§ Motion made, and Question proposed, That this House do now adjourn.—[Mr. Chichester-Clark.]
§ 11.52 p.m.
§ Mr. Edward Gardner (Billericay)
Basildon is one of the most successful of the new towns. A true measure of its success is the fact that most people who live there seem to like it. They like its friendliness, vitality and sense of belonging to a new and thriving community. Visitors, particularly from the Continent and America, are impressed by the superb planning of its roads, houses, shopping centre and factories, which make it one of the most prosperous places in the area.
But they are equally surprised to find that Basildon is still waiting for a hospital and that on the present estimates will have to wait for one for the next eight years. During this time the population of Basildon Urban District Council, now about 100,000, is expected to increase at the rate of 6,000 a year and reach about 148,000 in eight years' time. The population of Basildon new town is expected to rise from its present 60,000 to 80,000 at the end of those eight years. This is, I believe, the largest increase of population in any district in the country. This increase of population alone is an 1227 overwhelming argument for a hospital for Basildon new town. The argument hardly needs pressing, for the case for the hospital has already been won and the Government accept it.
The real issue, therefore, is not whether Basildon needs a new hospital—it needs one and needs one badly—but whether the present estimated delay in planning and building this hospital, now reckoned at about eight years, is tolerable or necessary. All the figures and all present experience show that the delay is not tolerable and I hope to persuade my hon. Friend the Parliamentary Secretary that it is not necessary.
In October, 1960, I was fortunate enough to persuade my hon. Friend's predecessor, my hon. Friend the Member for Birmingham, Edgbaston (Dame Edith Pitt), to visit Basildon and see for herself how badly we needed a hospital. What she saw apparently convinced her that the need was urgent, and within a short time we had the announcement by the Government that our case for a hospital for Basildon had succeeded. In 1961, the North-Eastern Metropolitan Regional Hospital Board announced that a hospital of 345 beds would be started in 1964 and completed by 1968. This was at least reasonable and, although it did not satisfy everybody, it was an acceptable solution.
In 1962, the Government announced their £500 million Hospital Plan, which included 90 new and 134 remodelled hospitals to be started by 1970–71. This is a plan which is wholly laudable and for which the Government deserve high praise. Unhappily for Basildon, this plan has had and is having the unhappy effect of delaying the new hospital by at least two years over the original delay.
The reason for this was explained by the Minister of Health himself, when he visited Basildon last year. It is that the new town needs a hospital far larger than that planned in 1961. Instead of 345 beds, we are to get 853 beds. Instead of a comparatively small hospital, we are to get what will be a full-scale general district hospital, the most modern of its kind in the country, built with the wealth of experienced gained over the last few years.
But, according to the Hospital Plan, the building of the hospital will not start 1228 until the period 1966–67 to 1970–71. In practice, on this basis Basildon is unlikely to get its hospital working before 1971. Already the hospital facilities serving Basildon are reaching full capacity and any doctor in this area would tell my hon. Friend of complaints, going far beyond inconvenience or annoyance, of the difficulties of getting suitable and timely hospital treatment. Most patients from Basildon have to go to St. Andrew's Hospital, in Billericay. The result is that despite the devoted labours of the staff of that hospital, its services are grossly overloaded. I am told that out-patients have to wait for up to five weeks for medical treatment, and that anyone wanting a bed for surgical treatment may have to wait up to fourteen months.
Basildon new town has one of the highest birth rates in the country. The maternity services, I am assured time and again by letter after letter, are among the worst. The Cranbrook Committee on Maternity Services, in 1959, recommended the provision of a national average of 70 per cent. of confinements to take place in hospital, but in Basildon even a mother having her first child is fortunate if she can get a maternity bed in a hospital. Indeed, only one in three mothers is able to have her first child delivered in hospital.
The shortage of maternity beds is so acute and the waiting list so full that the longest practical notice of nine months is not always sufficient. To be certain of a bed a mother-to-be in Basildon new town would seem to need to take the advice of a fortune teller more than a doctor, and added to the shortage of beds there is a very serious shortage of midwives.
Apart from the vast industrial site already working in Basildon new town, fresh factories are expected to grow up, built by companies like Fords, Standard Telephones and Yardleys, which will bring about 9,000 more workers to the new town and, like those already there, they will want reliable and immediate hospital services if only to deal with casualty and accident cases.
