HC Deb 04 May 1965 vol 711 cc1269-78

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

11.29 p.m.

Mr. J. C. Jennings (Burton)

After the noise of jets, the quietness of a hospital After the battling of the Minister of Aviation, and the Parliamentary Secretary, the soothing voice and opinions of the Ministry of Health—at least I hope so.

I am grateful for the opportunity of bringing to the notice of the House, and particularly of the Ministry of Health, the position of the General Hospital at Burton-on-Trent. I tell a story of acute disappointment, of baffled frustration and of promise unfulfilled. I ask the Parliamentary Secretary to notice that I did not use the word "promises"; I referred to a "promise unfulfilled". We in Burton, for almost two years, have been living in a fairyland of anticipation of a new general hospital, and at one fell swoop our fairyland of promise was completely dissipated.

I shall be as brief as possible and cut out many of the details in the story, for the Parliamentary Secretary is very familiar with the general layout of the story. Suffice it to say that after long discussions and negotiations over the years there resulted agreement all round between the Ministry, the Birmingham Regional Hospital Board and the Burton-on-Trent General Hospital Management Committee for the building of a new general hospital on the Andressey site—not on the site of the present general hospital in the middle of the town.

This was destined to be in three phases, and we are discussing tonight phase 1 of this general scheme which was generally agreed. Phase 1 took in the out-patients' department, the casualty department and supporting services. The final cost of this phase was in the region of £1½ to £1¾ million. The story is that this was placed in the 10-year hospital programme and was one of the priorities. As early—or should I say "as late"—as June, 1963, the regional hospital board approved the scheme with its capital programme, and confirmed it. As far as Burton-on-Trent was concerned, everything looked promising. Two years ahead lay phase 1 of the new general hospital. Gone would be many of the frustrations from which we and many other general hospitals had suffered.

Over these two years from 1963 to the present time everybody in the general hospital—the management committee, the surgeons, the staff, the administrators—geared everything to the thought that in 1965 would be started the new general hospital. What did this mean in their thinking and planning? It meant that in our unselfish way—for we in Burton-on-Trent are very unselfish and public spirited—we said, "We shall not involve the Birmingham Regional Hospital Board in more capital expenditure on buildings which are to be replaced by a new general hospital." So we clamped down on the development schemes in view of the land of promise which was awaiting us in two years' time.

It has been denied in various quarters that a starting date was mentioned. I have never said at any time publicly or privately that the Minister gave a starting date. He is not even in a position to give a starting date now. But a starting date was given—that of 15th June this year. It was actually minuted in the records of the Burton-on-Trent General Hospital Management Committee. So everybody was happy. I am not trying to score a party point here. The Parliamentary Secretary and I know each other too well to use a hospital for the purpose of scoring party political points.

The fact that this is in November, immediately after the General Election, literally has no political connotation, because we know the whole thing is in a pipeline, but in November the bombshell fell, and the management committee was informed that the new building of phase I was to be taken out of the 1965 programme.

I ask the hon. Gentleman to come to Burton some time and have a look at our casualty department. I put Questions some time ago asking for statistics, to the nearest convenient date, of how many accidents and admissions had been dealt with in the casualty department. The staggering figure was 17,000. Is the hon. Gentleman aware that we serve not only Burton-on-Trent, but a very large industrial area in South Derbyshire, and also in Staffordshire, in the Tamworth and Lichfield area—and an area in South Derbyshire including a large portion of the constituency of his right hon. Friend the First Secretary of State? I should like to do the Parliamentary Secretary a good turn as well as myself!

What I am asking now is that the Parliamentary Secretary tell me why this has happened. Here was money earmarked for Burton-on-Trent, £1¾ million or thereabouts. We were in a priority list. What has happened to the money? Who has got it? Whose priority is greater than ours? These are the simple questions I should like the Parliamentary Secretary to answer. If only we knew whose need is greater than ours, we might be a bit happier, and in our unselfish and public-spiritedness say, "Good luck, chums. We give way to you because your need is greater". I am expecting the Parliamentary Secretary to tell me that.

I conclude by saying I am grateful to the Parliamentary Secretary for letting me have a letter yesterday in which he gives me certain information. There are three points I would like to take from that letter. First, he tells me that the Ministry has been able to give Birmingham Regional Hospital Board formal approval for its sketch plans and final cost limit for stage one of the district general hospital scheme for Andressey, Burton-on-Trent. Secondly, he goes on to say that this means that An important planning hurdle is now cleared". In other words, he is telling us that he will give us permission, that the cost has been approved, that we can now go ahead planning and costing and putting out tenders when the appropriate time comes. That is all very nice, but, to use a colloquialism, "there ain't any money." So the crucial question is: when do we start? When do we get the money?

The sting is in the last sentence of the letter. The letter is nice and sugary to start with, and I appreciate that, for I like sugary things, but it then goes on to say that it does not affect the Answer you were given in the House, that the start of the scheme is at present forecast for 1967–68. In other words, a forecast—not an assurance—a forecast of two years' hence.

