HC Deb 11 February 1970 vol 795 cc1410-20

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

10.40 p.m.

Mr. Michael Jopling (Westmorland)

I am grateful for the opportunity to raise in the House a matter of the greatest interest and importance to many of my constituents and some people outside my constituency. I refer to the Ethel Hedley Hospital at Windermere, which is threatened with closure and whose future is in some doubt. I am very glad to see the Parliamentary Secretary in his place to reply to the debate.

This is a small hospital which belongs to the trustees of the Hedley family. For many years it has been used as a children's orthopaedic hospital. At the outset I pay tribute to the many people who over the years have done wonderful work for children at the hospital, both medically and in the educational field. I have visited the hospital and have been greatly impressed by the devotion of the medical and educational staff.

As is well known, many children's orthopaedic diseases are subsiding. The hospital has about 50 beds. During recent years the occupancy rate has fallen below 20. I do not quarrel with the decision to change the use of the hospital from being a children's orthopaedic hospital.

The difficulty arises when one thinks of the future. I do not believe that the Parliamentary Secretary has had the great advantage of seeing the hospital. I hope that he has seen photographs which I have handed in previously. The hospital is on a most beautiful site. It is close to Lake Windermere and has unrivalled views of the lake and the mountains behind. It is fully equipped for that purpose for which it has been used. Almost £10,000 has been spent on it since the war. My firm view is that it would be best to continue the use of this place as a hospital. If this is so, I believe that it should be used for geriatrics.

This is not merely my view. I am supported in this view by all the district councils in the immediate neighbourhood. The Lakes Urban District Council, the Windermere Urban District Council, the South Westmorland Rural District Council, the Lonsdale Rural District Council and Kendal Borough Council support my view that the best use for this place is as a hospital for geriatrics.

On 21st April, 1969, I had the great advantage of leading a delegation which was received kindly by Lady Serota. We put the case to her as best we could and explained why we felt it was necessary that when the hospital closes as a children's orthopaedic hospital it should be converted for use by geriatrics. To our great disappointment, Lady Serota wrote me a letter last December saying that she rejected this idea. Despite that, having been backed by all the local authorities I have mentioned, we must persist in our demand that the hospital be converted for geriatric use.

I will explain why we believe that geriatric use is the best one for this place. The South Westmorland area is served by the Manchester Regional Hospital Board. At present geriatric patients go to Kendal Green Hospital, Meathop Hospital or Lancaster Moor Hospital.

Meathop Hospital is an old sanatorium and is due to close before long. It is remote, being miles from anywhere, and, most important of all, it is hopelessly inaccessible to visitors. As the Minister knows, visiting and visitors are of vital importance to geriatric patients. Lancaster Moor Hospital is not as remote, being in Lancaster, but it is old fashioned, dreary and extremely inaccessible from the Lakes area and from the area beyond Kendal.

We are told that Kendal Green Hospital is to be revamped. At present it has 50 beds and in January of last year the Manchester Regional Hospital Board announced that it intended to put in train a development to add between 25 and 28 new beds. That announcement was made at a meeting in January, 1969, which I was excluded from attending.

The meeting was arranged for the local authorities concerned and the notice convening it was almost identical to one that I had received for a previous meeting, which I attended. When the notice came I had every intention of attending, but when I wrote to the secretary of the board saying that I intended to attend, I was told that I was not wanted there. I will not make a great issue of this tonight, except to point out that throughout this whole business the Manchester Regional Hospital Board seems to have acted in a clumsy and clodhopping way and seems to have had no idea of public relations. As the local M.P., I should have been welcome at the meeting, had I wished to attend.

It was announced at that meeting that the Kendal Green Hospital would be extended by between 25 and 28 beds. This will mean, therefore, that when that development has been completed there will be between 75 and 78 beds at Kendal Green Hospital.

I come to the needs of this part of Westmorland for geriatric beds. The background is that in Westmorland we have a relatively old population. Having seen the figures, the Minister will know that the Lake District is an area where many people go to retire. Consequently, we have a large proportion of people of pensionable age. Using the norm, which is accepted by the Government—of 10.8 geriatric beds per 1,000 of the population over the age of 65—will mean that in 1975 we shall need at least 110 geriatric beds in this area, and this figure has not been disputed by anybody.

As I have explained, there are already between 75 and 78 beds in prospect at Kendal Green Hospital. Thus, in 1975 we shall be 32 beds short in South Westmorland. What is to happen to these people? Lady Serota implied in her letter that they would have to go either to Meathop Hospital or Lancaster Hospital. We in Westmorland who know the area say that this is not a good idea. Indeed, we are bitterly opposed to this point of view. I ask the hon. Gentleman to ponder the fact that, among those who say "No" forcibly to the prospect of the surplus patients going to Meathop and Lancaster are Kendal Borough Council and the South Westmorland Rural District Council. Both authorities are nearer to Lancaster and Meathop and one might have expected them not to have been so bitterly opposed to the move, but they are as keen on changing the Ethel Hedley Hospital to a geriatric hospital as anyone else.

