HC Deb 26 July 1966 vol 732 cc1679-88

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

2.40 a.m.

Mr. Will Griffiths (Manchester, Exchange)

The subject I am raising this morning is particularly appropriate at the end of a sitting which began with a debate on the state of the nation's economy.

When winding-up that debate my right hon. Friend the President of the Board of Trade drew attention, quite rightly, to the Government's decision to exclude from the economy measures investment in housing, schools, education and hospitals, and he said—I noted his words down—that in those fields there were "new and greater priorities". We shall see. I shall speak now of the hospital requirements of an important number of Manchester citizens, and, though I speak of Manchester, I recognise at once that this is simply a national problem in microcosm.

On page 62 of the Hospital Building Programme, published in May this year, we find a review of the Manchester hospital region, and this is said: The main problem in the region is that most of the existing hospitals have their origins in the industrial revolution", and then, visualising the future, it is said in the same paragraph: Accordingly the programme will be mainly one of phased rebuilding of major hospitals either on their existing or new sites. I appreciate that the situation described there in the Hospital Building Programme is typical of most of our industrial areas and it is not exclusive to Manchester. As regards hospital building, it is a sad story that the nation has had to tell since the war. When Galbraith used the phrase "private affluence and public squalor", he could have found here in Great Britain plenty of evidence of public squalor in our hospitals. I never cease to wonder at the noble work which is being done by people employed in the hospital service in surroundings which are a disgrace for both the professional workers and for the patients who have to attend hospital.

I come now to East Manchester and my own constituency, and at this point I shall recite a few facts with which I hope the Parliamentary Secretary will be able to agree. There are in Manchester three hospital management committees outside the teaching group, the West, North and South Hospital Management Committees. In the present structure of the service in the City of Manchester, there is no specifically eastern group. Taking East Manchester as including those suburbs of the city such as Beswick, New Cross, Gorton, Openshaw and parts of Ardwick, we have here a segment of the population of Manchester amounting at present to about 145,000.

In this area, there is only one hospital, the Ancoats Hospital, as my hon. Friend the Member for Openshaw (Mr. Charles R. Morris), whom I am glad to see here tonight, will know. Going north from Ancoats, one does not find another one until reaching the Northern Hospital. To the south, there is the teaching group under the control of Manchester United Hospitals. To the west, one goes into the City of Salford, with its Salford Royal Hospital, and to the east one goes to the Borough of Ashton, with the Ashton-under-Lyne General Hospital.

The Ancoats Hospital is situated in a highly industrialised area surrounded by a commercial and business section, very near to the centre of the City, but around it there is a considerable area of residential property and, what is more important, there are great areas—which will grow—of residential urban renewal. At present, I am told, this hospital treats approximately 1,000 casualties a week.

The future of this hospital has been considered by the regional hospital board on a number of occasions in recent years and from the board had come a stream of plans of varying quality and dimensions which have been widely publicised in the Press in the city. Because we have only a short debate, I will not go too far back, but will start to recite the history of the hospital from 1962. In July of that year the regional hospital board asked the Manchester City Council Planning Committee to reserve for future hospital development 15 acres. The corporation, after consultation with the board, agreed to reserve nine acres and that reservation remains today. It is still there if the regional hospital board wants to proceed, as I hope it will, with extensive developments of Ancoats.

In February, 1963, the chairman of the regional hospital board planning committee said of Ancoats: We shall extend upwards and outwards". This observation was publicised in the city at the time and taken by almost everyone to mean extensions to the existing building and virtually the construction of a new hospital in the same area. The board confirmed to me its intention to redevelop Ancoats along these lines.

As the Parliamentary Secretary knows, all this has been dropped and today all that is planned for Ancoats is a new outpatients' department and improvements to the accident department. Goodness knows, it is modest and certainly urgent, but even this, as I understand, is now in the far distant future.

In March, 1965, the regional board wrote to a colleague who is an alderman on the Manchester City Council and said that the board hoped to start work on this limited project in 1967–68, but that it was now clear that it was not to begin before 1968–69. The Parliamentary Secretary to the Ministry of Health wrote to me in May, 1965, only two months later, and said that it had been originally intended to begin this work in 1967, but that events had arisen which compelled a postponement for one year. That is approximately the same story as that given by the board to my colleague on the city council. As the Parliamentary Secretary will recall, he went on to say: It remains high on the priority list". The pattern of development in the Hospital Plan published in May this year, from page 62 onwards, shows a list of projects which it was hoped to begin in the Manchester region. It shows schemes which it is hoped to start in the period up to 1969–70 and it does not include the development of Ancoats Hospital despite the fact that in March the regional board was saying that it was to start in 1968 and that in May the Ministry was saying the same thing.

Indeed, when we look further in this revision of the Hospital Plan, it is not until after 1969–70 that we find Ancoats mentioned again. under a sentence that reads: According to present plans, the start of these schemes"— that is, the schemes to be commenced in the period up to 1969–70— will be followed by the start of … and against we find Ancoats mentioned.

