§ Motion made, and Question proposed, That this House do now adjourn.—[Mr. Gibson-Watt.]
§ 8.25 p.m.
§ Mr. A. E. Cooper (Ilford, South)
It is seldom that an hon. Member gets more than two hours for his Adjournment debate, as has happened this evening, but I undertake that I shall take very little more than the normal time allowed on these occasions. My right hon. Friend will be aware that from time to time the Ilford Borough Council and other local organisations have made the strongest possible representations concerning the inadequacy of hospital accommodation in the Ilford, Barking and Dagenham areas, and a conference convened by the Ilford Council requested the opportunity to put a case for the Minister's consideration in February, 1956, but at the Minister's suggestion representatives first consulted the North-East Metropolitan Regional Hospital Board.
In June, 1956, the Chairman and members of the board discussed with a deputation representative of the three boroughs the inadequacy of hospital facilities in those areas, and the board's representatives promised that earnest consideration would be given to the problem in order to achieve some improvement in the very difficult situation as quickly as possible.
Briefly, the case which the board was asked to consider was that the existing hospital provision in the three areas falls so far short of what is needed that the services are stretched beyond their capacity, and, in consequence, large numbers of patients from the areas have to seek treatment in hospitals outside the Ilford and Barking group. This, in turn, leads to the overtaxing of the services in 472 neighbouring areas and in unnecessarily long and expensive journeys having to be made by the patients and their relatives, with an additional financial burden being placed on the ambulance service.
Indeed, for much of the year they have to enlist the aid of their neighbouring hospitals in order to accommodate their surgical patients. In addition, there are virtually no beds for the elderly chronic sick patients. The pressure on King George Hospital, as can be seen from the statistics, is far heavier than average, which creates great strain on the beds and ancillary services and also on the staff, particularly the nurses. In the King George Hospital alone there are no less than 35,000 attendances recorded in the casualty department and the accommodation has recently been castigated in the local Press as a disgrace, but within the limit of these resources the service given by the staff is excellent.
It was submitted that the need for more hospital accommodation in the area is so great that the mere augmentation of existing services would be neither an economic nor a helpful way of dealing with the problem, and it was considered that a new hospital of about 800 to 1,000 beds was the only possible means of meeting the present difficulties. I am the first to admit that, locally, there is a conflict of opinion as to the best means of dealing with this situation. The local practitioners are of opinion that the creation of this new hospital is the only means of dealing with this very serious problem. But the hospital management committee and the local area board are of opinion that an extension of existing services—that is, additional beds both at Barking Hospital and at King George Hospital—would meet the situation.
I am a layman and I am not in a position to pass judgment on the merits of these two schemes, but, on balance, it seems to me that, having regard to the funds which may be available, providing it was done quickly, an extension of the existing Barking Hospital and King George Hospital would meet the immediate situation. I stress the point, however, that speed is of the essence of this matter. We cannot be put off by some hope that in the future, some indeterminate future, we shall be able to deal with this problem. We must tonight have some assurance from the Minister of a date upon which work will be started.
473 The main factors supporting the case for an entirely new hospital are briefly the area and the population served. The population comprises, approximately, 250,000 people, and in this figure is not included the proportion of the population of Dagenham which normally is served by the Barking Hospital and King George Hospital. The existing hospitals in the group comprise the King George Hospital, the Barking Hospital, the Ilford Maternity Hospital and the Ilford Isolation Hospital. As present, the number of beds available in the group for all purposes is 662, but the number of staffed beds of all departments, excluding tuberculosis, infectious diseases, mental diseases, mental and convalescent beds, is 346.
After using the standards proposed in previous planning reports, the board estimates that the approximate number of beds required in the group, excluding those previously mentioned, is 1,051 giving a total deficiency of no less than 705. That is truly an appalling figure. There are approximately 170 beds in the group which can be brought into use immediately, for example, by utilising existing wards now operating for clinic and other purposes, and under the board's long-term developments it is envisaged that an additional 100 beds will be provided at King George Hospital and an additional 200 beds at Barking Hospital, making a total of, approximately, 470 additional beds. Therefore, for general hospital purposes there will still be a deficiency in the group of 235 beds.
