§ Motion made, and Question proposed, That this House do now adjourn.—[Mr. Wills.]
§ 11.10 p.m.
§ Mr. Graham Page (Crosby)
I wish to raise the matter of hospital accommodation in the constituency which I have the honour to represent, and refer in particular to the Waterloo General Hospital in Crosby. This is a small hospital of 51 beds. It is the only hospital in the National Health Service in the Borough of Crosby and the urban district of Litherland, and it serves the population of that area. It comes within the jurisdiction of the Liverpool Regional Hospital Board and I am anxious to call attention to the decisions made by the Board as they affect the hospital.
I believe that in doing so I shall be able to convince my hon. Friend the Parliamentary Secretary, and through him my right hon. Friend, that this is a case in which the interests of economy 1194 in the hospital service and in the interests of the provision of a service for a particular locality it is a matter of which he should take note. In my constituency the Waterloo Hospital is very much "our hospital". There is an element of pride and prestige in this matter. Prior to the appointed day in 1948 there was never any difficulty about obtaining help for the hospital and the citizens of the district were very proud of it. Even today the activities of the hospital management committee and the hospital's League of Friends are matters of great local concern.
Before 1948 plans had been prepared for an extension of the hospital. Three acres of land adjoining it had been purchased and the accommodation was to be extended to about 450 beds. Of course, the whole project was called off in 1948 and we waited to see how these preparations would fit in with the plans of the Liverpool Regional Hospital Board for the whole of the area. It was with some satisfaction that my constituents read the Report of the Board in 1951. The Report stated that, suitably extended, the Waterloo General Hospital was well placed to serve the Waterloo, Crosby and Litherland area, and that the Board had asked the planning authority to earmark the land for that purpose.
That statement in the Board's Report was made as part of the explanation that in accordance with the memorandum from the Ministry entitled "The Development of Consultative Services" the area of the Liverpool Regional Hospital Board was short to the extent of 5,500 general hospital beds; and furthermore that there were three very large hospitals at Walton, Sefton and Newsham, the size of which should be reduced. It was in connection with the reduction of the size of the Walton Hospital that the extension of the Waterloo Hospital was particularly associated.
That is not surprising when one considers the number of cases which are sent from the Crosby area to the Walton Hospital which is a considerable distance away. Taking the 1955 figures, 37 per cent. of the cases from the Crosby area went to Walton, involving an ambulance mileage of 4,375 miles. It may be a small matter, but one can understand from that sort of ambulance mileage for the patients the great inconvenience and 1195 the financial hardship to those who, from a distance, have had to visit relatives or acquaintances in that hospital.
There were two other proposals in connection with the reduction of the size of Walton Hospital, namely, the new hospitals at Fazakerley and Ford. I stress that those projects were for new hospitals and would involve a far greater expense in the setting up of new organisations, new buildings and administration, compared with the extension of an established hospital such as Waterloo.
So much for the 1951 Report, which gave my constituents some cause for anticipating that their needs would be met. I deliberately say "their needs" and not just their pride in their local hospital, because, taking again the 1955 figures, only 25 per cent. of local cases could be accommodated in the Waterloo Hospital. The remaining 75 per cent. of cases were, during that year, sent out of the district to Walton, or to Bootle, or to some other hospital at a distance from my constituency. As many as 14,029 ambulance miles were involved in that alone during 1955. That was for inpatients only. For out-patients the ambulance mileage for sending patients out of the district reached the enormous figure of 56,088. The ambulance mileage for out-patients to Waterloo Hospital—only some 25 per cent. of cases from the district—was only one-seventh of the total ambulance mileage for the year.
In January, 1955, I obtained an assurance from the Board that it was part of its long-term policy that Waterloo Hospital should be extended in size to become a district hospital of about 200 beds. That seemed satisfactory, or at least adequate, although not as much as had been hoped for under the plans before 1948. What the Board meant by "long-term policy" became evident when the Board's Report for 1955 was published. That Report set out the Board's development plans for the next twenty-five years. Although the extension to Waterloo Hospital was mentioned in the 1951 Report, no mention appeared in the 1955 Report. The Fazakerley project was to go ahead, but Waterloo Hospital extension had apparently been shelved for at least twenty-five years. Crosby Borough Council immediately took up the matter with the Board, and was assured that it was the Board's 1196 intention to extend Waterloo Hospital to a district hospital of 200 beds. But apparently that cannot take place until after 1980.
