§ Motion made, and Question proposed, That this House do now adjourn.—[Mr. Fitch.]
§ 11.29 p.m.
§ Mr. Julian Ridsdale (Harwich)
I asked for this Adjournment debate to draw attention to the problem of hospitals in north-east Essex. I particularly want to concentrate on the task which at present is being imposed on the Clacton Hospital. The population in Frinton, Walton and Clacton will have been increased by about 10,000 by the end of this year compared with what it was in 1959. We have absorbed in that area what could be said is the equivalent of a small new town, without any appreciable improvement yet in the available hospital service. The problem is made more serious because a large proportion of this new population are elderly people joining a community which already has a high percentage, the proportion of elderly people in our people being 22 per cent. as compared with the average for the country as a whole of only 12 per cent.
All this has resulted in the waiting list of 57 in 1956 for 50 beds and eight cots being increased in 1964 to 252, to the number attending out-patient clinics increasing from 5,568 in 1961 to 10,771 in 1964, to the units of work increasing in the X-ray department from 7,507 in 1961 to 12,034 in 1964. Moreover, ours is a seaside resort area, and our population of 40,000 is doubled in the summer months. Taking both this factor and the large percentage of the elderly, our problems are almost as serious as those taxing the hospital in Colchester, but I shall eave that to be dealt with by my hon. Friend the Member for Colchester (Mr. Buck), if he is fortunate in catching the eye of the Chair.
With reference to Clacton Hospital, will the Minister tell us when we are likely to have the additional beds promised after I went, with the previous chairman of the Clacton Council, to see the North-East Metropolitan Regional Hospital Board in January, 1964, and the Minister of Health, after receiving advice from the Board, included our programme in the second revision of the Hospital Plan published in May, 1964? I understood then that 1964 would be the 1242 first year of a three-year programme to provide essential temporary improvements such as new X-ray apparatus, a new children's ward, a new additional ward, and other items. What is the present position as regards these essential temporary improvements and the other things which have been promised? Is the time-table being met? Does the right hon. Gentleman realise how serious will be the danger if there is a slippage?
Second, when is the land for the promised new main hospital to be bought? Why is it that the Ministry of Health can acquire land only five years in advance for the building of hospitals yet there is no such limitation for educational building? Does the right hon. Gentleman appreciate the serious problem this entails in proper planning? Moreover, because of the limitation, there is a danger that the land scheduled for the new hospital may be used for other purposes. Can this ruling be altered so that the land may be acquired in advance of the five-year limit?
Over and above these questions, however, is the most important problem we have in our area in the care of the elderly. For Clacton Hospital there is no alternative to having a large number of its beds occupied by geriatric cases, with the consequence that facilities for acute cases are, to that extent, markedly reduced. The situation is most serious and demands immediate and progressive remedy, and it is this particularly which moved me to ask for this Adjournment debate. If we could find the means to cater for the growing number of geriatric cases, we should be able to ease the requirement for a new general hospital.
I am attracted more and more by the idea of a day hospital on the lines of that developed in Cambridge. It should be possible, with modern building methods, to construct an economical and efficient hospital to which the elderly could go from their own homes for treatment. But this calls for more district nurses, more home helps, and a wider use of the meals on wheels service.
I am sure that this could be developed into a human and economical service and could cater particularly for the special needs of our area where people, quite rightly, like to live in their own homes for as long as possible. I would make such a hospital an urgent priority. It is 1243 something which can be done quickly and could help to solve not only the problem of the geriatric cases but would make more beds available for more acute cases.
Let the right hon. Gentleman make urgent inquiry into this and report on whether something cannot be done along these lines to ease both treatment of our geriatric cases and the problems facing the Clacton Hospital. Is the right hon. Gentleman satisfied that the present priorities are the right ones? It is because I believe it is necessary to concentrate our limited resources on our vital needs that I ask for this urgent inquiry.
Lastly, I pay tribute to the doctors, surgical nurses, hospital staff and many other voluntary workers, including those serving on the boards themselves who do so much with the limited means available to help cater for the special needs that face us. We are not asking a great deal, but as our area is growing quickly, particularly catering for the retired, we cannot be complacent.
It is vital that something be done quickly to meet these urgent requirements, and indeed we should think and plan on a big enough scale to meet the larger population expected in the next 20 years. There is a danger that, unless there is a new look for the hospital services in the area, the medical services will be in danger of becoming in a critical state in 10 to 15 years time. Some good authorities have told me that if there is to be a considerable increase in population the services will be in grave danger of breaking down unless early remedial action is taken. There is still time for action, but now is the critical point when important decisions have to be made.
