HOSPITAL, OUNDLE (CLOSURE) (Hansard, 24 July 1968)

§ Sir Harmar Nicholls (Peterborough)

I in no way begrudge that this debate comes at the end of an all-night sitting. It was worth waiting for, and I think it right that we should have it. In 19 years as a Member of Parliament and 15 years as a local councillor, I have never had such a spontaneous and sincere reaction from local residents as I have had following the suggestion to close the Glapthorne. Road Hospital at Oundle in my constituency. I have to say that there is no question of attributing malice or carelessness to the regional hospital board from any of my sources. Nor has there been any suggestion of a lack of regard by the authorities for the needs of the area. That is not the point.

This is a case of local opinion, representing the social strata of the area through all its gradations, genuinely feeling that its judgment of the matter is better based than is the judgment of the regional hospital board. Because of the intense and fair-minded way in which the representations have been made to me, I feel it my duty to suggest to the Minister that he would be doing his duty if he used any powers which he may have in a way that will prevent any precipitate action being taken in regard to the closure of this hospital.

The Minister may well be aware of some of the feeling which has been engendered in the district. There has been a petition signed by 1,900 residents; it was sent in by a minister of the Church and it was got together quite spontaneously. I have had representations from many organisations of real authority and standing—The Oundle and District Care Committee, the Thrapston Rural District Council, the Oundle 943 Urban District Council, the Nassington Parish Council, the King's Cliffe Parish Council, the Yarwell Parish Council, the Easton-on-the-Hill Parish Council, the Aldwincle Parish Council.

In addition to those official bodies, pretty well all the local branches of the County Women's Institute have sent in their protests and asked me to forward them to the Minister. I have had protests and objections from the Roman Catholic, Church of England, Methodist and Congregational ministers in Oundle and district. I have had representations from the Oundle branch of the British Legion. Four local doctors have written to me in some detail putting points from their specialised knowledge.

Those are only a few of the organisations and innumerable local residents who have added their voice in spontaneous reaction to the suggestion that the hospital should be closed. That is a formidable representation, worthy of the time and attention not only of the House, in the form of this debate, but of the Minister and his Department.

The view of the four doctors is especially worthy of mention, and it is quite clear. They say that the closure of the hospital will cause great hardship to the elderly patients and their relatives, and that neither Wellingborough nor Kettering, where alternative hospital beds might be made available, is easy to visit. Visiting would involve a journey of from 16 to 20 miles and would mean spending pretty well the whole day getting there and back because we have only a very inadequate bus service in the area, because of the poor demand for it for normal use, and the local railway line has been closed. Not everyone has a car or can find a friend to take them on these essential journeys. The result would be virtually to separate the sick from their relatives and friends at a time when frequent and easy visiting is of great importance.

The doctors say that they believe that instead of being close this Oundle hospital could be used to relieve the pressure on the district general hospitals at Peterborough and Kettering. As well as taking care of selected geriatric patients it could take convalescent patients who no longer require complicated care and treatment from these 944 hospitals. The doctors say that older patients who need complicated investigation or treatment could go to St. Mary's Hospital in Kettering first and then return to Oundle, where they would be near their relatives. Simple pathological investigation could be done by the Kettering laboratory, as it is at present, and the use of the domiciliary portable X-ray unit could cover the need for chest X-rays or X-rays for suspected fractures. The hospital could be run by the local general practitioners under the supervision of a visiting consultant.

These are constructive suggestions for economic and sensible ways in which the hospital could be put to even better use. If Kettering hospital does not wish to continue the supervision it could be done from Peterborough, that is only 12 miles away, and with Peterborough there is a good bus service. This is a constructive alternative which the Minister could and should take into account.

The doctors are convinced that with this sort of reorganisation the hospital could continue to serve their community at no extra expense to the National Health Service. They would be able to integrate their work with that of the district general hospitals, to the benefit of both patients and the staff involved. These medical men have told me that on the grounds I have set out they earnestly beg the Minister and the regional hospital board to reconsider the decision to close the hospital. Closing it would not save a great deal of money, and would cause much hardship to the people of Oundle and the surrounding scattered villages. It would remove a service that would not be replaced by any of the suggested alternatives. That is the view of the doctors practising locally, and there is no better authority to form a judgment on such a matter.

