that the shortages will settle themselves and the work become once more attractive.

I said at the beginning that this was a constituency point; that I would speak of a local hospital but, as the Minister knows, similar examples could be produced from all over the country. I should like to refer to a resolution passed in 1954 by the Conference of the National Association of Hospital Management Committees. It stated that to avoid a breakdown of the hospital services the immediate attention of the Minister should be drawn to the critical position relating to the ancillary staffs' wages and conditions, and that they be altered so as to allow the hospitals to compete with local government and industry. I am in wholehearted agreement with that. It bears out what the people in this hospital in my own constituency are saying, and it also bears out the feelings of hospital workers throughout the country.

There is a serious danger that the hospital services in general, and mental hospital services in particular, will break down; and, if they do, we have not the right, as a society, to impose any longer on the loyalty which the staffs have always shown. I recommend the Parliamentary Secretary to study the Hospital Management Committees' resolution. I recommend her to think over the points which I have raised about the hospital with which I am concerned, and I ask her to take some action.

11.10 p.m.

Mr. Glenvil Hall (Colne Valley)

I rise to support the appeal made by my hon. Friend the Member for Huddersfield, East (Mr. J. P. W. Mallalieu). I know the hospital to which he has referred extremely well. For a time it was in my constituency, and it was only at the last redistribution that it went into Huddersfield, East, the constituency which is so ably represented by my hon. Friend.

I can assure the Parliamentary Secretary, in case she does not know, that the facts are as my hon. Friend has stated them. There is gross overcrowding, the accommodation being quite insufficient and patients sleeping in corridors, and the staff is very much undermanned.

Eighteen months or two years ago, a very valiant attempt was made to recruit staff. We held, among other efforts, a mass meeting in Huddersfield in an attempt to attract nurses, male and female, into the hospital. I am sorry to say that the campaign had practically no results whatever. Making inquiries afterwards, I easily discovered why. It is because the pay is insufficient and the hours are much too long. In that area it is possible for people to have much more money for many fewer hours' work per week. Unless a woman or a man has a vocation for this work, it is impossible to attract persons into an institution of this kind—certainly into this institution—purely by the return that they get.

Can the Parliamentary Secretary tell us why the Ministry is so bent on taking away the very lucrative farm which is part of the establishment? If it were run at a loss, I could easily understand why the Ministry should be so anxious to sell it, but it is extremely well run and makes a profit of about £5,000 per annum, and it provides fresh vegetables, fruit, eggs and other food for the patients. I cannot understand why the Minister is so anxious to get rid of it.

Now that we are on this subject, perhaps the Parliamentary Secretary can tell us what the present situation is with regard to the farm. I gathered that inquiries were being made to ascertain whether it could remain as part of the institution. It would be of interest to my hon. Friend, myself and all concerned to know whether at long last the Minister has seen the light and whether the farm may remain with the hospital.

11.14 p.m.

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

I am grateful to the hon. Member for Huddersfield, East (Mr. J. P. W. Mallalieu) and the right hon. Member for Colne Valley (Mr. Glenvil Hall) for raising this important subject, and I appreciate the various problems which they have put forward.

I will deal, first, with the farm, because the answer is very clear. My right hon. Friend would be pleased if he could continue to run farms in conjunction with mental hospitals at a profit, but it has been found that under the powers conferred by the National Health Service Act he has no power to run farms as such. He can only run them within the strict limit that they should provide considerable occupational therapy for the patients.

It has been found that modern farms, with their mechanical implements, when run by hospitals are solely farms rather than centres for occupational therapy for the patients. We have no power, under the Act, to run farms as such. My right hon. Friend, has had to bow to the interpretation of the law. That is the basic reason why farms, as such, are no longer permissible, and why they never have been in the wide application given to them by some mental hospitals. They could not have been continued, and the Minister has had to bring into conformity with the law the farming at mental hospitals.

Mr. Glenvil Hall

Does that mean that this farm, in so far as it gives work to patients—and I believe that it gives them considerable work—will be allowed to continue?

Miss Hornsby-Smith

I was not aware that this point would be raised tonight. All farms of any size run by hospitals are being reviewed by the Ministry, and where we are within the law laid down by the National Health Service Act in continuing certain farm services we are prepared to allow their continuance. We are, however, strictly bound by the Act, and farming as such is not within our province. Therefore, we have to confine it to cases in which it can be shown that the main purpose of the farm work is for the occupational therapy of the patients in the hospital.

