HC Deb 04 May 1962 vol 658 cc1449-60

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

4.2 p.m.

Mr. Walter Edwards (Stepney)

I wish to tell the hon. Lady the Parliamentary Secretary to the Ministry of Health, who obviously is to reply to what I have to say this afternoon, that the main reason why I have asked for this Adjournment debate is because of what is contained in the Blue Book entitled "A Hospital Plan for England and Wales", particularly on page 109, which deals with a children's hospital in my constituency. That hospital is the Queen Elizabeth Hospital for Children, Shadwell, E.1.

In the Blue Book this is the only hospital under the North-East Metropolitan Regional Hospital Board which it is suggested must close shortly. The Report makes various suggestions about other hospitals under that board, but nothing so drastic as this. I do not know if the hon. Lady knows, but it is a well known secret that the North-East Metropolitan Regional Hospital Board has been trying for years to close this children's hospital in the same way as it closed a hospital very close to it in Wapping a few years ago, the St. George-in-the-East Hospital. I wonder whether the personnel of the North-East Metropolitan Regional Hospital Board feel that there should be no hospitals for the people living in Wapping, Shadwell and Limehouse. Perhaps the hon. Lady will tell me how many hospitals have been closed in the North-East Metropolitan Regional Hospital Board's area since the passing of the National Health Service Act. Let us see whether they are concentrating on closing hospitals in East London.

It is only because the hospital management committee, which appears to have more sense than the regional board, has been objecting to the closing of this hospital for the last four years that it has remained open. The reason that the hospital management committee is objecting to the closing apparently is that it wants to be satisfied that when this hospital is closed there will be sufficient accommodation for nurses who have to be transferred to the Hackney Hospital as a result of the closures. No satisfaction has been given to the hospital management committee in that respect. But now we have more or less a demand by the experts who have drawn up the hospital's plans for the Ministry of Health that the hospital should shortly be closed. Perhaps the hon. Lady will tell me exactly what is meant by "shortly". Will it be a week or a month, or five years or ten years? With such announcements we never know exactly what is meant.

When a statement such as this appears in a Blue Book it takes away the incentive of the people who are employed in a hospital and makes the situation very difficult not only for those working in the hospital but for those who have to send their children to the hospital for care and attention. I do not know what the Ministry will do about this plan. I suppose that at the moment nobody knows. But after the experience of the St. George-in-the-East Hospital in Wapping, we know that if the North-East Metropolitan Regional Hospital Board says anything at all about closing the hospital, the Ministry will immediately jump at the opportunity of closing it.

I understand that in this case the Stepney Borough Council has already opposed all ideas of closing this hospital following what has been read in the Blue Book on hospital plans for England and Wales. I agree that Ministry officials, who are very kindly souls, have said to the Stepney Borough Council, "You need not worry. We shall consider your representations and consult you before we do anything about it". But I am going back in my mind to the period before the hon. Lady was in the Ministry of Health, and I hope that she will bring about some change in the Ministry's ideas about consultation. When the proposal was made to close the St. George-in-the-East Hospital, the Minister of Health went as far as to come to Wapping with me and two representatives of the regional board to see the area in which the hospital was situated and for me to explain exactly what took place there and how difficult it would be for the people in the area if the hospital were closed. He not only did that, but he received representations against the closing from the Stepney Borough Council, the Health Committee of the London County Council, No. 5 Divisional Committee of the London County Council, the London Executive Committee of the Health Service, the London Trades Council and trade unions. After all these representations, the hospital was closed.

It will be no good the hon. Lady telling me this afternoon that the Ministry is prepared to reconsider this demand on the part of the proposers of the Hospital Plan and the board to close the hospital. It is no good holding out any hope that we shall get any results from representations. It is nothing but a lot of nonsense to invite interested parties to make representations against the closing of this hospital, because the Ministry's mind is already made up. It is made up by the regional board and by the Hospital Plan.

