HC Deb 09 March 1966 vol 725 cc2253-70

10.39 p.m.

Mr. Peter Emery (Reading)

As we appear to have had no answer to the question so ably put by my hon. Friend the Member for Bristol, West (Mr. Robert Cooke)—I hope hon. Members will note that this has happened in a "time for decision"—perhaps we might pass to just as important a matter in Berkshire, and one which affects particularly the health and medical services of the whole of the region.

A medical dream started in Reading in 1958 and 1959, which, by hard and persistent work, by an immense amount of planning; and forethought—with medical staff and doctors meeting sometimes twice a week over 18 months—was finally turned into a planning reality. A new 600-bed hospital was envisaged, was planned and was accepted as being a major requirement for the whole of the Reading community, and to service the outlying areas of Berkshire, which is the fastest-growing area, in the greatest need of medical services, in the whole of Great Britain and Northern Ireland.

There are three absolute needs in Reading. The first is the need for more beds and the second is the need to raise what is sub-standard—and I will not describe how sub-standard or how much is sub-standard of the accommodation which has to be used in the hospitals servicing Reading. It is a wonder that the medical staff have been able to continue their work under those conditions, and it is a great tribute to them that they have done so without epidemics and without the service breaking down. The third need is for a fair deal for Reading and district hospitals. This is essential. Ever since I have been Member for Reading, since 1959, I have pressed for this. Accusations could be made against both parties at certain times, but it is essential that something constructive should be done for the future rather than waste any more time.

May I pay a tribute to the staff of the hospitals? Their work load over the last four years has increased by 18 per cent. while the available beds have increased by only 5 per cent. The efficiency of the hospitals cannot be questioned. The Royal Berkshire Hospital is perhaps the centre of the group and is regarded as the centre of the area. By any possible statistical analysis, the efficiency of this hospital has increased even with the fantastically inadequate facilities which are available. Bed occupancy has risen from 84 per cent. in 1961 to nearly 88 per cent. in 1965. Discharges and deaths in general medicine have nearly doubled from 760 persons to 1,327. The total figures have risen over four years from 12,500 to nearly 14,500. With the shortage of beds the length of stay in Reading hospitals is shorter than almost anywhere else in the country, and the work load on the outpatients department has risen from 94,000 in 1961 to nearly 118,000 in 1965. The efficiency of the hospitals, by whatever standard they are judged, is beyond reproach and worthy of warm congratulations.

May I analyse the problem and see why the problem is so serious in Reading. It is imperative to recognise that Reading is one of the major parts of the Oxford Regional Hospital Board. In its statement to the Ministry of Health in 1961 the Oxford Regional Board said that "One factor which created a degree of quite distinctive urgency in the case of the Oxford Region is the pressure of demand on the hospital services owing to increasing population." I am concerned that in the provision of capital allocations that have been made for the next 10 years insufficient recognition has been given to the factor of population growth. Indeed, the provisional allocations were made before the population predictions for 1981 were known, and this seems to me to be absolute nonsense.

May I prove my case about population growth. It is interesting to see that of the 12 regional hospital areas, including the Metropolitan area, the Oxford region, of which Reading is part, is the second smallest. However, the absolute increase in population in the Oxford region is estimated over this period to be over half a million people—574,000. Although, as I say, the Oxford region is the smallest but one, this is the greatest percentage increase compared with any other area in the whole of the country.

The percentage increase in population in the Oxford region is estimated to be 32.5 whereas in the next major area, Birmingham, where there is an increase of 930,000 people, the percentage increase is only 18.7. In other words, the percentage increase in population in the Berkshire area of the Oxford Regional Hospital Board is nearly 15 per cent. greater than the next largest area in the country.

The flabbergasting point is in the projected figures. It was originally suggested that the regional hospital board should plan for an increase of just under 16 per cent., and now this figure is more than doubled and the board is having to plan for a 32½ per cent. increase.

I turn to the proposed total capital allocations, and it is a matter of public interest that these figures should be made known. People have a right to know this. The total capital allocation which at the moment is projected for the Oxford Regional Hospital Board for the period 1966–67 to 1975–76 is £34½ million. For the whole of the region this is £3.46 million a year. I have shown that the percentage increase of population is twice as great as anywhere else in the country. Therefore, surely the total percentage capital allocation should match the great need of this region. But fantastically that is not the story.

