§ Motion made, and Question proposed, That this House do now adjourn.—[Mr. R. Thompson.]
§ 11.28 p.m.
§ Mr. E. G. Willis (Edinburgh, East)
At Question Time today, the right hon. and gallant Gentleman the Joint Under-Secretary of State for Scotland gave my hon. Friend the Member for Midlothian and Peebles (Mr. Pryde) a rather flippant reply when he asked whether he did not think that there should be additional hospital beds in Edinburgh. The right hon. and gallant Gentleman seems to have forgotten the Answer which he gave to my hon. Friend a few weeks ago in reply to another Question. That Answer was to the effect that there were at present over 3,000 people waiting admission to the Edinburgh Royal Infirmary. That reply could be given about most of the hospitals in the South-Eastern Region of Scotland. It applies not only to general hospitals but also to mental hospitals, where most of us experience difficulty in trying to obtain admission for constituents, and also to institutions for the chronic aged sick.
The general picture from outside is one of overriding shortage of accommodation, particularly for mental cases and the chronic aged sick. When we speak to members of the hospital boards for the south-east of Scotland we have that picture filled in. We find a number of boards, composed of men and women who are doing an excellent job of work, but who are suffering from a great sense of frustration owing to the almost savage 2032 restrictions that are placed on their activities.
If I may take the Edinburgh Northern Group as an example, those responsible for the Western General Hospital are at present building a new neuro-surgical unit and putting on an additional teaching unit and an additional radiotherapy unit. The board feels that it is almost necessary to have new central buildings, because these new additions are being built round central hospital buildings which are completely out of date and should be replaced. In the same hospital, the power house is out of date, Lancashire boilers are still being used, and the laundry is inadequate. In fact, there should be a central laundry for the whole group, thus saving the board a considerable sum.
A similar tale can be told of other hospitals in the same group. We also find that in many cases work is being financed out of endowment funds. These funds are being used for capital expenditure and for maintenance which, I should have thought, was a burden which should be borne by the Government. There is no time to detail them tonight, but there are similar clamant demands for new buildings throughout the Eastern Region. The hon. and gallant Member for Roxburgh and Selkirk (Commander Donaldson) is always asking about Peel Hospital and a new general hospital. My hon. Friend the Member for Midlothian and Peebles is always raising questions about Peebles Memorial Hospital, which, as the right hon. and gallant Gentleman knows, is very badly sited and, at certain times, places on staff and patients uncomfortable and unpleasant duties.
It is against this background of acute shortages in the area, out-of-date equipment and overcrowding in mental hospitals, that we have to examine the statement made by the Minister on 9th February. Inasmuch as it indicated that there would be some additional money available for capital expenditure for Scotland, that statement was welcome, but on examination I find it disappointing and inadequate. As I read the statement, we get nothing for the ensuing year, no additional money at all, but in the year after we can expect an additional sum for Scotland of £300,000 and in the year following that—that is, in three years' time—another additional £300,000.
2033 The first sum of £300,000 which we get next year, is less than the amount by which the Department cut down the submissions of the South-East Scotland Regional Hospital Board last year. According to my information, the Board made a submission to the Department for capital expenditure totalling £978,000, and that was cut down to £461,000, that is by £517,000. In South-East Scotland today we could use the additional expenditure which has been granted for the whole of Scotland for 1956–57 and 1957–58.
When we look at some of the individual cuts that were made, the position certainly seems rather frightening. Edinburgh Royal Infirmary, incidentally, is not mentioned in the statement of 9th February as being even up for consideration, either under the present scheme or in the near future. The infirmary has a waiting list of over 3,000. That waiting list has been characteristic of the infirmary for as long as I can remember. We find that its submissions for £38,000 were cut to £26,000. In the case of the Northern Group, the submissions for £82,000 were cut to £34,000; and Edinburgh Southern Group from £65,000 to £4,000—I repeat, £4,000. So the sorry story goes on.
