§ Motion made, and Question proposed, That this House do now adjourn.—[Mr. Fitch.]
§ Mr. James Dance (Bromsgrove)
I am extremely grateful to have this chance to raise the whole question of the problems of hospital accommodation in Redditch. Even at this very late hour, there are two aspects which we must look at: first, the ordinary general hospital accommodation in the Smallwood Hospital; and, then, the question of providing maternity accommodation in this greatly expanding new town of Redditch.
Our problem is not new. It has been with us for some years, but the urgency for more beds, in particular maternity beds, gets more and more acute every year. Ten years ago, on another Adjournment debate, I made a speech explaining the urgent need for maternity accommodation. Then the population of the town of Redditch was 25,470. Last June, it was 36,680. During those past nine years, therefore, we have seen an increase of 11,210, and the increase is continuing at an even greater rate at present.
I should like to deal with the ordinary beds at the efficiently run Smallwood Hospital. Here we have accommodation of merely 32 beds for a town with a population of 36,680. That was a year ago, and the population is higher now. It must be quite clear to everybody that the accommodation is completely inadequate.
We must also bear in mind that the town is growing rapidly year by year and we are told that the population will be something like 80,000 in about 10 years' time. At the moment we have no resident doctor at the Smallwood Hospital, and we feel that it is essential that we should have one, because Redditch is growing rapidly not only as a town for peopb to live in, but also as an industrial town, with new industries coming in ever, day. Therefore, it is not surprising that we have quite a high proportion of industrial injuries.
I agree that serious illnesses and bad accidents are better dealt with in a large hospital with all the modern facilities, 1667 such as the Queen Elizabeth Hospital in Birmingham, but many of these injuries are not very serious, provided they are dealt with on the spot, and that is what the people of Redditch demand—adequate facilities for dealing with illness and accidents on the spot.
Land is available, and I have discussed the problem with matron and her staff. Whilst they would naturally prefer permanent building to be started immediately, they are quite prepared to accept some form of temporary accommodation until the new hospital is available. What worries the people of Redditch so much is that they understand that under the present proposals it will be 12 to 15 years before the new hospital is available. Although we understand that within 10 years the population will be about 80,000, we shall still be left with one hospital with just 32 beds and no maternity accommodation.
This is a young town with a lot of young married couples. More and more are coming to the area every month, because one of the chief reasons for expanding the town was to cope with Birmingham's overspill. The birth rate is high, and yet we have no maternity accommodation in the town of Redditch itself, and expectant mothers must go to Bromsgrove or Evesham. These hospitals may not seem so very far away on the map, but I firmly believe that if a young mother has to have her baby in hospital it should be at a local hospital, really close to where she lives. One of the main arguments for this is that it is only natural that a husband should wish to visit his wife and baby as often as possible, but that is almost impossible under existing conditions. The husband's lunch break would be a most convenient time for a visit, but if he has to travel long distances, go home, change and smarten himself up, by the time he arrives at the hospital in Bromsgrove, Evesham or where-ever it may be it is too late for visiting. This is an intolerable situation.
Feelings run very high in Redditch on this matter, as the Minister well knows, and I thank him for the courtesy with which he received a small deputation I brought to see him. In a very short space of time 4,000 signatures were obtained on a petition calling for improved hospital services which I presented to him. I sincerely 1668 hope that the Minister will not brush this aside, as Ministers are apt to do.
This is a serious human problem, which must be tackled now—not in 15 years' time. I hope that the Minister will give me and my constituents a positive assurance that work will start on the new hospital right now, and if he cannot give me that assurance because there is lack of finance to build the main new permanent hospital, will he give me an assurance that he will provide more temporary buildings until the new hospital is built?
I know that he disagrees with me on this matter, but I suggest in all sincerity that it would be much wiser to restore prescription charges to those who can afford to pay them, but not, I stress, to those elderly people or those on the margin who cannot afford them. Would it not be wiser to restore those prescription charges and raise about £50 million a year, and spend that money on providing urgently needed hospital accommodation in towns such as Redditch, where we do have industrial injuries and where immediate treatment can prevent a minor injury from becoming a major one? Above all, this money could be used to provide the maternity accommodation which the town of Redditch rightly demands so that young Redditch wives can have their babies near home and their husbands can visit them during normal visiting hours.
