ROYAL FREE HOSPITAL, LONDON (Hansard, 20 February 1959)

§ Mr. Michael Cliffe (Shoreditch and Finsbury)
Considerable local anxieties are felt about the proposed closure of the Royal Free Hospital in Liverpool Road and the Garrett Anderson Hospital. The Garrett Anderson Hospital is a teaching hospital for women. Some sick people, particularly women, like to go to lady doctors and to feel that the staff around them is composed mainly of women staff nurses. While we may not consider that this is an important point, to people who feel that way when they are sick it means a tremendous amount to them.
I am particularly concerned with the Royal Free Hospital. Local interest in this matter is extended to almost all sections of the community. The Shore-ditch and Finsbury Labour Party and both councils, which consist of both Labour and Conservative members, have passed resolutions, and, in addition, a questionnaire was submitted by the medical officer of health to twenty-one local practitioners, seventeen of whom replied, which I would say is a record. The fact that seventeen people out of twenty-one replied is an indication of the tremendous amount of interest which they are taking in this matter.
In addition to expressing anxiety regarding the proposal to close these hospitals, the seventeen practitioners who replied to the questionnaire referred to the shortage of hospital accommodation in the area and to the fact that patients must go a long distance in order to find such accommodation. While it may be administratively convenient to transfer these hospital services to a site at Hampstead, the decision to do so takes no account of the human element which is involved; and it would seem that no 780 attention has been paid to the economics of the matter. It may be considered a useful idea to put a hospital upon the perimeter of London, but a number of problems will arise.
The Minister will appreciate that people develop a certain faith and confidence in a particular hospital, and when they are desperately ill and are patients in the hospital that confidence may assist their recovery. In my own constituency I have never heard a hospital mentioned other than the Royal Free Hospital and Barts. Another important matter is that hospital patients should be able to receive visitors. This proposal to remove these hospital services to Hampstead will result in my constituents who wish to visit patients in the hospital having to pay fares amounting to 2s. 6d. from Finsbury and a little more from Shoreditch. Regular visits by, say, two members of a family would involve an expenditure of about 30s. a week or even more, and that is a considerable sum of money for members of a working-class family to provide. A great many of my constituents belong to the working class. This, I believe, is a further consideration to be taken into account.
The Royal Free Hospital has no more than 250 to 300 beds for in-patients, and it is therefore suggested that it cannot meet the needs and requirements of a teaching hospital. I would say very definitely that I have examined this carefully with people whom I have come to regard as pretty expert on matters of this kind, and I am assured by very reliable sources that, provided the Minister were prepared to help, to develop the site where destruction was caused as the result of enemy action, accommodation could be provided for at least another 250 or 300 beds, which would mean, of course, that there would be between 500 and 600 beds for in-patients there. While neither the Goodenough nor the Gray-Topping Reports considered that to be the minimum number for a good teaching hospital—they thought the minimum number should be 800—nevertheless, that number would go a good way towards it.
In Liverpool Road we have a maternity hospital and a children's hospital, and I would say that at present there is there a serious waste of ground. It is more than three and a half acres in extent, and 781 there are straggling buildings all over the place simply crying out for modernisation and improvement. I believe that, provided that the Minister would be prepared seriously to consider the need for retaining hospitals where they are at present, arrangements and improvements could reasonably be made there to allow accommodation for double the number of patients who can be taken in there at present.
In anticipation of this point being made to me by the hon. Gentleman in reply, for I think he is likely to make it, I will make it now, and that is the problem of staffing and accommodation. I am not in a position at this stage even to suggest what possibilities exist. I had hoped to be able, as the result of efforts which I have made over the last few days, to say something a little more positive in connection with the position.
However, I would say that there is opportunity of providing accommodation for, roughly, from 300 to 400 staff, and in addition an excellent assembly hall. If we could take advantage of the possibilities for development which could take place at Liverpool Road and also at the Royal Free Hospital, and—I will not say by ingenuity—by careful examination of the area provide this accommodation and the assembly hall, I think we should achieve a development in an area where such an achievement is more possible than it is in any other part of London at present.