I can summarise the views of the lay organisations that have been in touch with me very briefly. They say that the hospital has given good service and is still capable of giving it to the elderly and chronic sick of both sexes, particularly those who need nurses but do not need a great deal of medical attention. The lay people make the point very strongly, because it is within their experience that this is the fact. The hospital is at present well served by a competent day and night staff, and it 945 is the only institution of its kind in the area of Northamptonshire north east of Kettering.

The local residents believe that if it is closed patients can be accommodated only in Kettering or Wellingborough, which would mean the long journeys to which I have referred, and the transport facilities are inadequate. It would mean, they say, that the relatives and friends of patients who are dependent upon public transport would be prevented from paying the number of visits which would be normal and helpful to the patients. They argue—and I pass it on with all the support I can give—that it is well to bear in mind in cases such as these that not only are the patients elderly and infirm but often the relatives and friends who would want to visit them are old and infirm, and the lack of facilities for frequent visiting is not only a severe hardship but can be a grave setback to the well-being of the patients. On these grounds alone they claim that there is a strong case for the reversal of the reported decision to close the hospital.

Further, they make the pertinent point that beds are just not available at the moment in the hospitals in the area for geriatric patients, and such patients, far from being sent to Kettering and Peterborough, are actually coming from those areas back to the Glapthorn Road Hospital.

I should like to make my constituents' point clear to the Minister. It is agreed that the Part III accommodation of the building, which is old and outmoded, should be demolished, but the geriatric hospital, built in 1901, which stands in a quiet part of the countryside, should be retained, and it is this section only to which the whole of their arguments for retention are directed. They claim —I support them—that in terms of economy so much money has been spent on the hospital in recent years that it would be improvident now to allow it to go out of use when merely by a little more capital expenditure vast improvements could be made and the hospital could be part of a system in the area which would be of general benefit.

On the question of staffing, it would be a great pity to dispense with the capable staff at the hospital, many of whom are employed on a part-time basis 946 because they live in the area and alternative vocational outlets in Oundle are very limited.

I believe that my constituents have submitted an outstanding case which justifies the Minister's looking with care and sympathy into their suggestions and avoiding the closure. If he can prevent the closure being carried out I am certain that he will be doing a service to the general Health Service for which he is responsible, and he will be recognising the authority with which the local doctors and residents speak.

§ The Parliamentary Secretary to the Ministry of Health (Mr. Julian Snow)

It may be helpful if, first, I explain the background of the proposal to close Glapthorn Road Hospital.

I have known the hon. Member for Peterborough (Sir Harmar Nicholls) for many years and very much admire the care with which he looks after the interests of his constituents. I am sure that after an all-night sitting he and I can think of places where we might prefer to be. We have travelled abroad a great deal.

In explaining the background position it is, first of all, important to get clear that the hospital is a former Public Assistance institution and since the appointed day it has been a joint-user establishment owned and maintained by the Northamptonshire County Council. The council provides residential accommodation for 44 people, and the Kettering Hospital Management Committee has the use of 60 beds for long-stay patients, although it is currently using only 50 of them.

At discussions between the county council and the Oxford Regional Hospital Board the council has indicated its intention to replace its residential accommodation at Glapthorn Road Hospital with new welfare homes, and to this end it will gradually withdraw its patients from the hospital. With the planned withdrawal of the county council, the regional hospital board is now considering the future of the hospital accommodation. This is distinct from the county council's responsibility.

I would like to deal with the local authority's future plans. It is my right hon. Friend's policy, as it has been of successive Ministers, to close former Public Assistance institutions—the "place 947 on the hill", as they are euphemistically known. Closure has been going on for a number of years all over the country and we should like to see the remaining ones go before the end of the 1970s.

The Northamptonshire County Council's Welfare Committee has produced plans for the closure of its former Public Assistance institutions which we approve. It is proposed that, by 1974, the last of these old workhouses, namely, Glapthorn Road Hospital, will have been replaced by modern homes suitable to the needs of the elderly who require the care and the accommodation which will be provided there. There should be no doubt as to the need to get rid of these outmoded places and bring old people more within the community, in consonance with the modern approach to the care of old people. This is why we and the county council want to design well-designed, small, modern houses to bring these people into the community and give them the greatest possible comfort. The hon. Gentleman and I are at one on this need.