It is a disappointing story, and I do not think that it is explicable wholly in terms of a deteriorating financial position. There seems to be a lack of clear understanding on the part of the regional hospital board as to what it wants in a new general hospital for this area, and where it wants it.

Because I am sure that the House wants to hear what my hon. Friend has to say, and because I do not want to take up any more time, I sum up what I. have had to say in this way. On the evidence of the attitude taken by the regional hospital board, of my hon. Friend in his communications to me, of the Answer which the Minister gave to me in the House a week or two ago, and of the hospital building programme published in May of this year—on all the evidence from those sources there is no doubt that the needs of East Manchester are recognised.

Secondly, there are existing buildings at the Ancoats Hospital and, most importantly, there is an extremely valuable and large enough site. Thirdly, planning permission has already been granted some years ago—acceding to the request of the hospital board—by the Manchester City Council. I must point out, however, that as the tempo of Manchester urban renewal increases there is no guarantee that the site can remain undeveloped for ever. As I say, it is an extremely valuable site.

I therefore beg my hon. Friend the Parliamentary Secretary to ask the regional board to look at all this again. I understand perfectly well that a feasability project is now under consideration for the development of the teaching hospitals of Manchester. That, I welcome very much, because that is also in my constituency, but on the basis of the story I have put to the House, I ask my hon. Friend at the very least to ask the board to examine the subject again, and to see whether, first, the essential minor works at Ancoats can be carried out more speedily than is at present envisaged and, secondly, to consider whether the whole site could not be, as was said by the chairman of the planning committee a few years ago, developed both upwards and outwards as a new general hospital.

2.52 a.m.

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

My hon. Friend the Member for Manchester, Exchange (Mr. Will Griffiths) has spoken with his usual eloquence and force about the problems of the hospital service in East Manchester, and particularly about the future of Ancoats Hospital. Before deal with the points he has raised—and by the time I sit down I hope to have dealt with most of them—I should like to say a few words about the considerations that must govern planning in a great urban area like Greater Manchester.

In such an area it is particularly difficult to say which hospitals serve which parts. There are really no hard-and-fast boundaries, communications in general are fairly good and, further, near the centre of the area, there is a group of teaching hospitals, including the well-known Manchester Royal Infirmary, to which patients come from all over the area. Again, broadly, there are, and will continue to be, substantial internal movements of population as slum clearance and rehousing proceed.

I know that my hon. Friend will agree that the Manchester of 20 years' hence will present a very different picture from that of today and a very different picture from that of yesterday, whose needs most of the existing hospitals were built to serve. I submit to him that the lesson of this is that it would be bad planning to plan for one part of the area without taking into consideration developments in the area as a whole.

At present, hospital services for patients from East Manchester are provided by the hospitals of the North Manchester Group; that is, by the Crumpsall, Northern, Victoria Memorial Jewish, and Ancoats Hospitals, as well as the Beech Mount Maternity Home. Many patients from this area, however, are treated at the teaching hospital. Child patients are treated at the Royal Manchester Children's Hospital and the Booth Hall Hospital, and patients requiring some highly specialised treatments will receive them at hospitals elsewhere where regional or sub-regional centres exist. On the other hand, the North Manchester Group of hospitals admits patients from outside the city, from the central and southern parts of the city, and, in the specialties of neuro-surgery, urology and psychiatry, from an even wider area.

I have said that when the services to be provided in East Manchester are viewed in the wider perspective, developments taking place in other parts of the area must be considered. In the south, at Wythenshawe, a new district general hospital is currently being built and the maternity department is already open. Withington Hospital is in process of redevelopment and extension. An entirely new district general hospital is to be built at Cheadle. To the south-east, Stepping Hill Hospital, in Stockport, is to be rebuilt and extended.

Extensive hospital developments are planned in Salford and district towards the west and north-west of the area and similarly on the periphery developments will take place at Oldham and Ashton-under-Lyne, to the east of Manchester. At the centre, it will be necessary to provide a new and larger teaching hospital to replace the old and unsatisfactory existing buildings. This new teaching hospital will serve as a district general hospital and it seems reasonable to assume that it will be used by many patients from East Manchester, particularly as, with new or redeveloped hospitals to the south of Manchester from which many of its patients now come, it will have increased capacity. The new teaching hospital will be only 11-miles from Ancoats Hospital.

My hon. Friend will, I hope, agree that in these circumstances the planning of the future of the hospital service for East Manchester is a matter of some complexity. The effect of the peripheral hospital developments to which I lave referred cannot be measured for some years yet and there is a real danger that if decisions are taken now which fail to have regard to them, there is more than a possibility that hospital provision will be made on the wrong scale and, possibly, even in the wrong place.

As I have said, there will continue to be internal movements of the population of the area as a whole and plans for improving the road network could change the whole pattern of communications. All this points to the wisdom of postponing final decisions about the future hospital service in East Manchester as long as is reasonably possible.