I want the Minister to give this matter more than sympathetic consideration. I want him to give a categorical assurance that this urgent problem is to be tackled at once.
§ 5.45 a.m.
§ The Parliamentary Secretary to the Ministry of Health (Mr. Charles Loughlin)
The hour is late, but I can quite understand the hon. Gentleman the Member for Bromsgrove (Mr. Dance) wishing to raise the subject of hospital facilities in Redditch even if the hour were later still for, as he has rightly said, there is much local disquiet about it.
The hon. Gentleman recalled that in May he brought a deputation to see me to present a petition bearing 7,000 signatures about local hospital facilities, and my Department is at the moment making arrangements to see a deputation from the Redditch Urban District Council. The present population of Redditch is about 1669 30,000. The hon. Gentleman said that it was about 36,000——
§ Mr. Loughlin
There is a discrepancy in the figures, and our information is that the population is about 30,000. But I shall not argue with the hon. Gentleman on that. Redditch has only one small hospital, the Smallwood Hospital, staffed by general practitioners and with consultant out-patient facilities. It has, as the hon. Gentleman said, 32 beds. Over the years, there have been many improvements, especially in the X-ray department, the out-patient department and the physiotherapy department. The people of the town and neighbouring districts look also for the full range of normal hospital services chiefly to hospitals at Bromsgrove, about six miles from Red-ditch, where there is a general hospital with just over 300 staffed beds, including a maternity unit. They look also to the hospitals of the adjacent Worcester district and, to a lesser extent, to the hospitals, particularly the specialist hospitals, of the Birmingham conurbation.
The hospital service of the future is planned on a network of district general hospitals providing a wide range of treatment and diagnostic facilities for inpatients and out-patients, including units for active psychiatric and geriatric treatment. In this way the most economical use will be made of the limited resources available, including the rare skills which are so necessary to ensure that the patient gets the maximum degree of care and attention.
This concept of the district general hospital implies a hospital of about 600 to 800 beds serving a population of 100,000 to 150,000. In closely knit urban communities such as the Birmingham conurbation it would be possible to have a larger hospital serving a population of up to 200,000. The new hospital planned for Redditch would serve that town and a district including Bromsgrove. I know that there is particular concern in Redditch about maternity services and the hon. Member made reference to it. At the present time there is a consultant maternity unit of about 36 beds at Bromsgrove General Hospital and one of 1670 about the same size at Evesham dealing with general practitioner cases.
Here it is necessary to spend a few moments explaining the policy on hospital maternity services, but I should not like the House to think that I am unsympathetic to the difficulties with which people are faced and to which the hon. Member made reference, such as those of husbands who want to visit their wives who are in hospital for maternity purposes. We recognise this but obviously—and I think that the hon. Member will accept this—it is inevitable that with a major maternity unit there will sometimes be inconvenience for visitors.
A maternity unit will normally be part of a district general hospital where full and continuous consultant cover will be on hand for all beds including those available for general practitioners for the care of their own patients undergoing normal confinements. In this way it will be possible to have all necessary resources immediately available for any emergency. There will be not only resident doctors, but also facilities for premature babies and specialist teams for infant resuscitation. In pursuance of this policy, designed for the maximum care for the mother and her child, additional maternity beds will normally be provided only at or close to general hospitals with consultant staff, provided that the access is reasonable.
The population of Redditch and neighbourhood at present would not justify a viable maternity unit in addition to the unit at Bromsgrove, even if financial provision could be made. However, arrangements are being made to increase the number of maternity beds at the Bromsgrove hospital. Proper maternity facilities do not just mean hospital beds. There is also the domiciliary service and here the local authority has an important part to play, and so has the general practitioner. The need to achieve the utmost co-operation between all three has always been recognised and in all areas the authorities engaged in maternity services have set up local maternity liaison committees.
The Worcestershire County Council's revised 10-year programme includes the provision at Redditch of maternity and child welfare clinics, and I am glad to say that the Redditch Development Corporation is collaborating closely with the 1671 County Council in planning domiciliary maternity services. Sites have actually been acquired for housing additional domiciliary midwives.