The Government are in charge of these allocations. Whether they made these allocations originally or not, the fact is that they are now responsible for them, and the figures have not been "upped". I have been able to check up today that these figures still apply. It will do the Minister no good to say, "I have not had time to deal with this" or "It is not my responsibility because we have been in government for only 15 months". If I have anything to do with it, he will not be there after the General Election.

An Hon. Member

Nor will you.

Mr. Emery

That is what hon. Gentlemen opposite said before the last election. I was able to prove them wrong, as I will do this time. Whatever they may be thinking in their wildest dreams, they will have to put up with me in the House for a great deal longer.

I return to what is fact and not prediction; the position of the growth of the total capital allocation to all the hospital regions. Including the Metropolitan region, the Oxford region is tenth out of 12. There are only two allocations smaller than that projected for Oxford. Indeed, areas which are much lower, with total increases in population of only 9.1 per cent., such as Newcastle, where the population increase is about half that of Reading, are getting a sum a great deal larger than Reading.

Consider the various allocations. In the Metropolitan region it is £161 million; Birmingham, £69 million; Sheffield, £68 million; Manchester, £60 million, Southwestern, £46 million and Liverpool, £45.8 million. There is a tie between Newcastle and Wales, with £42.2 million. Leeds gets £39 million and then, and only then, we get to the Oxford Board, including Reading, with £34 million.

Why is this state of affairs so chronically wrong? One must make comparisons. The allocation of capital per additional head of population shows that the Oxford Regional Hospital Board area is at the bottom of the list. The average allocation of capital per additional head of population for England and Wales is £100. In Reading it is £60. In Newcastle it is £141 and in Wales—why Wales, I do not know—it is £200.

If one considers the allocation of capital per additional bed, one finds that, again, the Oxford region is at the bottom of the list. The allocation of capital per additional bed in Wales is £23,000. It is one-third of that in the Oxford region, which gets £7,095. It is obvious that the Ministry is totally neglecting this serious problem in the Reading and Berkshire area.

I pay tribute to the Reading Evening Post, which ran a series of articles just before last Christmas. My only possible criticism of those articles would be that they were not hard-hitting enough. They were factually and realistically presented and resulted in a great deal of the public unrest and concern which has been evident over this problem. It is a problem which might previously have been considered to have been swept under the carpet. It is now in the open. I see the Parliamentary Secretary laughing. He would not laugh if he saw the out-patients department at the Royal Berkshire Hospital. He would not laugh if he could see the queues, or could realise the time and waste involved in attending the outpatients department in conditions—

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

I want to make it absolutely clear to the hon. Gentleman, to the House and to the people in his area that when I was laughing I was not laughing about the substance of the debate but solely about the electoral fortunes of the hon. Member.

Mr. Emery

Then the hon. Gentleman will laugh on the other side of his face about that as well. He would not, as Parliamentary Secretary, allow these conditions to occur in his constituency, and it is a matter of the greatest seriousness that this sort of tragedy could happen anywhere at the moment.

Perhaps I might illustrate two aspects of this tragedy. Firstly, it would seem that the shortage of beds is considerably limiting some very specialist work being carried on by Dr. Hunt-Williams in the treatment of the young hard-of-hearing. This subject is considered to be so serious that the members of the Reading Hard-of-Hearing Association—which is a very small body—have clubbed together to raise £300 as a sort of self-help for their own people in trying to obtain extra beds in order that Hunt-Williams can continue his work.

The position in the E.N.T. department is that the number of operations has risen from 900 in 1956 to just on 2,000 in 1965. This is the growth of the work; this is the size of the problem. Can the Minister in all seriousness tell me that he thinks it right—with his views on socialised medicine—that it should be necessary for the sort of voluntary scheme I have outlined to have to be introduced in order to help hard-of-hearing young children, who could be affected for life if treatment is not given at an early stage?

If the hon. Member laughs at my electoral prospects, let him look at some of the promises that were made by the Socialist candidate at the last election—who is again attempting to come to this House. He led the electorate of Reading to believe that the whole problem would be dealt with quickly and expeditiously if the Minister should be sitting on that side of the House as a Socialist. Some of those asurances given were words with no action, and I believe that they will be so judged.

