§ Motion made, and Question proposed, That this House do now adjourn.—[Mr. G. Campbell.]
§ 10.5 p.m.
§ Mr. J. P. W. Mallalieu (Huddersfietd, East)
The hospital whose affairs I want for a short time to discuss tonight is in my constituency, but covers an area much wider than that, and the problem which I want to raise may apply to many similar hospitals throughout the country. It is the problem of the acute shortage of staff in this hospital, which used to be known as a mental hospital, but which is now quite rightly known solely as a hospital.
I believe that the general level at which the Ministry aims is to have one nurse for five patients. At the moment, in Storthes Hall Hospital we have one nurse for 10 patients. It is not unusual for one nurse to be left at night in charge of two wards, each holding 18 patients, some of them possibly suicidal, and the two wards separated by two flights of stairs. Nobody pretends that this is a satisfactory state of affairs. We know how it has arisen. These hospitals, some of them fairly old, were often built in rather isolated areas. In addition, nowadays there is tremendous competition in terms of jobs from other employers who can often offer as good or better wages in the towns.
Storthes Hall Hospital has been trying its best to get over this difficulty by recruiting in neighbouring villages, and it has run a private bus service of its own in those villages to bring in staff. My information is that that bus service was free until the Ministry of Health stepped in and stopped it, but I am not absolutely certain about that and perhaps the Parliamentary Secretary to the Ministry of Health will let me know.
Unhappily, it has not been found possible to recruit sufficient staff in the neighbouring villages, and so the hospital management committee has been looking further afield, and, in particular, to Barnsley, where there is a possible surplus of women labour. Unhappily, when the management committee began to try to recruit staff there, it found that it was in competition with Huddersfield 480 firms such as Imperial Chemical Industries and Brook Motors, and one or two textile firms, all offering wages at least as good, as well as free transport.
The girls said that they were not prepared to pay 6s. a day—for that is what it would be—on the ordinary bus service to go to work at Storthes Hall. The hospital management committee has, therefore, been anxious to provide a free bus service of its own. To do so, it was prepared to use the two buses which it owns.
I know the area very well and I do not see how Storthes Hall Hospital is to recruit sufficient staff to deal with the existing number of patients unless it can offer the inducement of free transport. The other day, the Parliamentary Secretary told me—and I was glad to hear it—that she was hoping to deal with the problem in part by reducing the number of patients. That certainly needs doing, because the hospital is desperately overcrowded.
However, I am sure that the hon. Lady knows that the amount of reduction of the number of patients which must be achieved before the number of staff comes up to a reasonable ratio is tremendous—about 50 per cent. I am very keen to reduce the number of patients, and the best way of doing it would be to cure them, but that will not be done unless they get the regular care and attention which a full staff could give. I do not know of any plans for another hospital, for example, to reduce the number of patients so that the present staff level becomes at least adequate.
It may be that the Ministry has other plans for increasing the staff as well as for reducing the number of patients. If so, much of what I am saying will fall to the ground, but we do not know of it in Huddersfield, and I would be grateful if the Minister would tell us tonight what specific plans the Ministry has for increasing the staff at Storthes Hall Hospital.
If the Ministry has no such plans, or if the plans prove to be inadequate, I cannot see any possible reason for refusing the plea of the management committee to run a free transport service. I know that there are ideological objections on the other side of the House to running things free, but the party opposite prides itself on not being dogmatic. 481 If it can find no other way of ensuring that the patients of this hospital are properly treated than by providing a free transport service which would increase the staff, it ought at once to say that it will be prepared to agree to it.
§ 10.11 p.m.
§ Mr. Kenneth Robinson (St. Pancras, North)
I hope that the hon. Lady the Parliamentary Secretary will listen and respond to the plea made by my hon. Friend the Member for Huddersfield, East (Mr. J. P. W. Mallalieu) on behalf of the hospital that serves its community. I am sure that the hon. Lady, above all people, does not need reminding of the difficulties which all hospital authorities have in recruiting grades of staff of all types to hospitals for the mentally disordered. This is bad enough in the South of England and Metropolitan regions, but I believe that it is considerably worse in the North of England.
There are many reasons for that, but one is unquestionably the fact that nearly all the hospitals, for historical reasons, are sited away from centres of population and away from most public transport routes. In circumstances like this, I would have thought that it was the obligation of us all, and of the Ministry in particular, to give every reasonable encouragement to the recruitment of staff.