As long ago as 1960 the need for a hospital in Basildon new town was accepted by the regional hospital board. Indeed, the population figures alone were decisive. The board appreciated that the 1229 population of the catchment area it serves would reach a total of 233,000 in 1964–65, and Basildon Urban District Council wisely pointed out that on these figures—and one has to bear in mind that they will be reached next year—the area would need all the existing hospitals and the new hospital which is still to be built at Basildon if disruption of the hospital services in this area were to be avoided.
This means that we need, and should have, a hospital in Basildon built, staffed, and working next year if we are to be guided strictly by population figures, but on the present plan a new hospital cannot be expected there until 1970–71. This will not do. It is an intolerable situation caused, as I see it, primarily by delays in planning, delays which I submit must be eliminated.
As the Hospital Plan is careful to point out, it takes several years to plan and carry out any major hospital development. There is no lack of enthusiasm among the staff of the regional board. The architects and planners are already at work on this hospital and they have accomplished a good deal of ground work. I am told that the preliminary plans and estimates will be ready by September, and that the board hopes it will have ministerial approval by November. But after November of this year—until January 1967—more than three years will be taken up on detailed planning. After that, another three years will be taken up on the actual building of the hospital. So now we have at least seven and possibly eight years to wait. It is too long.
I see that the experts have agreed—and most people sympathise with the view—that there are great difficulties in building a hospital of this kind, with the ambitious future it will have, in under three years, but surely we can do something about the time taken up on planning this hospital. Do we need to plan it right down to the last doorknob, nut and screw, in detail, so that every one of those minute details has to be considered by the Ministry? Cannot we now adopt some other method which would accelerate what must be, in the ordinary course of the Civil Service, a very slow process? Cannot we do something about adopting hospital plans which are already in use?
I have been told by the Minister-indeed, on one occasion a deputation of 1230 representatives from Basildon new town came with me to see him—that there were difficulties. The difficulties were appreciated—they were certainly explained very fully—in adopting the plans we used for that splendid hospital in Harlow new town. But cannot we go beyond Harlow new town, or beyond this country? Let us look to the Continent and the new hospitals there, or to America, and see what we can find in their plans to adopt, in order to save time and to bring this hospital, which is needed so urgently, into a reality far sooner than it is going to be built under the present plan.
I would be most grateful, and I am sure many people in Basildon new town would be most grateful, if my hon. Friend the Parliamentary Secretary would give the House an assurance that the only thing holding up the building of this hospital is the planning and architectural work that must be done upon it, that the Government have all the funds available and are willing to provide all the funds necessary to build it, and that there is nothing by way of finance that is creating a barrier to its building.
I plead with my hon. Friend to see that everything is done—everything that is within the power of the Ministry, including, if necessary, an increase in the planning and architectural staff—to speed up the detailed planning and to bring the plans to a stage where the building of this hospital can be started. The present state of affairs is not only disturbing; it is quite intolerable. I plead with my hon. Friend and the Government to see that there is a speedy conclusion to the present state of affairs, and the application of an effective remedy.
§ 12.9 a.m.
§ The Joint Parliamentary Secretary to the Ministry of Health (Mr. Bernard Braine)
I fully understand the anxieties of my hon. and learned Friend the Member for Billericay (Mr. Gardner) and I know how faithfully he has represented the interests of his constituents in this matter.
My right hon. Friend announced the scheme for building a new hospital at Basildon in his statement in the House in January, 1961. This announcement was made at the earliest moment when we knew that capital could be allocated 1231 for the development, and therefore, planning was still in its earliest stages. It appeared to us at that time that the right thing to do was to regard St. Andrew's Hospital, Billericay, and the new hospital at Basildon as complementary and that, therefore, a hospital of 345 beds would be needed at Basildon.
Shortly after the announcement, my right hon. Friend met a deputation in March, 1961, and explained to them that the new hospital was not likely to start before 1964–65. In view of what he said, the people of Basildon may have had some justification for expecting that the building of their new hospital would start at least in early 1965. I can understand their deep disappointment when it was announced in the Hospital Plan presented to Parliament in January last year that instead the hospital would start in the period 1966–67 to 1970–71. I accept that the reasons for the change in the likely starting date might well have been explained at that time and I am sorry that this was not done. I understand, however, that they have since been explained. I understand, too, that the reasons for the change were perfectly sound and, as I hope to show, in the long term they are in every way to the advantage of the people of Basildon.
