§ Motion made, and Question proposed, That this House do now adjourn.—[Mr. Hughes-Young.]
§ 2.15 p.m.
§ Mr. Wedgwood Benn (Bristol, South-East)
I rise to draw attention to an issue which is of very great importance in my constituency, or at any rate that part of my constituency which falls under the authority of the Gloucestershire County Council. I venture to suggest that, though this is a question of one old people's home for which a loan sanction has been refused by the Ministry, it raises a rather wider matter than would simply emerge from the district that I jointly represent. I should like to tell the House very briefly the background of this story. It is a very simple story and I do not intend unduly to detain the House.
Some years ago the Gloucestershire county council was struck by the need to provide more accommodation for old people, who would otherwise have to go into hospital because they could not find suitable accommodation. This is a question of a general problem, which everybody recognises. It is that, as life's span increases—the problem is a real one—old people tend to go to hospital when they ought to be somewhere where they could be looked after without needing skilled medical treatment all the time.
The Gloucestershire County Council prepared a plan as long ago as 1953 in order to meet this need, and, as one would expect from a council anxious to do these things with the greatest possible regard to economy, it tried to find an existing building which could be adapted 1850 for the purpose, but was unsuccessful. That is why this issue arises at all, in a sense, because it is the loan sanction for the provision of an entirely new building.
In 1954, the authority acquired the necessary land from one of the urban district councils in the county—the Kingswood Urban District Council—and received a permission at that time from the then Minister to do this. It then proceeded further with the plans, but there were a number of delays, which the authority greatly regrets now, because it feels that the economy axe has only fallen on it as a result of these delays. At any rate, delays in planning took place, and it was not until November of last year that the authority finally submitted the plans to the Ministry of Health. I have here a letter from the Ministry, dated 21st November, 1955, in which the appropriate department expresses the Minister's approval of the plans. It states:I am directed by the Minister of Health to refer to your letter of 4th November and to say that he agrees to the Council's revised proposals for the erection of the abovementioned premises at an estimated cost of £39,970.The letter went on, as is no doubt customary in these cases, to tell the authority that it could now invite tenders and must accept the lowest, unless there were circumstances of an abnormal kind, and so on, and the council then proceeded to go ahead.
Finally, in February of this year, the authority wrote to the Ministry and said that it had complied with the regulations that had been laid down, and now sought support for the loan sanction. It was at this moment when the authority received a letter which is the cause of this debate. On 12th March, without any great explanation, the Minister replied:As the council will be aware from Circular 3/56 the Minister is, in the present economic situation, unable to recommend authorisation of loan sanctions except to meet the most essential needs, even where approval of the scheme has been given. I am. accordingly, to inform the council that the Minister regrets he is unable on the information before him to sponsor the loan application in connection with this scheme at the present time.I need hardly say that the news that the Ministry has taken this line has 1851 caused very great distress in Gloucestershire. This question surely arises, and this is really the only reason why I raise this: is the old people's home in Kingswood to be regarded as a priority which should be completed even in the present period of national economy, or is it one of those little frills and luxuries which we have been told should be cut out? I want to direct the rest of my remarks, quite simply, to that question.
I want to say, first, that the three-year lag since the plans were first prepared is itself a factor which the Minister should take into consideration. This is not a new thing. It is not something which has come up recently and which we feel may now be postponed, but an issue which has concerned the people in authority in Gloucestershire for some time. Indeed, with the passage of time, the need for accommodation for these old people has become greater rather than less.
I have been sent some figures by the clerk to the county council, who has been very helpful in this matter—and, indeed, he gives me the names of those concerned, because personal experience is much better than statistics. He gives the name of 14 old people at present in hospital who could certainly be accommodated in an old people's home. Therefore, if the problem of overcrowding of hospitals is to be considered as a factor I can almost undertake to produce out of my hat, as it were, 14 hospital beds which could be vacated by these old people.
In addition, in this part of the county there are ten people who are on the waiting list for old people's homes. Without in any way wishing to stir a deep political controversy—the difficulties of old people are very well understood on both sides—if we get people who have been accepted for admission to an old people's hostel we can be fairly sure they are in rather more need of care and attention than is the ordinary old-age pensioner. There is, therefore, as a result of the delay, additional hardship to these ten people.