The waiting-list problem is of the greatest interest, because the work of the consultants and the hospital has, in ratio, been decreased, but, in fact, there are such problems that weekly I have letters from constituents asking whether I can take action to see that their operations are dealt with expeditiously. I had a letter only yesterday with regard to an operation for prolapse. The lady is greatly concerned and worried and asks whether I can do anything to help. On the maternity side, there is considerable worry that there are not enough beds available, although I grant to the Minister that a certain amount has been done in that respect, to which I shall refer later.

One of the great tragedies is that in this hospital a considerable amount of work has been done on a special care unit. There is extra work for the unit, which has come into being with a great deal of work by the consultants. This is not a single unit as one envisages it in the United States; the special care unit is spread round the hospital. Equipment is trundled from one ward to another and the beds are placed in any ward where the patient happens to be. Would the Minister tell us if he thinks that is right or something which should be corrected?

I ask the Minister whether the Ministry has come to any decision about a medical school as one of the improvements to be effected at Reading. There is a very strong case for a medical school in Reading. One of my hon. Friends has pressed for the establishment of a medical school in the Wessex area. If it is imperative that only one can be provided, will other hospital areas be considered? Although Reading is often considered to be in the Wessex area, for hospital purposes it is in the Oxford Regional Hospital Board area. There could not be a stronger case than that for Reading to be considered in this respect. The university on the other side of the road, has nearly all the ancillary facilities for the creation of a new medical school. It seems only common sense when the Government have announced the need for new opportunities, to see the establishment of a medical faculty at Reading where there is a whole range of biological studies more or less complete except for medicine itself.

With the vast extension and the creation of a 600-bed hospital, the money we are spending on that and the facilities at the university across the way, there could be a link established which would be second to none in any other university and hospital. The matron of the Royal Berkshire Hospital would not allow me to put my foot in the hospital again if I did not present her pet plea for in parallel a faculty of nursing whereby post-graduate work could be carried on for nurses trained at the hospital. This would be similar to that at the Royal Hospital and the University in Edinburgh.

There is a matter which could affect the saving of money. Because of the shortage of pharmacists in certain areas, in order that prescriptions shall be properly filled in, hospitals may use form E.C. 10 H.P., which allows prescribing to be done at a retail chemist's. In my opinion, there has been an increase of nearly £30,000 this year in the drug bill in the Reading hospitals. Probably the greatest cause of this has been shortage of pharmacists to deal with prescribing by hospital authorities. I am informed that the extra cost met by having the prescriptions filled in by retailers would allow not only a major increase in pharmacists' salaries, but would also ensure a considerable saving by the Government and the hospital management board. Why can we not have some action on this matter. In special circumstances such as these, does not the Minister have power to act to save the taxpayers' money?

One of the main tragedies of this situation which has resulted from the postponement of a major new hospital in a large block—"skyscraper" is the term which has been used—is that more and more temporary work is being put in hand for Reading by the regional board. This work includes a temporary accident department in Battle Hospital costing £160,000. Yet the accident unit is to be moved to the Royal Berkshire Hospital at a date now projected as being in 1968–69. In this temporary accident department there is no pathological unit, no "path" services at all. They have to be provided by the Royal Berkshire Hospital, a matter of a drive across town. There is no complete blood bank, essential in a hospital unit of this kind. Of course, there are blood stocks, but not a complete blood bank able to deal with all the different varieties of blood grouping. Yet this is a unit serving the whole of the area around Reading and with acci- dent cases coming from the A4, the Newbury Road and the roads from Windsor which are frequently littered at the weekends with accidents, often major accidents.

Only last week, a temporary outpatients' building was started at a cost of £90,000. The staff does not know what is to happen to this unit when the new hospital is built. Building this temporary accommodation is a matter of some waste. There was an outcry about the lack of maternity beds and there is now a temporary maternity unit costing £100,000. It is suggested that eventually this unit will be usable for some other purpose, but most of the staff say that that is medically impracticable.

