BEARSTED MATERNITY HOSPITAL, HAMPTON COURT (Hansard, 21 April 1969)

§ Mr. R. Gresham Cooke (Twickenham)
A very popular, highly respected local maternity hospital, namely the Bearsted Memorial Maternity Hospital at Hampton Court, has been murdered by the action of the North-East Metropolitan Hospital Board and the Department of Health and Social Security.
This small but well-placed maternity hospital of some 32 beds serves not only my own constituency of Twickenham, which includes Teddington, Hampton, Hampton Wick, but also such surrounding areas as Richmond, Kingston, Molesey, Thames Ditton, Sunbury, Shepperton and Feltham.
In the second half of September last year, I was informed by the North-East Metropolitan Hospital Board that the Board was proposing to recommend to the Minister of Health that the hospital be closed. It may seem strange that a hospital in the south-west of the London area should be under the North-East Board—and I feel that that odd circumstance may have contributed to its closure—but the hospital was originally an off-shoot of a hospital at Stoke Newington providing a maternity service for Jewish mothers, and since the introduction of the National Health Service it has come under the National Health Service and provides a local service for mothers of all denominations.
Immediately the Press notice was published by the Board uproar broke out in my constituency. Every section of the community was shocked. I sent a strong letter of protest to the board in which I said: This is the only maternity hospital in my constituency. Considerable sums had been spent on a new operating theatre and modernisation. It is extremely convenient, being served by local buses, and its closing down would be a very real loss to the district. In reply the Board stated that no final decision had been made. It said that the matter would be reviewed in the light of any representations before it made a recommendation to the Minister. It recognised the high standard of work at the hospital but considered that other 217 local hospitals could meet the need. But, of course, these other hospitals are six or seven miles away—for instance, at Chiswick, West Middlesex and Ashford, Middlesex.
To get to these hospitals from Hampton means awkward journeys for expectant mothers and their families. Going by bus means having to change buses. The rail journey means changing trains. Surely this sort of journey is not good for pregnant women going for consultation before childbirth.
After this statement by the Board, a very large number of representations were received locally from the Richmondupon-Thames Council, the Teddington and Hampton Women Citizens' Association, the Strawberry Hill Residents' Association and other bodies, many doctors and clergymen and public and social workers of all kinds. A public petition was organised by two council members, Alderman Crane and Councillor Kenton, of Hampton, and nearly 8,000 signatures were quickly gathered against the proposed closure. More could readily have been obtained if the petition had not been closed at the beginning of December. In due course I presented the petition to the House.
On 16th December, a strong delegation of local councillors, a local doctor, the G.L.C. representative, Mr. Toby Jessel, who has been taking a close interest in the matter, went to the Board which was then chaired by Sir Graham Rowlandson. I was also on the delegation, which told the board that the great majority of local doctors were in favour of the retention of the hospital, together with the local clergy, by a majority of 21 to one.
The whole matter was summed up by one Teddington general practitioner when he said that the hospital … is staffed by first class Consultants in Obstetrics. It is very popular with patients. It is easy of access for those in the Catchment Area. The liaison with the family doctors is excellent. Were it to be closed the local maternity patients would need to be directed to other Hospitals some distance away. This would not be in their interest when attending ante-natal clinics in inclement weather by public transport, and in addition it would make evening visiting more difficult for their husbands after their day's work. The Archdeacon of Kingston said: Maternity Hospitals seem to me to be in a rather unique position. The patients are not 218 really ill and what the mothers need most of all is a sense of security, and they find this by being reasonably near home so that they can be regularly visited. I would have thought it possible to know which would be acute cases who would then be sent to Hospitals that have specialised services. A lady doctor at Twickenham commented: For patients who have been unable to have their babies in their own homes and yet scared to be admitted to a large hospital, it has been a boon. The hospital, therefore, is of great psychological value.