So, in Burton, we are in the unfortunate—indeed, the tragic—position of having first of all been in a priority list in the 10-year programme, of having had well over £1million allocated to us, of having been living in the dreamland of anticipation for two years of having a new general hospital to be started in June this year, and then, by a bombshell, seeing this position of certainty blasted into the realms of uncertainty. Now we are told that there is no guarantee that even in two years' time we will start our new general hospital.

The Parliamentary Secretary and I know each other well. As I have sat here waiting through the long debate on airports—and I am grateful to the hon. Gentleman for waiting so patiently, too—I asked myself this question. Having watched the hon. Gentleman over the years when he sat on the Opposition benches, what attitude would he have taken had he been in my place? In that spirit, I should like him to answer.

11.41 p.m.

The Parliamentary Secretary to the Ministry of Health (Mr. Charles Loughlin)

I want to try to meet the case which has been put forward by the hon. Member for Burton (Mr. Jennings), who has presented it in his characteristic courteous and, in parts, slightly humorous manner, even though he feels, rightly, that he is smarting under an injustice by my Department. I am glad that he has given me the opportunity to explain fully where the important development scheme to which he has referred stands.

As the hon. Member has said, there are two main hospitals at Burton-on-Trent, the existing General Infirmary and Andressey Hospital. We are grateful to the hon. Member for making clear that we are talking tonight about the scheme for the new general hospital to go on the Andressey site, because the decision to choose this site was reached only after very careful consideration and thought.

The General Infirmary, which is in the centre of Burton and has 255 acute beds, was at one time considered to be suitable for further development, and the provision of a new casualty and outpatient department there was in mind. As the hon. Member knows, however, the site is bounded on three sides by roads and on the fourth by a railway, and it covers only 1.8 acres and is already extremely congested. From the time that the Birmingham Regional Hospital Board had comprehensively assessed the hospital needs of Burton and the area surrounding it by modern standards, it was clear that a much larger site would be required.

Again as the hon. Member has said—and he has made my task easier because he has outlined some of the things to which I want to refer—the population to be served by the Burton hospitals is estimated at about 130,000, which includes about 40,000 from the neighbouring areas, including some of the area of my right hon. Friend the First Secretary—

Mr. Jennings

A mining area.

Mr. Loughlin

—so that a population of this size justifies a district general hospital.

Once the decision to seek a larger site had been taken, it became clear that the site at Andressey was the right one, for although at present this is largely a long-stay hospital of 319 beds, it has extensive grounds amounting in all to about 37½ acres, about half of which contains no buildings. After detailed discussions with the Burton-on-Trent Hospital Management Committee, it was finally determined that the new district general hospital should, therefore, be developed at Andressey.

It followed that the new out-patient and accident departments would be the first stage of this new hospital. This necessarily involved a larger and more expensive scheme than had earlier been thought of, for a modern accident and emergency department works best in association with other parts of the hospital, such as the in-patient beds for various types of cases.

The Birmingham Regional Hospital Board was then in a position to provide the detailed outline of functions embodying all the planning proposals, and this was formally submitted in November, 1962, incorporating the firm decision that the first state should consist of out-patient, accident and emergency departments with a full range of supporting services. For the reason I have mentioned a ward block of 87 accident and orthopaedic beds, including a five- bed intensive care unit, was included in the first stage of the scheme.

The hon. Gentleman referred to approval being given to the board's outline of functions in June, but, in fact, it was in May, 1963. The board had prepared the schedules of accommodation detailing the number and size of the rooms to be provided, together with the estimated provisional cost of the buildings. With this material, the board was able to set itself a target date for its budgetary planning purposes. It hoped to begin spending money in the financial year 1965–66, the cost of the scheme being envisaged as about £1,300,000.

From then onwards, the board continued with its twofold task of taking forward the detailed planning of the scheme and of fitting it into its financial programme. I should like to make it absolutely clear—especially in view of the title of the Adjournment debate, which refers to the cancellation of the hospital—

Mr. Jennings

It should be postponement, not cancellation.

Mr. Loughlin

—that there has never been any question of cancelling the scheme. There has been no question of abandoning either the major proposal to provide a district general hospital at Andressey, or the immediate intention of proceeding as fast as possible with the first stage. I am very grateful to the hon. Gentleman for agreeing with me that instead of cancellation it should be postponement.

The Andressey site is a good one, but it is on a slope with a fall of 30 feet and very detailed site investigations had to be made and there have been particular drainage problems to be looked at very closely. I should like also to emphasise that we are talking about a very substantial hospital development scheme costing on the latest estimate—to take my account a little further forward—more than £1,400,000, or nearly £1.7 million including fees and equipment.

In addition and over and above the costs I have mentioned, there will be substantial and necessary new staff accommodation provided. The costs of this are not yet determined, but they may be about £100,000 and the board intends that they shall be ready by the time the main scheme which I have described is completed.

I mentioned earlier that the board had recently now reached a close estimate of the cost of this first main stage of the development. In more detail, it has now completed its preparation of the sketch plans for this stage and on 19th March, this year, we were able to give formal approval to them and to the related final cost limit of £1,426,390. This is a very important planning hurdle which has been cleared, for now the board can proceed to prepare working drawings and bills of quantities. My latest information is that these may be expected to be ready by the end of October, this year, and thereafter, before work could begin, there would remain only the invitation of tenders and the letting of a contract.