Lady Serota wrote to me on 18th December and justified the decision in a number of ways. She said—and this was the core of her argument— …modern medicine requires a wide range of diagnostic and treatment facilities which can be provided only at the larger hospitals where efficient use can be made of our limited resources. That, in my view, is the wrong attitude. In reply, I must refer to the prefatory note to a document issued recently called "The Functions of the District General Hospital". The note was signed by the Secretary of State for Social Services and the Secretary of State for Wales. It said: In particular a lot more thought must he given to the best way of providing for people who need long-term care, and also to the functions of smaller hospitals supplementary to the district general hospitals. That, one would think, is a strong case for converting the Ethel Hedley Hospital into a geriatric hospital.

In that same document, on page 11, under the heading "Small Hospitals in Peripheral Towns", there was the following statement: But many small hospitals will still be needed. Some will be retained as maternity units, though any additional provision will nearly always be at the district general hospital. Others will provide long-stay geriatric units…Finally, though this is not indicated in detail in the plan, many small hospitals where no beds, or, at least no acute beds, need eventually be retained will be suitable for providing out-patient services. That last sentence referred to a piece in the document which I have not read out dealing with circumstances where the local population is in a remote and inaccessible area or where isolated towns receive an exceptional seasonal influx of visitors. That is exactly the situation in the Lake District, which has a large seasonal influx of visitors.

I believe—and I have the support of a very large proportion of local opinion here—that the Ethel Hedley Hospital is an ideal place for a hospital for geriatric patients. There is great local need for this and I ask the Minister to look again at the whole problem. I do not want to make too much of it, but there has been a pretty drastic trail of muddle over this case. When Lady Serota wrote to me in December, she said when talking about the difficulties of finding a use for the Ethel Hedley Hospital: In this our task was made the more difficult because the property does not rest in the Secretary of State and a new lease would have to be negotiated. That was an unfortunate phrase. It made the trustees of the hospital extremely angry, and their solicitor wrote to the Department on 7th January, when he said: With respect, I consider this a misleading remark, since the Ministry was initially given a 21-year lease and throughout the last few years it has been made clear at all times that there would be no difficulty in granting a further lease to your Ministry provided that the premises were used for some purpose which would be of benefit to the community. This therefore represents no sort of difficulty and I think it only right to point out to you that the Trustees and the Hedley family share the view of the people in this area that the Department is seeking an alibi in order to put this matter to sleep. I strongly agree with that view. The way in which the trustees have been treated in this matter, particularly in not being given notice of the six months' stay of execution which Lady Serota suggested, has been cavalier and inconsiderate, and I hope that the hon. Gentleman will say something about that.

The other aspect of the muddle is mentioned in the Minister's letter when she referred to her discussions with the Westmorland County Council. Perhaps I should draw a veil over this and say only that it ended with the Minister having to write to the chairman of the county council on 20th January. I quote only one sentence: I am sorry about any embarrassment which this has caused the council. It was a most unfortunate phrase.

This was a sorry story of muddle and misapprehension. I give Lady Serota credit for coming up to see the Ethel Hedley Hospital during the summer, although I was somewhat surprised that she did not inform me that she was coming to my constituency—I do not make too much of that. But she has the answer wrong. She has suggested a six months' stay of execution in which time another use for the hospital should be sought.

I do not wish to speculate on this other use tonight. I am aware that tentative inquiries are already being made by other organisations. I rest on the case which we put to the Minister last April. We stand by our argument of the need for more geriatric provision at this hospital and the need for more geriatric beds for the area. There is an excellent case. I hope that tonight the hon. Gentleman will acknowledge its strength and will agree to take back the Ministry's decision and say his Department is prepared to reconsider because of the great need for the provision of more geriatric beds in the area and that he will come to what we believe to be the right conclusion.

10.58 p.m.

The Joint Under-Secretary of State for the Department of Health and Social Security (Dr. John Dunwoody)

I have long been aware of the deep concern which the hon. Member for Westmorland (Mr. Jopling) has about the future use of the Ethel Hedley Hospital, Windermere, and I am glad that he has raised the matter tonight. I understand in particular his views on the suggestion which has been made to my right hon. Friend the Secretary of State, that the hospital should be converted to use as a long-stay geriatric hospital to serve the needs of the Windermere area.

The Secretary of State does not accept this suggestion, for reasons which I will come to, but it may help if I first put the whole matter in perspective. As long ago as 1962, the Hospital Plan foresaw that better provision would be made elsewhere for the services which the Ethel Hedley Hospital gives, that is children's orthopaedic care, and this would lead to closure of the hospital. More immediate consideration to the hospital's future was however given in 1967 when the expiry of the 21 years' lease on which the property was held from the owners, the Ann Hedley Trust, became imminent.

