§ 23. Miss Herbisonasked the Secretary of State for Scotland how many men and women suffering from tuberculosis are waiting for hospital beds in Scotland; and how many are on the waiting list in Glasgow. and how many in Lanarkshire.
§ Mr. J. N. BrowneAt 30th April last, 334 men and 199 women suffering from respiratory tuberculosis were waiting for hospital beds. For Glasgow the figures were 111 men and 59 women and for Lanarkshire 36 men and 13 women.
§ Miss HerbisonWould it not have been possible to send some of those who are waiting for accommodation in Scotland to Switzerland, instead of keeping them waiting for beds?
§ Mr. BrowneThe physicians are finding it extremely difficult to fill the beds in Switzerland which are available for us. As the hon. Lady knows, there are 120 beds available for us at the sanatorium at Mont Blanc.
§ Mr. WoodburnWould the hon. Gentleman tell us why these people are waiting for beds? Is it due to the absence of beds or to lack of nurses to attend the beds?
§ Mr. BrowneWe have made a vast improvement. We have reduced a figure of 1,872 last year in Scotland to 533, and the waiting time for urgent cases is not more than seven days. The position, therefore, is that there are beds for urgent cases, and the waiting time in Glasgow for non-urgent cases is three months and in Lanarkshire two months.
§ Mr. WoodburnWith respect, the point was rather different. Whatever may be the cause now, some time ago it was the absence of nurses and not the lack of beds which was responsible for the waiting list. Is it still a lack of nurses or is it a lack of beds in Scotland?
§ Mr. BrowneI speak subject to correction, but I believe it is the lack of beds.
§ Miss HerbisonSince it is the lack of beds, can the Minister give us the reason why the medical staffs in Scotland are finding difficulty in filling beds in Switzerland when we have these people in Glasgow and in Lanarkshire perhaps infecting many more people?
§ Mr. BrowneEverybody who is prepared and suitable to go to Switzerland can go there, as the hon. Lady knows.
§ 24. Miss Herbisonasked the Secretary of State for Scotland if he will make a detailed statement on the methods used to reduce the waiting list of patients who are suffering from tuberculosis.
§ Mr. J. N. BrowneThe main factors that have led to the decline in waiting lists are the availability of more hospital beds, advances in treatment techniques leading to shorter average periods of stay in hospital, and more extensive use of domiciliary treatment in suitable circumstances. With permission, I will circulate a detailed statement in the OFFICIAL REPORT.
§ Miss HerbisonIs the hon. Gentleman aware that there is much feeling about this matter in Scotland, and that many inquiries are being made about how these figures have been so greatly reduced in such a short time? Since many people feel that domiciliary treatment is being 1123 used more than it ought to be, can the hon. Gentleman assure us that that is not so?
§ Mr. BrowneI think the hon. Lady should await the statement, and if, after reading it, she wants to put down another Question, I hope she will do so.
§ Following is the statement:
§ Treatment of respiratory tuberculosis
§ 1 Waiting list and hospital beds
§ The peak figure reached by the waiting list was 3,018 in June, 1949, and the list stood at over 2,000 throughout the five years before June, 1951. Thereafter it varied between 1,600 and 2,000; at March, 1954, it stood at 1,997. Since then it has declined rapidly, reaching 515 by the end of 1954. Detailed figures of the waiting list and of beds available from 1950 are given in the following table:
| — | Staffed beds available | Waiting list | |
| December, 1950 | … | 5,335 | 2,303 |
| December, 1951 | … | 5,636 | 1,700 |
| December, 1952 | … | 5,773 | 1,711 |
| December, 1953 | … | 5,974 | 1,794 |
| December, 1954 | … | 6,098 | 515 |
§ 2. Improved methods of treatment
§ Advances in treatment, especially the more extensive use of drugs such as streptomycin, P.A.S., and isonicotinic acid hydrazide, have made it possible to curtail the average period which patients have to spend in hospital. It seems likely that the detection of the disease at an earlier stage is also contributing to this result. In the Western Region of Scotland, the average duration of stay for patients discharged in 1954 was 169 days, compared with 200 days for patients discharged in 1953, making possible a considerable increase in the turnover of patients who could be treated. For Scotland as a whole the turnover increased from 6,762 patients discharged in 1950 to nearly 10,000 in 1954.
§ 3. Domiciliary treatment
§ With the increase in the range and efficiency of medical treatment it is possible to treat more patients at home and as out-patients, provided home circumstances are suitable. Patients undergoing domiciliary treatment are not included in the waiting list for hospital admission unless the disease fails to respond to treatment.
§ Safeguards in the management of domiciliary treatment are provided by the oversight of the area chest physicians who, under a re-organisation of the chest service in the Western and South-Eastern Regions, are now being given a fuller measure of control of all facilities in their areas for the care of patients, whether as in-patients or as out-patients. This closer integration in the chest service has also assisted the more effective use of hospital beds.