The general policy of the board, which the board has approved in principle, is that the construction of a new hospital is not considered the best and most economical way of providing for the requirements of the area, and it has suggested that it is better to increase the number of beds at King George Hospital by additional building, and improving and extending the Barking Hospital.
Ideally these two extensions should be done concurrently, but I am advised that during the time that the extensions were under construction at King George Hospital, it would cause considerable dislocation to the work of the hospital, and for that reason it is recommended that the extensions should commence at Barking Hospital where the space is immediately available. The work can be carried on without any dislocation of 474 existing services, and once this additional facility is provided, the work at King George Hospital can then continue without too much difficulty being experienced.
I have said already that I personally am not in a position to judge of the merits of the two proposals—that is, the creation of new hospitals or the extension of the two existing hospitals. I am very conscious of the great local feeling that there is on this matter, which demands that some additional accommodation be made available immediately, and I emphasise that although in the long-term it would seem that a new hospital may be necessary, immediately on balance it would seem that the extensions may provide a readier solution to our difficulties.
Once again I would emphasise that speed is of the essence of this matter, and I hope that tonight we shall have an assurance from my hon. Friend that funds will be made available for the work to commence without further delay.
§ 8.35 p.m.
§ Mr. Somerville Hastings (Barking)
I am very grateful to the hon. Member for Ilford, South (Mr. Cooper) for bringing before the House this very important question. As the Member of Parliament for Barking, I am constantly approached by my constituents who tell me of the difficulties they have in getting into hospital. When they do get into hospital, they find that it is a long way from their homes, and many of the maternity cases have to go to the East End Maternity Hospital in Stepney, while many general cases have to go to Romford, old people have to go to the Langthorne Hospital, and so on.
On the other hand, I am also grateful to the hon. Gentleman because, as a member of the North-East Metropolitan Regional Hospital Board, I can say that we have been considering this matter for a good many months. The hon. Gentleman referred to a deputation which approached the board. I was one of the representatives of the board who received that deputation. We have given a great deal of consideration to what ought to be done and to the order in which it should be done. The only difficulty, of course, is that the regional hospital board does not provide the money; only the Government can do this.
As the hon. Gentleman pointed out with very great truth, as regards general 475 hospital beds—that is to say, hospital beds for acute and chronic cases, for specialities and maternity cases, but not for infectious diseases, tuberculosis and mental disease—there are at present provided for a quarter of a million people 346 beds. We on the regional hospital board, using ordinary standards which no one can dispute, feel that nothing less than 1,051 beds are necessary. In other words, there is a deficiency in regard to general beds for ordinary cases, excluding those categories I have mentioned, of about 700 beds.
The question is how these beds ought to be provided. In Ilford, there is a very good hospital—the King George Hospital—and I agree with everything that the hon. Gentleman said about the splendid work that is done there. There we have 200 beds, but the site is limited. Another 100 beds could be added, and the out-patients' department, as the hon. Gentleman said, could be enlarged, and, in my opinion, sooner or later that ought to be done. Even the provision of another 100 beds still leaves us 600 beds short, and these ought to be provided somewhere.
At Barking, quite near Upney Station, very central and very easily reached from many areas, there is the Barking Hospital, so far with only some 78 beds. But here is an area of many acres on which a large hospital could be built. We on the regional hospital board have given very great consideration to the best way of carrying this out, and, in my view and in that of a great number of my colleagues, the method to be employed should be as follows.
At first, we should develop the facilities that are immediately available in Barking. Some wards, not of the best type, but reasonably good, are now used for other purposes, such as for recreation clinics and physiotherapy. If about forty more beds were brought into the hospital in this way they would be of very much value. Barking Hospital has practically no out-patients' department. If a large consultative out-patients' department were built in that area it would be needed sooner or later. A good many cases which now have to go to hospital might be seen there, and treatment could be provided.
I feel very strongly that these are the first steps to take. The hon. Member 476 for Ilford, South is inclined to agree with me there. As soon as those facilities had been provided there would be beds to deal with the immediate need. Then it would be possible to add 100 beds, for which there is room on the site of King George Hospital, Ilford.
