§ Motion made, and Question proposed, That this House do now adjourn.—[Mr. Howie.]
§ 4.36 p.m.
§ Mr. John Hunt (Bromley)
I am very grateful indeed to have the opportunity this afternoon of raising a matter which has caused a great deal of resentment and dismay to many of my constituents, namely, the decision indefinitely to postpone the redevelopment plans for Bromley Hospital. This debate this afternoon arises from a highly unsatisfactory Answer which was given to me some weeks ago by the Parliamentary Secretary, who, I see, is to reply to this debate, when he said that he was unable to give any indication as to when the work on the redevelopment plan for Bromley Hospital would be able to start. So I hope that this afternoon we shall have no more of the evasive wriggling with which I was confronted on that previous occasion.
At that time the Parliamentary Secretary shielded himself behind the South-East Metropolitan Regional Hospital Board by saying that the decision to defer the work had been made by the regional board in reassessing the priorities of its development programme.
What we are entitled to know today is who asked the board to reassess the priorities. The board is eager and ready to proceed with this work as soon as the money is made available by the Government. So I hope that the Parliamentary Secretary will accept his responsibilities in this matter and will admit frankly to the House that this deferment, like many others which are going on in many parts of the country at present, is a direct consequence of this Government's deplorable decision drastically to cut back on the hospital building programme which was launched by the Conservative Administration.
It really is ironical to recall that only nine months ago people in my constituency, and, indeed, all parts of the country, were being assured that Labour would press ahead with a revised hospital plan, and, as the First Secretary of State and Secretary of State for Economic Affairs saidThe health of the nation demands and will get an intensified programme of new hospital building.1080 All that I am asking for this afternoon is that so far as Bromley is concerned that election pledge shall be honoured, and honoured without further delay.
The Bromley scheme was first drawn up in 1962, and, as the Parliamentary Secretary will be aware, envisaged the eventual rebuilding of Bromley Hospital as a new district general hospital, with 400 beds, and the first phase was to have been dealt with in 1966–69, at a cost of £600,000. One of its main features was to have been the provision of an accident centre to replace the present cramped, out of date, and totally inadequate casualty department at the hospital. I do not need to remind the House that, unhappily, the number of road accidents is rising steadily month by month, and Bromley is no exception in that respect. One ought to warn the Government and the Ministry of Health that it is impossible to expect the existing facilities at Bromley Hospital to cope for very much longer with the mounting casualties on our roads.
As well as the new accident centre, the first phase of the Bromley Hospital plan also envisaged improvements to the out-patients department, and to the X-ray and physiotherapy departments, all of which at present are operating under very considerable difficulties indeed. One of the most frustrating features of this matter is that the surgeons and senior staff at Bromley Hospital have spent many hours discussing and preparing the details of plans which have now been callously cast aside, and, understandably, a wave of anger and indignation swept through the hospital when the Minister's veto became known.
An additional point of complaint which was put to me when I visited the hospital some weeks ago was that over the past two or three years many minor improvements had been shelved in anticipation of the major building scheme going ahead as planned as from April of next year. Now, they have not only been denied the major scheme, but they have lost the opportunity of making the minor improvements as well. Meanwhile, the waiting lists grow longer every day, and the morale of everyone concerned is at a very low ebb indeed. I hope that the hon. Gentleman will take account of that. This is a deplorable and a deteriorating situation, and unless something is done about it, and done quickly, it will have 1081 a serious effect on the health and welfare of many of my constituents.
A further important factor which I urge the Parliamentary Secretary to bear in mind is that Bromley is now the geographic and administrative centre of a vast new London borough of 300,000 people. In view of that, it is surely not too much to ask that Bromley should have a hospital of a size and standard appropriate to its new status and importance as one of the major centres of population in the South-East of England.