§ 11.37 p.m.
§ Mr. Antony Buck (Colchester)
I welcome the opportunity to raise some of the problems which confront the Colchester area generally and, in particular, the Essex County Hospital. The position in Colchester is already desperate. There is, of course, a vast plan for increasing the population of Colchester and an influx of population has been brought about already through the admirable new university which we have situated just outside Colchester, virtually on the boundaries of my constituency 1244 and that of my hon. Friend the Member for Harwich (Mr. Ridsdale).
All these factors are likely to cause the position to become worse unless something dramatic is done. The present position is well known to the Minister. I wrote to him about it soon after he took office, and I know that he has gone into it with great care. I have been in telephonic communication with the chairman of the St. Helena Group tonight and am informed that the waiting list at the Essex County Hospital is nudging 3,000. Of that figure, nearly 600 have been waiting for a period of upwards of a year for treatment. Many people are going about in discomfort because of what is known as lack of cold surgery for things like varicose veins and other complaints which can cause great hardship. People in this category have been waiting to be dealt with for a year.
The position can best be illustrated by the fact that, in Colchester, with a population of over 60,000 and a large catchment area, there are about 200 beds available at the Essex County Hospital. Before the First World War, when the population was about 45,000, there were 175 beds available. The former Administration must take some responsibility for this and we must see that the position is rectified. The only reason that there is not a total breakdown at the moment is good faith. First there is the utter, complete devotion of those who work at the Essex County Hospital—the doctors, the nurses, those in what are often known as the professions ancillary to medicine, and the whole lay, non-medical staff of the hospital. They are working in the very gravest conditions at a tremendous pitch. It is largely through their utter devotion that there has not been a breakdown.
Secondly, there has not been a breakdown because of what may be described as the improvisation, the emergency measures which have been taken. The facts are that there has been an alleviation of the position through the utilisation of other hospitals, and the new surgical unit which at some considerable expense has been set up and is helping considerably. Further, there is increasing use of the military hospital. I went to see it some two years ago and found it was working at well under capacity, and I made a plea for greater utilisation of the 1245 services of that hospital, and that has now been brought about. One is very grateful to the Army medical authorities, and also for the way in which the civilian doctors are co-operating with them. This has been another factor. The position in the last few weeks has somewhat improved because of slight betterment of the recruiting of nurses which has taken the pressure off slightly at Severalls Hospital. But it is only because of these factors, the utter devotion of the staff of the Essex County Hospital, the new surgical unit at Severalls Hospital, the military hospital, and the improvement of nursing recruitment which have caused the position to be held.
Improvisation cannot go any further. We must have a new hospital in Colchester. We must have it now, or at the very first possible opportunity. It came as a bitter disappointment, to put it at its highest, that last summer the postponement of the new hospital for two years was announced by the right hon. Gentleman's predecessor. I spent hours with the right hon. Gentleman's predecessor—working on him, if I may use that colloquial phrase; and I have started the same process with the right hon. Gentleman, as he knows. From both I have had a good deal of sympathy, but nothing concrete. I regret to say that in the last letter from the right hon. Gentleman he will still not be able to offer me anything concrete. He could only confirm that the new hospital has been given the highest priority commensurate with other regional commitments.
Tonight I very much hope the right hon. Gentleman will be able to tell us something concrete. We should be able to forgive a great deal of what has happened in the first 100 days if, just after them. We could now have a new sense of urgency about these health matters. Tonight I plead with the right hon. Gentleman to give us a direct undertaking that the starting date for Colchester's new general hospital will he brought forward from 1972. I ask him also to take this opportunity particularly to refute the rumours which are going round that the present Government are contemplating a further postponement of hospital building. I hope that if these rumours are right—and they have reached certain people in Colchester—he will give us a direct undertaking that nothing short of a national emergency 1246 of almost warlike proportions will cause there to be any postponement. What we should like tonight above all things is for the right hon. Gentleman to announce that there is to be a bringing forward of the starting date, but at the very least we are entitled to have an assurance to settle these rumours going round about the possibility of a further postponement. I plead with the right hon. Gentleman to deal with this matter by direct assurance tonight, and by an announcement of the bringing forward of the new Colchester hospital so desperately needed.
§ 11.44 p.m.
§ The Minister of Health (Mr. Kenneth Robinson)
Perhaps I could first refer to the last observation by the hon. Member for Colchester (Mr. Buck). I really must ask him to be patient a little longer and to await the statement I shall be making very shortly about the hospital building programme.