After the immediate steps which I have described, there would still remain need for many beds. The hon. Member has suggested that 200—I think it would be nearer 600—would eventually need to be added to the small hospital which exists in Barking, the Upney Hospital. Arrangements would have to made in the very near future for the staffing of the proposed consultative out-patients' department at Barking and of the extended hospital with 110 or more beds.
It would be much better if the staffing were carried out from the King George Hospital, Ilford. The treatment of a patient requires continuity. A patient may be treated as an out-patient for a time and may then want to go into the hospital. It would be very much better that he should go into Barking hospital or into the King George Hospital, Ilford, where a more varied type of treatment would be obtainable.
Next is the question of nursing. Many hospitals in the North Eastern Region are understaffed, not for financial reasons, but because of the difficulty of getting nurses. A small hospital with fewer than 100 beds has difficulty in getting permission from the General Nursing Council to form a nursing school, because of the necessity to provide all the facilities and the different varieties of patient that are needed for the teaching of nurses. If a small hospital is associated with a larger hospital, for instance if the small hospital at Barking were associated with the King George Hospital, Ilford, nurses could be transferred temporarily from one to the other and the nursing difficulty would then be very much reduced.
I have had personal experience of that in connection with the teaching hospital at Hammersmith, of which I was chairman for several years. I know that nurses can be obtained for a smaller hospital by temporary transference from a larger one. To get nurses nowadays a school is essential to which probationers may be attracted and trained because trained nurses are limited in number and difficult to obtain. I suggest that the consultative out-patients' department and the 477 extended in-patients' department at Barking should, in the first instance, be associated closely with King George Hospital, Ilford. That would provide staffing, both medical and nursing, for that hospital.
That would be only the first step. It would help to provide for the immediate necessities, but an additional 100 beds at King George Hospital would do more. Certain adaptations could also be made in the Dagenham Hospital, which is now used for tuberculosis cases. There is less call for such accommodation and some of those beds could be used for old people, but that would be a makeshift arrangement. It is essential, sooner or later, to have many more general hospital beds, and the right place for them must surely be at the Upney Hospital site in Barking. I would not say how many are required, possibly 600, but I am hopeful that fewer will be necessary.
If a good consultative out-patients' department is provided many more cases which otherwise would have to go into hospital might be treated at home. There is a general tendency now, where accommodation is satisfactory, to treat more people in their homes if proper facilities for nursing, home helps and medical services can be provided. More cases might be treated at home if a good out-patients' department were available. There will be plenty of time to consider that when the new hospital is started.
No doubt a big hospital could be planned, and plans may exist for a large hospital in the Barking area, but how soon and to what extent it will be completed depend on the funds which can be made available by the Government. I feel very strongly that something should be done at once. There are a quarter of a million people with only one-third of the general hospital beds generally admitted to be needed. I appeal to the Minister to get on with the job and provide the funds necessary to make a start on this scheme so that when I go to my constituency I shall no longer hear complaints by patients that they cannot get into hospital or have to go such long distances from their homes.
§ 8.50 p.m.
§ The Parliamentary Secretary to the Ministry of Health (Mr. Richard Thompson)
When he put down this subject for the Adjourment my hon. Friend 478 the Member for Ilford, South (Mr. Cooper) informed me, in his usual courteous way, of the main heads of the matters which he proposed to raise.
I acknowledge at once the need for further hospital provision in the area. Both the North-East Metropolitan Regional Hospital Board and my right hon. and learned Friend are satisfied that there is need for further development of the hospital services in the Ilford and the Barking area to make good existing deficiences.