I am sure that my hon. and learned Friend will appreciate that the release, upsurge and flowering of ideas, which accompanied the development of the Hospital Plan caused all concerned with hospital planning, those at the Ministry of Health and in the regional boards to think much more boldly about the hospitals of the future than they had done in the past. We put on one sidethe "just about good enough"schemes and looked at the hospital pattern as a whole. What principally emerged was the concept of the large, comprehensive district general hospital in which could be brought together the wide range of facilities and expensive equipment needed for the most modern diagnosis and treatment.
This was the atmosphere in which the planning of the new hospital for Basildon developed after the announcement of the scheme. Moreover, when the North-East Metropolitan Regional Hospital Boardand the Minister got down to the detailed planning we also had more reli- 1232 able information about the population growth of Basildon and it became very clear that the idea of a new hospital complementary to St. Andrew's at Billericay was not the rightone. Basildon needed a comprehensive district general hospital large enough to serve the area of which Basildon would be the natural centre.
We and the regional board therefore came to the conclusion that what Basildon needed was a hospital not of 345 beds but nearer 900 beds. This obviously presented a very difficult planning problem from the smaller hospital originally envisaged. In the light of the definitive studies of the hospital needs for Basildon and our conclusions about the range of facilities required, a revised but wholly realistic time-table was forced on us which will allow building to start early in the second quinquennium of the Hospital Plan. This is the earliest that is practicable. I realise how frustrating it is for Basildon folk and formy hon. and learned Friend to see the empty site reserved for the hospital and no present sign of building activity, but I can assure them that the hospital is well under way. In hospital building at least 50 per cent. of the time needed is used up away from the site in the planning rooms and drawing offices. Meticulous work at the planning stage is the key to proper hospital provision.
We are always hearing about new medical techniques which are saving life and making medical treatment safer and more effective. I am sure that the people of the new town of Basildon who more than most are living with the most modern industrial techniques do not need reminding that these medical advances call for the most complex physical equipment. A modern hospital is perhaps the most complicated building structure that can be devised, combining a range of technical services which few factories could rival in diversity, domestic provision as carefully planned as in the largest and most modern hotel and the laboratory and teaching facilities of a technical college. Planners, designers, architects and engineers have to produce a structure which is efficient, flexible and, perhaps most important of all, one which is human in scale and atmosphere.
Clearly, this calls for a different scale of planning from say an office block with simple units inside the framework. 1233 In a hospital the inter-relation of wards, operating theatres, diagnostic departments, and so on, each of which is complicated enough, is an intricate planning exercise. Of course, a great deal is being done to shorten the planning time by disseminating information on good and tried procedures by means of building and equipment notes, but the fact remains that every hospital has to be tailor-made to fit the needs of the particular community which it will serve. I am sure that the people of Basildon would not wish it to be otherwise. As for borrowing ideas from others, let me say that there is no country in the world that has embarked on such a large and comprehensive programme of hospital building as we have.
My hon. and learned Friend has suggested that the plans of a hospital already built could be adapted to meet the needs of Basildon more quickly. For the reasons I have touched on, I do not think that this is the right solution, but the end can be achieved by other means. My Department is producing a mass of guidance material on the design of hospitals, aimed at bringing to the attention of all boards the best of current practice. This work is being extended and accelerated all the time.
Simultaneously, a large number of study groups has been set up to examine the scope for variety reduction in the building of hospitals and to rationalise building procedures and techniques. These groups are manned from the regional hospital boards, from private professional firms and from the Ministry. Their efforts are directed at producing recommendations of national application. They are working on such subjects as the production of standard ranges of cupboard units, sanitary fittings, ceilings, doors, floor finishes, structural components such as beams and wall units, partitions, engineering components, light fittings, and a thousand and one other things, all geared to the national system of dimensions recently announced by the Ministry of Public Building and Works.