I am very glad that the hon. Member for Harwich (Mr. Ridsdale) and the hon. Member for Colchester have given me this opportunity tonight of referring to the problems of the hospital service in the north-east Essex area. I would at the outset like to join them in the tribute they have paid to the staffs of these hospitals serving this area in the face of admitted difficulties.
As we have found all over the country, each area has its own special problems, and north-east Essex is not alone in its difficulties. North-east Essex is served by hospitals in the St. Helena—formerly Colchester—group and falls into three parts. First, there is the coastal strip of holiday resorts; secondly, the Port of Harwich and the rural area of the Tendring peninsula; and, thirdly, urban Colchester with the nearby rural area to the west.
What we have to tackle, therefore, is how to develop hospital facilities for an urban centre while at the same time ensuring good facilities for the more scattered population in the rural areas, and how to supply hospital care for the residents in the coastal resorts while making the necessary arrangements to cope with the influx of summer visitors. That, in short, is the problem.
The population in this area, as the hon. Member for Harwich said, is increasing and is likely to go on doing so. 1247 According to my information, the 1938 population was 168,000; by 1963 it was 204,000. It is estimated that by 1975 the numbers will be 274,000 and by 1981 308,000. In Colchester itself, the present population of some 67,500 is expected to expand to 100,000 by 1981; and in Clacton, Frinton and Walton the present population of some 40,000 may increase to 70,000 by 1981.
Perhaps I may say a word about existing facilities for the whole area. Colchester, which perhaps not surprisingly is the particular concern of the hon. Member for Colchester, is a natural centre for hospital services and has a number of hospitals. There is the Essex County Hospital to which the hon. Gentleman referred and which is a former voluntary hospital of 179 beds. While buildings have been added to it at various times since the First World War, parts of it date back to the early nineteenth century. Most of the acute work of the group is undertaken at this hospital.
Then there is St. Mary's Hospital which is a former poor law institution of 170 beds which has been partly modernised. It caters mainly for geriatric patients. Then there is Myland Hospital which was originally an isolation hospital. It has 173 beds and treats acute, geriatric and chest cases. The hospital is housed in pavilion-type wards and First World War huts. Lastly, there is Colchester Maternity Hospital which has 59 beds and occupies two converted houses. However, the hon. Gentleman will not be surprised to know that in our judgment none of these hospitals is suitable for the large-scale development which we envisage for the future.
There is only one large hospital outside Colchester, and that is the Notley Hospital near Braintree with 438 beds, That hospital, however, is too far from the main centres of population to be of permanent value as a district general hospital. It was formerly a tuberculosis hospital, but now houses a number of specialist units which are used for the region as a whole.
Clacton, in which I know the hon Member for Harwich is particularly interested, has a small general practitioner hospital of 58 acute and 18 maternity beds and a medical rehabilitation unit 1248 which incorporates the Reckitt Convalescent Home. The remaining units in the group are Halstead Hospital of 17 acute beds, Harwich and District Hospital of 30 acute and 10 maternity beds, and Heath Hospital, Tendring, an old Poor Law institution which is wholly geriatric with 141 beds.
The North-East Metropolitan Regional Hospital Board, which is responsible for the planning of hospital services in the area, has proposed that the major hospital for the group should be at Colchester and a site for this hospital has already been earmarked. It is expected to be a large one of more than 900 beds and it will provide facilities for acute, paediatric, maternity, ophthalmic and isolation cases. There will be an intensive care unit, a geriatric unit and a special care baby unit and, of course, all the other modern services which a district general hospital can be expected to provide.
The board has tentatively selected a site which has a number of considerable advantages. Not least, it is easily accessible from the town and from the railway station. I assure the hon. Member for Harwich, however, that the planning of the new hospital does not depend at this stage upon a final decision as to site. It is not being held up on that account.
The regional hospital board also has plans to provide a small new district hospital at Clacton. The urban district council, I am informed, has been most co-operative in helping the board to find a site and there is every hope that a particular site under consideration would be admirably suited for hospital use and will be made available.
The hon. Member for Harwich referred in particular to the land on which it is hoped to build the new hospital at Clacton some years hence. The position about this site, which is about 11 acres, is that roughly two-thirds of it belongs to the urban district council, the remaining one-third being in private ownership. The regional hospital board, with the support of the urban district council, has asked for it to be earmarked by the planning authority, the Essex County Council, for hospital purposes. This request is still with the county council but, in the meantime, the private owner has, I understand, served a purchase notice on the county council 1249 on refusal of permission to develop his portion of the site for other purposes, and this purchase notice has been accepted. The site, which has been agreed locally to be suitable for the future hospital, is at present earmarked for educational purposes, for which the local council has, I understand, offered an alternative. The negotiations about all this are, I believe, going ahead quite normally and no hitch is expected.