Since both hon. Members have referred this evening to the financial aspect of the matter, I ought to say that provision has already been made in the Minister's programme of centrally financed schemes to effect essential improvements. The relevant passage in the Minister's answer to my hon. Friend the Member for Leeds. North-East (Sir K. Joseph) on 6th December, when he announced further major schemes for which the planning is to be completed in 1959–60, was as follows:I am also asking for plans to be prepared…for additional beds at Ilford or Barking, but details…have yet to be worked out with the boards concerned."—[OFFICIAL REPORT, 6th December, 1957; Vol. 579, c. 85.]While on the subject of funds, may I say a word to my hon. Friend the Member for Ilford, South, who was a little apprehensive that if it were eventually decided that the right course was the development of the existing hospitals rather than the building of a new hospital, the cost of the work might have to be found from the local resources of the board. I can assure him that that is not so. We are prepared to accept a number of developments at the existing hospitals for one scheme for inclusion in our centrally financed programme. I want to make that quite clear because I should not want him to think that there was any purely financial impediment involved in the alternative of developing the existing hospitals.
Turning to the alternatives which faced the board, the difficulty, as my hon. Friend fairly said, is to decide whether the additional facilities needed in the area should be provided by the erection of a new hospital or by the development of existing hospitals such as Barking Hospital, King George Hospital, Ilford Isolation Hospital, Ilford Maternity Hospital and Dagenham Hospital.
After a careful review of the available services and the future needs in Ilford and Barking, the North-East Metropolitan 479 Regional Hospital Board, of which the hon. Member for Barking (Mr. Hastings) is a member, have reached the conclusion that, on balance, it would be preferable to develop the existing hospitals rather than erect a new hospital. Their proposals, submitted for the Minister's consideration when he was choosing large schemes for his centrally financed programme, were based on a report by their senior administrative medical officer, to which my hon. Friend referred in his speech and about which I refreshed my mind in advance.
They suggested developments at, first, Barking Hospital and the Ilford Isolation Hospital, and, subsequently, other Developments at Barking and at the King George Hospital, Ilford, from which some patients would have to be removed to new wards at Barking before work could begin.
Alongside all this, as the hon. Members know, there is a site in Loxford Lane, Ilford, which for some years has been allocated for a new hospital in the county development plan. It is very important indeed that we are sure that we have the right solution to this problem before we relinquish this site, as the board has suggested we should do. It is not an easy problem to decide the best way of spending the available resources, having regard to the urgent requirements which undoubtedly exist.
Of course, I fully accept everything that both hon. Members have said about the strong feeling in the borough that the sooner a move forward with these plans can be made the better. That is of paramount importance, and provided that were done it would not matter so much whether it was the provision of a new hospital or the development of the existing facilities. However, the regional hospital board's view, to which we have obviously to attach a lot of weight, is that on balance the advantages lie in the proposal to develop existing hospitals rather than to erect a new one.
It would undoubtedly be many years before a new hospital could be built and the expense of such a project would be very heavy indeed. Expansion of the facilities at existing hospitals could be carried out more quickly and more economically and would provide a much 480 more rapid solution to what is admittedly an urgent problem. Against this, there would be obvious advantages to the area in having a new hospital, but as I said in a matter of this kind we must obviously attach very great weight to the views of the regional hospital board, because it has the responsibility of planning the hospital services in the area and it is in a position to take into account the considerations which have been mentioned tonight.
Before reaching a final decision we have to consider these points. If we are to favour the adaptation of existing hospitals, we must be sure that the expansion of the existing facilities will be practicable on the available sites and that the proposed expansion will be sufficient to meet the need. We are now awaiting further information which the board has promised us, and when we receive this we propose to inspect certain of the hospital sites in conjunction with the board.
May I sum up on this note? My right hon. and learned Friend has not so far reached a final decision in this matter. He is awaiting further information from the board about its proposals. When he receives it, he will have to weigh the arguments for developing existing hospitals against those for building a new one, but I must point out that an entirely new hospital could not possibly be completed for a very considerable time.
One of the factors that will have to be considered is, what is the best way to meet this urgent need? I am sure that the view that my hon. Friend and the hon. Member for Barking have expressed this evening will be taken into full account by my right hon. and learned Friend when he makes this decision in the near future. The undoubted need of the borough for additional beds is fully understood.
I have said a word about the financial question, which I hope will be comforting to my hon. Friend the Member for Ilford, South, and I can assure him that, as far as lies in our power, we will lose no time in pressing on with the decision on which plans must be based.
§ Question put and agreed to.
§ Adjourned accordingly at two minutes to Nine o'clock.