HC Deb 09 February 1955 vol 536 cc1901-7
The Minister of Health (Mr. Iain Macleod)

With your permission, Mr. Speaker, and that of the House, I should like to make a statement about the Government's plan for increasing the rate of hospital building in England and Wales.

It is proposed, subject to the voting by Parliament of the necessary funds, that the building programme shall be expanded in two ways, first by the starting of a number of new major building projects, including new hospitals, and, secondly, by a special allocation of money for a plant replacement and redeployment programme; and I intend to inform hospital boards now of the amount of work it will be feasible to undertake under both heads in 1956–57 and 1957–58. It is not thought that any significant increase in capital expenditure on major schemes can be achieved in the 1955–56 programme which remains unaltered.

It is proposed in 1956–57 and 1957–58 to start major new building projects to a total value of £7½ million and £10 million respectively. For the plant replacement and redeployment programme £2 million will be available in the first of these years and £4 million in the second. Quite apart from these amounts, there will be £9 million available in 1956–57 and £10 million in 1957–58 for capital expenditure on other works. It is difficult to be precise about the total annual expenditure involved in these two years, but it is expected to be about £13 million and £18 million respectively. I should add that these figures cover only work financed from Exchequer funds. I hope that a fair amount of hospital building work will be financed from other sources during this period, but, of course, I cannot give an estimate of what this figure may be.

I am communicating these proposals at once to hospital boards and full discussion with them will be necessary before all the projects to be undertaken can be settled. I cannot, therefore, give final details today, but the boards concerned have already been asked to bring to completion the planning of a first batch of major projects, to a total value of about £7 million and these will almost certainly be among those started.

They include new general hospitals, or the first stages thereof, for Welwyn, West Cumberland, West Cornwall, Harlow and Swindon, the development of the Glangwili Hospital, Carmarthen, a new mental hospital near Wolverhampton, major extensions at mental deficiency hospitals in the Newcastle, Sheffield and Liverpool Regions and in Wales, new outpatient departments at the Royal Victoria Infirmary, Newcastle, the Leeds General Infirmary and the Lewisham and North Middlesex Hospitals, a new block at St. James's Hospital, Balham, and major extensions to the Peterborough Memorial Hospital. Considerable expenditure is also likely to be needed during the period for making good structural defects at the Manchester Royal Infirmary.

There will also be many other projects which will need to be considered for inclusion, in the light of the further discussions to be held with hospital boards and the progress made with their preparation, and obviously, I cannot give any firm list of these at this stage. Examples of the type of project I have in mind to start within the next few years are the new Cardiff teaching hospital, the rebuilding of Charing Cross Hospital at Harrow, a new ward block at Guy's Hospital, new general hospitals at Slough, Boston in Lincolnshire, Coventry and Sheffield and new mental hospitals in Lancashire and Yorkshire, but I cannot at present say which of these will be started in 1956–57 and 1957–58.

There is, of course, much to be done and much will remain to be done. Nevertheless, the Government believe that these outline proposals represent what can reasonably be achieved over this period and they represent also the first programme of new hospital building in this country since before the war.

Hon. Members

Hear, hear.

Mr. Marquand

The right hon. Gentleman will be aware from the applause which has greeted his statement from both sides of the House that this long overdue announcement is very much welcomed. He will be particularly aware from the representations which have been made from this side, both by deputations and in Questions on many occasions, that we are glad to see this advance now being made. May I ask the right hon. Gentleman whether he can elucidate a little more that section of his statement which says that forms of hospital building work will be financed from other sources during this period? May I also ask him whether the various projects which he has mentioned in detail and the priorities apparently assigned to them have been worked out in consultation with the Central Health Services Council?

Mr. Macleod

The sentence that refers to work financed by other sources than from Exchequer funds refers to the possibility that in certain circumstances it may be that a wealthy hospital with endowments of its own would be able to contribute towards the expenses of a scheme which I could not meet within this amount from Exchequer finances. I thought it right to inform the House first on these matters, and my circular to the regional boards concerned and to hospital boards of governors is going out this afternoon. There will be no delay there. I have had no specific consultation with the Central Health Services Council.

Mr. Elliot

I am sure my right hon. Friend will recognise the lively pleasure with which his statement was greeted. Can he tell us approximately the number of beds he expects will be produced by this programme when it is completed, and, furthermore, may we expect a statement from the representatives of the Scottish Health Department?

Mr. Macleod

My right hon. and gallant Friend the Joint Under-Secretary of State for Scotland hopes to make a statement immediately after I have sat down, Mr. Speaker, if he catches your eye. On my right hon. Friend's first point, at the moment there are too many uncertainties for me to be able to give a firm figure of the number of beds until my consultations with the hospital boards are completed. I will let the House know as soon as I can make a reasonable estimate.

Sir F. Messer

Can the Minister say whether this special allocation from the Treasury will affect at all the normal capital allocations made to the regional boards?

Mr. Macleod

No, Sir. If the hon. Gentleman studies my answer carefully, he will see that not only are the original amounts available to the regional hospital boards fully maintained in the first of the two years to which I have referred, but they are increased by £1 million in the second, quite apart from both these programmes I have announced.