Another matter which is worrying the peple of Redditch and to which the hon. Member referred, is that of accident facilities. In particular they have asked for the appointment of resident medical staff at the Smallwood Hospital to deal with accident cases. I think that the hon. Member recognises that in recent years there has been a trend towards greater interdependence of the various branches of medicine and an increase in the number of accidents which produce multiple injuries, particularly road accidents. Frequently accidents occur where the skills of consultants in plastic surgery, neurosurgery, thoracic surgery and other specialties may be required.
It is, therefore, important that all injured patients requiring hospital treatment should be taken direct to accident and emergency units under the control of a consultant and staffed and equipped to deal immediately with major injuries and other emergency cases at any hour of the day or night. To achieve this it is necessary to concentrate the service in a pattern of units serving populations of at least 150,000, with supporting services in other specialties and with smaller hospitals receiving less serious cases.
Two major accident centres are planned for the Birmingham conurbation with a population of about 2 million, and designated accident and emergency units are proposed at the district general hospitals in the conurbation. It will be readily appreciated that the appointment of resident medical staff for accident cases would be impracticable for a hospital the size of Smallwood. In replying to the debate it has been necessary for me to pinpoint to some extent the concepts we have in relation to the types of services we will require in future, and the kind of hospitals we must establish if we are to get the services right. This is the only way to get the matter in its correct perspective when dealing with the problems facing Redditch and other small units of population.
It is intended that the hospital building programme shall remain flexible. Regional hospital boards are expected to keep their programmes under continuous review and 1672 to adapt them to changes in need. Each board will plan its programme from year to year in terms of an allocation of capital, and will be required to match its capital expenditure with its allocation and to adjust its plans as necessary. In this way it is hoped to achieve the maximum degree of flexibility. If it becomes necessary, the degree of priority given to, for example, the scheme for a new district general hospital at Redditch, can be changed.
§ Mr. Loughlin
We must take changes in population into account. Where, in a region, a project was envisaged to start X number of years ahead, but, by virtue of the changed circumstances of the district the board thought that it was justified in changing its plan—proceeding with the project at X-Y years—that should, and, in fact will, be done in many regions. So the answer to the hon. Gentleman's question is that it would be quite possible, bearing in mind the comparative needs of the region as a whole.
In considering the distribution of financial resources between the regions, we have paid regard to the state of the services at present provided for patients in each region, to the condition of the hospitals and to the rate and distribution of population growth now forecast, including that of new towns. The building programme of the Birmingham region is the largest of any in the country but it is impossible, even so, to do all that the board would like. A scheme for a new general district hospital at Redditch is in place of the former proposal for a new hospital at Bromsgrove and takes into account the proposed expansion of Redditch. In determining the priority for this scheme, the board have had to weigh it against the other pressing social needs of the region.
The Birmingham conurbation, including Redditch, has been treated as a whole for the planning of the services. The new hospital to be built at Redditch will eventually provide services not only for the people who live there but for those in neighbouring districts, including Bromsgrove. The hospital building programme 1673 includes the new hospital at Redditch, which is among the list of schemes expected to start after 1969–70. Discussions are taking place between the board and the development corporation about a site for the new hospital and one has been provisionally selected.
My right hon. Friend is glad to see that the Development Corporation is fully cooperating with the board. Until the new hospital can be built, the people of Red-ditch will continue to look for the full range of normal services to the hospitals which serve them at present—chiefly those at Redditch and Bromsgrove, supported by those in adjacent districts. The board is considering whether existing hospital services can be augmented. It is proposed to increase the number of beds at Smallwood Hospital, though this depends on whether the Development Corporation in redeveloping Redditch town centre will encroach on the hospital site.
1674 Steps are being taken to recruit more midwives and to increase the number of staffed maternity beds at Bromsgrove where, at present, 14 are closed because of the lack of staff. This underlines the point that it is no use having buildings without the staff.
I know that the hon. Gentleman will be slightly disappointed with my reply. The hospital services are personal and there is naturally much concern in Redditch about the effect of population growth. The board is conscious of the need to watch the position carefully. My right hon. Friend agrees with it on the priority accorded the new hospital at Redditch. I can assure him that the matter will be kept continually under review and that the existing services will be improved in the meantime.
§ Question put and agreed to.
§ Adjourned accordingly at four minutes past Six o'clock a.m.