PEEL HOSPITAL, SELKIRKSHIRE (Hansard, 22 February 1962)

§ Commander C. E. M. Donaldson (Roxburgh, Selkirk and Peebles)

I am very grateful for the opportunity, however late at night it may be, to raise a matter of principal importance in its effect both on my constituency and on the one adjacent thereto. Ever since 1951 I have taken an interest in the Peel Hospital, in my constituency, which, in effect, is the general hospital for Roxburghshire, Selkirkshire, Peebles-shire and Berwickshire. Therefore, what I have to say tonight not only affects my own constituency but part of Berwick and East Lothian.

This debate arises directly from the publication of the Hospital Plan for Scotland, which makes no mention, in the forecasts for the South-Eastern Region, of any change in the situation of the Peel Hospital, near Galashiels. I tabled a Question to the Secretary of State for Scotland on 7th February, asking why there was no mention of the Peel Hospital in the forecasted programmes for the ensuing ten years, and if the Secretary of State was satisfied that the present hospital is adequate and up to the standards required in the hospital service. My right hon. Friend the Secretary of State replied that minor works are being undertaken as necessary, and stated his belief that the hospital is providing an adequate standard of service.

In a supplementary question I stressed the unfortunate siting of this hospital and the difficulty of obtaining and retaining staff therein, and inquired as to the 800 possibility of a properly sited hospital for the future. My right hon. Friend replied that he was bound to have regard to the views of the regional hospital board, and mentioned a sum exceeding £230,000 which had been spent on this hospital over the past ten years. My hon. Friend the Under-Secretary of State for Scotland, who is to reply to this debate, has in his possession a collection of newspaper cuttings of some volume from the Border newspapers. I am certain that he should by now be well aware of the disappointment and, indeed, anger of people living in the area encompassed by the Borders Hospital Board of Management.

In brief, Border folk are angry, and it is my duty to make it clear that they are not going to rest content with the present system whereby the Peel Hospital, as to its fabric, is on a basis of "mend and make do". It simply is not good enough for the Borders of Scotland. Dr. Kenneth McLay, the Chairman of the Borders Board of Management, has said this: We are very disappointed, for we were hoping for a new hospital instead of Peel which, with its old wooden wards, is like a shanty town. For some time we have been telling the Regional Board that something must be done, but they say they have no money. Dr. McLay also said: The place is certainly sub-standard. In these conditions I think the work of the medical and surgical staff is outstanding, and I think they merit something better in the way of working conditions. What we desperately need is a new hospital for the Borders, not necessarily at Peel. Most of us think that it would be better to have it in Galashiels for the sake of attracting staff. The Medical Superintendent at Peel Hospital was shocked at the news—or lack of it—contained in the Hospital Plan for Scotland. Among other remarks, in expressing his amazement, he said this: 'Here at Peel the wards need re-roofing, and we will have to have some money spent on the hospital. For instance, we will have to have a spare ward for the patients when the re-roofing takes place'. He went on to state that the Borders Board had been asked to submit proposals for a "make and mend" of the 220-bed Peel Hospital, in my constituency. I understand that the Secretary of State should take heed of the advice of the Regional Hospitals Board, but he should also take heed of the Borders Hospital Board which, after all, has the responsibility for the hospital needs of these four counties. That is what I am standing here to make clear to him. 801 Border people are just not prepared to continue to lake this situation lying down.

Let me be positive. What is really required is a centrally sited hospital completely modern; and, whatever is left out of the present plan, it is high time to be thinking of the present necessities and how to meet those necessities in future. I cannot accept that the buildings of the Peel Hospital are up to modern standards. There is strong evidence to prove my point. I have here a letter from a constituent who was recently discharged from Peel Hospital following an operation. This lady is in fact the matron of another hospital in the Borders. While in Peel she had certain privileges which added to her comfort, but under no circumstances would she consider going back into Peel Hospital and she has increased her private subscription to the Hospital Society against such a thing happening again. This constituent was in Peel Hospital three years ago and it is her view that the conditions have worsened. They have worsened, in her opinion, largely because of the location and lack of amenities for the staff, which is very depleted at present. She states: Nobody had time to wash me after an abdominal operation. I was from the first left to wash myself. In every way the staff carry out their essential duties, but, being a nurse myself. I would say that they have no time to be real nurses, by which I mean giving to the patient that which a nurse gives to her patients". This matron was appalled at the closeness of the beds to one another and the total lack of privacy. She said: The toilets, kitchens and sluices are all gathered at the outside end of the ward and leave very much to be desired. She went on to say: Being placed as I was at the end of the ward at the door I received a whiff of every bed pan that came up. Surely this is both disgusting and disgraceful. Does anyone suggest to me that these conditions represent a standard of capacity and efficiency in a modern hospital? The Secretary of State will long since have received from a number of Border burgh councils resolutions addressed to him. I need not repeat them now, but my hon. Friend must ask our right hon. Friend to read and consider them with some sympathy. I understand that some years ago there 802 was an option on a site somewhere at St. Boswells for a possible new hospital. Am I right in thinking that that option lapsed?