There are no similar complications attached to the more immediate extensions planned at the existing hospital, which, I understand, will all be contained within its existing site. The council is being fully co-operative in considering the car parking needs of the hospital which, in view of the increased concentration of use of the site, will need to be outside it.
I should like now to say a word a bout the financial considerations. The regional board had hoped, as was stated in the original Hospital Plan, that it would be able to start work on the new Colchester hospital during the years 1966–67 to 1970–71, and I am told that it had been planned to make a start on the site in 1970. At the time of the second review of the Hospital Plan last year, however, the board had to re-examine the whole of its capital programme in the light of the enlargement and improvement in design of certain major schemes and the need to make more urgent provision for maternity services.
More detailed estimates of the cost of schemes had become available and in the light of the total allocation of capital moneys which was likely to be made available over the years, it was clear to the board that it would take longer to carry out the plan than was at first thought. As a result of this reappraisal, the board looked again at its priorities and, as the hon. Member for Colchester has said, decided with considerable regret that a start on Colchester was unlikely to be possible before 1972. The board is now planning on that basis. Although the board's intention to provide a small hospital at Clacton was mentioned in the Hospital Plan, there was never any possibility that this could be built in the very near future. Financial 1250 priorities make it unlikely even now that the work can start within the next 15 years.
The hon. Gentleman wondered whether we could not somehow divert funds to speed up hospital development in this area. I must make it clear to him and to the House that it is the responsibility of regional boards to decide priorities for the development of hospital services in their region, and in this case it is primarily for the North-East Metropolitan Board to decide on the allocation to individual schemes of whatever capital moneys are expected to be available. While I do not wish to hold out any hope that funds can be made available by diverting them from other projects, no doubt the hon. Gentlemen know that the later stages of the Hospital Plan cannot be regarded as firm in all respects. So much for the long-term future planning.
I should like, now, to say a word about the interim measures which are to be taken. I am aware, as the regional board is aware, of the present shortcomings in the hospital services in this area. Indeed, this is why we are having the new general hospitals which I have described, but the board is taking steps to mitigate the present difficulties which cannot be wholly solved until new hospitals are built.
The first obvious possibility to explore is extending the use of the Military Hospital at Colchester for civilian patients. The board has already made arrangements at Severalls Hospital, which is the psychiatric hospital for the area, for the operating theatre and 30 beds in an adjacent ward to be adapted for acute surgical cases in order to reduce the waiting lists of patients needing operative treatment. This, I think, is a welcome arrangement, and I understand that it has been favourably commented on locally.
Secondly, additional beds are to be provided at Colchester Maternity Hospital, which will also have a new lift, and in St. Mary's a bed lift has been provided, the sanitary facilities have been improved, and new boiler plant has been installed.
Thirdly, at Clacton, the board plans to carry out works which will enable the present hospital to cope with additional work until the new hospital can be built.
The hon. Member for Harwich asked about the timing. The present plan is that improvements to the X-ray department will be started this year, and, 1251 within the next two or three years, a new children's ward, additional kitchen and dining room accommodation, a new operating theatre and sterilising facilities and new wards. Here again the urban district council has been most helpful in considering whether extra land can be made available to the hospital in order to provide more room, and without that these developments would not have been possible.
As regards geriatric provision for Clacton, the hon. Gentleman told me in a letter, but I am not sure that he mentioned it tonight, that he had heard that consideration was being given to using a hotel in Clacton for geriatric patients. I understand that the regional board has no such proposal under consideration, and I do not think it is a proposal which would in any event commend itself to the board. It is true that there are no geriatric beds in Clacton, but the needs of the town are served by Heath 1252 Hospital, Tendring, where we made a small increase in the number of beds as recently as November last, and by hospitals in Colchester.
Taking the group as a whole, there are about 380 geriatric beds in the area, and this is above the national average of 1.4 beds per thousand population. It is well known that the area has more than its normal proportion of old people, but even on the basis of 10 beds per thousand people over 65, which is the alternative calculation, the provision seems to be a generous one. I do not think that as there is no geriatric hospital—
§ The Question having been proposed after Ten o'clock and the debate having continued for half an hour, Mr. DEPUTY-SPEAKER adjourned the House without Question put, pursuant to the Standing Order.
§ Adjourned at one minute to Twelve o'clock.