I only quote one more figure, but it is an important one from the point of view of the planning of the Gloucestershire County Council itself. There are 15 people from this part of the county who should be in an old people's home in Kingswood but who, because there is not 1852 such a home in Kingswood, are spread among the old people's homes in other parts of the county. Indeed, any local authority, any county council, which is trying conscientiously to plan the distribution of old people's hostels must try to see that each part of the county bears its own share of the responsibility for its own old people.
I am assured, however, that if the old people's hostels were available in Kingswood, some of those who are now accommodated in other old people's hostels would be sent there and so free accommodation in other parts of the county. The hostel nearest to Kingswood at the moment is at Chipping Sodbury, which is some distance away, and even there there is considerable overcrowding to meet present needs.
I now come simply, and almost finally, to the question of whether this project is to be regarded as a priority or not. In this connection, I feel that I must, if it is not unfair, draw attention to the fact that the Minister of Health, in going round the country and making the sort of weekend speeches which are a necessary part of a Minister's duties, so I am told, has been stressing and I think absolutely rightly—that as far as he is concerned the three greatest priorities are the need for capital investment to modernise hospitals, the improvement of conditions in mental hospitals, and the provision of better care for the old—which, in fact, was the first priority that he mentioned.
Perhaps I may quote his exact words, because I echo the sentiments and admire the language. He said, when speaking at Jarrow, on 6th April:The problems of the aged should be a challenge to the public conscience.He went on to say that improvements in medicine hadadded years to life and that his task was to add life to years.A happy phrase, and one that sums up the problem very well indeed.
I submit that this question of the old people's home at Kingswood, though probably only one of many such that have to be considered, is one that must be regarded as a matter of priority. I confess that I quite fail to understand why the Minister should put at the top 1853 of his own list of priorities something in general when, in particular, he tells the authority concerned that to meet the needs of national economy, he must exclude it. Therefore, I very strongly hope that this matter will be looked at again.
I just say one other word about the way in which the Gloucester County Council itself has tried to meet the Government's plea for greater economy. It is a county council which is not controlled by people who share the same political views as myself. It is a Conservative council, and I feel that one may be very confident in saying that the best co-operation between Government and local authority on this type of issue arises where the two are in political harmony. There is, therefore, no question of the Gloucestershire County Council trying to resist the Minister's plea for economy—far from it.
I am told—and although I have not all the details I am sure that they can be confirmed—that in response to the circular issued by the Minister the county council has already excluded a lot of work which it would like permission to have done. These were not luxury items. The county council regarded them as essential but has excluded certain of them because, in its own opinion, the old people's home project should be allowed to remain.
I refer, again, to what the Minister said in his speech, that the provision of old people's homes was the sole responsibility of the local housing authority. That being so, if we find, as in this case, that the Gloucestershire Council Council regarded this matter as being so important that it was willing to cut out other things in order to leave this scheme in being and that the Minister, who previously approved, then turns it down, it must, I think, cause very great public concern.
I must add just one other thing, if it is not too critical of the Minister himself. He gave approval to the project and said that loan sanction would be granted at the appropriate time. He gave that approval in November last, after the autumn Budget, at a time when there 1854 were already factors urging us to national economy. Those factors were there then almost to as great a degree as now, and I cannot understand why, in the circumstances of those times—which led the Chancellor to introduce his autumn Budget—the Minister should have found himself able to approve the project, and now cannot find himself able to carry on with it.
Before sitting down, I must broaden this debate to some extent. As I go about in Kingswood, which is the part of my constituency where the home would be built, I see other building work going on. I see a new petrol station, and all sorts of repairs and developments going on which are not under the control of the local authority and which, I know, are not the responsibility of the Minister of Health. I do know, however, that two public-houses in Kingswood are to be developed, one at an expense of £23,000 and the other at a cost of very nearly £25,000. I think it a very deplorable thing that the axe of economy should fall upon a really vital project like an old people's home when, as a result of the Government's other policies—and I do not, of course, propose now to go into their merits—this other inessential building is allowed to proceed.