Unlike a number of areas, that of the Kettering Hospital Management Committee has no deficiency of geriatric beds. There are sufficient beds in total to meet the estimated needs of the present population over 65 and the projected population in 1981, the year which we are using for intermediate planning purposes. The regional board accepts that many available beds, however, including those at Glapthorn Road, are not up to an acceptable standard. They have plans for the development of the geriatric services in the Kettering Group on modern lines. Acute assessment beds for geriatric patients already exist at St. Mary's Hospital.

My experience since I have held this office is that one must find the true balance and desirability as between modern care of old people and the convenience of their families. This is not a clear-cut issue, but I have taken the hon. Gentleman's point about visiting and keeping these old people in touch with their families.

The completion of Phase II of the new Kettering District General Hospital, which is at an advanced stage of planning, will provide a new geriatric unit, 948 which will, of course, be supported by all the modern facilities of a district general hospital. It is by no means certain that an old person having once been taken into a geriatric ward cannot, with modern science and treatment and assessment, come back fully into the community. In addition, there will be a new geriatric day hospital in Kettering this year. A further day hospital will also be built in Wellingborough in 1970.

Modern medical practice is directed to preventing the patient from becoming institutionalised and to achieve this, supporting rehabilitation services, which are wholly lacking in many long-stay hospitals, are needed. With this more active approach, we can expect the number of beds required to be considerably reduced.

This brings me to the economy in the use of hospital resources. It is the Minister's policy to encourage the closure of these hospital buildings and services which will not be required as part of a modernised and rationalised hospital service. A number of closures have taken place as the hospital building programme has progressed. The accelerating numbers of new hospital building, the continuing pressure on needs upon revenue and the increasing cost of running new hospitals has meant that it has become essential to carry out a thorough-going review of all existing services and my right hon. Friend recently asked hospital boards to do that review. The Oxford Regional Board, which has responsibility here, has, I am glad to say, responded wholeheartedly to the Minister's request.

This, therefore, is the background against which the regional board has been considering its present commitment at Glapthorn Road Hospital, from which the local authority has announced its intention to withdraw in about six years. There are, of course, obvious difficulties. Oundle is 17 miles from Kettering and those patients and their relatives who come from Oundle itself and the immediate vicinity naturally wish to see the hospital retained. Those whose homes are further from Oundle may be as conveniently served by hospitals in Kettering or Wellingborough and the second group, is, I understand, the larger of the two.

949 Then there is the question of the future medical care of patients in this area, to which I referred, and the many economic factors which should be assessed if this old building, which would serve a very limited purpose, were to be retained, as the hon. Gentleman suggested, by the regional board. These are some of the facts of the situation which the board has to weigh in reaching a conclusion.

I am well aware—this happens in my own constituency—of the affection and attachment which local residents have for their local hospital and I know that, in this case, many individuals have come forward to support the case for retaining the hospital. I agree that the hon. Gentleman produced an impressive list of organisations and individuals, in cluding doctors, to support his case. I can assure him that the regional board is having consultations with all local interests most conscientiously. As he is no doubt aware, as part of this process senior officials of the board attended a public meeting in Oundle in the last week and the board will certainly take full account of the views expressed by local residents.

950 When the board has reached a conclusion, it will make a recommendation to my right hon. Friend, at which stage the Minister will personally consider the case, as he does all other cases of hospital closures, and will take into account not only the representations of the regional board, but also those made directly to him and the views expressed here today, before he reaches a decision.

I have tried to put over to the hon. Gentleman that there are always conflicts of interests here, whether an economic conflict between the regional board, dependent as it is on the Government for finance, and the views of local residents, who, for sentimental and certainly some practical reasons, think that the present proposal is undesirable. We will keep this in mind and, before any decision is taken, I will have a discussion with the hon. Gentleman to explore the situation generally. He has done a useful service in raising this matter and no doubt his constituents will be well pleased with what he has done.