But, of course, every scheme within a board's programme has to be contained within its financial allocation for capital works, and although the scheme might be ready to start in the early months of next year if the remaining stages go very smoothly, tenders cannot be invited, of course, unless the board can provide the funds to pay the bills from start to finish of the scheme. The Birmingham Regional Hospital Board has been active in bringing a large number of much needed schemes to planning completion, and in this current financial year it will be aiming to spend over £8½ million.

Mr. Jennings

Not in Burton.

Mr. Loughlin

No. This is by far the greatest sum ever reached by the board. But the board has a responsibility in its area for determining priorities. It has to examine the whole of the region for which it is responsible.

Mr. Jennings

Why did it drop this scheme?

Mr. Loughlin

This is something which the board has to determine, and I think that the hon. Gentleman will agree that where there is a constant reviewing of the position, on occasions there are revisions to, and alterations in, the time schedule of the proposals. The sum committed for the current financial year include a considerable number of very large schemes which will have reached a start in 1965–66, and which will continue at least from 1966–67 with as much, or even more, being spent on them in that year as is provided in 1965–66.

Even if it had just been possible from a planning standpoint to make a start on phase 1 of the new district general hospital at Andressey, involving a relatively small expenditure in the last month or so of the financial year, there would have remained a financial commitment for 1966–67, in particular, which the board found that it could not possibly contain. Its intention is, therefore, as the hon. Gentleman was informed on 8th February, to start this major out-patient and accident and emergency department scheme, the content of which I have described, as early as possible in 1967–68, and for it to run straight through to completion.

Mr. Jennings

That is phases I, II and III?

Mr. Loughlin

I said to run through to completion. I want to be careful about this, because I am not too sure whether that means the whole of phases I, II and III.

Mr. Jennings

When the hon. Gentleman talks about running straight through to completion, does he mean the completion of phase I, or the completion of the whole scheme, that is, phases I, II and III?

Mr. Loughlin

That is what I began to hesitate about, because I did not want to say something which was likely to be wrong. I said phase I only, and I find that phase I only is correct.

All this is fairly and squarely within the context of my right hon. Friend the Minister's statement to the House on 8th February about the review of the hospital building programme. The House will remember that the Minister reminded us that because individual hospital schemes which comprised the plan had been imprecisely defined and costed, the resources originally thought necessary were found to be far from sufficient for all the schemes to be undertaken. He made it clear that he was now reviewing the future building programme with boards with three objectives in view.

First, a still closer look at the content and estimated cost of each project so that the total programme could be more realistically matched with the resources likely to be available. Secondly, an examination of priorities, particularly to ensure that the needs of geriatric and psychiatric patients were properly weighed. Thirdly, so that special attention could be given to the co-ordinated planning of hospital, local health and welfare and general medical services. The boards and the Department will be undertaking this important and detailed reassessment during the coming months.

The Minister also made it clear that the Government had added £5 million to the 1965–66 capital programme so that schemes which were ready and scheduled to start in that year could go ahead. The planning of the Andressey scheme had not reached the stage of finality when a firm starting date could be fixed, and more especially, as I have explained, the regional hospital board, on its most up-to-date assessment of planning timetables, would not have been able to contain the consequential expenditure in 1966–67 even if starts could have been achieved at the end of 1965–66.

The Birmingham Regional Hospital Board, naturally, explained this position in confidence to the Burton-on-Trent Hospital Management Committee before reaching any final decision at Board level. I recognise that the postponement of this scheme has caused disappointment to the management committee and to the Burton-on-Trent Borough Council and other authorities who have been in touch with the board and the Department. But similar disappointment has been the result of the many previous deferments and deletions which have occurred since the hospital plan was first published, and this one is the result of that over-commitment of the plan in the past which the Minister described in his statement of 8th February.

I am confident that the House will be reassured that there is no question of the cancellation of the new district general hospital at Burton-on-Trent. In fact, the Birmingham Regional Hospital Board is pressing firmly ahead to the completion of phase I of this hospital. Both the board and the Minister accept the importance of this scheme and the planning stages have now been completed so that it can quite firmly be said that the scheme will start just as soon as the board can contain it within their budget. I repeat that on present assessments this is seen as being in the year 1967–68.

Lastly, I want to deal with the final question which the hon. Gentleman asked me, that is, whether some definite starting date can be given on this project. It is very easy for Ministers, and even junior Ministers, to be able to come to Members of Parliament who raise, quite properly, problems which they have in their constituency and say, "I have managed to solve your problem for you." I can only regret that I have not been able to come along on this occasion and say to the hon. Member that in view of the representations he has made, quite rightly and very well on behalf of his constituents, I will be able to do the job.

But I think that he can take this assurance, that without there being some unforeseen developments—and I mean that in the broad sense of the term—the present intentions of the board and the Ministry will be carried out and the first phase will start at the date we suggest, namely, early in 1967–68.

Question put and agreed to.

Adjourned accordingly at two minutes to Twelve o'clock.