I very much hope that in replying to this debate the Parliamentary Secretary will be able to give some hope in this matter. I do not expect that just because I have been lucky in getting the Adjournment she will be able this afternoon to give me all I ask, and all that the Gloucestershire County Council asks, though, if she is intending to do it, I hope that she will not be put off by my own cautious optimism. Nevertheless, I think that she should give an assurance that this will be looked at once again in the light of its very pressing urgency from the Gloucestershire point of view and also, perhaps, that she would be willing to discuss it further with the county council and, perhaps, fix a date in future when the project could be proceeded with. At any rate, I hope that she will be able to give some assurance that it will be considered, and it is with those hopes in my mind that I bring my remarks to a conclusion.
§ 2.30 p.m.
§ Captain F. V. Corfield (Gloucestershire, South)
I am very grateful for the opportunity provided by the hon. Member for Bristol, South-East (Mr. Benn) to discuss this matter, which is of very great importance and has caused considerable disappointment in Gloucestershire.
In the middle of last month there was, throughout the whole of the County of Gloucestershire, only one vacancy for a male resident in the various homes for old people under the control of the county council. As the hon. Member has stated, there were no fewer than 14 old men occupying beds in hospitals, nearly all of them in the southern part of the county, waiting for the type of accommodation about which we are talking. As a result, hospital beds badly needed for other people could not be released.
The hon. Member referred to the nearest alternative accommodation being at Chipping Sodbury. As a result of my own visits to the Chipping Sodbury Old People's Home, I can confirm that it is grossly overcrowded. There is no possible prospect of squeezing any more into it.
The hon. Member referred to the Minister's speech at Jarrow. It is cheering to realise how close this type of project is to my right hon. Friend's heart, but the very fact that he made the speech and appeared to give such great priority to this type of development has increased the disappointment felt by the Gloucestershire County Council and other bodies and individuals in that part of the world at the intimation that he is not ready to sanction the financial resources required.
I find a certain amount of difficulty in supporting, on the one hand, as I do most strongly, the urgent necessity for economy in Government and local government expenditure, and in trying, on the other, to press for exceptions, which if pressed throughout the country, would, in the aggregate, completely defeat the Government's purpose. However, in a project of this type, where considerable sums have already been spent on purchasing the site, and where the money inevitably lies completely idle and unproductive until there is further expenditure, it seems to me that there is a case 1856 for exceptions, apart from the case on hardship grounds so ably made by the hon. Member.
Consequently, I join the hon. Member in pleading with the Parliamentary Secretary to impress upon the Minister the importance of reconsidering the decision and ascertaining whether the project can be moved very much higher in the scale of priorities in order to allow the county council to proceed with the plans which it has already prepared, which would probably have received sanction had there not been the delays to which the hon. Member referred.
I would add to his plea that, even if my hon. Friend can give us no assurances today, she will try to impress upon the Minister the desirability of further consultations with the county council with a view to finding a more economical method of carrying out the project, perhaps by having a building which could be added to in the future, so that it need not all be erected at once, in order that the very urgent need can be met without undue delay resulting from the present financial circumstances.
§ 2.34 p.m.
§ The Parliamentary Secretary to the Ministry of Health (Miss Patricia Hornsby-Smith)
I am grateful to the hon. Member for Bristol, South-East (Mr. Benn) and my hon. and gallant Friend the Member for Gloucestershire, South (Captain Corfield) for the manner in which they have dealt with this subject. I recognise the very real disappointment felt by the Gloucestershire County Council that we have not been able to give it sanction to go ahead at the moment with the scheme for building a new home at Tennis Court Road, Kingswood.
It is true, as the hon. Member for Bristol, South-East said, that plans were approved by the Ministry in 1955, the cost being estimated at £40,000. The county council was told at that time that it had approval to go to tender. The normal preparatory work of a county council in completing the working drawings and bills of quantity generally takes between six and nine months. During that period the Government announcement was made imposing restrictions on local authority capital expenditure.
1857 On 17th February all local authorities were advised that loan sanction issues in the succeeding six months at least would be limited where borrowing was for the construction of old people's homes—that is, so far as the Ministry was concerned under the wider direction of Government policy—and that such borrowing for old people's homes would be restricted tothose required to meet the most essential needs.It was pointed out in that circular that the fact that a scheme had already had Ministerial approval did not necessarily mean that it could proceed.