The proposed cost of this first phase—which is all that we are talking about at the moment—was to have been £600,000, and yet Government money is not available to carry out this urgent work. Government money has, however, been made available to carry out a totally irrelevant and unnecessary action, namely, the abolition of prescription charges, at an annual cost of £30 million. What a sad commentary that is on the Government's distorted sense of priorities within the National Health Service!
Even at this late stage, I beg the Minister and his Parliamentary Secretary to look again at the amount of money which they are making available for hospital improvement work in this country, and in particular to reconsider the needs of Bromley Hospital which, as I hope I have shown this afternoon, are very real and very urgent.
§ 4.45 p.m.
§ The Parliamentary Secretary to the Ministry of Health (Mr. Charles Loughlin)
The hon. Member for Bromley (Mr. J. Hunt) has tried to reiterate this afternoon some of the foolish things that he said on the previous occasion when he tabled a Question to me, when I said that his charges against the Minister were nonsense. They are equally nonsense today. The mere repetition of them does not prove anything.
I will turn shortly to the project to which he has referred, but it is about time that we tried to explain, or to spell out in simple language to hon. Members—not merely the hon. Member for Bromley (Mr. Hunt), who has been here this afternoon but to other hon. Members who have had Adjournment debates of this kind, and to hon. Members who will want to have them in the future—the general framework within which decisions on individual projects are taken.
1082 The hon. Member will recall that on 8th February my right hon. Friend the Minister told the House that because individual hospital schemes which made up the previous Government's Hospital Plan had been imprecisely defined and costed, the resources which they had thought to be necessary were soon found to be far from sufficient for all the schemes listed in the plan to be undertaken.
This was already evident in the two revisions of the plan which were made not by the Labour Government, but by the previous Administration. Schemes had then to be deferred on a considerable scale. Obviously, the schemes which were deferred by the previous Administration, in the plan that they themselves had prepared, and which were costed in such a way as to create dismay once the plan had been tabled for a period of time, caused disappointment to hon. Members on both sides of the House.
On the Adjournment on 18th May, the hon. Member for Cheadle (Mr. Shepherd) referred to the deferment of a hospital building project. I referred them to the badly costed schemes that were entered into the Hospital Plan of the previous Government. I thought that it was wise to tell the House on that occasion what we meant when we talked about badly costed schemes. What I said then is on the record. I gave a number of examples of schemes which had originally been costed to a certain figure and in respect of which, the real cost was found to be substantially in excess of that which was laid down in the plan. I do not propose to reiterate the illustrations that I gave. It might be a good exercise for the hon. Member to read the report of the debate and see what those illustrations are.
On 8th February my right hon. Friend explained that the position that we inherited remained difficult and that the Plan would be reviewed. One of the main objects of such a review is to look still more closely at the content and estimated cost of each project in order that the schemes embarked upon can be more realistically matched with the resources likely to be available. The hon. Member again referred to the suggestion that Labour had broken its promises. Considering the fact that the previous Administartion had had to make two revisions. I do not see that it can be 1083 established that we have broken any promises so far.
There are two points which I should like to emphasise. First, my right hon. Friend has not interrupted the programme which he inherited, nor has he reduced the amount of money allocated to it. Indeed, despite the difficult economic situation, the Government decided that the £63 million envisaged for hospital building in the current financial year by the previous Government, of the party to which the hon. Member belongs, should be increased by £5 million to £68 million so that all those schemes which were ready to start this year could start. If we had not increased that allocation by £5 million it would not have been possible for the schemes which had already gone into the pipeline for this year's start to be put into effect.
Secondly, the review is being carried out by the regional hospital boards, as statutorily responsible for the planning of the hospital service in their areas. It is true that the content of and cost limit for each major scheme, that is one costing over £120,000 exclusive of fees and equipment, is agreed by the boards with my Department; and my right hon. Friend determines what sum of money each board may expend on hospital building each year. But within the sums made available for them each year, it is for the boards and not the Minister to determine which schemes they can afford to proceed with and which they must hold back.