Edinburgh Royal Mental Hospital—and we all know that in the Annual Report of the Department for Health the fact is mentioned that overcrowding in mental hospitals is more acute in South-East Scotland than anywhere else in the country—had a cut from £29,000 to £4,000. These are staggering figures; especially in the case of the mental institution at Gogarburn, where the requirement was cut from £10,000 to £300. These cuts are frightening, and it is no wonder that the members of the hospital boards feel themselves under an enormous sense of frustration in their work.
I think that the Joint Under-Secretary stated that priority attention was given for schemes of replacement of old equipment such as boilers and laundries; and we all know that the set-up of laundries can save hospital boards large sums of money. But when one examines some of the requisitions made by hospital boards in connection with these schemes, one finds that the same ruthless process has been applied. At Haddington, where 2034 the water services needed renewing, the estimated allocation of £7,000 was cut to £2,000; and this in spite of what was said about encouraging these schemes. The Peel Hospital had a cut from £21,000 to £15,000, and Dingleton from £7,000 to £6,000; and there was similar treatment in other schemes undertaken by hospitals elsewhere. It is quite obvious that the first point which I made tonight seems to be very true, namely, that this present increase announced by the right hon. and gallant Gentleman will, of course, in no way measure up to the requirements of the South-Eastern Region or of Scotland as a whole.
I should like to ask one or two questions about which I think we could be given information. Have the Department of Health of the Scottish Office and the regional boards made a measure of the total amount of work which ought to be done in the district, and come to any conclusion as to what it would cost? We should have some information about that by this time. We have a ragged sort of picture; for instance, we know of cases where expenditure has been severely curtailed, and where urgent work cannot be done. But I cannot find an overall picture of the amount of work which is required to give us an adequate and efficient hospital service.
Is there a short-term programme; is there a long-term programme? What is its nature, If it exists, and how does this proposed increase, even with the existing rate of capital expenditure, measure up to this particular job? We are entitled to know how we are getting on with the job. What is its size? What is the contribution we are making each year? What does this extra £300,000 mean? What increase can the South-Eastern Regional Hospital Board expect to receive? It is true that on 9th February the Joint Under-Secretary enumerated certain major proposals which were to be tackled with the use of this £300,000. Only one of them was in South-East Scotland and that was a new surgical block in Victoria Hospital, Kirkcaldy. What other work is to be done in the region with this money? I should also like to know what kind of sum the board can expect to receive from this additional allowance.
Why did the right hon. and gallant Gentleman not say that anything was to be done to provide more accommodation 2035 at Fife General Hospital, which has long been recognised as urgent and necessary, which is required to relieve the pressure on the Edinburgh Royal Infirmary, and which obviously needs to receive some priority? To what extent does the right hon. and gallant Gentleman expect this appalling pressure which is continually exerted on the Edinburgh Royal Infirmary to be eased? To what extent will it be relieved by the expenditure of these additional sums in the South-Eastern Region? I feel that it may make very little difference, but I may be wrong. The pressure has caused much concern for many years and something should be done to relieve it.
I conclude by saying that we have made the hospital service a national responsibility and that it is up to us to see that the Minister responsible, the Chancellor of the Exchequer and the Government face up to the fact that the service has to be made efficient, adequate and up to date.
§ 11.43 p.m.
The Joint Under-Secretary of State for Scotland (Commander T. D. Galbraith)
The House will want to congratulate the hon. Member for Edinburgh, East (Mr. Willis) on the great amount of work he has put into obtaining the facts and figures about the situation in the South-Eastern Region of Scotland. I should like to say at the start that there was, of course, nothing flippant in my reply to the hon. Member for Midlothian and Peebles (Mr. Pryde). He was referring to population as the basis for the number of hospital beds and I thought, rightly or wrongly, that the number of hospital beds should have some relation to the number of people requiring them.
§ Mr. David J. Pryde (Midlothian and Peebles)
The point was about the mining area. The mining industry has the heaviest casualty rate in the country.