I sympathise very much with the case made by the hon. Member for Bristol, South-East. The county council had had that permission. However, we also have to take into consideration that by the time bills of quantity, etc., have been prepared, the scheme has gone to tender and the building has been erected, two years may have elapsed. Therefore, if we were to say that every project which had had the initial approval of the Ministry could go forward, regardless of the Government's economy instructions, it would virtually mean that the Government could take no practical action on their decision to economise, for there would be such a bulk of work to be carried out in the next two years that we should have no practical economies to show.
§ Miss Hornsby-Smith
No, expenditure on old people's homes is one capital expenditure under the general direction of the Government which affects my Department in its dealings with local authorities. The Government decision was not limited to that. I am referring to the interpretation of the circular as it affected the expenditure of local authorities upon old people's homes among any other capital expenditure which they carried out for the Ministry. It is fair to say that, if practical application was to be given to those economies, it was inevitable that some part of the work which would otherwise have proceeded during the next two years should be curtailed.
The demand for additional old people's homes is universal. They have a very valuable contribution to make to our social services in providing for the care 1858 of old people, especially those living alone, who can no longer maintain their own dwellings and look after themselves satisfactorily enough to lead independent lives and who cannot manage even with the domiciliary services which local authorities may provide. The homes also make a very valuable contribution, as the hon. Member rightly said, in relieving the pressure on hospital beds in that they give accommodation to old people who no longer require special hospital services but who are not able to go back into their own independent establishments.
My right hon. Friend is fully aware of the great importance of this service. Indeed, he does not depart in any way from the three priorities that he has laid down—the mental hospitals, the hospital building programme, and the care of old people. However, this is an enormous programme, the complete fulfilment of which will entail enormous financial burdens upon the State. Obviously, it cannot be fulfilled in a short while, nor, indeed, can we carry out, while playing our part in the economy scheme, all that we should like to do immediately. That does not mean to say that we have changed the priorities; there is nothing else detracting from them. So far as we have the capital available, that capital is still going towards those three priorities. Unfortunately, it cannot cover as wide a programme as was previously envisaged, particularly for old people's homes.
It is fair to say also that if anyone speaks in this House about Government economy, what he says is generally reasonably well received; but the moment somebody talks about a specific economy, there are always a dozen objections as to why that particular service should not be cut. Any economy imposed upon local authorities or, indeed, on any Department, is always likely to give rise to disappointment because this or that project, each with its particular claim— whether it be education, roads, hospitals or, as in this case, old people's homes—is affected.
No one likes having to curtail or temporarily retard a programme of this nature. But the Ministry, in common with all Departments, has to make its contribution to the general economy. Our share has entailed an exhaustive survey of the quite large number of schemes which had provisional sanction, and the difficult task of limiting the "go- 1859 ahead," to the number which we knew had best claim to be included in a limited capital programme.
For the time being, therefore, we cannot recommend immediate loan sanction for every project which we have before us for providing new old people's homes. My right hon. Friend has endeavoured, in the period since the need for restrictions became apparent, to concentrate loan sanction on schemes which seemed to him to be both urgent, and in the most advanced stage of preparation. I would say that many were further ahead in preparation than this one; tenders were in, or nearly so, quantities were completed, and they were some five or six months, perhaps, ahead of this scheme. There were other counts upon which they could be said to have greater call—a smaller proportion of old people's homes in their area, for instance, since there are areas with a greater demand than that of Gloucester.
Inevitably, this postponement has led to disappointment, which I fully appreciate; but the temporary—I emphasise the word "temporary"—withholding of sanction in respect of some new building schemes, such as this one at Kingswood, does not mean that they are forgotten; indeed, it only means that they are postponed in the dates at which they can be started.
In Gloucester, the existing Part III accommodation is a little over 750 beds, representing 1.7 beds per thousand of the population. Much of it, I readily concede, is in old institutions, some used jointly with the regional hospital board; and the only provision in the part of the county immediately outside Bristol city boundary is, as the hon. Member for Bristol, South-East said, at Chipping Sodbury, where the accommodation is in an old institution retained by the county council and is not as up-to-date as we would like. Nevertheless, the facilities in the county are slightly above the average in the country, and certainly well above the inadequate level of some areas, which are below the national average of 1.6, and whose claims have, therefore, an additional priority in the current allocation.
