HC Deb 05 December 1960 vol 631 cc1027-34

Motion made, and Question proposed, That this House do now adjourn.—[Mr. Wakefield.]

11.18 p.m.

Mr. Hugh Delargy (Thurrock)

I am grateful for this opportunity to discuss the future of Orsett Hospital in Essex. It is a subject which is causing worry and alarm to everyone who is connected with the hospital.

Orsett Hospital is a collection of old buildings, some of which were built as long ago as 1875. It was not intended to be a hospital. It was a workhouse, a casual ward for tramps, and a police station. Although during two world wars it was used as an emergency medical centre, no attempt was made to adapt it to general medical purposes until 1948, when the National Health Service was introduced. At that time the hospital, such as it was—ancient and inconvenient—was already far too small for the population it was meant to serve. The population then was 70,000. It has increased by more than 50 per cent.; today it is about 108,000. In five years time it will be 120,000.

The hospital is not only too small. It is woefully deficient in all essentials. I could provide the Minister with a long list of its deficiencies, but tonight I will mention only two or three outstanding ones.

There is one operating theatre, and what a grim and dismal place it is! The first time I saw it I was chilled to the marrow, and the doctor who was showing it to me remarked, "It is rather less cheerful than a primitive morgue." Further, it is most inconveniently situated. Persons requiring operations—for example, women in childbirth, housed in another block—often have to be carried through the grounds in the open air, in all weathers, to reach this grim theatre.

The X-ray department is equally bad. There are two units. The main one is, like the operating theatre, most inconveniently situated. The second unit is even worse. It is placed in the day room of a ward, through which walking patients must pass to reach the toilets. If the X-ray set is in use, they cannot use the toilets. If they are already there, they cannot leave them until the all-clear is given by the radiographers.

The staff accommodation is so cramped, mean and uncomfortable that I often wonder why the staff remain there at all. Only their zeal and devotion can explain why the resident medical and nursing staffs submit to these conditions.

Finally, I mention the out-patients' department, which exists, but only just. People are just squeezed in wherever possible, and always in the greatest discomfort.

I am well aware that the Minister understands many of these deficiencies. He and his predecessors have agreed that the hospital should be extended and modernised. Four years ago the then Minister agreed that this scheme of extension and modernisation should be included in the centrally-financed general hospital building programme. During those four years there has been a very long series of negotiations, correspondence and deputations between the management committee, the regional board and the Ministry.

Ten months ago, namely, at the beginning of February of this year, final agreement was reached—at least, we thought it was—about what is described as stage I of the redevelopment plan. Stage I will include an operating theatre, a maternity block, and casualty and radiological departments.

That was ten months ago, but nothing has happened so far. There are plenty of nice designs on the drawing boards, but nothing has happened on the ground. We anxiously ask: how soon will the actual work begin? That is the first question I ask the hon. Lady. I shall ask only one other.

I want to make one final observation about the stages of the redevelopment plan. To divide the work into stages with an abrupt separation between the two, with no link or continuity, seems both illogical and wasteful. One example will suffice to show how illogical it is. In stage I, as I have already said, an operating theatre will be built; indeed, it will be an operating tower, because included in it will be a pharmacy and a central sterile unit. But no mention is made of the ward block. Presumably that will come in stage 2. It seems rather absurd to build this theatre tower without at the same time approving its linking with the ward block, the lifts and the other parts of the hospital. Without this linking with the new ward block it is difficult to understand how the operating theatre will be used at all.

This division into stages is also wasteful in time and money. I hope that this argument will weigh with the Minister of Health, who is said to be very economically minded. I would never argue about the large sums of money spent on the National Health Service. I am one of those who think that not nearly enough money has ever been spent on it. But that does not mean to say that I want to waste money. All the builders and constructional engineers are certain that a huge saving could be made if the whole job were contracted for at the beginning and the actual staging left to agreement between the contractors and the board. There must be continuity, so that the scheme is sensibly planned from the beginning, with the least delay and the greatest saving.