An example of the reputation of the hospital locally is given by the reply to a question put by a local vicar to an expectant mother. He asked her, "Which hospital are you having your baby in?" She replied, "I'm not having it in hospital—I'm having it at Bearsted." A local clergyman said: This seems to me to indicate very forcibly that Bearsted ideally fulfils the needs of any expectant mother—the combination of 'home' conditions together with expert medical treatment.… A Kingston doctor stated: It is the warmth of a friendly staff in intimate surroundings that gives mothers the reassurance they need, and prevents many of the complications which strike terror into the hearts of so many women. This is what makes the Bearsted popular among our patients. When this matter was being discussed with the North-East Board, the question of the birthrate was raised and whether it was falling. I should like to point out that in 1947 to 1950 the birthrate reached a peak. This means that there are many young people in their twenties who may well produce an equivalent peak in 1969 and the 1970s. I have a news-cutting which states that The beginning of a baby boom in England and Wales is forecast by the Registrar General", who expected an upward trend in births this year. In the south-west area of London there has been a 10 per cent. increase in births.
Despite all that we said, the board persisted in its view on closure and, on 18th December, evidently put its final recommendation to the Minister. I was not told of this at the time, but I read it in the Press after Christmas, and on 6th January I asked for confirmation from the Board. It was confirmed. I had previously been in correspondence 219 with the Secretary of State for Social Services and an interview was arranged for me with the Minister of State, the hon. Member for Dover (Mr. Ennals).
When we went to see the Minister of State we put a powerful memorandum to him. We had the support not only of local representatives but of Dr. David Brown, Director of the Postgraduate Institute of Obstetrics and Gynaecology at Chelmsford. We also had support from the hon. Member for Feltham (Mr. Russell Kerr). We pointed to the popularity of the hospital, the difficulties of patients going elsewhere, the question of transport to other hospitals, the excellent maternity record and the fact that the hospital was not costly to maintain. As far as I understand, its cost per patient is below that of most maternity hospitals.
To crown all, however, at the moment the extension to the maternity block at the West Middlesex Hospital, which consisted of 17 beds and two delivery rooms, had to be closed through subsidence of the foundations. I asked the Minister of State whether we could really afford to lose 49 maternity beds in the district all at one time. We pointed out to him that, as one Twickenham doctor said, Bearsted's statistics for maternal and foetal mortalities for the last three years are better than for the larger units. As a Hanworth doctor said, In large maternity or surgical hospitals, sepsis is always a problem. Smaller units usually have no trouble, a most important factor in favour of a smaller maternity unit. In addition, Mr. David Brown, the Director of the Postgraduate Institute of Obstetrics and Gynaecology at Chelmsford, made a powerful case for a general practitioner maternity unit to be built into Bearsted to maintain the interest and train general practitioners in maternity work, as otherwise that type of work is gradually being swallowed up and will, I think, be gobbled up by the specialist units all over the country.
That interview took place on 28th January. We were given to expect a decision by the Minister in, perhaps, four or five weeks. I told the Minister of State that I would postpone my application for an Adjournment debate to give him time to go into all the factors and the evidence that we had collected.
220 But now comes what I consider to be the disgraceful train of events. The weeks went by without a decision by the Minister, on whom the onus now rested fairly and squarely. By 23rd March I began to get restive as I had heard rumours that staff were leaving because of the uncertainty of the future of the hospital. I sent a telegram that weekend to the Department of Health pressing for a decision and followed up with an urgent letter to Baroness Serota, the Minister of State, who had now taken over responsibility from the hon. Member for Dover. I asked that a reprieve he given to Bearsted while this matter was being considered. I also made a statement to this effect in my constituency at that time. But on 25th March I heard on the grapevine, through a constituent whose daughter was at Bearsted Hospital, that new patients were being turned away and existing ones were about to be transferred to another hospital. There was no official statement yet by the Government, but then I heard that the Tottenham Group of the North-East Metropolitan Regional Hospital Board had issued a statement that owing to staffing difficulties it was necessary to refuse admission. Indeed, the Tottenham Group, to which I spoke, was very concerned and upset about the position.