The county council has been active in the establishment of new homes for the old; six old people's homes have been opened since 1948, and, in addition, 1860 two homes for the blind have been provided. The county has therefore already provided eight additional homes. Liaison with the hospital authorities is very close, and the proportion of admissions to the county homes of persons discharged from hospital is more than one in three, which, in comparison with the rest of the country, is quite a satisfactory average, as against some areas where the figure is lower, for various reasons of accommodation and the type of patient who may or may not require Part III accommodation.
I do assure hon. Members that my right hon. Friend gave these various projects the fullest possible consideration. It was an unpleasant decision to have to make, but one which devolved upon us from our having to take our fair share in this economy programme. It is right to emphasise that had we not taken it on a variety of these schemes very similar to the Gloucester one, then we should have been able to effect no practical economy for two years hence, because all the programmes for the next two years are at a similar stage. The initial consent being given, the project going out for quantities, planning, and final building—these processes in all take, for an old people's home, up to two years.
Taking all these matters into account, therefore, it was felt that Gloucestershire's case for the granting of an immediate loan sanction was not stronger than the case of a number of other authorities who were similarly affected by the imposition of the restrictions, and that it was, indeed, less strong than some.
Very considerable progress has been made by all local authorities. We have had more than 700 new homes built since 1948. The hon. Member for Bristol. South-East suggested that this was not an item of frills or luxuries. I could not agree with him more; but I assure him that in the building programme which we have, whether it be in the sphere of mental hospitals, general hospitals, or old people's homes, no project which we have sanctioned comes under the heading of frills and luxuries. The decision was not as easy to make as that. The decision had to be to postpone projects which we fully support, projects which we should like to see, and which we hope to see, carried through, but which, because of this 1861 general limitation to which we had to make our own contribution, have to be delayed.
The situation is not static. I can assure the hon. Member for Bristol, South-East that a further review of outstanding loan sanction applications will be made this autumn, in the light of the situation as it then exists, in the light of progress which has been made in various areas, etc. This project, with six others in a very similar category which have been postponed in the same way, in Sheffield, Newcastle, Lancashire, and Shropshire, which have, like Gloucester's case, a high position in the list for consideration, will be reconsidered in the situation as it then exists. If the essential preparatory work on the Kingswood scheme has been completed—I do suggest that there should be no delay in carrying on with that—and if the county council is ready for the scheme to go to tender, we would very much hope—I am afraid I can go no further than that—that it would then be possible to recommend the issue of loan sanction; but that would, of course, depend upon the economic situation obtaining at that time.
I hope that the county council will go ahead with quantities and tendering, and be as far advanced as possible by the autumn. I can assure the hon. Gentleman that we will consider the project as favourably as it is possible to do within the limits of our capital allocation in the autumn.
§ 2.48 p.m.
§ Mr. Ede (South Shields)
I should like to thank my hon. Friend the hon. Member for Bristol, South-East (Mr. Benn) for raising this matter, and particularly for the way in which he did it. Personally, I want to express my thanks to him for the assurance that, on both sides of the House, the difficulties of old people are understood. Having regard to the lack of years of the hon. Gentleman himself, I was particularly pleased to hear what he had to say, since I have not always noticed that my juvenile friends do appreciate the difficulties that come with old age.
§ Mr. Ede
If my hon. Friend expects the Gloucestershire County Council to 1862 provide old people's homes for people of his age, I can well understand the perturbation of the Minister. I am disappointed with the speech of the hon. Lady, except for the glowing testimonial which she has given to the Gloucestershire County Council. I can only imagine that if it gets fully reported in all the local newspapers in Gloucestershire, the inhabitants of the county will be surprised to hear of the high regard of the Minister of Health for their county council.
This is one of the disappointments that we are coming up against every day in all branches of the social service. The right hon. Gentleman the Minister of Health went to Jarrow and made a speech which was commented upon by my hon. Friend, and quoted, as it was also quoted by the hon. and gallant Member for Gloucestershire, South (Captain Corfield), in which he talked about adding life to years. Now I understand that everybody has to have two years added before the life begins in this particular phase of public activity. The most that can be said is that the six local authorities which were mentioned by the hon. Lady may have some hopes for the autumn if, by that time, the economic situation has improved.