As I said at the beginning, this delay and lack of continuity is causing grave alarm to all those who are interested in the hospital. I have spoken to most of the consultants, distinguished physicians and surgeons, the chairman and members of the management committee, members of the nursing staff, and many patients and others, and they are really alarmed. I hope that I have proved to the House tonight that they have some cause for disquiet. I hope that the hon. Lady the Parliamentary Secretary will give us some assurances, particularly on the two questions I have raised, which I now repeat: first, when will the actual work begin; and, secondly, may we have some assurance that once it is begun it will continue and not be divided into abrupt stages?

11.28 p.m.

The Parliamentary Secretary to the Ministry of Health (Miss Edith Pitt)

The hon. Member delivered some rather severe strictures on this hospital, but I gather from the information available to me that it is by no means adequate for the job it has to do. The full name of the Orsett Hospital is the Orsett branch of the Tilbury and Riverside General Hospital. The Orsett branch at present has a bed complement of 227 beds; the other branch at Tilbury is much smaller, having only 74 beds.

The Ministry has been well aware of the deficiencies at the Tilbury and Riverside Hospital. The Orsett branch is a former public assistance institution—as the hon. Member has said—of which the majority of buildings are outworn and completely inadequate. People of Orsett are being served, and beds are available, although there is an admitted shortage on the maternity side, and the ancillary services are inadequate. Facilities in most departments are grossly inferior, and few of the existing buildings are really worth retention, but there is ample room on the site for the erection of the necessary new buildings.

For these reasons the development of the Orsett branch was early given a place in the list of the major projects to be centrally financed and this was announced by the Minister in December, 1956. Prior to this considerable discussion was necessary on the site of the new development, about whether it should go on the same hospital site, and then followed the detailed discussions on the planning in relation to what was there already.

After discussions with the Ministry's officers at various stages of the preliminary planning, the regional hospital board has proposed a development plan which will convert the Orsett branch into a modern general hospital. This will involve virtually rebuilding it at a cost of over £1 million. It was decided to carry out this major development in two stages. Stage 1 will deal with the priority needs, and will consist of a new out-patient department, a new 60-bed maternity block, and a new accident department; with the ancillary services such as an operating theatre, a radiological department, a central sterile supply department, pathological department, and pharmacy needed to provide an efficient service as soon as possible. In addition, the most urgent need for residential accommodation for doctors and nurses will be met. This includes two bed-sitting hostels for sisters, two nurses' hostels, two doctors' houses and a bungalow for the matron.

The second stage, that is the second hall of the project, will consist mainly of a new ward block of about 200 beds which, with the improvement of those existing wards which will be retained, will provide 344 beds. The present population in the area is 108,000, as the hon. Gentleman said, and it is being catered for without, we hope, too much inconvenience. But it is accepted that the population is growing and the proposed complement of 344 beds has been related to the forecast of a population of 120,000 in the area in 1971. More residential accommodation for nurses and doctors, and the less urgent services will be provided in stage 2.

The hon. Gentleman queried these provisions being divided into two stages. Although we should not necessarily have taken this work up in two stages if we were considering it now for the first time, there were financial reasons at the time which made it necessary and circumstances which justified—and would still justify—the decision. Not only was the money available sufficient only for the more urgent works I have already mentioned in stage 1, but the work had to be planned in such a way that the hospital could continue to function while the building is in progress. Although some extra beds seemed to be inevitable, it was considered that with the development of full out-patient and ancillary facilities, the ultimate need for beds might be somewhat different, depending on the population changes, from what seemed necessary at the time.

Separation of the work into two stages need not cause delay. The site is such that the priority needs could be met first, and this is what is being done in carrying out the development in two stages. The regional hospital board recognised from the outset that the outpatients' department was the most urgent need, and with that I think the hon. Gentleman concurs. Indeed, so much so that the board decided from the beginning to finance this part of the scheme from its own capital allocation. Planning was completed some months ago, and now the board is awaiting tenders. The preparation of working drawings for the rest of the first stage of the development is well advanced. That the board is well aware of the need is shown by the fact that it has given stage 2 of the development first priority on the list of schemes which it has submitted for consideration for inclusion in the Minister's list of centrally-financed projects.