What had happened was that the consultant physician at Bearsted, knowing that the medical registrar was leaving at the end of the month, had made valiant efforts to get a replacement, but who would come to the post without any certain future? The consultant could not even offer a month's employment to a registrar. He became so fed up with the situation that he put in his resignation. All the dilly-dallying and unconscionable delay in making a decision about the future of the hospital led to staff leaving, and the hospital to die from inanition.
I at once got in touch with the Minister in charge, the Baroness Serota, and put to her the plight of the mothers already there. Owing to her efforts, I believe that two mothers remained, but the rest were moved or discharged. This was a great shock to the mothers who were there, and a great distress to the mothers already booked to go to Bearsted.
So we come to the death of a gallant little hospital by painful inches and a thousand cuts spread over exactly six 221 months, and all made worse by the delay and dithering of the Government since my interview with the Minister of State on 28th January. I indict the North-East Metropolitan Regional Hospital Board and the Government for closing a much-loved maternity hospital; an amenity to the district; one much more convenient to mothers, fathers and families than any of the others several miles away; one that costs no more than any other maternity hospital, and which is cheaper than some; one that may be needed for a rise in births, as I am told that Ashford Hospital is sometimes overcrowded and the extension to the West Middlesex Hospital is still closed; one that has a very good mortality record—better than that of other hospitals in the district; one with a higher than average use of beds; and one that used local staff who might not be able to work elsewhere.
Altogether, the closing of Bearsted is a tragedy for my constituents which will not soon be forgotten.

§ Mr. Anthony Royle (Richmond, Surrey)
I intervene briefly to support my hon. Friend the Member for Twickenham (Mr. Gresham Cooke) in his very powerful speech in support of keeping Bearsted Hospital open. He has led a magnificent campaign and has brought to bear all the pressure possible to keep this hospital alive. This debate is very important both to my hon. Friend and to his constituents. I have a link with him on this, in that we are both Members representing parts of the borough of Richmond upon Thames, I on my side of the river and my hon. Friend on the other.
We are also suffering from the depradations of yet another regional hospital board. The South-West Metropolitan Regional Hospital Board last year, with the inefficiency of the Minister's Department, then the responsibility of his predecessor, got itself into a muddle over the future of the casualty department for the Royal Hospital, Richmond, a very old and well-established hospital. I had two interviews with the chairman of the regional hospital board, who treated both me and members of the Friends of the Royal Hospital with great courtesy, but a firm decision was taken as recently as 222 February this year that the Board gave approval in principle to the closure of the Richmond casualty department.
This has caused great distress in my constituency, just as distress has been caused in my hon. Friend's constituency the other side of the river. It has not yet come to the Secretary of State, and I do not expect him to give a detailed answer to these points, although I have given him notice of them. But would he just assure me that, when the decision on this proposed closure comes before him, he will receive me and a small deputation, so that we can put our very real concern about the closure of a very old and respected hospital, which is highly valued in my constituency?

§ The Secretary of State for Social Services (Mr. Richard Crossman)
It would under-rate the hon. Member for Twickenham (Mr. Gresham Cooke), to say that he has fought tenaciously for the Bearsted Hospital, because he has done a very fine job. He has lobbied the chairman of the regional hospital board, has bombarded me personally with letters, and led two deputations to my Ministers before a decision was taken. When he met my noble Friend, the Baroness Serota, I got the impression that when he was informed of my decision to close the annexe he accepted the decision, although he criticised the procedures beforehand. I gather that his case now is not that the closure should not take place but that the Annexe could have a future as a general practitioner maternity unit—

§ Mr. Gresham Cooke
I accepted that because the staff had already gone and nothing could be done.

§ Mr. Crossman
I will come to the procedures.
I should get the history right, because it is important for the Bearsted family.