That does not quite come into what I have to say at the moment, but I am aware of the fact which the hon. Member has thought it necessary to remind me about.
I should like to refer to my statement on 9th February, because it is of very considerable importance and has a bearing on the matter we are now discussing. I said that the total pro- 2036 vision for hospital building in Scotland is to be increased from its present level of £1,900,000. That will be the amount which will remain next year, and it will be increased to £2,200,000 in 1956–57—that is, by £300,000, as the hon. Gentleman said—and by another £300,000 to £2,500,000 in 1957–58.
Yes. There will be an increase in 1957–58 of £600,000 over the amount being spent this year. Of the additional funds to be provided, £50,000 in 1956–57 and £150,000 in 1957–58 will be used to supplement the present special programme of plant renewal which has been going on for some time. We expect to spend £250,000 in 1956–57 and £350,000 in 1957–58.
The balance of the additional funds—that is, £300,000 in 1956–57 and the extra £300,000 in 1957–58—will be used to increase the number of major building schemes undertaken, and. as I told the House on 9th February, I expect it will be possible to put in hand schemes to a total value of £3 million during the period of three years. I will, naturally, give the House particulars of that programme at the earliest opportunity, that is, as soon as it is decided.
I would, meantime, like to deal with the preparatory work which is going ahead on the major schemes. These include, in the South-Eastern Region, the now block to which the hon. Gentleman referred of 120 beds in the Victoria Hospital in Kirkcaldy, mainly for surgical purposes. Already in that region there are two major projects under way. The first of these is the radiotherapy institute for treatment of and research in malignant diseases. The total estimated cost of this is £350,000. The main part of the institute, I am glad to say, is nearly ready. The second is a new unit of 60 beds for neuro-surgery. That is costing £300,000.
Both these schemes are at the Western General Hospital, in Edinburgh. The building of these units with those facilities for the application of new and highly specialised techniques and for research shows that the National Health Service in Scotland is not neglecting the vital importance of giving full scope for the application of the latest advances in 2037 medical science in the treatment of the individual patient. Among the major projects to begin in 1957–58 is the reconstruction and extension of the Royal Mental Hospital in Edinburgh at a cost of £450,000. The hon. Gentleman was asking me what we were doing about that, and suggested that nothing was being done. That extension is to go ahead in 1957–58.
§ Mr. Willis
I am sorry to interrupt, but the right hon. and gallant Gentleman said in his statement that this was only being considered. Up to the present, nothing has been done.
The hon. Gentleman asked me about long-term and short-term programmes. He must take the long-term with the short-term. I have told the hon. Gentleman that in 1957–58 we are going ahead with the reconstruction and extension of the Royal Mental Hospital, in Edinburgh. I got a certain impression from the hon. Gentleman when he spoke of these sums of money which were needed. I wonder whether he has considered what it would amount to if he were to add it all up.
Exactly, but I am not a lightning calculator any more than the hon. Gentleman is, and at the moment I could not possibly tell him what it comes to. But supposing that the demand is of the nature that he has indicated and it were general throughout the whole of Scotland, England and Wales, I wonder what the cost would be.
These things have to be approached in progression. One cannot just put the whole world right at once. The hon. Gentleman must not expect all these things to be done immediately. The hon. Gentleman suggested that the South-Eastern Region was being badly treated, and I would point out that the population of that region is 22 per cent. of the population of Scotland. Against that they had 23⅓ per cent. of the total capital expenditure on hospital building work in the year 1951–52; in 1952–53, it was raised to 27 per cent., and, in 1953–54, to 30 per cent.
§ Several Hon. Members rose—
I am not giving way. I have only about three minutes 2038 in which to say what I have to say. Hon. Members must wait for another occasion.