Surely it is nothing short of folly to place deterrents and disincentives in the way of the recruitment of staff. One cannot get people to work in these hospitals for the wages which the hon. Lady's Department is prepared to allow hospital authorities to pay, and then to expect them to pay fares to come from their homes many miles from the hospital.
These objections surely cannot be just brushed aside on pedantic administrative grounds. As my hon. Friend said, in this instance a hospital bus is available. It has a driver. It can be used for this work, and the cost of running a service like this must be almost negligible. This situation is not peculiar to this hospital. It exists in other areas, and I should like the hon. Lady to tell me whether she is satisfied that no hospital management committees run either free or heavily subsidised services for their staff who live some miles away from 482 the hospital. I am certain that this happens in some parts of the country.
This is a reasonable request. Like my hon. Friend, I do not see how a hospital like the one to which he referred will get the staff it needs unless it goes out of its way to make it not only possible, but easy, for the staff to work there. My hon. Friend said that firms like I.C.I, paid wages as high as the hospital could offer. My guess is that I.C.I, offer considerably higher wages. If the hon. Lady simply says that under the present practices, or under the present administrative arrangements within her Department, services of this kind cannot be sanctioned, I ask her whether she does not think it time that those administrative arrangements were reviewed.
§ 10.15 p.m.
§ The Parliamentary Secretary to the Ministry of Health (Miss Edith Pitt)
As the hon. Member for Huddersfield, East (Mr. J. P. W. Mallalieu) said, Stortes Hall Hospital is the largest psychiatric hospital in the Leeds Hospital Region and, again as he said, its comparatively isolated situation is one of the main causes of its staffing difficulties. When it was built in the old days, in a remote district—as was the pattern then—I do not think that anybody foresaw that in modern times this might produce difficulties which would mean that we were unable to recruit the number of staff that we would like. I should explain that although most patients come from the Leeds Region the hospital serves a wider area. It serves an area around Barnsley, which is in the Sheffield Region, and a number of patients come from that area.
I need not emphasise that the Leeds Regional Hospital Board is very conscious of the problem of staffing at Storthes Hall. Over the years the hospital management committee has made intensive efforts to recruit more staff, but it is difficult to attract and retain staff. As Storthes Hall is in a green belt area, any expansion of the local population is unlikely and we cannot look for help in that direction. Because of its isolated position, the hospital has to draw staff from the Huddersfield County Borough and the small scattered townships in the neighbourhood, such as Kirkburton, 483 Shepley, Shelley, Thurstonland, Stocks-moor, Farnley Tyas, and other small areas.
The population of the area, in which there is a high level of employment, is considered by the hospital board to be insufficient to provide the number of persons interested in mental nursing which are needed adequately to staff a hospital of this size. As the hon. Member said, competition from light industry and the textile mills for the services of unskilled staff accounts for the hospital's inability to attract orderlies and porters who could relieve nursing staff on non-nursing duties.
I can assure the hon. Member that the management committee has not limited its efforts to recruit staff to Barnsley and the neighbouring areas. In fact, its efforts have been extended to other parts of the country. Although, in the twelve months ending 30th September last, there was a welcome increase in the number of student nurses and nursing assistants, the total staff remains below the number which the management committee considers it needs. It is regrettable that Storthes Hall has not been able to secure its share of the increases in whole-time trained staff which have been enjoyed by psychiatric hospitals as a whole in recent years. Due to this staffing situation it has not been possible to begin the introduction of an 88-hour fortnight for the male staff.
Because of the difficulty of introducing the 88-hour fortnight, and because we realise that this is an exceptionally difficult place to staff, the Ministry has endeavoured to assist the management committee in its efforts to improve the staffing situation by recruiting more male nursing assistants, by giving the committee authority to fix men's starting pay up to three increments above the minimum of the scale.
The hon. Member said that he did not know of any other plans to alleviate this difficult situation. It is important to put on record not only the situation in respect of transport but in connection with what is being done in other directions, and the action being taken to reduce the load on Storthes Hall.
The Leeds Regional Hospital Board has recognised that because of the continuing difficulty of staffing the hospital, 484 measures to reduce the number of patients must be adopted, and it has been examining with the Sheffield board what it could do by these means to reduce the pressure on the staff at Storthes Hall. The Sheffield board has agreed to transfer to hospitals in its region about 60 patients from that region. Some are to be transferred at once, others within twelve months. The Leeds board intends to reduce the number of patients at the hospital and is considering ways of achieving this. That is the short-term plan to try to relieve the pressure.