I calculated that £350,000 was being spent on temporary buildings, but when I got in touch with some of the consultants and said what a catastrophic figure this was, I was told that I had missed out something. There is also a temporary X-ray unit costing another £50,000. Therefore, instead of getting on with the major building, which was originally planned to start in 1965–66, we are to have £400,000 spent on temporary buildings. Surely the Minister can appreciate the tragedy of fractionalising this vital centre for medical services throughout Berkshire when he ought to be going forward with the major scheme.

I conclude by asking two questions. There is growing frustration among the doctors, the patients and the nurses. One has only to visit the hospital to sense this feeling of frustration. The staff was quite prepared to serve in all sorts of bad accommodation when in the early 1960s it was thought that the major new hospital was going forward.

This was the dream to which I referred at the beginning of my speech. They were willing to undergo any conditions with the knowledge that Reading would have one of the best hospitals in the country if not in Europe. Now they see that this will not happen and that the Government are doing away with the central plan, having different parts of the hospital developed on different sites, and cancelling parts of the project. The building of the laundry was delayed—a major cancellation—with the result that a consultant told me today that the laundry service was so bad that he had to operate on different days using the same pair of white trousers. This may sound a foolish analogy, but in these days in matters of hygiene this should not be allowed to happen in any hospital let alone a hospital of this reputation.

It is the frustration that goes with this that brings the demand on the region and on the Minister to patch up facilities which ought now to be in the process of being scrapped in expectation of the development of the new hopsital. Will the Minister use his special powers to ensure that there is a greater allocation of money to the Oxford Regional Hospital Board? The allocation of £34.5 million over 10 years should be increased over the same period by £20 million. This would be a matter of only £2 million a year. It would still leave the Oxford region in total allocation way below most of the other regions and the amount spent on each new bed way below the cost in Wales and many other areas. This would mean that one would have the money to proceed with existing plans to continue with expansion not only in Reading but in Wokingham and other parts of the region.

I believe that even in the electioneering mood of the present Government there is little chance of obtaining any promise on that first request. I therefore have a second request. In order that it may not cost the Government any more money, will the Minister give a firm undertaking that he will see that within the proposed allocation of £34.5 million payment is stepped up in the first five years of the period 1966–7 to 1975–6? If the Minister will not give any more money to meet the present need, will he bring forward £1 million a year in the first five years and decrease the allocation by £1 million a year in the last five years? This would allow the hospital to get on with more of the job.

However party-political some exchanges may have been tonight, I want to forget party politics for a moment, because this improvement in the hospital service is a crying need of the whole population of this area. The need goes much wider than my constituency. It is not a matter of party politics. It exists, and the growth factors are getting worse, not better. Will the Minister give a sym- pathetic hearing to the case which I have put and consider either the immediate grant of more money to this hospital or, failing that, the reallocation of the proposed grants so that much more can be received during the first five years of the period?

11.16 p.m.

Sir Charles Mott-Radclyffe (Windsor)

I support what has been said by my hon. Friend the Member for Reading (Mr. Peter Emery) from what I might describe as an adjacent point of view. Although Reading, for which he speaks so eloquently, lies in a regional hospital board area different from that covering the adjacent area of East Berkshire, which is my principal concern, the points which my hon. Friend has made about Reading reflect almost exactly the problem in the whole of East Berkshire, that is, the astonishingly steep rise in the growth of population.

Although we are on the eve of a General Election, I say at once that I am not here trying to score party political points. Any Minister of Health and his Parliamentary Secretary are faced with great problems, no matter what party is in power. They have not got unlimited funds, and they must see that the funds they have are properly spread. Their second problem is that the equipment of any modern hospital is so complicated and so expensive that they must avoid unnecessary duplication.

It is, so to speak, a judgment of Solomon to decide where to extend, to rebuild or to build anew in the hospital programme. If I were faced with the question whether it was wiser to spread the butter properly on a few pieces of bread, or to spread it thinly and inadequately over a great many pieces of bread, I should be very much inclined to come down in favour of spreading the butter properly over the few.