This is the second Stepney hospital to be closed since the National Health Service Act. The people in this area, the southern area of Stepney—Wapping, St. Georges, Shadwell and Limehouse—will have nothing when this hospital is closed, whereas before the passing of the Act they had two hospitals. They have to pay higher National Health contributions, but the Ministry and the regional board tell them, "It is all right. You have nothing to worry about. You can go to another hospital".

Do these most experienced persons ever take into account the incomes of people who have to go to these hospitals? Do they know how much it costs in fares to go from Wapping to Mile End Hospital, for example, because very few of these people can go into London Hospital because that caters for people coming from Essex? It costs a great deal in fares, time and inconvenience to a sick person. Neither the Ministry nor the regional board has done anything to overcome the difficulties created by the closure of the St. George-in-the-East Hospital. They will do nothing at all if eventually they agree, as I am sure that they will, to the closing of this hospital in Shadwell.

Have they thought about this? Why should poor people, old-age pensioners and people on low incomes be forced to travel farther and farther to receive hospital treatment which they were able to get nearer at hand twenty or thirty years ago? Is this what is called a National Health Service? Hospital facilities are being taken away. If that is what a National Health Service is, I do not know where we are getting to. On this occasion the Ministry must pay far more attention to the needs of the people than it did when St. George-in-the-East was closed.

If the Ministry and the regional board desire to take these services away from the people in the southern half of Stepney, is it not possible, if they have a case for closing a big building like a hospital, for them to provide some service within the area to prevent these people having to pay these high transport charges and incur the inconvenience which they will have to incur as a result of the hospital being closed?

Is it not possible to replace it with something? I must be careful what I say now, but I understand that when the closing of the St. George-in-the-East Hospital was suggested by the North-East Metropolitan Regional Hospital Board, the Ministry expected some sort of clinic to be put in its place. But nothing happened; the hospital was simply cleared out. We have enough bombed sites and bare sites in Stepney without the Ministry making more. When the St. George-in-the-East Hospital was closed by the board, with the consent of the Minister of Health of the day, it was just left empty, and the children in the neighbourhood smashed every window in it. No thought was given to redeveloping the site. The board just said, "Shut the hospital, stop the people going in, and let it go to hell."

If the worst comes to the worst, and even if the people at the Ministry of Health are no more sympathetic than were those in charge when the St. George-in-the-East Hospital was closed, will the Minister tell the board to do something? In any case, as I said at the time of the closing of the St. George-in-the-East Hospital, nine out of ten of the board members do not know the first thing about East London. They come from Clacton and all over Essex, trying to get new hospitals for that part and, at the same time, supporting any closing of hospitals in my part.

It is about time that my people got some consideration from the board and from the Ministry, and I hope that the hon. Lady will assure me that if representations are made by interested parties—and we are told that they will be invited—those representations will be considered, and not thrown into the waste-paper basket as they were before. I hope that every interested party will be allowed to put its case against the closing of yet another hospital in Stepney before action is taken.

4.18 p.m.

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

I must make it clear from the outset that my right hon. Friend has not yet finally decided the future of the Queen Elizabeth Hospital at Shadwell. It is true that closure is foreshadowed in the Hospital Plan but, as paragraph 49 of that Plan makes abundantly clear, the final decision can be made only after consultation with interested bodies.

My right hon. Friend is aware that the North-East Metropolitan Regional Hospital Board has it in mind to propose the closure of this hospital. I think that the hon. Member for Stepney (Mr. W. Edwards) knows—indeed, he has said so this afternoon—that when it was proposed to close St. George-in-the-East Hospital, opportunities were made for representations to be made, and there will be an opportunity for all those interested to make their views known about this present proposal—

Mr. W. Edwards

But are they to be ignored, as they were ignored before?

Miss Pitt

I do not accept that they were ignored. I have not looked at the history. As the hon. Gentleman mentioned, I was not at the Department at that time. I am sure, however, that they were given full consideration and I can say to the hon. Gentleman today that I am equally sure that such representations as are made will be very fully considered by the regional hospital board, which is the planning authority for this area. It is very important both that representations should be made and that they should be considered. My right hon. Friend will certainly take all representations into account before making his decision.