I appreciate that the Board intends at a fairly early date to extend the outpatient facilities at the hospital, but that is really a mere drop in the ocean. One cannot help feeling that this hospital is being de-graded and that there is the possibility that in due course we shall be told that it is not worth extending it at all.
Only during the last few days I have learned that whereas it has always been a hospital for training State registered nurses, it is now to become one for training State enrolled assistant nurses. The reason given for that is that in a small hospital there are not the facilities for training State registered nurses. They have been trained there before. Therefore, I can only think that this means that the facilities must have been recently reduced. I fear that that is a process which is bound to occur in a small hospital under National Health Service conditions if there is no prospect of the extension of that hospital at an early date.
It becomes more and more difficult for a small hospital of 51 beds to obtain consultant services. Another part of this vicious circle is that ambulances are directed not to take orthopaedic cases to Waterloo Hospital, but to take them to other hospitals some considerable distance away. Thus, if in a road accident or is crippled in an accident at home in Crosby there is a suspicion that the injured person has broken a bone, that injured person is rushed to a distant hospital. It causes this ridiculous spectacle, that a boy who, playing on one of the many school playing fields within a radius of a mile of this hospital, sprains his ankle while playing football, is whisked away to a distant hospital.
I am very well aware that a hospital board has only a certain amount of money to spend, and that it is the board's responsibility to decide how it spends that money, and what priorities it will adopt amongst the several schemes within its area. However, I ask my hon. Friend to interfere in this case for the following reasons, which I summarise. The first is that the district cannot go on for another twenty-five years, as this 1955 Report of the Board anticipates, with a hospital which serves only one-quarter 1197 of the needs of the district. Secondly, it is extravagant to build new hospitals rather than to extend established hospitals. Thirdly, it is grossly uneconomical to continue to expend such an enormous ambulance mileage in taking both in-patients and out-patients out of the district. Fourthly, a small hospital cannot retain even its existing facilities if there is no prospect in the near future of its being extended.
In connection with this hospital there is a real fear, supported by recent evidence, that it will meet the needs of the district less and less. Therefore I ask my hon. Friend to appreciate that there are matters of major principle involved, and not to tolerate the running down of an established hospital, to the detriment of the population it is trying to serve, in favour of new buildings and new projects.
§ 11.23 p.m.
§ The Parliamentary Secretary to the Ministry of Health (Mr. J. K. Vaughan-Morgan)
I am very grateful to my hon. Friend the Member for Crosby (Mr. Page), first, for the lengthy notice which he gave me of the matters that he proposed to raise in the debate. Moreover, I think it is excellent that he should have chosen this subject for debate on this Motion, as I know that he and the inhabitants of the Borough of Crosby and of the Urban District of Litherland whom he represents have been for a long time concerned about the hospital facilities within their boundaries.
I deal first with one small matter which my hon. Friend mentioned; what he called the down-grading of the nurse-training school. No decision has been taken, and the suggestion is now under consideration. I would remind him that it is in the long run entirely a matter for the Nursing Council, in which the Minister would not normally intervene.
I will turn, if I may, to the question of accommodation, which was the main subject of my hon. Friend's speech. The fact is that the Waterloo Hospital, which has served the area well for many years, is unable to meet all the present-day needs. As my hon. Friend said, proposals were already in hand for an extension of the hospital before the appointed day in 1948. The Regional Hospital Board fully agrees that the hospital should be enlarged beyond its present accommodation of 51 beds, and it is its inten- 1198 tion that in due course it should become a district hospital of 200 beds. It has land attached to it which, if suitably extended, would provide a site for the extension of the hospital.
The fact is, however, that there are other parts of the region which are expanding more rapidly than either Crosby or the population of Litherland and which in consequence are more urgently in need of hospital accommodation. For example, developments taking place or already completed at Netherton, Kirkby, Croxteth, Daysbrook, Fazakerley, Sparrow Hall, and in Litherland itself will in the near future provide a population of some 100,000 persons, and the Board considers that priority must be given to the new hospital at Fazakerley to cater for the needs of that area.