It should be possible to form a preliminary judgment of the likely effects of all these developments—at least of their effects on the hospital maternity services in the area—in the fairly near future. The new maternity units at Wythenshawe and Withington are already beginning to show their effect on the load on the existing St. Mary's Hospital and although these are early days it seems at least possible that the new and enlarged St. Mary's Hospital which is now being built will have an increased capacity to accommodate mothers from the East Manchester area, to which my hon. Friend referred. But it will be some years before a firm conclusion will be possible.

My hon. Friend will not, I hope, draw the conclusion that the needs of East Manchester are being ignored or given a low priority merely to facilitate planning. They have been most carefully considered both by the regional hospital board and my Department. An essential part of the revision of the Hospital Plan for England and Wales, which has just been completed, was, of course, a check on the priority being given to the provision planned for each area.

The Manchester Regional Hospital Board has many claims on its resources and we are satisfied that, in giving high priority not only to those developments in the Greater Manchester area to which I have referred but also, for example, to developments in the Blackpool, Blackburn and Preston area, all of which have far more pressing problems than East Manchester, it has made the right decision.

Mr. Will Griffiths

What has happened in the board to make it change its view of planning between 1963 and now?

Mr. Loughlin

The planning of the whole of the service for Manchester has been a continuous process. I will come a little later to the particular case of the Ancoats Hospital. I must emphasise that the current needs of East Manchester are not being forgotten. A scheme for a new outpatients and accident department at Ancoats Hospital which was not on in the original Hospital Plan is now listed in Command Paper No. 3000. It enjoys a much higher priority than many schemes listed in the original plan. It is true that I cannot say now the date on which this development will commence; but I can tell my hon. Friend that it is under active consideration at the moment.

In the whole of our approach to these plans on this occasion, we have attempted, as far as possible, not merely to give a high degree of flexibility, so that there are not any particular dates on listed projects, but we have also said that, even where we may give a list of projects which should or might be finished at given dates, it has to be recognised that a degree of flexibility even in this aspect has to be accepted and that some will be brought forward while others may be put back.

In addition, major developments are planned at Crumpsall Hospital to improve the existing services there, mainly to upgrade the maternity unit and provide ante-natal facilities. Pending the permanent redevelopment of the service for the area, there is reason to hope that the existing hopsitals can be relieved of some pressure by the United Manchester Hospitals, as pressure on them is relieved by other peripheral developments.

It is clear that Ancoats Hospital must continue for some time to come at least but, for the reasons I have given, it is not necessary now to conic to a final decision on its permanent future or on the future pattern of the hospital service for East Manchester. We have said in Command Paper No. 3000 that, in the long term, North and East Manchester will require two district general hospitals, but what we will not be able to say for some time yet is what their size will be.

My hon. Friend has rightly raised very sharply the question of Ancoats Hospital and I agree with him that the hospital has a very high reputation. It is well known to us and we are all well aware that this reputation does not stem from the buildings, which leave very much to be desired, as he rightly said, but from the successful efforts of the medical, nursing and other staff to overcome difficulties imposed upon them by the inadequacies of old buildings unsuited to the needs of modern medicine.

I would like to echo the praise for the devotion of the staff, particularly in the light of the pressures under which they are working at present. Yet, however sympathetic we are to the conditions, we cannot ignore the fact that the life of the existing premises is limited. The ward units are old and lacking in ancillary accommodation. It may be that it would be possible to build "high and wide", as my hon. Friend suggests, but there are difficulties in that.

Mr. Will Griffiths

As the hospital board says.

Mr. Loughlin

As the chairman of the regional board's planning committee says.

The whole point here is that there is a site of three acres, with the prospect of an additional six acres, and not nine as has been said, but making nine acres in all, on which it is assumed that we can build a major district hospital. Speaking "off the cuff", I think that it is accepted that we normally require about 30 acres for a 600 to 700-bedded hospital with the accompanying services. If we require 30 acres for this type of hospital when we have only nine acres, then obviously the height to which we would need to build the hospital would present difficulties; not only in respect of the height itself, but in terms of engineering, ventilation, and heating; and in all, it would be a very expensive unit indeed.

So, even if the chairman of the regional board's planning committee says that this site could be developed for a major hospital, I would hesitate before agreeing to develop a limited site of this kind for a major hospital. We cannot commit ourselves at this stage as to whether Ancoats will be part of the ultimate hospital pattern serving East Manchester, and it is clear that the maximum amount of land we can get to extend the site will not permit the building of a comprehensive district general hospital. But despite these limitation, it is at present an essential part of the hospital services in this area and I think it is true to say it will remain so for some years yet.

I hope, therefore, that we can put into effect the greatly improved facilities for dealing with the out-patients and the accident cases. I am sorry that I cannot tell my hon. Friend the precise date when we hope to have the accident and emergency departments fully in operation, but I give the definite assurance—

The Question having been proposed after Ten o'clock on Tuesday evening and the debate having continued for half an hour, Mr. SPEAKER adjourned the House without Question put, pursuant to the Standing Order.

Adjourned at ten minutes past Three o'clock a.m.