They are also working on the codification of methods of assembling the briefing required by architects engineers and quantity surveyors and of recording this material so that clear instructions are given to the actual designs, and time- 1234 consuming practices and uncertainty are reduced.
As an example of what can be achieved, early this year the Ministry provided for all regional hospital boards and teaching hospitals sketch plans for a complete 104-bed maternity unitdesigned by the Birmingham board. This design reflects the features approved by the Ministry for this type of building. Its use, adapted to the needs of particular sites, could result in a saving of months of design time and make a contribution to the problem of accelerating the provision of maternity beds which faces the country at present. We hope to extend this policy of recommending acceptable designs to all departments of a hospital.
For practical reasons the hospital at Basildon will be built in three phases. The first phase will provide a viable hospital with 168 general beds, 44 maternity beds, 30 pædiatric beds, and 56 geriatric beds, as well as provision for babies needing special care, and an infectious diseases unit. The next phase which should overlap or even coincide with the first phase will provide a psychiatric unit of 260 beds. This will be an exciting new departure from the old concept of a mental hospital. There will be a short stay unit of 60 beds and a rehabilitation unit for 200 mentally ill patients who need a longer stay before they return home. The final phase will extend the hospital by an additional 272 beds and an extension of the diagnostic facilities provide in the first phase.
In short, the work on the new hospital, which is at present hidden from view in the planning offices, is forging ahead as fast as the architects and engineers can physically manage. I can assure my hon. and learned Friend that nothing in the way of financial considerations is holding it up. As soon as we have the right plans for the hospital they will begin to take physical shape. As to when the right plans will emerge, and whether, as my hon. and learned Friend suggests, an increase in the planning staff would hasten their appearance, I assure him that the regional hospital board is firmly of the view that its present planning team is of the right size and that increasing its numbers would not have increased its rate of progress.
All the technical planning work is being done in the board's own offices, where 1235 planning can progress with the greatest ease of consultation and with the greatest degree of control over the work and where the board can adjust the scale of the planning efforts according to requirements. The board expects to complete planning in time to permit building to be started in March, 1967.
We and the North-East Metropolitan Regional Hospital Board have always recognised the need of the people of Basildon for hospital services whilst they are waiting for their new hospital, and for this reason the hospital board has been pressing on with the development at St. Andrew's, Billericay. My hon. and learned Friend himself opened the new out-patients' department in October, 1960. Two new nurses' homes have recently been opened by the Lord Lieutenant of Essex, a new boiler house has just been finished, and the building of a new pathological laboratory is due to start shortly.
These facilities, which are perhaps misleadingly called ancillary facilities, are, of course, very necessary for the proper running of the hospital and have a direct impact on its efficiency and quality of service. But, at the same time, the board is doing what it can to increase the number of available beds. A ward which has been out of use for some time was reopened early this year, and wards in another block have been upgraded.
My hon. and learned Friend drew my attention to the acute difficulties being experienced by the maternity services. It is true that heavy demands are being made on the existing services. Work ona new maternity department at Orsett Hospital should start within the next few months and this department should give 1236 relief on completion two years later. I am glad to say that the Essex County Council is planning a substantial expansion of its domiciliary midwifery service—high standards of housing in this area make a high rate of home confinements more acceptable—and I am sure that the county council will have regard to the growing needs of the Basildon area.
I can understand the desire of people in Basildon to get their hospital as speedily as possible, and I can assure my hon. and learned Friend that we and board do not accept that the planning of a new hospital allows us to shrug off our responsibility for seeing that the current needs of the people of Basildon for hospital services are met. As I have indicated, there have been improvements and there will be more.
I hope that what I have said will reassure my hon. and learned Friend that we and the hospital board are doing all we can to see that the necessary hospital buildings, both in Basildon and, in the meantime, at Billericay, are available as soon as possible. But, as was shown in the guidance which my right hon. Friend sent to hospitals earlier this year about reducing waitinglists, new buildings are not necessarily the only answer; there are ways and means of making better use of existing facilities. Indeed, I know that the staff of the hospitals near Basildon are fully aware of this and are devotedly applying themselves to the task of giving the people of Basildon a full hospital service until they get their own hospital.
§ Question put and agreed to.
§ Adjourned accordingly at twenty-one minutes past Twelve o'clock