My right hon. Friend is seeing the chairman of the regional hospital board tomorrow. He has asked me to say that he will be happy to discuss the points raised tonight with him. I hope that that will satisfy the hon. Members concerned, because I was not aware that this question of the farm was to be raised, and I do not know the extent, or the diversity of the farming there.

Now let me turn to the real problem of Storthes Hall. It is situated 6 miles south-east of Huddersfield, and 1¼ miles from a main bus route. It would be unrealistic to suggest that we can possibly do without this accommodation. We require more in the region. Therefore, we have to face the great difficulties of getting staff to this rather distant location. Against that, however, the hospital is beautifully positioned. It has spacious and well-planned wards, and so far as conditions in the hospital are concerned they do not appear to be unreasonable as compared with other mental hospitals.

I do not deny that the hospital is overcrowded and understaffed; but it is fair to say that in facing the problem over the whole country we have had to meet a situation in which most of our mental hospitals were built during the last century, and in which there has been an increasing demand on accommodation because of an increase in voluntary patients. I do not mean that there has been an increase of mental sickness, but an increase of voluntary patients seeking early treatment. That has increased the demand on accommodation, and until last year no new mental hospital had been built for a considerable number of years.

As the hon. Member knows, two years ago deliberate priority was given to the mental side by the allocation of the "Mental Million," and under schemes approved, we are providing 2,800 additional beds. Many schemes are in prospect, including the early provision of one new mental hospital, with two others to follow as soon as planning can be completed. The provision of new beds by building new units of hospitals, or entirely new hospitals, is not likely to produce an early solution of overcrowding because we have also to face the waiting list on the mental defective side, but we consider it is necessary to look also in other directions, to relieve what we appreciate is very severe overcrowding in some hospitals.

A lot of this arises from the increasing longevity of the mentally sick patient and from the increasing number of elderly sick within the range of population that will have to be cared for within the next few years. At present, a complete survey of the facilities for the chronic sick and elderly is being carried out, and the results are being studied at this moment. In this connection, we have very much in mind the position of the elderly mental patient and the considerable relief of overcrowding which would follow if we could find some half-way intermediate accommodation elsewhere for this type of patient. It is, therefore, not entirely wise to contemplate at present additions to such a very large hospital as Storthes Hall, which has already more authorised beds than the Ministry has thought desirable.

With regard to our policy on further development, the share of the available capital resources for the mental and mental deficiency hospitals has increased very considerably in recent years. It is not easy to determine what proportion at any one time in relation to general hospital priority is being given, because that is entirely a matter for the regional board. The local people, who know their county areas or the area of their particular region, determine the priorities between their own hospitals.

Nevertheless, I can say this. In addition to the ordinary regional capital allocations, the Ministry has found it possible to make specific allocations for the provision of additional beds at mental and mental deficiency hospitals for schemes totalling £2.3 million over and above the ordinary regional allocations. Further, my right hon. Friend announced last July an expanded hospital programme with provision for centrally financed large schemes of hospital buildings to the total of 17.5 million, in which many schemes are included for mental and mental deficiency hospitals.

The general drive to upgrade the mental hospitals should be able, under this deliberate priority, to gather considerable momentum. We quite understand the desire to accelerate progress, but I can give hon. Members the assurance that my right hon. Friend regards the mental health services as a prime priority. He has always given very deliberate priority to them.

If I may deal specifically with Storthes Hall and the staff questions which the hon. Member raised, I think we have to face the fact that it is not only in the nursing service that there is a shortage of staff. Every single profession and trade is advertising at present for staff, and it is idle to suggest that merely by raising salaries we could automatically acquire the number of people needed, because we know that at the moment, with full employment, one has only to open any newspaper to see that, whether it is employment in trades or the professions, all are seeking more pairs of hands.

This being the fact, I regret very much that the local branch of the National Union of Public Employees should have refused to accept the recommendation of the hospital management committee to recruit Nigerian nurses. Our first con- cern in the Ministry is for the patient. We recognise that there is an overwhelming shortage of hands in the country, whether it be in the teaching profession, in office work, or in most other trades or professions.

The hon. Gentleman assures me that there is no colour bar in the hospital, and, indeed, in making public its resolution the union claims that it has no colour bar. Frankly, the terms of its resolution imply that the employment of these nurses will depress their standards.

Mr. J. P. W. Mallalieu

No, surely not—that they would help the authorities to keep the existing standards very depressed. They would not depress them further. Their point is that bringing nurses in will provide an excuse for not doing anything. They want them to come in.