I say that for these reasons. I have read these Reports, and each of them has come to this conclusion, that what is required more than anything else in an area if it is to supply the necessary facilities is that it should be easily accessible by road and rail and that there should be main line termini. All these facilities considered ideal exist in that area.
It is proposed to close the hospital because there has been a decline in the population of the Central London area. I do not deny that there has been a decline, but I submit that it has not been serious. At the time when the Reports to which I have referred were concluded, it was generally accepted that there would be a dispersal or redistribution of the population out of Central London, which would have meant a very serious reduc- 782 tion of the local population. It was even suggested at that time that Holborn would be used entirely for commercial purposes but, since then, a number of housing schemes have been carried out.
I do not propose to quote from an analysis of the annual figures relating to the hospital since 1953, but I assure the House that what I have said is absolutely correct and that the figures are available. The number of new out-patients using the casualty department in 1958 was 17,583, and the number of visits to the department 105,407. These figures exclude entirely all V.D. patients and dental patients. It might be of interest to the House to know that the hospital is in an area where more accidents occur than in any other part of London. The fact that the area is adjacent to main line stations and that it covers Islington, Finsbury. Shoreditch, St. Pancras and Holborn means that a minimum of two million people come in to it every day. As a result of the ever-increasing daily influx of people, the accident figures in the area are very high.
I want to give a little time for my hon. Friend the Member for Holborn and St. Pancras, South (Mrs. L. Jeger), who particularly wants to speak on this subject, and for the Parliamentary Secretary to the Ministry of Health to reply. Therefore, I will content myself with a final reference to Bart's Hospital which has been suggested as an alternative. I want to make it clear that I have the most reliable information that that hospital's out-patients department is stretched to its utmost capacity and that there are at present 1,300 people on their waiting list, of whom at least 5 per cent. are considered to be urgent cases which should be dealt with immediately. I hope that I have said sufficient to support my plea to the Minister that he should reconsider the proposal that these establishments should be moved out and that at least should give some consideration to the points which I have been able to make.

§ Mrs. Lena Jeger (Holborn and St. Pancras, South)
It would be a discourtesy to the Minister for me to do otherwise, owing to shortness of time, than to associate myself with the anxiety felt by my hon. Friend the Member for Shoreditch and Finsbury (Mr. Cliffe) in this matter.
783 I welcome the news that London is to have a new teaching hospital in Hampstead, but I beg the Minister to consider whether this automatically means the closing of the other buildings. I hope the hon. Gentleman will give us an opportunity to meet him in order to put forward suggestions as to a possible way in which our apprehensions could be met. No Minister can persuade me that there are enough hospital beds in Central London. The wife of a general practitioner could tell the Minister a great deal about the number of hours' sleep lost in the homes of doctors in the neighbourhood in fighting desperately to get very ill people into hospital. So we must work on the basis that we need more beds, not fewer.
As regards the Elizabeth Garrett Anderson Hospital, I hope the Minister will be able to ensure that it is preserved with its separate identity. It is not only a milestone in the history of the fight of the medical women of this country for professional recognition, but it meets the need of many women who feel unable to go to our big teaching hospitals for an intimate examination at which they may be surrounded by hordes of young men students. This is a very real problem to many people, to which I am sure the Minister will be sympathetic.
I know the hon. Gentleman appreciates the large daytime population in the area and that over half the admissions to the Royal Free Hospital, Grays Inn Road, are emergency admissions, and that the out-patients department is near the main line termini. If we all put our heads together, I am sure we can find a use for the existing buildings which would allay all our anxieties, in which case we could look forward all the more to what we hope will be a wonderful new hospital at Hampstead.

§ The Parliamentary Secretary to the Ministry of Health (Mr. Richard Thompson)
I recognise the great constituency importance of this matter to the hon. Member for Shoreditch and Finsbury (Mr. Cliffe), and I am glad he has raised it because it may perhaps help him if I can clear up one or two misconceptions in the course of my remarks.
The decision to rebuild the Royal Free Hospital at Hampstead on the site of the 784 Hampstead General Hospital and the North Western Hospital adjoining dates back to the end of the war period and was founded largely on the recommendations of the Goodenough Committee on Medical Schools, which reported in 1944, and the London Hospital Survey of 1945. At that time it was recommended, broadly speaking, that certain teaching hospitals should migrate from Central London. This recommendation was made in view of the likely decline in population—there has been some decline, though I do not make too much of that point—and in view of what was considered to be the over concentration in the London area of medical schools, with their associated hospitals.