Moreover, a new hospital is urgently required in Birkenhead. More general hospital accommodation is also required for the south Liverpool area and a hospital is contemplated to cater for this need. The rapidly developing area of Ellesmere Port will also require hospital provision in the near future. In addition to all these urgent requirements, the Board has also to bear in mind the urgent need for accommodation for mental health and mental deficiency purposes and for the chronic sick.
The Borough of Crosby adjoins Bootle, and the residents can readily take advantage of hospital facilities available in the north Liverpool area. Bootle Hospital and Walton Hospital are easily accessible, and there is close contact between the Northern Hospital branch of the United Liverpool Hospitals and Waterloo Hospital.
A number of accident cases from the Crosby area go to Bootle Hospital which is recognised as an accident hospital and which receives a large number of casualties from north Liverpool and the nearby dock and industrial area.
In view, therefore, of the existing hospital facilities in the adjacent area to the Borough of Crosby and of the more urgent needs of other areas for new hospital accommodation, the Board regrets that it is unable to contemplate any new hospital developments at Crosby in the near future.
It is, I think, fair to say that residents of the borough do not have to travel unduly far for hospital treatment or, 1199 indeed, as far as is the case in many other areas. My hon. Friend quoted certain statistics which sounded overwhelming, but in fact the average number of ambulance miles per out-patient in Crosby is 6.9, which is precisely the national average. It cannot be claimed that Crosby is exceptional in this matter.
It has been suggested by him that because Waterloo Hospital is not mentioned in the Liverpool 25-year hospital development plan, the further development of Waterloo Hospital cannot be contemplated for the next twenty-five years. I do not think it is right to make so pessimistic an assumption. The Liverpool 25-year hospital development plan has been prepared by a joint planning committee of the Regional Hospital Board, the Board of Governors of the United Liverpool Hospitals, and the University of Liverpool, in order to coordinate the Regional Hospital Board's long-term plans with the proposals for the development of a new teaching hospital.
There are, no doubt, many desirable improvements not mentioned in the 25-year plan which the Board will need to consider, but the Board's building programme at present does not go beyond the year 1959-60. In view, however, of the many urgent claims for hospital improvements which it has to take into consideration, the Board does not think that any major development at Waterloo Hospital is very likely in the near future. It is, however, entirely aware of the inadequacy of the out-patient facilities at Waterloo Hospital and is considering proposals for improving the out-patient and physiotherapy departments and of making some re-adjustments in the operating theatre in the near future. I understand that the sketch plans for the proposed new departments have been prepared and that they have been agreed with the North Liverpool Hospital Management Committee and the medical board of the hospital. Subject to the necessary capital being available, the Board intends to start work on this project in the spring of 1958.
The Walton, Bootle and Waterloo hospitals, all of which belong to the same hospital management committee group, i.e. north Liverpool, to some extent have consultant staff in common. There is also 1200 an emergency bed bureau service linked with the local ambulance service. Above all, the hospitals are not a great distance from each other; they are all within two to five miles.
The responsibility of regional hospital boards in planning the hospital services in their areas is not an easy one. Funds available for capital development are necessarily limited and the board has to make the best plans it can within the limits of the sums allocated from year to year. There are a number of other schemes which the Liverpool Regional Hospital Board considers more urgent than the extension of the Waterloo Hospital. It has come to that view after considering all the hospital needs of its area. I am sure that in doing so it has given full weight to the representations made in the past by my hon. Friend and by Crosby Borough Council. It would be quite wrong on my part to press the Board to assign to any particular scheme a priority which it did not consider justified.
A further point is perhaps worth mentioning. In any one year the Board does not know, nor does the Minister, precisely how much money is to be available during a particular future year. The use which can be made of the allocations for new schemes depends largely on how much is required to be spent in each year on the schemes already in progress. Moreover, development in the matter of hospital requirements is not subject to exact prediction. Unforeseen needs may arise or anticipated requirements may turn out to be more or less urgent than was originally expected. One could not ask the Board to say exactly how soon it would proceed with this scheme which, as I have said, does not rank very high on its list.
To sum up. Within the limits of capital available for development, the matter is in the hands of the Regional Board. It is the responsible body and the best qualified to decide priorities within its area, but in making its plans it will no doubt take into account what my hon. Friend has said so moderately and so fairly tonight.
§ Question put and agreed to.
§ Adjourned accordingly at twenty-seven minutes to Twelve o'clock.