I may be asked, in view of this, why it was necessary to make the forthright statement in the Hospital Plan that it will be possible to close the branch of the Queen Elizabeth Hospital at Shadwell shortly. The answer is that a plan of this nature must make forthright statements of the main lines of policy if it is to be a realistic basis for planning. Only by this means can it be an effective stimulus to honest and lively discussion. This debate is an example of what can and should be happening to help us to make this bold plan really work.

Although my right hon. Friend has not yet received formal application for approval of the closure of this hospital, I think it right that I should make a few comments on the known facts which he will have to take into account if the regional hospital board makes a formal approach to him. The hospital has a long and honoured history. The East London Hospital at Shadwell was first started in 1868 by a brilliant young surgeon called Nathaniel Hekford and his wife. They took over a loft of a sail maker's warehouse in the Ratcliffe Highway not far from the site of the present hospital.

Having used all their own money in providing treatment for poor sick children in that part of East London between Limehouse and Tower Bridge, they had to face the threat of it being closed down. The hon. Gentleman may feel that there is an historical parallel here but, as I hope to show later, the present threat, as he no doubt feels it, arises from different and more honourable reasons.

On this occasion Charles Dickens came to the help of Dr. Nathaniel Hekford. He passed the building while looking for local colour for one of his books. He was told about the financial predicament and he immediately launched a public appeal which was most successful. Dickens wrote two articles about the hospital; one, in the typical emotional tones of the literature of the time, was called "Star of the East" and, in the other, he told the story of Nathaniel Hekford and his own interest in the hospital. He wrote I felt as though the child implored me to tell the story of the little hospital. Laying my world worn hand upon that little unmarked clasped hand at the chin I gave it a silent promise that I would do so". It is not surprising that Dickens got the money for the Hekfords. The appeal was, in fact, so successful that not only were the Hekfords able to continue their fine work, but the site of the present hospital was bought and a new hospital built. The hospital has continued its work on this site for more than eighty years. In 1932 the title was changed to the Princess Elizabeth of York Hospital for Children.

Many famous doctors and nurses have served on the staff. Many thousands of patients have received treatment. In the hospital world the word "Shadwell" has always conjured up a picture of a busy little hospital where excellent work was being done for children in East London and where hundreds of doctors and nurses have acquired specialised knowledge of children's diseases.

In the 1930s it was apparent that the hospital ought to be rebuilt, but it was decided not to build in London but to have a new "country hospital for town children" at Banstead in Surrey. Banstead was built and is actively carrying on its function as a country hospital for town children. But war and subsequent events caused the various governing authorities to retain Shadwell in its present form. In the general interests of East London's sick children, it was decided to amalgamate the Queen's Hospital in Hackney Road with the Princess Elizabeth Hospital at Shadwell as one organisation. In 1942, an Act of Parliament established what is now the Queen Elizabeth Hospital for Children. The three parts of the hospital—Hackney Road, Shadwell and Banstead, together with a convalescent home at Bexhill—are now administered by the Queen Elizabeth Group Management Committee.

I have mentioned the history of the hospital to show that my right hon. Friend has a very acute sense of the fine traditions of the hospital and the affection which it must obviously hold for the people of East London. It is a fine example of the philanthropy and self-help which was characteristic of social work in East London, but I am sure that the hon. Gentleman himself will agree that East London is a very different place now from what it was in the period I have described.

Mr. W. Edwards rose—

Miss Pitt

No; I cannot give way because I have a lot to say, and the hon. Gentleman took his full time.

Mr. Edwards

I do not agree with what the hon. Lady said.

Miss Pitt

I hope that the hon. Gentleman will agree that the children of East London today are as healthy and bright-eyed as children of other areas.

Mr. Edwards

Of course, but there are as many children there now as there were before.

Miss Pitt

No, that is not correct, as I shall explain. The children of the East End have their ailments and accidents just like children anywhere, but they no longer suffer from the degrading conditions which caused Charles Dickens to write his highly emotional prose. We all ought to be grateful that it was possible to write in the Hospital Plan that it is no longer necessary to provide special hospital facilities for the children of Stepney. Of course, this is not to argue that they do not need hospital facilities in the area. Of course, they do, and they need them in a convenient and efficient form just as people in those parts of the country best served by hospitals need them. This leads me to the Hospital Plan for the area of which Stepney forms a part.

