§ 2.0 p.m.
§ Mr. Walter Edwards (Stepney)
We have been dealing with a London transport problem, and I am about to raise a matter which I think concerns the health of the people in a particular part of London. A short time ago the North-East Metropolitan Regional Hospital Board made an announcement that it would recommend to the Minister the closing of St. George-in-the-East Hospital which now serves a district of London. The board made that announcement before even giving the local authority the chance to consider its views. I can assure the Parliamentary Secretary that when this announcement was read in the Press by people living in Wapping and Shadwell it gave them the biggest shock they have had even since the beginning of the war.
This hospital has been there for well over fifty years; I do not know exactly how long, but certainly longer than I have been on this earth. Yet an announcement has been made by the regional board that the hospital which has been serving the people in that area for so long is to be closed. This week I asked the Minister a Question to find out the names of the people who comprise the regional board. I am certain that it will 2391 be accepted that very few of these people know the particular situation in Wapping and Shadwell and its relationship with St. George-in-the-East Hospital. Most of them probably do not know that Wapping and Shadwell form more or less an island and that the bridges which allow ships and barges to go in and out of London Docks are on the fringe of Wapping and Shadwell and of St. George-in-the-East Hospital.
Apart from the fact that this is a service which we had even in the Poor Law days, even before we paid National Health Service contributions, the decision to close this hospital is particularly regrettable. The people face a difficult situation with regard to exits and entrances, even for ambulances, and the effect of closing the hospital will be that the people in this part of London will have to suffer a greater inconvenience in their hospital service than anybody else in London.
I do not know what made the regional board reach this decision, but I believe that one reason given was the falling population in the area. I wonder whether the board has even been informed by its advisers that before the war, when the population of Stepney was about 200,000, there were four hospitals in the area; and that one of them, St. Peter's Hospital, was bombed during the war and has never been used since. I do not know whether the board is aware that London Hospital, which is one of the remaining hospitals in Stepney, admits very few Stepney people; most of the patients there come from well outside Stepney. In any case, people have to wait for months and months before they are admitted.
Thus, of the four hospitals which we had before the war, St. Peter's is out and London Hospital cannot provide services for the people of Stepney. That leaves us with the Mile End Hospital, St. George-in-the-East Hospital and the London Jewish Hospital. The London Jewish Hospital is more or less a specialist hospital.
When we bring it down to the hospitals now providing services for the people of Stepney, we see that if St. George-in-the-East is closed we shall be left with one hospital, compared with four before the 2392 war. I cannot understand why the regional board is doing this or why the Stepney Hospital Management Committee has agreed to it, although I must tell the hon. Lady that when this matter was discussed in the council chamber at the last meeting of the Stepney Borough Council, the chairman of the House Committee of St. George-in-the-East Hospital, who is also a member of the hospital management committee, stated quite definitely that the hospital management committee was forced to accept the decision of the regional board. That is contained in a letter which the hon. Lady may have in her possession and which was sent to the Minister of Health by the town clerk of Stepney.
The regional board has not waited until the Minister has heard the representations from other bodies which he has told me in a letter he is prepared to hear before he makes a decision. Even more than this, the board has let its determination to close the hospital be known all round London. The effect is that the staff are very worried and many of them, rather than be pushed out later, are looking for places elsewhere. That may suit the places elsewhere and may fill vacancies elsewhere, but it will take away a service which is absolutely necessary for the residents of Wapping and Shadwell. In addition, the chairman of the hospital management committee sent out a circular to all members of the staff of the hospital saying that the hospital is due to close some time in July and that the committee will do whatever it can to find other appointments for them.
I had a letter from the Minister in which he told me that no decision has been taken about closing the hospital. I understand that admittance to the hospital is at the moment being refused to the medical staff in anticipation of its closing. The Minister said in a letter dated 26th March that no decision has been taken. He had asked the regional hospital board to consult the other authorities responsible for providing health services in the area and until he knew their views he would not come to a decision. By now the Minister ought to have the view of the health authorities in the area. Stepney Borough Council has decided unanimously to oppose the proposal to close the hospital and has done so in the strongest terms. In case the 2393 Ministry has not yet been notified, I can inform the hon. Lady that Division No. 5 of London County Council, which deals with health services in the area, has also passed a resolution opposing the proposal.
I read in the Evening Standard the night before last that a number of London doctors have met. They are also opposing the closing of this hospital and asking for a deputation to be received. I live in the area and I am an out-patient of St. George-in-the-East receiving treatment for a knee injury. I can assure the hon. Lady that nothing has created more feeling among the people in the area than this proposal. They are all working-class people.
The regional board deliberately prevented the house committee of the hospital from expressing views until a decision had been taken. It was after the borough council met and expressed its views that the house committee was given an opportunity to express its view. We hear a lot about petitions. I have with me a number of petition forms signed by people living and working in the area. Ninety per cent. of those who signed the forms live in the area and no doubt work in the docks. Possibly 10 per cent. work in the industry but live out of the area.