I also ask my hon. Friend if the Department has—or if not, if it will seek—an option on a site for a new hospital in the Galashiels area with a view to the future. A hospital so situated would have great advantages both from the point of view of amenities for the staff and from the point of view of more easy access for out-patients and visitors. People from Kelso have to take three separate bus trips to reach the Peel Hospital—it is a day's journey there and back. A hospital centrally located in Galashiels would be on a line of direct approach by bus routes from all the Border burghs. I urge in the strongest possible terms that such a site should be sought on option forthwith.

In support of this, I have in my hand a letter from the Hon. Secretary of the Scottish Rural Women's Institutes for the Counties of Roxburghshire, Selkirkshire and Berwickshire. The letter represents the strong views of some 3,000 women. Time does not permit me to give the full details now, but the big point they make is the siting of the Peel Hospital and there are five other important points relating to the hospital as it now is. In brief, they are as follows: first, the lack of side wards for seriously ill patients; secondly, the noisy and disturbing apparatus used in the wards, which is due to the first point; thirdly, the beds are too crowded together; fourthly, lack of privacy, sometimes amounting to positive indecency; and, fifthly, a matter to which I have already referred, bad toilet facilities for "up" patients in the women's wards.

There are also other matters, details of which I will send to my hon. Friend, concerning a proposal that in future girls wishing to become nurses must first hold the new Scottish Certificate of Education. The Borders Hospital Board of Management has studied the records of Peel Nurse Training School and an analysis shows that of the nurses successful in the final State Examination, approximately 75 per cent. left school at or before the age of 15 and of the remainder only roughly half attained a proven standard of education equivalent to the new certificate. Surely 803 this must show my hon. Friend that the new qualification is unnecessary. But the most important point about it is that Peel Hospital will be almost without new nurses if this new condition is brought in.

Let me sum up, and reiterate the anger which is felt in my three counties and adjoining. Let me emphasise once more the necessity to plan for a new site for a new hospital, and let me add that whatever the expenditure of £230,000 has achieved in the past ten years, it appears that a great sum of money will be required to maintain even the low standard of the building during the next ten years. It is high time that my constituents and those in Berwickshire had some reassurance from the Secretary of State that their views will be considered and not only the exclusive opinions of the South-East Regional Board, which appears to be remote from the feelings and the necessities of the area for which I have been speaking.

I ask my hon. Friend to be sure of this neither I nor the people I represent will rest content until some positive action is taken in the matter of Peel Hospital.

§ The Under-Secretary of State for Scotland (Mr. T. G. D. Galbraith)

I listened with sympathy to the case which my hon. and gallant Friend the Member for Roxburgh, Selkirk and Peebles (Commander Donaldson) put before the House tonight. We all know the close attention which he always gives to all that concerns his constituents, and it is not surprising, therefore, that he should seek to have a discussion tonight on the future of Peel Hospital.

My hon. and gallant Friend has told us in his usual forthright way of the strong feelings which exist in his constituency, and I can well understand how disappointing it must be to him and to those who live in the Borders to learn that they are not have a new general hospital in the immediate future. I hope, however, to be able to persuade him that this is the right decision, fairly taken, and that, however much we should have liked to meet his point of view, there are other demands on the hospital service Which should have even higher priority than Peel in the great 804 hospital building programme which has just been announced.