Miss Hornsby-Smith

If they want them to come in, there is nothing to stop them.

Mr. Mallalieu

At decent rates of pay.

Miss Hornsby-Smith

The rates of pay for any coloured or foreign nurses who come to this country are identical with those of any United Kingdom student, or nurse or assistant nurse, as the case may be.

Mr. Mallalieu

Of course they are, but those rates are too low either for white or coloured persons. That is the point.

Miss Hornsby-Smith

I still do not accept that it is right to deprive patients of the nursing staff whom they want as a deliberate means of pressure against the authority.

The authority is not the Government. We do not decide wages or conditions within this House. They are decided by means of the normal negotiating machinery between employer and employee, in this case the Whitley machinery, and I hope that they always will be. I hope that wages and working conditions will never be a matter for decision in this House and that we must not have Dutch auctions as to which industries are to get whom and what. If they were to be decided in this House they would bring with them the direction of labour to one or other industry. I am convinced that wages and working conditions should—as, indeed, I am sure all hon. Members on both sides will agree—remain a matter for negotiation between the staff and the employers' side of whatever the industry or profession may be.

I deplore the terms of this resolution because, frankly, we have a dual duty. There is an acute shortage of pairs of hands in this country and, whatever the wages, we should still not be able to fill all the vacancies there are for teachers, physiotherapists, radiotherapists, and nurses. If we did not take many of the pairs of hands we have from colonial and foreign staff in mental hospitals, the position would be far worse than it is at present.

Mr. Mallalieu

That is not disputed.

Miss Hornsby-Smith

I feel very strongly about this, in view of the fact that any nurse, from whatever country, and of whatever colour, comes to this country on equal terms with nurses from the United Kingdom. They get the same pay, they take the same training, they have to qualify by the same examinations. As British citizens—as is the case with the Nigerian students whom the hospital management committee wished to take—they have a right to be treated equally.

We in this country have very good reason to be grateful for the hundreds of coloured nurses who are now serving in our hospitals and doing a wonderful job, in co-operation with their United Kingdom colleagues. Let us also remember that we have a duty to the Colonies to provide the training ground for coloured nurses who have no training in their own countries and who rely on the training they receive in our hospitals to enable them to go back and to man the services in their own countries.

Mr. Mallalieu

It is simply a question of whether they are being brought over here on fair conditions. They are very welcome here for all sorts of purposes. We need them and they are needed in the Colonies when they are properly trained; but it is not fair to bring them over here on unfair conditions.

Miss Hornsby-Smith

Wages and conditions are questions for the Whitley machinery.

Mr. Glenvil Hall rose—

Miss Hornsby-Smith

I have only a minute left to me, and I have not covered half the ground I had hoped to cover.

I wish to inform the House that a claim for increased remuneration and allowances has just been before the Whitley Council. I want to emphasise that this is a matter for the Whitley Council and not decision by the Minister. That claim has resulted in increased allowances being granted. The new basic training allowance for student mental nurses is £285 for the first year, instead of £270; £295 for the second year instead of £280; £310 in the third year. The supplementary allowance paid to students with dependants will rise from 15s. to £1 a week for wife or other adult dependant.

I cannot accept the protestations that there is no colour bar and no prejudice in this particular resolution. We are desperately short of hands in every profession in this country. I will endorse the remark of the hon. Member for Huddersfield, East about the magnificent work which has been done by the staff of this hospital in very difficult circumstances. That I accept, but I most sincerely hope that the National Union of Public Employees will again consider the resolution which it has passed, and which is a reflection on coloured nurses.

Mr. Mallalieu

No.

Miss Hornsby-Smith

It is very strangely phrased. Not only does it deprive those nurses from getting their training in this country when they are willing to come, but it also deprives patients of additional staff which we believe they should have, if possible.

The Whitley Council decision, was made only yesterday afternoon, and I was glad to have the chance to give early information to the House about the £15 increase. I should like to point out that in all these salary questions we have to work in consort with the General Nursing Council and the Whitley Council. The Whitley Council makes the decision and there is a limit to which one can expand the disparity, or, shall we say, the increase between the mental and the general nursing staff. It is a matter—

The Question having been proposed after Ten o'clock and the debate having continued for half an hour, Mr. SPEAKER adjourned the House without Question put, pursuant to the Standing Order.

Adjourned at twenty-eight minutes to Twelve o'clock.