This hospital not only serves the needs of residents of Shadwell, Wapping and St. Georges, but also deals with casualty cases from the docks and wharfs. I have letters from trade union branches and from wharfingers, all expressing concern about the service being taken from the people in this part of London. We are not asking for anything new but for a service to be retained.
Considerable sums of money have been spent by London County Council and the National Health Service, yet the regional board, most of whose members do not know conditions in the area, has made this preposterous recommendation. The petition contains about 1,500 names and addresses, which I hope to give to the officials of the Ministry after this discussion. The names are all genuine names of people who are perturbed about their health and the health of their children. Once the hospital closes, if ever it does, it will become a derelict building, to the shame of the National Health Service.
I really cannot understand the decision. Plenty of use could be made of the hospital if the regional board and the 2394 management committee liked to put their heads together. It is said that nurses cannot be obtained, but if we closed all hospitals of the country, as they are short found, we would close almost half the hospitals of the country as they are short of nursing staff. The important thing I emphasise is that if the hospital is allowed to close it will be made terribly inconvenient for people who live in the area and have been using the hospital who will have to go to other hospitals.
I have a knee injury which makes it very difficult to get up and down stairs. If I were not able to go to St. George-in-the-East Hospital, I should have to go down one of the oldest underground stations, Wapping Station, crawl down the stairs, get into a train, go upstairs again at Whitechapel Station and then cross a busy road to Mile End Hospital for treatment every morning. Mine is only a minor case compared with dozens of cases I see there every morning. The answer may be that patients can travel in ambulances, but it is not everyone who wants to travel in an ambulance.
The area is bordered by swing bridges owned by the Port of London Authority. Before the war a general practitioner was living in the area. Today there is no general practitioner in the area because his premises were bombed and have never been replaced. If a dock worker or someone at home meets with an accident there is not even a clinic to which he may go unless he crosses two main roads to get to Mile End Hospital.
People have to suffer this inconvenience, yet there is this hospital to which they could go. I assure the hon. Lady that the people of the area love the hospital. It is well run and everyone is perfectly happy about it. It would be a tragedy if at any time it were decided to close the hospital. No doubt the hon. Lady knows that Stepney Borough Council has suggested that there should be an inquiry before a decision is taken. My view is that there is not even the necessity for an inquiry. The hospital can be made to work and to continue to give the splendid service it is at present giving, provided the regional board goes into the matter in a proper way.
I beg the hon. Lady to take all these things into consideration, to consult the Minister, and make certain that whatever else happens under the National Health 2395 scheme no one—whether in Wapping, Shadwell, Bayswater, or Mayfair—shall have to suffer inconvenience as a result of a decision made by her right hon. Friend and by the regional board.
§ 2.19 p.m.
§ The Parliamentary Secretary to the Ministry of Health (Miss Patricia Hornsby-Smith)
The hon. Member for Stepney (Mr. Walter Edwards) has put a very forceful case on this question, but I think that he has been less than just to the regional hospital board. The board has behaved quite constitutionally in this matter. It is the authority responsible for planning the whole of the hospital services within its area. Although the hon. Member laid the blame all on the side of the regional board, the fact remains that the hospital management committee, whatever may have been said in another committee, has voted and recommended to the board that this hospital should be closed.
It is quite correct to say that the house committee should not have come into the question at that stage, because it is not the executive body responsible for the day-to-day running of hospitals in the group. Nothing can take away the executive responsibility from the hospital management committee. Therefore, any representations to the board would naturally come from the hospital management committee and not from the house committee.
My right hon. Friend is aware of the board's suggestion that the St. George-in-the-East Hospital should close. To give full and proper consideration to the views of all interested parties, my right hon. Friend asked the board to seek the views of the London County Council, the London Executive Council and the Stepney Borough Council. When all those views have been received, my right hon. Friend will come to his decision. Meanwhile, although the hon. Member has freedom to put all his case as he would wish, it would clearly be improper for me to discuss the merits of the proposal, which will be a matter for the decision of my right hon. Friend. It is, however, fair that I should make a few comments on some of the published and known facts and some of the points which have already been made public by the regional hospital board.
2396 The regional hospital board, having the responsibility for services in the area, quite properly published a notice of its intentions, knowing that the proposal it was putting forward would have finally to be decided upon by the Minister. Although the hon. Member said that nobody else was consulted, I should in fairness point out that the last paragraph of the published statement, a copy of which I have with me, states that the London County Council, the Stepney Borough Council and the London Executive Council have been informed of these proposals and their observations invited.
§ Mr. W. Edwards
I was talking about what was read in the Press. The London newspapers which I read had nothing whatever in them to say that consultations were taking place with other authorities.
§ Miss Hornsby-Smith
In that event, I welcome this opportunity to put the board's case fairly. I was quoting the official recognised statement which was issued. The hon. Member knows as well as I do that the Press picks out the bits that it thinks make good news. The fact remains that the regional board behaved quite properly and in its statement made it plain that it had invited any observations from those three authorities.
In 1945, as the House will know, the Ministry of Health carried out a survey of hospital facilities in London as a prelude to the introduction of the National Health Service. In that report—as far back as 1945—it was recommended that this hospital should be closed as soon as possible. At that time, of course, it was under the control of the London County Council, who also had contemplated the desirability of its early closing. That is a matter of record and fact and not of opinion.