The Bearsted Memorial Annexe, comprising 35 maternity beds, was improvised during the war in a converted hotel to provide maternity accommodation, additional to that at Stoke Newington, for Jewish patients. This annexe was retained after the war and was taken over, as part of the parent hospital, by the North - East Metropolitan Regional Hospital Board, although physically the unit is in the area of the North-west 223 Metropolitan Regional Hospital Board. In fact, for many years the hospital has taken patients from the Twickenham area and has almost ceased to be used by Jewish patients. In 1967 there were 14 Jewish out of 972 patients.
The Bearsted annexe has become, in fact, a small maternity hospital for the Twickenham area. It is natural that people there have formed an attachment to this hospital and the proposal to close was not acceptable. I can understand the strong emotions roused when the Hospital Board suggested it might be closed. But Boards have a duty to provide the best possible medical service. In the balance between local loyalties and easily accessible points of treatment on the one hand, and, on the other, the most up to date and specialised services the latter must be given more weight.
It is desirable that a maternity unit should be an integral part of a district general hospital. Then we can be sure that there will be continuous medical cover on the spot with full supporting services. In maternity cases an emergency may arise quickly. Then it is desirable that the obstetrician should have the assistance of a team to provide whatever he requires for the patient such as blood for transfusion, anaesthesia, or the pathological facilities necessary to monitor treatment. The trouble was that, although the Bearsted annexe provided a satisfactory service for normal deliveries, it was dependent on an anaesthetist from the West Middlesex, seven miles away, and for pathology and the supply of blood from the Kingston Hospital. Under favourable conditions it took an hour or more to obtain blood from this source.
I know that it was argued that without the Bearsted annexe the area was inadequately served by maternity beds. But the latest available figures reveal that there were, on average, forty-four vacant maternity beds in neighbouring hospitals. In the same period, there was an average of twenty-four occupied beds in the Bearsted annexe, leaving 11 unused. This does not take account of the modern maternity facilities now available at Ashford. One has to admit, therefore, that the Bearsted Memorial Annexe beds were surplus to the requirement of the area.
On staff and patients reallocation, I should point out that of the 42 permanent 224 staff 27 have already found other employment and alternative employment is being negotiated for the others. As for patients' reallocation, I understand that arrangements were made to accommodate all the patients in the annexe before it was closed, and that the two patients who were there when it was closed were moved to other hospital accommodation.
I want now to turn to a point that particularly concerned me.
My predecessor in another Administration assured Lord Bearsted in July, 1952, that the Bearsted Hospital would be extended and at the same time the Annexe would be closed. Last year my predecessor discussed with Lord Bearsted the future of the Bearsted Hospital in the greatly changed circumstances of the present hospital service and suggested that, instead of extending the present hospital, it should be rebuilt as a wing of a district general hospital in North-East London. I would like to take this opportunity of publicly reassuring Lord Bearsted and his family. I am not able yet to formulate precise proposals nor to indicate when and at which hospital these new facilities will be provided. But I will ensure that the North-East Metropolitan Regional Hospital Board takes account of this undertaking in its future plans, so that a Bearsted wing is provided with the special facilities desired by the Jewish community. It is important that in these matters commitments entered into by a predecessor should be honoured by his successors.
I turn to the second problem, raised in the last minute or two by the hon. Member for Richmond (Mr. A. Royle) about the future of the casualty department at the Royal Hospital, Richmond. I think that I can satisfy him in that regard.
The Board on 28th March this year circulated a statement of its proposals to the hospital management committee concerned, and to local health authorities, executive councils, and local medical committees, and to the public. When the views of these bodies and of the public have been received, the Board will decide whether a firm recommendation should be made to me to close the casualty departments at Richmond and at Surbiton. I give him his assurance, that no action will be taken to effect the closure of these departments until the views of 225 all interested parties have been received and have been considered both by the Board, which will then submit to me a final proposal, and by myself. I have as yet, therefore, not given authority for these departments to close, and I will not do so unless and until I am satisfied that the new arrangements proposed by the Board are the best that can be made in 226 the interests of the public and as part of the representations of the service.
On the question of representations, I shall myself be delighted to receive a delegation headed by the hon. Gentleman.