As the hon. Gentleman knows, there has been a very considerable shift of population from East London into the new towns and the outlying parts of Greater London. For example, in 1939, the population of Stepney was 197,000. At the last census, it was down to 92,000. This is the pattern over almost the whole of East London. It is, therefore, quite unrealistic to argue that places like Harlow, Basildon and Barking where so many East Londoners now live should have new hospitals while maintaining that hospitals in East London should not only be retained but should be increased in size. There might be some justification for this if there were a deficiency in the number of beds in East London, but this is not so.

In fact, there is a very high proportion of hospital beds for the number of population. The trouble is that so many of the beds are by present-day standards in bad hospitals badly served by ancillary facilities. The only answer to this problem is a rationalisation of the hospital services—fewer beds but in properly equipped hospitals. The Hospital Plan aims to do this. It might, I agree, mean that some people have to travel a bit further, but not very much further. Adjacent hospitals are still within a reasonable distance. I have looked at the map and I see that Hackney Road is about 1½ miles away. I do not believe that people will object to paying, perhaps, 6d. bus fare instead of 3d., and, of course, for ambulance cases this consideration will not arise.

The Queen Elizabeth Hospital in Shadwell is in a most unsatisfactory building. I think that it is a good deal to the credit of the hospital staff that so much good work has been done and is being done at this hospital. As I have explained, it was recognised even before the war that the Children's Hospital at Shadwell needed replacing and the new hospital at Banstead was intended to do this in part.

Throughout the country there has, happily, been a reduction in the demand for paediatric services. This trend, coupled with the effect of migration from East London, has had a marked effect on the work done at the Children's Hospital. Of late, the hospital has been dealing with a much smaller number of children. All the major general hospitals in East London have children's departments, and, for the same reason, they are half empty.

Mr. W. Edwards

Mille End?

Miss Pitt

There is no question of adequate facilities for children not being available close at hand if the Shadwell Hospital is closed. In addition to the 44 beds at Shadwell, there are 386 beds at hospitals in East London, 80 at Banstead and 120 infectious diseases beds at the Eastern Hospital, most of which are used by children.

The hon. Member has asked what use will be made of the site of the Hospital for Children in Shadwell if it is closed. I repeat that the closing of the hospital has not yet been decided upon, but that, if and when it is, the normal procedure for disposing of hospital property will be followed.

The hon. Member also asked whether we have any idea of providing some form of clinic on the site. I am not sure what he has in mind, whether he means a children's welfare clinic, which is within the province of the local authority, or whether he has in mind an out-patient clinic.

Mr. Edwards

Yes.

Miss Pitt

If the hospital is closed and such a proposal were made, it would, of course, be considered. I emphasise again that no final decision has been made about this hospital in Stepney. All interested parties will have an opportunity of making representations. Indeed, they will be encouraged to do so. The question of provision for nurses certainly would be taken into account, although I should be surprised, if closure is decided upon, that there was not adequate accommodation for nurses. Certainly, there will be need for them in other hospitals.

I hope that at the proper time all those interested will make representations, for it is only by having all the facts before him that my right hon. Friend can decide what is a proper course for putting into effect the part of the Hospital Plan which affects the people of Stepney.

I understand and appreciate the concern, the loyalty and the pride of the local people in their hospital and that in some cases that part of the plan which foreshadows closure will be received with reluctance. Some closures will, however, be inevitable if we are to have an up-to-date hospital service which represents current needs and gives the right opportunities for use of modern medical skill. [Interruption.] The hon. Member asks me to pay attention to the needs of the people. That is the whole purpose of the Hospital Plan—to provide the best possible service for the people who will use it. We shall welcome the interest—

The Question having been proposed after Four o'clock and the debate having continued for half an hour, Mr. SPEAKER adjourned the House without Question put, pursuant to the Standing Order.

Adjourned at twenty-eight Minutes to Five o'clock.