Turning to the long-term picture, last January my right hon. Friend authorised the board to complete the planning of a major scheme for acute psychiatric and geriatric beds at Huddersfield and the sketch plans for the scheme are being examined by my Department. These psychiatric beds will take some of the load off Storthes Hall. In the Sheffield region sketch plans are being prepared for the first phase of a new psychiatric hospital at Crookhill Hall, between Doncaster and Rotherham. These steps are being considered now and other measures are planned to come into effect when the building schemes are completed, which will do a great deal to relieve the staff at this hard-pressed hospital.
I turn to the suggestion made about the provision of a free bus service between the hospital and Barnsley. Let me say at once that there are no proposals by the hospital management committee on this matter before my right hon. Friend. Non-resident staff in the hospital service generally are expected to make their own travelling arrangements, at their own expense, to get from home to the hospital where they work. It is only where there are exceptional recruitment difficulties that hospital authorities provide special transport to hospitals which are isolated and badly served by public transport.
This transport is not free. As I explained to the hon. Gentleman in answer to his Parliamentary Question earlier, senior staff pay the cost of the journey and junior staff pay the equivalent of the public transport fare within a maximum of Is. a day. The hon. Gentleman asked me to state from what date this had operated, as he thought that earlier it had been a free service. 485 I am advised that the hospital management committee decided, on the advice of my Department, to introduce a maximum charge of Is. a day in November, 1960.
The hon. Member for St. Pancras, North (Mr. K. Robinson) invited me to say that there were hospital management committees running a free or heavily-subsidised transport service. To the best of my knowledge there are no hospital management committees running a free service of this kind suggested by the hon. Gentleman. I think that there are probably some instance where the hospital management committee is providing a service, although not for the whole journey. Where a long journey is involved members of the staff are expected to pay their own transport fares, but where, in the latter stages, the hospital is so remote that there is no public transport, I believe that sometimes arrangements are made to take the staff on the final stages of the journey to the hospital.
§ Mr. J. P. W. Mallalieu
Suppose those efforts to reduce the number of patients do not bring the staff ratio to patients to a reasonable level. Is there anything which would prevent the hospital management committee from running a free service if it cannot get staff otherwise?
§ Miss Pitt
It would certainly need to seek the consent of my Department. I want to emphasise very firmly that the hospital management committee has made no approach to my Department in this matter. It would be quite wrong in principle for hospital staff to be provided with transport wholly at the public expense when others have to meet their own travelling costs in full.
At Storthes Hall there is already a hospital bus service, as the hon. Member said. It is used to bring staff in from nearby villages where there is no public transport. Staff are charged Is. a day return fare for the journey from some villages and 6d. a day from those which are nearer to the hospital. Although some local firms, I understand, find it worthwhile to provide special transport from Barnsley for their staff—but not always free of charge—the hospital management 486 committee has not made any proposals to run a bus to Barnsley because, I understand, it does not think such a service would materially improve the staffing position. Moreover, when previously it considered the matter, the committee was reluctant to risk discontent among existing staff by giving new recruits from Barnsley special travelling facilities while leaving others to continue to meet their own travelling expenses.
I should like to emphasise—contrary to what the hon. Member says, that the hospital management committee was anxious to provide this bus service—that it certainly has not made any proposal to introduce such facilities. The committee and the hospital board know that we shall be prepared to consider any practicable and justifiable measures which might help them in their difficulties. We cannot, however, hold out any hope of a free hospital bus service. Even if, notwithstanding their doubts, the hospital management committee proposes to run a bus to Barnsley on the basis that staff using it would pay a Is. a day, we should need to look at the proposals very closely. We should want, for example, to see whether the number of staff to be carried justified the cost and to be sure that there was no risk that such transport would merely draw staff away from hospitals in or near Barnsley which themselves are experiencing staffing difficulties.
As I said, we shall certainly look at such a proposal if one is forthcoming, but it is not just a question of transport which is the problem here. It is a problem of an isolated hospital which finds it extremely difficult to recruit staff. The board, the hospital management committee and we at the Ministry are aware of the difficulties. Incidentally, I should like to pay tribute to those members of the staff who are carrying on. We are most anxious to keep them. I think one of the practical ways to help is to reduce the number of patients there. I hope that what I have said will show the hon. Member that we have this very much in mind and in whatever we can help we are willing to consider it.
§ Question put and agreed to.
§ Adjourned accordingly at twenty-eight minutes past Ten o'clock.