Mr. Vaughan-Morgan

Can my right hon. Friend add something to what he said about the extra money for the plant replacement programme, and also say what economies will flow from that and what the results will be?

Mr. Macleod

This is an agreement between myself and the Chancellor for a special allocation of funds for the replacement of inefficient plant. In general, I take that to cover engineering services like boiler services and such other things as laundries, kitchens, and so on. There can be no doubt at all that the replacement of old and inefficient plant by up-to-date and modern plant will bring economies in maintenance costs in many hospitals in this country. Of course, it is not possible at this stage to say what the figures will be.

Mr. Blenkinsop

Would the right hon. Gentleman say why plant replacement and redevelopment schemes should not go ahead in this coming financial year as many schemes are, in fact, ready now in the Newcastle region and in other regions which could very well be put into force? Do we need to wait for the year that he is proposing?

Mr. Macleod

I think so. As a matter of fact, the two biggest new schemes to be started under the 1955–56 programme are both schemes of boiler replacement or redeployment along those lines, and I think we need the full year indicated here for the bringing of many of these schemes up to the point when they are ready to go into operation.

Mr. Gough

Will my right hon. Friend say how this plan will affect the present needs of Crawley, of which he is well aware? Also, why should Crawley appear to be an "also ran" compared with one or two other new towns which he has specifically mentioned?

Mr. Macleod

My hon. Friend must realise that the list I gave is not exclusive. I said that many other projects would qualify, and as far as Crawley is concerned there is an £80,000 scheme which would not come into the category of a large scheme. This proposed smaller scheme is for a maternity and out-patients' department; and I understand that there is a very good hope—I do not want to put it any higher than—that it will be included in the regional board's programme for one of the years under review.

Mr. G. Thomas

As the Cardiff proposal has to satisfy the teaching needs for the whole of Wales, can the Minister say when we shall be able to go ahead with the enterprise?

Mr. Macleod

No, Sir. I cannot. The Cardiff teaching hospital retains the first priority in both England and Wales for a completely new teaching hospital. On the other hand, it is an enormous project and it is nowhere near ready yet. In fact, the architectural competition has not yet taken place. It would therefore, be the wildest guess to say when it will be started.

Miss Ward

Am I right in assuming that under my right hon. Friend's new proposals the Newcastle Regional Hospital Board is improving its position in regard to capital allocation? Is my right hon. Friend aware how much generally it will be appreciated that we now appear to be entering into an era of three-year planning which a great many people think of great importance for efficient and stable hospital administration?

Mr. Macleod

I think it is true—as one would expect—that those areas which were less well served before will benefit most from this statement. I think that Newcastle has more projects particularly mentioned today than any other region. In reply to the hon. Lady's second question, it is true that if it is intended to build new hospitals—which is a very big step and one which is very welcome to us all—it cannot be done wholly on a one-year basis. Regions must be given some assurance of what is to come to them for at least three years ahead.

Mrs. Braddock

Is the Minister aware that his statement is a complete vindication of the policy adopted by the party on this side in making hospitals a national responsibility, and that it would have been completely impossible to put any scheme of this sort into operation under the control of local authority finances? As these projects are rather for the future will the Minister also look at the staffing side, as many hospitals, even at present, have difficulty in getting adequate staffs for the services which they run?

Mr. Macleod

The staffing problem does not unduly worry me. With all the difficulties, there has been a steady increase since 1948—and it is continuing—in the numbers of staff. It will be easier to attract staff to good new hospitals than to old ones. On the more political issue which the hon. Lady raised, I find it difficult to reconcile her remarks with the fact that, even at the end of the programme, we shall not be spending as much in real terms on the completing of new hospitals as we did in the 'thirties, when most of them were voluntary.

Mrs. Braddock

That is a silly answer.

Mr. Alport

Does my right hon. Friend's statement about the new Charing Cross Hospital at Wembley mean that the new hospital will be begun before the end of 1958? Further, does his programme include any additional accommodation for mental deficiency cases in hospitals in East Anglia and, particularly, the Royal Eastern Counties Hospital?

Mr. Macleod

It is proposed to build the new Charing Cross Hospital at the site already obtained at Northwick Park, Harrow. Whether or not it will get into the 1957–58 programme depends on many things, but, as I have indicated, it stands a very good chance. In reply to the point about mental deficiency hospitals, particularly in the East Anglian Region, a major scheme is not indicated today but, as I have said, the list is not exclusive and many proposals will come forward. In addition, we shall have the normal capital programme coming from the regional boards.

Mr. I. O. Thomas

Is the right hon. Gentleman aware that the question of hospital facilities for East Shropshire—covered by the West Midland Regional Board—was raised with his Department some time ago and that I was advised to refer my inquiries direct to the regional hospital board? Can he now say whether any developments in East Shropshire will be included in his provisional list?

Mr. Macleod

There is not one in the provisional list, but—I am sorry, but I must repeat—that list is not exclusive. That means that projects will have a chance both of coming into the list when it is finally drawn up and also of obtaining their due priority when the regional boards' proposals are put to us.