The present hospital programme for East Berkshire is based, broadly speaking upon an extension of the main King Edward VII Hospital in Windsor, the rebuilding or building anew of the Wexham Hospital at Slough, which is in Buckinghamshire, with geriatric patients still going to Upton, also in Buckinghamshire, and an extension of the Heather-wood Hospital in Ascot, which deals for the moment with the population of Bracknell, although my guess is that in the very near future, again because of the steep rise in population at Bracknell, other problems will arise there. That is the plan at the moment.

It so happens that the Maidenhead area finds itself, almost by the accident of geography, in a vacuum, but it is in that area that by far the biggest rise in population has occurred and is likely to develop in the next 10 or 15 years. When one puts the Borough of Maidenhead together with the Cookham rural district, the estimated population by the early 1970s is more than 70,000. The problem with the hospital accommodation in Maidenhead is that at the moment it is split into three. There are St. Mark's Hospital, which is really the old Poor Law institution furbished up a bit; the Maidenhead General Hospital, which has a large number of hutted wards; and the Canadian Memorial Hospital at Cliveden, which takes a very large proportion of the maternity cases. These are all highly efficient, but they are not very easy to manage together because there are several miles between them and the services are all split up as well, and all this in an area where there is a very steep growth of population.

While I am certain that the regional hospital board was right to decide, whatever else it may have decided, to build on to the Windsor Hospital, because that is already a well-established all-purpose hospital of high repute, the fact remains that, for a number of reasons into which I will not go now, the growth of population in the Windsor area in the next 10 or 15 years cannot be anything like as steep as it is likely to be in the Maidenhead area. So one gets to the stage when if Windsor Hospital is to be the main general purpose hospital for the area, from the far end of the Cookham rural district patients and their relatives may have to travel 10 or 12 miles to the Windsor Hospital, and this with a very inadequate and eccentric bus service, which presents very considerable difficulties.

The Parliamentary Secretary was kind enough, a few weeks ago, to receive a deputation from the local authorities concerned, and we discussed a number of these problems. I would not dream of pressing him for an answer tonight, for it would be unfair to do so, and this is not the right occasion to press for that sort of answer. But my feeling is that he or his Department—we do not know what is to happen in this way in the future—must begin to work out whether in the next phase of the hospital building programme consideration ought not seriously to be given to the arguments in favour of building a hospital where the density of population is known to be great now and by any reasonable forecast is almost bound to increase. I should simply like to know this evening the direction in which the mind of the Parliamentary Secretary of the Ministry is working in this respect. That is all I ask. It would not be fair to ask anything other than that in a debate of this type at this time.

I would again express my thanks to the Parliamentary Secretary for the great trouble that he has taken over the problem during the last few weeks, when he and I have had many conversations, quite apart from the deputation which I took to him.

11.24 p.m.

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

I should like to deal, first, with the question raised by the hon. Member for Windsor (Sir C. Mott-Radclyffe), because I might be able to dispose of it fairly quickly. The hon. Member accepts, as he said, that I have some concern about the developments in the Maidenhead-Windsor area. I have additional concern, because I, like the hon. Member, represent an area which has similar transport difficulties. I appreciate, and there is an increasing awareness, that the transport difficulties are a real and serious problem in rural areas of the kind of which we have been speaking.

I would not want to contradict anything that the hon. Member has said about our recent discussions. Apart from the time when he brought a deputation to see me, the hon. Member and I have discussed these matters on two or three occasions in the corridors and elsewhere in the House.

As the hon. Member knows, I listened carefully to the case advanced by the members of the deputation. I told them that I would go into the points they had made, with particular reference to whether it would be fair to proceed on the basis of the plan to extend the Windsor Hospital as population development in the area was more likely at Maidenhead and Cookham.

I should, however, make it plain that the regional hospital board has been doing what the hon. Member said ought to be clone, and that is to seek to avoid serious duplication of services in a particular area. The problem facing the regional hospital board was that there were certain services at the Windsor Hospital which could be an integral part of a new or developed hospital, but that if the site for the hospital were changed from Windsor to Maidenhead there would be additional cost and wastage of services, because that would mean a duplication of the services at Windsor and, possibly, the non-use of existing services there.

I should like the hon. Member to know that even though I considered the regional hospital board to have a valid argument, I accepted that his deputation put forward reasoned and cogent arguments and a case that had to be examined. The case has been examined in my Department and we have decided to look closely at the problem and to ascertain whether, in practice, it is possible to make any change in the plans for the area.