§ Miss Hornsby-Smith
The right hon. Gentleman is rather suggesting that no plans have been allowed to go forward. I have only mentioned those which, unfortunately, have been postponed, but that does not limit in any way the many projects that have gone forward.
§ Mr. Ede
There is no complaint about those that have gone forward. The hon. Lady really should not assume that because she draws the line at a certain place, or her Ministry draws the line at a certain place, those people below the line who do not get through feel any very great satisfaction for seeing those above the line going forward.
I cannot imagine why, after the testimonial which the hon. Lady has given to the Gloucestershire County Council, its good work in the past should not be rewarded by some assistance in the present. Of course, this is a doctrine which is being applied all round. If one gets on with the job and does it, one can rest assured that it will be held against one if difficult times come, if, in the days when moving was possible, one moved. I 1863 know of one Welsh county which always produces a wonderful scheme for education development the moment a financial crisis occurs, and then complains that whenever it tries to move, the Government of the day, no matter what colour it may be, is always against it.
Here we have a county council which, on the hon. Lady's own showing, has done very well, and which has a number of buildings which it is using—and all honour to it for using them—which are not of the highest quality and which have involved a certain amount of ingenuity in even making them adaptable to the present circumstances. I think that authorities such as that, when we get to these difficult times, instead of it being said, "You have done something, but there is another county or county borough which has done nothing at all, or has done very little, and, therefore, we are going to give it preference now", should be encouraged to get on with the job.
§ Miss Hornsby-Smith
With great respect to the right hon. Gentleman, I would suggest that however much he may wish to encourage authorities which do their job well, our first responsibility is to the over-riding needs of the patients. If the patients in an area have had less than the average provided for them, we have to provide a spur and stimulus to see that they get their share.
§ Mr. Ede
If there were a spur and stimulus, I would be glad to see it. But the hon. Lady did not say, "We are now going around stirring up these other people and saying that because we are shutting down on Gloucestershire they can have one." There is no spur and stimulus, as I understand, at the moment. Everyone has to wait until the autumn.
§ Miss Hornsby-Smith
Not everyone has to wait until the autumn. Many of the projects are going through as approved. But in the total programme there was some limitation to be made, and the six which I have mentioned are the six which are delayed, but there are many other projects which have not been changed in any way.
§ Miss Hornsby-Smith
I cannot tell the right hon. Gentleman without notice, but if he cares to put down a Question I shall be only too happy to tell him how many of these building projects are going forward under this year's building programme. The right hon. Gentleman mentioned the date since approval was given—which was November, 1955—so the figure he has in mind is virtually last year's approvals, which include that of Gloucestershire. I think he wishes to know how many are still going forward.
§ Mr. Ede
That was not the question I asked. How many have been sanctioned since the date in February, when Gloucestershire County Council was told that its scheme could not go forward? Have any schemes been sanctioned on those lines since February? If so—and I do not expect the hon. Lady to tell me this today—how many? Have any schemes been sanctioned since February?
§ Mr. Speaker
I hope that this will not degenerate into an argument. The House is debating the Question, "That this House do now adjourn." These rapid exchanges are quite out of order.
§ Mr. Ede
If the hon. Lady is anxious to answer the question, I will put a Question on the Order Paper.
I want the hon. Lady to realise that these delays in the provision of objects which councils have been urged for some years to provide, especially in the case of those councils who have responded reasonably well in the past, cause great dislocation in the offices of local authorities. They also cause considerable disappointment to the voluntary people who are engaged on the committees of these homes.
I hope that when the time comes, if not before, not merely the six authorities the hon. Lady mentioned, but others which are anxious to get on with this work, will find sympathy from the Ministry and some assistance in getting on with tasks to which, as she said, in some cases they may have had to be spurred and stimulated, but which, in the case of Gloucestershire, appear to have been undertaken cheerfully and willingly, as a recognition of the public duties which they have to discharge.
Question put and agreed to.
Adjourned accordingly at two minutes to Three o'clock.