As hon. Members know, it is the duty of a regional hospital board to plan the hospital and specialist services in its area, and it is right that it should consider from time to time, in the light of all the changing demands, including any shift in population, which is very noticeable in this part of London, which of its hospitals should be further developed and which might be "run down". I do not in any way minimise the inevitable conflict of loyalties which might arise when, perhaps, the patients of an older, less well-equipped hospital could be dealt with at 2397 a neighbouring larger hospital with greater facilities and which has empty beds. In such cases there is always a conflict of loyalties, and my experience at the Ministry is that no hospital is ever dosed, for whatever purpose, without giving rise to local protest.
It is, however, the responsibility of the regional board, in the light of whatever changes may arise in its region, to assess the requirements of the population and the facilities that it has for patients in the Health Service. It is only in this way that it is able to provide both an efficient and an economic service, always bearing in mind the overriding priority of the needs of the patients. I assure the hon. Member that in the representations that are made to him, my right hon. Friend will have to be satisfied that the needs of the patients can be met.
There is one point which it is fair to put. The regional board has asked those other authorities to make their views known to the board. In courtesy, those authorities should do so. The board, quite properly, has come to a decision on its experience and knowledge and has made a recommendation. It has, quite properly, invited the views of other interested bodies. Any representations and any opposition to the board's proposals should in fairness be put to the board first.
Those representations may persuade the regional board that its decision is wrong and that there is a case for maintaining the hospital fully as at present. It would, however, be quite wrong for those bodies, having been invited, quite constitutionally, by the regional board to put their case, to ignore the board in an endeavour to come straight to the Minister. Those representations should first be made to the board.
§ Miss Hornsby-Smith
The suggestion is that, without going to the board, deputations should be received by the Minister and the representations should not be made to the board. That is how I understand it so far.
§ Mr. Edwards
I assure the hon. Lady that when the town clerk of Stepney wrote to the board in connection with the views of the Stepney Borough Council, a copy of the letter was sent to the 2398 regional board. Surely the hon. Lady realises that the regional board has come to its decision—it has said so in black and white. The circular from the chairman of the management committee said that this matter is now in the hands of the Minister of Health. If people are objecting, is it not far better for the Minister of Health to know rather than the regional board, which has already made up its mind?
§ Miss Hornsby-Smith
No. The hon. Member is being unjust to the regional board. If a county council makes a decision and invites the opinion of interested local authorities, it expects those authorities to make their representations to the county council. In the same way, it is right and proper that, representations having been invited by the Board, the authorities concerned should make their representations and objections to the board.
Since the inception of the Health Service, the board has made many improvements in the hospitals in the region and a number of additional beds have been opened. The responsibility for planning the whole area is, of course, that of the board. The hon. Member conveyed a suggestion that the hospital should be maintained because people pay their National Health Service contributions to it. I must remind him that National Insurance does not now pay for the Health Service. It is paid for by over £400 million of direct taxation by this House.
During the period in question, there has, as the hon. Member knows, been a considerable shift of population from London into the new towns. It is really quite unrealistic to petition, on the one hand, for hospitals in the new towns to serve the population which has left London, and at the same time to ignore the lessened demand for beds in London. In 1939, for example, the Stepney population was 197,000. In 1949, it was 100,000, and in 1953 it was 98,000, which is half what is was in 1939. Obviously, since the population in Stepney has halved since 1939, the demand for beds has fallen.
That there has been a steady lessening of the demand in the area is shown also by the fact that in November last, when a check was taken, there were 98 vacant beds plus 20 beds temporarily unavailable at the Mile End Hospital; there were 2399 85 beds which with staff could become available at St. Andrew's Hospital, and there were 24 beds available but unstaffed at St. Clement's Hospital.
Among other hospitals in the locality are the London Hospital, the London Jewish Hospital, Poplar Hospital and Bethnal Green Hospital. An analysis of the demand on this group of hospitals in the area shows that in the East End the demand on the number of available beds is running down. Simultaneously, the demands elsewhere are increasing as many people are moving into Harlow, Basildon, Ilford and Barking.
The board has to consider all these factors when assessing the need for beds and facilities in the area. The matter has been very fully considered by the hospital management committee and by the hospital medical advisory committee, and their recommendations have gone to the board. Following the board's statement, my right hon. Friend suggested, although the offer was already made in their statement, that the board should seek the views also of the London County Council, the London Executive Council and Stepney Borough Council. I have no doubt that the views which the hon. Member has voiced today will be formally stated to the board. My right hon. Friend, having received all those representations, will then make his decision.
I would emphasise again that no decision has yet been made, although the board, with its experience of and its responsibilities for services in this area, has come to the conclusion that the hospital should be closed. It is only proper that all interested parties should have an opportunity of putting their objections should they wish to do so. I can assure the hon. Member that those objections will be fully considered. In view of the wide publicity which has been given to one side of the case, I thought it only fair that the board's position should be put into proper perspective.