The figure for the current year is not yet available, but it is probably about the same as for 1953–54. Total expenditure for Scotland for the last three financial years was about £4,400,000. Of that, the South East Region's share was £1,200,000. The allocation for the current year is £520,000, and for 1956–57 it is likely to be about £660,000 and, for 1957–58, about £690,000. This will include provision for plant renewal and major schemes.
It will be seen that the Government have in mind to helpas much as is possible towards creating better conditions in hospitals. I would remind the House that the actual works to be undertaken are determined by the regional board. It is for the board to consider the various competing claims in the light of medical needs and priorities. I have not time to attempt to review in detail the service in South-East Scotland, but there are one or two general points to which I will allude. I admit, candidly, that there is scope for further capital expenditure on the hospital service not only in this region, but in many parts of Scotland.
The increase of capital allocations which I announced on 9th February represents a definite contribution towards meeting these needs. In general, the need is less for new bed accommodation than for improvement and modernisation of existing services. It is true that some new beds are needed. In Fife, there is a definite shortage of accommodation for patients, and I have mentioned the special steps being taken in that area in connection with the infirmary at Kirkcaldy. [An Hon. Member: "What about a new general hospital?"] That is not in the first programme. In other parts of that region the main need is for further accommodation for the mental health service. That has been recognised by the approval, in principle, given to the major scheme for the reconstruction and extension of the Royal Edinburgh Mental Hospital.
Further beds are also needed for mental defectives, and a scheme of this kind will have to be undertaken in the Edinburgh area when progress has been made on the major schemes already scheduled. It is also important to see that hospital 2039 facilities are available to enable advances in medical science to be brought to bear in the treatment of patients. Two important schemes of this kind I have already mentioned.
Apart from the programme of capital works, a prime concern of the hospital authorities must be to see that the best use is made of existing resources. We are all very much aware of the long waiting lists: but it is not a good thing to judge by the waiting lists alone. Urgent cases are admitted promptly. It is a good thing to look at the number of inpatients dealt with in the course of a year. At the end of the year, there were 8,567 people on the waiting lists for hospitals in Edinburgh—that is, all of them. Against that figure, the number of patients discharged last year was 59,750. If one works that out, one finds that there was a turnover of beds seven times in a year. No one can have had to wait long. It is satisfactory to know that the turnover of beds was so rapid.
I hope that I have answered most of the questions put by the hon. Member for Edinburgh, East in the short time that was available to me.
§ 11.55. p.m.
§ Mr. David J. Pryde (Midlothian and Peebles)
I regret to say that the position of the Government tonight is indefensible. In fact, I should put it more strongly. The recent conduct of the responsible Ministers has been reprehensible in the case of Peebles. Yet the Joint Under-Secretary of State made no reference to it, although his conscience pricked him when, recently, he suddenly rushed oft, accompanied by two of his top-ranking officials, to examine the position in Peebles for himself. Had he taken me with him, I would have shown the right hon. and gallant Gentleman how the Peebles War Memorial Hospital is totally inadequate and unsuited for any purpose to which it is applied
2040 Then there is the case of Dalkeith. Under the Labour Administration the South-East Scotland Regional Hospital Board decided that there would be a new hospital built there. The Minister knows perfectly well that Midlothian County Trades Council, the Midlothian County Council, and the Peebles Town Council have petitioned the Government about hospital services, and that in South Midlothian we have to carry our casualties to Edinburgh hospitals. I submit that this state of affairs is intolerable.
I have approached the hospital board and the Midlothian County Council has done so, but the board simply says "We are in the hopeless position that we do not get the money from Westminster." It is the Minister's job to see that we get it. That is why we have raised this matter tonight. It is the job of the Scottish Office to go to the Chancellor of the Exchequer and put the position plainly to him, because it is rousing the ire of the people of Scotland..
I pointed out that the priorities were fixed by the regional hospital board and not by my right hon. Friend the Secretary of State for Scotland. I beg the hon. Gentleman to bear that in mind, because neither of the projects he has mentioned are on the list of priorities of the board.
§ 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 two minutes to Twelve o'clock.