As my hon. and gallant Friend knows, the plan covers the ten years 1961 to 1971. In formulating the plan it was first necessary to decide, against the background of the need for hospital services, how much building we could reasonably expect to do during this period. As my hon. and gallant Friend appreciates, hospitals are only one of many services, such as housing, schools and roads, which make considerable demands on the capital investment programme. For the present, therefore, we are planning to spend £70 million on hospital building over the next ten years, but although this represents a very substantial increase on what was spent in the last ten years, it obviously is not enough to replace all the 400 hospitals which exist in Scotland at the same time. Therefore, accepting that even the greatly increased sums available for hospitals are not sufficient to replace everything at once, it is clear that a choice had to be made as to which would go into the plan.

In making a choice three factors had to be borne in mind. The first was the sheer age of the hospital. The second was the extent to which an area was not well served when the National Health Service came into operation. The third was the need to provide hospitals for areas with new and growing populations. I mention these factors because they form the background to the decision taken by the Regional Hospital Board, and they explain the priorities given to certain types of hospital in different areas.

As for age, the biggest decision of all was the decision to replace some of the main teaching hospitals and to make substantial improvements in others. This was a very expensive decision since a new teaching hospital can cost up to £9 million, but it is a decision in which the Secretary of State agrees entirely with the Regional Hospital Board because it is the quality of the teaching hospitals which sets the tone throughout the whole of the rest of the service.

As to areas which were not well served when the National Health Service took over, Fife is one of the worst. For example, there was no sizeable general hospital at all there, and the Regional 805 Hospital Board decided to provide a new one at Kirkcaldy. This process of bringing up what one might call the black areas nearer to the average level has obviously had to have priority over many other things, such as Peel Hospital, and it has obviously used up the money.

There are, also, the expanding areas, and this explains the replacement of Bangour Hospital which, like Peel Hospital, is one of the E.M.S. hospitals. People living in the area may wonder why a decision has been made to replace Bangour rather than Peel, since both are of the same age. A deciding factor was the new development in West Lothian. First there was the new B.M.C. development at Bathgate, and then the decision to build a new town at Livingston.

Given these priorities and the choices—choices made by a Regional Board that represents the whole area—there was no room within the programme for another large new hospital for the Borders.

So far I have been giving the background in explaining the priorities, but now I turn to Peel Hospital itself and I will try to answer some of the questions which my hon. and gallant Friend raised. I should not like to leave any impression that we consider that Peel Hospital is not doing a satisfactory job, for, in common with other E.M.S. hospitals, it has rendered and is still rendering a magnificent service to the people of the area. My hon. and gallant Friend referred to finance. A good deal of money has been spent on Peel Hospital to keep it in reasonable condition, to enable it to undertake new tasks and to improve the working conditions of the staff. Over the last fourteen years about £230,000 has been spent on the hospital, but that figure is only about one-seventh of what a new hospital would cost and, no matter how new a hospital is, money must still be spent on maintaining it. That is often forgotten. My hon. and gallant Friend referred to the lavatories at Peel Hospital. He will be glad to know that a scheme for improving all of the sanitary annexes there is in 806 progress and is well on the way to completion.

Peel is not the only E.M.S. still in use. There are others, for example, the hospitals at Law, Ballochmyle and Stracathro. These, too, have rendered, and are rendering, excellent service. While I concede immediately that Peel Hospital is not conveniently situated for the population it serves, I would resist any implication that the hospital in itself does not provide a service which compares well with the general hospital services being provided in other hospitals in Scotland.

My hon. and gallant Friend raised what is really an ancillary point to do with the educational qualifications for entry as trainee nurses. I will certainly consider what he said. As to the difference of opinion between the Board of Management and the Regional Hospital Board, it is often the case that a board of management will see things from its own point of view while a regional hospital board will take a wider view. I hope, by what I have said tonight, that I have put the problem of Peel in its proper perspective. Three of the Regional Hospital Board's members live within the Borders.

As to the future, all I can say is that, of course, all these E.M.S. hospitals cannot go on for ever. Good though they are and good service though they have given, they will need to be replaced in due course, but the need in this particular case is not such that it can have sufficient priority to merit the treatment my hon. and gallant Friend requires.

I can assure the Regional Hospital Board and my hon. and gallant Friend that my right hon. Friend will certainly look sympathetically at the needs of the Border area when the next stage of the continuing—and I emphasise this fact—hospital plan comes to be considered. When this time comes and an assessment is made of the relative merits, the points that have been so persuasively and forcefully put by my hon. and gallant Friend will be kept very much in mind.