Let us get this absolutely clear. There is no question of the Minister, once a project has been determined by the regional hospital board and agreed by him, vetoeing any project. The hon. Member for Burton (Mr. Jennings), on the occasion when the hon. Member was putting his Question, asked whether the Minister ever vetoes such decisions by a hospital board. The answer then and the answer now is that when a board has been appointed after consultation with local interests to administer the hospital services in its region it must be the judge of the relative priorities of the different schemes in the region.
I do not know what the hon. Member wants us to do. Does he take the view that when we have regional hospital 1084 boards with whom we agree on costings and who themselves determine the priorities within the region the Minister, unlike Ministers in previous Administrations, should tell the boards what to do, even though the regional people ought to know the priorities within their regions, because some hon. Member opposite is not satisfied with judgments taken in the region? Is this the type of policy that the hon. Member is urging upon the Government? It is important that the hon. Member should get the position clear in his mind. It is not the slightest bit of use his charging the Labour Government with not honouring their promises if, in the first instance, he does not understand the simple mechanism by which we arrive at a decision.
§ Mr. Loughlin
We make the money available and we agree on a programme for a period of time. The regional hospital board then determines in its own region which schemes shall be put into effect. If regional hospital boards cannot do that, who can? Can we? Of course not. After the regional hospital board has prepared its programme, we do not put a veto on it. The board determines it.
I come now to the particular case of the Bromley Hospital. It is remarkable that the hon. Gentleman has again quoted today a figure much lower than the one which really applies to this project. This is a large and expensive scheme intended to provide a full-scale accident and emergency department, two operating theatres, a new physiotherapy department, two diagnostic X-ray rooms and 56 additional beds. The cost of the scheme is not £600,000 but just short of £700,000.
One of the essential parts of the scheme is the accident and emergency department, since the existing accident departments at Bromley, Farnborough and Beckenham Hospitals are at present, we readily admit, under heavy pressure. The South East Metropolitan Regional Hospital Board, which is the planning and administrative authority for hospital services in the area, is as aware as we are, and as the hon. Gentleman is, of the need for up-to-date accident centres.
1085 I do not know what the hon. Gentleman meant when he spoke of the regional hospital board's attitude in this. I hope that he will forgive me if I misconstrued what he said. I do not want to be unfair to him. He suggested that I had been responsible for evasive wriggling, that I had sought to shield behind the regional hospital board, and that the regional hospital board was ready and eager to go ahead with this project, when the money is forthcoming. So is every other regional hospital board ready to go ahead with every possible project ever envisaged in its region. But does the hon. Gentleman suggest that the regional hospital board has informed him that we are the only people stopping this project going forward? Is that what he meant to convey?
§ Mr. Loughlin
All I can say is that, if this project had gone forward under the previous Government, something else would have had to be taken out. I have already reminded the House that the money thought to be sufficient by the previous Government has been increased by £5 million. If it had not been increased by £5 million, somewhere in the country, whether in London or elsewhere, some current projects envisaged at that time would have had to come out. One cannot have more projects in the pipeline than one has money to meet.
The Board itself has recently completed a new minor accident centre at Woolwich and is either engaged on or about to build major accident centres at Dartford, Gillingham and Canterbury. Also, it has pressing demands for new maternity units, out-patient departments, diagnostic X-ray departments, operating theatres and other specialised units. We have drawn the board's attention to the particular and detailed need for accident and emergency departments and I am glad to see that the South-East Metropolitan Hospital Board has taken this advice so much to heart.
I come now to the reason for the South East Metropolitan Hospital 1086 Board's decision to defer the building scheme at Bromley Hospital which it had hoped to start in 1966. The Board was faced with the position that it had in progress eight major hospital building schemes, each costing over a quarter of a million pounds, and it had five more major schemes planned to start in 1965–66 and 1966–67. But the Board found that the money available to it, even though increased by the present Government, could not be stretched to cover all these schemes. Something had to go. After very careful consideration, the Board decided that the scheme at the Bromley Hospital must be deferred.