As in all works of this nature, it is difficult, and even misleading, to give a firm date when building work may be expected to start, but the board hopes that it will be possible to start building the out-patients' department towards the end of the current financial year.

Mr. Delargy

When is that—in March?

Miss Pitt

It is in March.

Mr. Delargy

Is the hon. Lady aware that it was the firm opinion of most members of the management committee that work would already have begun last August? That is what we were led to believe, but now it is stated that it will be next March. What is the reason for the delay?

Miss Pitt

There has been considerable discussion on the plans, as I tried to make plain in the earlier part of my speech, to make quite sure that we had the right development of this site, and the out-patients' department is to come first. Work on the rest of stage 1 obviously will be begun later, but the board hopes that it will be able to start some time next year.

Mr. Delargy

That is on stage 2?

Miss Pitt

No, that is stage 1 which the board hopes to start next year. Stage 2 has not yet been accepted by my Ministry for central finance, although the board has put it at the top of the list of priorities it submits to us.

I want to deal with the minor points which the hon. Member raised and of which he kindly gave me notice. One was about the fact that maternity cases have to be wheeled across a yard to the operating theatre. That is so but the situation will be put right when we come to stage 2. The other point was about the X-ray unit which was so sited that people either could not get to the lavatory or, having got there, might be fenced in, as it were, while the X-ray unit was being used. I have also made some inquiries and I am told that it is true that one X-ray unit—mobile and not frequently used I should explain—is sometimes moved to other parts of the hospital and is at present operated in a day room through which patients have to pass to the lavatory. A scheme is in hand, however, for the erection of a temporary building to rehouse this mobile set pending the provision of a new X-ray department, which is part of stage 1. This temporary building should be ready in a matter of months.

There has been delay in this project, but on the general situation, for the benefit of hon. Members interested in hospital building, I say that the general question of hospital planning very much concerns us. We have set up a development unit which is staffed by professional people. They have already prepared plans for hospital units which will be available for use or adaptation by hospital planning authorities. We hope that this will be useful both in the preparation of plans and in our agreeing them and that it may help to avoid delay in future.

In conclusion, it is understandable that the people of Thurrock feel that it is an unconscionable long time before they can see some building work being carried out on their hospital. They are naturally impatient at having to put up with what we all admit to be bad hospital accommodation. In April this year the building works committee of the North East Metropolitan Hospital Board met a deputation from Thurrock Urban District Council. I understand that there was a very full discussion about the hospital and that the board's representatives explained what was being done. It must be remembered that it is in the early planning stages that the shape of the hospital is formed. Errors of judgment at that stage which might be avoided—and I hope have been avoided—by thorough discussion would mar the hospital service for the rest of the long working life of the hospital buildings. So I believe there has been value in this detailed discussion.

There was, therefore, long and detailed discussion between officers of the board and of the Ministry during the early stages of the planning of this hospital at a time when there was a ferment of ideas about hospital planning, including the important part which hospital design plays in avoiding dangers of cross-infection.

Some measure of the change of plans resulting from this may be obtained when I say that the original proposals were for improvements to the hospital estimated to cost about £350,000. The scheme which has now come to fruition is for a largely rebuilt modern hospital at a cost of more than £1 million. We agree that the preliminary planning has taken a long time, but the result, we hope, will be a hospital worthy of the busy developing area of Thurrock.

In conclusion, I should like to pay tribute to the service that the hospital staff has given and is giving with particularly difficult living and working conditions. Great credit is due to the staff and the hospital management committee for the way in which they have made the most of their inadequate facilities.

Mr. Delargy

Will the hon. Lady impress upon her officials the need for continuity in the work once it begins?

Miss Pitt

Yes, Sir. I will do that.

Question put and agreed to.

Adjourned accordingly at nineteen minutes to Twelve o'clock.