With the setting up of the National Health Service in 1946, the group of hospitals we are discussing this afternoon—by which I mean the Royal Free in Grays Inn Road, the London Fever, the North Western, the Elizabeth Garrett Anderson and the Hampstead General—were designated as a teaching group in 1948, in consultation naturally with London University, with the long-term aim—I stress that—of rebuilding the Royal Free at Hampstead.
This decision was not a light one. It was not hurriedly or carelessly taken. It was not taken because it was thought that it would be nice to have a hospital at Hampstead. There is one there already. It was taken after a great deal of thought by the responsible authorities who have to plan our hospital services to give the maximum benefit to the community.
The general proposal, as I have mentioned, was agreed in principle by the board of governors, the North-West Metropolitan Regional Hospital Board, and, very important, the University Grants Committee. When the new hospital has been built—there we are talking a long way into the future—the intention ultimately—I stress ultimately",—is to close the Royal Free Hospital, the London Fever Hospital, the Elizabeth Garrett Anderson Hospital and the New End Hospital at Hampstead.
It is the latter part of this scheme which has aroused controversy and which is really the subject of the debate. The London Local Medical Committee has welcomed the rebuilding at Hampstead, but in addition to that it would prefer, 785 as the hon. Member said, the retention of the old Royal Free building, if necessary no longer as a teaching hospital, the Elizabeth Garrett Anderson Hospital and the London Fever Hospital. In other words, it is inclined, at present at any rate, to want both the new hospital at Hampstead and the continuing use of the existing buildings.
On 19th November at the headquarters of the British Medical Association representatives of the general practitioners in the area and the London Local Medical Committee discussed the problems arising in central London following the proposed removal of the Charing Cross Hospital to Fulham—that is another example of the policy of moving a teaching hospital out of the centre of London—and the Royal Free Hospital to Hampstead. It was agreed at that time that the problem would need a great deal of further study but everybody realised that as the proposed closure was several years distant further discussion ought to be deferred until the future needs of the area took shape and were apparent to everybody.
In considering the effect on the Finsbury area, which is, of course, of great importance to the hon. Member, it ought to be remembered that the Royal Free Hospital, because it is a teaching hospital, serves a much wider area than the locality where it is situated. Being a teaching hospital, it cannot be, and is not, restricted to local patients only. Many of the people it now treats are unquestionably not local residents. Equally, I have no doubt that when it goes to Hampstead it will still draw off some of the hon. Member's constituents.
We have also to think of such factors as future population trends and the development which is taking place, and will continue to take place, of National Health Service hospitals on the periphery of London. Taken over a period of a few years, this may throw up a very different pattern of hospital need from the one that we look at today. I must 786 say that Finsbury can be expected to benefit from the other hospital developments in London, which will certainly not stand still over the period of years I have in mind.
Perhaps I could say a few words to the hon. Lady the Member for Holborn and St. Pancras, South (Mrs. L. Jeger). I have noted very carefully what she and her hon. Friend have said about the special position of the Elizabeth Garrett Anderson Hospital. I assure her that no final decision would be taken in this matter without the fullest consultation with the teaching group and the regional board. I hope that is fully understood.
It is too early now to make hard and fast decisions about ultimate closures. The future pattern of services must involve very close co-ordination of the services of the North-West and North-East Metropolitan Regional Boards, the board of governors, and the neighbouring teaching hospitals, and, of course, further consultation with the London Local Medical Committee and representatives of the general practitioners. If all goes well, we should make a start on the Royal Free Hospital in 1960–61. As I have said, however, the project will take several years to complete. It is complicated, because the building will have to go on while the hospital is actually continuing to give full service to patients, so that it will not be a quick or easy operation.
I hope I can reassure the hon. Gentleman that it is far too early now to be thinking in terms of taking final decisions on closures. We have to indicate a general policy to be followed. It is a policy which has been arrived at after very great thought and discussion, but our minds are not closed in this matter. We must see what progress we make and what we find the needs of the future turn out to be.