In saying this, I hope that the hon. Member—I feel sure that he will not—will not take this as being anything like a firm promise to deal with the situation in that way. I assure him, however, and I think that he will accept this assurance, that I have attempted to deal with the problem in the way in which he would want to deal with it—in other words, as objectively as I can, but taking into account the convenience of patients and visitors as well as the convenience from the viewpoint of the regional hospital board.

Now I turn to the hon. Member for Reading (Mr. Peter Emery). In his last few remarks he said that he felt that this was not a matter about which party points should be scored. I wish he had felt that when he began his speech, and for seven-eighths of the speech which he delivered, because I felt that at one time he was putting a little electoral hysteria into the case he was presenting. It is true that we had a little bit of fun about his small majority. It may well be that he will come back here after the General Election. I hope he will not, but if he does—well, we shall be able to put up with him on that side of the House, once those circumstances arise.

I am not making excuses, and I shall deal with the case as far as I possibly can, but I wonder sometimes whether hon. Members, who discuss the possibility of our having built substantial hospitals in the period in which we have been in power, really think of the tremendous amount of planning which has to be done before we can get a hospital, not off the ground but off the drawing board. As the hon. Gentleman knows, my right hon. Friend, for some of the reasons which the hon. Gentleman advanced tonight, decided that the only way we could deal with this situation in its entirety, and in a way in which we could be assured of the right type of hospital service in the future, was to review fully the planning of hospitals and to scrap the plan which was introduced by the right hon. Member for Wolverhampton, South-West (Mr. Powell).

There was reason for this, and the reason for it was not very hard to find. When we looked at the plan we discovered that, on the basis of project after project, on a clear analysis of the first phases—the hon. Gentleman will accept that we build large hospitals in phases—the costings, on taking into account changing monetary values from the time the plan was first put down to the present time, were really all at sea.

It is true that when the Government, no matter of what party, decide to do a review of this kind it is a long and protracted sort of investigation. My right hon. Friend initiated this review, and the regional hospital boards have gone into the whole question of what they think will be their requirements over a given period of time, and we are in a position to examine their findings. The hon. Member will ask, how long is it going to take? It will possibly be one or two months yet. I should not think it will be much more than one or two months. I am not giving any firm commitment on that. If the hon. Gentleman just thinks for a second he will know that if a Minister is examining proposals which have been placed before him it would be presumptuous of the Parliamentary Secretary to give a firm commitment on behalf of his right hon. Friend.

We have not taken too long about this plan. If the hon. Gentleman cares to make a comparison with the previous plan—and I am not being critical about what took place on a previous occasion—he will find that the time scale is very much the same.

There is no dispute about pressure on the hospital services in Reading and Berkshire. Quite clearly, the hon. Gentleman put his finger on the kernel of the problem when he referred to the population explosion in that part of the country. I want the hon. Gentleman to realise that my right hon. Friend, my Ministry, the Oxford Regional Hospital Board and myself are just as concerned with the problem as anyone else. The explosive growth of the population in the county generally and the area in and around Reading in particular is really the kernel of the problem with which we are faced.

It might be as well to recognise that the hospitals in the Reading Group now serve a population of 340,000. In practice, that is an increase of 70,000 over the last 15 years. The growth is continuing, and we estimate that by 1981 the population of the area will reach 500,000. Obviously the hospitals will be under great pressure for some time in the future.

My right hon. Friend has made it clear on a number of occasions that in attempting to assess the requirements of all parts of the country, when looking at the hospital building plan which we are now in process of formulating, not merely is there bound to be concern for populations as they are at present, but, in arriving at the types of services that will be required in a particular area, consideration will have to be given to the estimated population projections.

Mr. Peter Emery

I accept immediately what the hon. Gentleman says about his acceptance of the population explosion in the area. But when he says that his Ministry is cognisant of it and wants to be able to deal with it, may I ask him why, realising that demand, it was necessary to cancel this major project? It was one of the few cancellations in the whole country, and the result has been that the hospital service for the whole area is now at breaking point. Surely that is not realisation of a major problem?