I have made reference to a number of projects and I asked previously what the hon. Gentleman would do. What does he propose to do here? We have X number of projects, and he says, "Well, mine must go forward."
§ Sir Keith Joseph (Leeds, North East)
I would be grateful if the Parliamentary Secretary would leave me one minute before the time for the adjournment comes.
§ Mr. Loughlin
I am sorry that the right hon. Gentleman did not indicate that before I started speaking, because, in practice, it is not quite fair for the right hon. Gentleman now to give me notice that he should be granted an additional minute when I have no opportunity to reply to him. I am replying to the debate and not the right hon. Gentleman. If he wants to adopt that practice, then he must do so when another Parliamentary Secretary is at the Box.
§ Sir K. Joseph
The hon. Gentleman is not following the conventions. When I was at that Box, I always gave time to an Opposition Front Bench spokesman, now the Foreign Secretary, to have one or two minutes at the end of my speech. It is common practice.
§ Mr. Loughlin
I have been in the House for a number of years now, and it is not common practice. It may well be that the right hon. Gentleman had his own conventions, created them and maintained them.
§ Mr. Loughlin
Of course I am taking up time. The right hon. Gentleman will 1087 not have any time, I can assure him. I resent the very idea of the right hon. Gentleman indicating that he wants a minute when a speaker from this side is answering a debate. If he had come to me beforehand, it would have been a different matter. It is not as though we were short of time. We were waiting for half an hour.
§ Sir K. Joseph
If the hon. Gentleman had given the sort of reply to my hon. Friend that we had understood, I would not for a moment have wanted to intervene. But he must realise that an Adjournment debate is a debate, and it is open to Opposition representatives to question or comment on some of the Government's answers. I regard the hon. Gentleman's answer to my hon. Friend as inadequate, and I wanted to point out why. I hope that he will give me the courtesy of one minute to do so.
§ Mr. Loughlin
The right hon. Gentleman is saying that, not having heard the completion of the case I am presenting, the case so far is inadequate. If the right hon. Gentleman is to advise anyone, I would suggest that he advises his hon. Friend that the way to get a reasonably clear statement of this kind is not to initiate debates solely for political purposes and not for the purpose of assisting the regional hospital board and the constituents about whom he has spoken this afternoon.
§ Mr. John Hunt
I resent that very much. Is the hon. Gentleman implying that I have not the right to raise matters on behalf of my constituency? I resent the implication that I am doing it simply for political purposes, because nothing is further from the truth.
§ Mr. Loughlin
The hon. Gentleman says to me, with his hand on his heart, that he is looking after his constituents, that he was really serious and wants me to try to persuade the regional hospital 1088 board that this project ought to go back into their scheme of priorities, which is the only purpose for which such a debate should be initiated.
There is no point in initiating a debate of this kind unless the hon. Member wishes the Ministry by some method to bring pressure to bear on the regional hospital board. I should have thought that the very last thing he would have done would have been to spend the first two or three minutes of his speech talking about the Answers to Questions I gave on 31st May and saying that he did not want today the evasive wriggling of the Parliamentary Secretary, that he did not want the Parliamentary Secretary to seek to shield himself behind the regional hospital board.
§ Mr. Loughlin
I am now saying it again. The hon. Gentleman might as well learn now. He may want an Adjournment debate in the future, and if he wants a fruitful Adjournment debate he had better learn the technique.
When I came here today I had intended to be friendy towards the hon. Gentleman, to try to give him as much information as I could both on the general principles and on his own project. But if he comes here and expects to get away with the type of political propaganda that he attempted to get away with—[Interruption.] Then what is the reason for raising the subject of these deferments and the cut-back of the previous Governments plans—
§ The Question having been proposed after Four 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 six minutes past Five o'clock.