Mr. Loughlin

I hope that the hon. Gentleman is not going to make a speech every time that I stress a point with which he is not in entire agreement. I will come to some of the things that he talked about in a moment. I agree that the staff of these hospitals are doing magnificent work, often in difficult conditions, and with poor facilities. I would not like a degree of frustration to become widespread in these hospitals. I know that the medical profession and the nurses take a lot, and have taken a lot over a long period of time. I do not want to make party points, and I am not going to make a party speech tonight, but, in view of what the hon. Gentleman said, I ask the staff at these hospitals not to get too frustrated, to be a little patient, as they have been in the past, so that we can provide them with the facilities which they ought to have.

I agree that the hospitals are coping with a tremendous increase in all sorts of ways, and we accept the need to push ahead urgently with the developments planned for Reading. I should stress that a good deal has already been done. It is no good the hon. Gentleman saying that the projects which have been carried out in the past, the projects which are now being carried out, and those which will be carried out in the immediate future, are a waste of money because we should be using the money to build a new hospital. I repeat what I told the hon. Gentleman earlier, that this work has to be done. How can we deal with a population explosion simply by waiting until a whole new hospital is built? After all, 15 months is not a long time in this context. If this hospital had been started a number of years ago, it might well have been valid to argue that we need not put in what the hon. Gentleman referred to as emergency and temporary projects, but if, as things are, we do not do something like this, and we wait for another five years until the hospital is built, how will we deal with the present population explosion?

Over the last few years the regional hospital board has completed more than 20 schemes at a cost of just under £500,000, and I believe that the regional hospital board was right to complete those schemes. A start has been made with the development of the Royal Berkshire Hospital as the main acute hospital for the area. Work is in progress on a new ophthalmic department, at a cost of over £500,000, and on a new out-patients' department costing over £100,000. Work is due to start this summer on a new maternity department which will cost £1½ million, and a number of minor projects have started, or are about to start, to improve the services and residential accommodation at the hospital. Developments have also taken place at Battle Hospital. The maternity unit there has been extended at a cost of over £100,000, and work is nearly complete on a new casualty and X-ray department costing nearly £200,000. A new operating theatre is being built, and numerous minor works are in hand.

On the maternity side, the hon. Gentleman accepted that additional beds and improved facilities had been provided. Apart from the major improvements at the Royal Berkshire and Battle Hospitals, a general practitioner maternity unit has been built at Townlands Hospital, and a new maternity unit at Wokingham, and the Dellwood Maternity Hospital has been extended. Altogether these projects have provided 60 additional maternity beds. The number of births in hospitals in the area has risen from 3,800 in 1961 to 5,800 last year, and it is wrong for the hon. Gentleman to talk in terms of not doing this work and waiting until the major hospital is started.

Plans for further developments are now under review. Broadly, the intention is to press forward with the redevelopment of the Royal Berkshire Hospital as the major hospital centre for the area, and with further improvements at Battle Hospital.

The timing of the major projects will depend on the outcome of the current review of the Hospital Plan, but I can assure hon. Members that there is no complacency either on the part of the regional hospital board or of my Depart- ment about the situation in Reading and Berkshire. We are fully aware of the need to press ahead with major hospital developments to meet the growing population in the area.

We can bandy figures about, but I should say that some of the figures used by the hon. Member—related, as they were, to the smallest region in the country—drew what may well be a very false picture. I do not say that the hon. Member did this intentionally, but if a comparison is made region by region it is easy to draw a false picture if special care is not taken.

The hon. Member was concerned mainly with two points. The first related to the 10 year capital allocation at present projected, and whether that could be increased to deal with the increase in population. My right hon. Friend is bound to take into account the estimated projection of population growth, in the revision of the Hospital Plan. I cannot commit him, but if the estimated projections of populations are accepted there may be need for an increased allocation not merely for the area that we are discussing but for all areas affected by the population explosion.

The second point concerned the question whether or not there was a possibility of increasing the total in such a way that there could be a pushing forward in the first four years. I cannot give an undertaking of the kind asked for, but I will draw my right hon. Friend's attention to the hon. Member's suggestion and assure him that we will do everything we can to meet the requirements of this area, because the regional hospital board and ourselves are as concerned about it as he rightly is.

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