The Ethel Hedley Hospital, as my hon. Friend the Member for Westmorland knows, was built in 1789 as a mansion house. It was adapted for use as a hospital for the first time in 1914 and used as a hospital for officers during wartime. In 1920 its use was changed to that of a children's orthopaedic hospital, at a time when there was a wide range of orthopaedic problems in childhood being treated in the community, and as such it was absorbed into the National Health Service on 5th July, 1948, on the inauguration of the Service. The property has been held on a 21-year lease, which has now expired. I had already been given to understand that a new lease for hospital purposes could be obtained, and the hon. Member has confirmed this tonight. I certainly would not want to suggest that the expiry of the 21-year lease was being used in any way as an alibi for any decision which might be taken by my right hon. Friend.

Much good work has been carried out at the hospital during the many years it has functioned and as a result of this it has earned a place for itself in the hearts of the local community. However, it is not well suited to meet the demands of modern hospital treatment. Although planned for 50 children, its long, narrow wards have made it impracticable to use more than 36 beds and even with this reduced number the occupancy of the beds has dropped over recent years to an average of well below 30. Also, in spite of the fact that the hospital falls within the Manchester Hospital Region, about 60 per cent. of its patients have come from the Newcastle Regional Hospital Board area. On economic grounds, the continuation of a separate children's orthopaedic unit at the Ethel Hedley Hospital could not be justified and an alternative means of providing for the work done at the Ethel Hedley Hospital had to be found.

Consultation on the proposal to cease to provide children's orthopaedic services at the Ethel Hedley Hospital were undertaken on a wide basis by the Manchester Regional Hospital Board. There was no serious objection to the proposal to cease children's orthopaedic services, but it became apparent during the discussions that there was a strong feeling locally that the hospital should be converted to use as a long-stay geriatric hospital to meet a need for more beds and to enable patients from the Windermere and Ambleside areas to remain nearer to their homes and families than is at present possible. The nearest long-stay geriatric accommodation to the Windermere area at present is at Grange-over-Sands, Kendal or Lancaster.

A deputation of local representatives from the area, led by the hon. Member for Westmorland, came to London and was received by my noble Friend the Minister of State. She was most impressed by their sincerity and listened carefully to all the arguments which the deputation made in favour of converting the Ethel Hedley Hospital to geriatric long-stay use. She promised the representatives that she would give their arguments her most serious consideration.

The Hospital Plan, issued in January, 1962, which I mentioned earlier, foresaw the provision of an active geriatric unit at each district general hospital to which elderly people would be admitted. This, I think, is a reflection of the changing type of geriatric care that we are providing in the hospital service today. It is no longer purely of a custodial nature but is much more an active speciality with a positive rehabilitation rôle. That was the proposal in the Hospital Plan.

Normally, some long-stay geriatric beds would be provided at the district general hospital itself, but limitation on the size of the main hospital, or its distance from smaller towns which it serves, would often justify long-stay annexes on separate sites or geriatric provision at smaller hospitals. This point was underlined in the quotation given by the hon. Member from the Bonham Carter Report, on which, incidentally, the Government have not yet given a decision.

Following that policy, the Manchester Regional Hospital Board examined the geriatric provision in the Windermere-Kendal-Lancaster area and consulted widely with local interested bodies. The board recommended the addition of a 28 bed purpose-built ward to Kendal Green Hospital and a further 25 beds in upgraded accommodation at Lancaster to meet the needs of the area. This was calculated to bring the ratio of geriatric beds per head of population above the national norm, which was mentioned in The Hospital Building Programme, issued in Bay, 1966, and amounts to 10 beds per thousand persons aged 65 and over. The new proposals would, at the same time, provide adequate geriatric beds for the Windermere-Kendal area at Kendal.

I have not had the good fortune to visit the hospital, but my noble friend the Minister of State who, as I have said, has taken a deep interest in the question of the geriatric provision for the area, paid a personal visit to the Ethel Hedley Hospital to see for herself the premises. She also visited Kendal and Lancaster to see the geriatric accommodation available there.

The cost of converting the Ethel Hedley Hospital to a 25-bedded geriatric hospital of an acceptable standard was estimated, as the hon. Member for Westmorland knows, to be £66,000. However, high running costs, due in part to the smallness and isolation of the unit, were also expected. The estimated cost of providing the proposed new purpose-built accommodation at Kendal Green Hospital was £75,000 for a 28-bedded ward, but running costs would be significantly less than they would be with a conversion of Ethel Hedley Hospital. But cost, important as it is, was not the only matter which had to be kept in mind in considering this difficult choice. The Ethel Hedley Hospital, although set in beautiful surroundings, and dear to the heart of the local community, is remote from the larger centres of population and was thought to have potential staffing problems which might well be worse in the summer months when alternative employment became available. The overriding factors however, were the advantage to be gained by providing the extra geriatric beds at Kendal near to a general hospital where active treatment could be given and the accessibility of Kendal to a larger section of the population for whom the beds would be provided.

My right hon. Friend the Secretary of State came to the conclusion that the right course was to base the additional geriatric beds at Kendal Green Hospital and reluctantly he agreed that the provision of hospital services at the Ethel Hedley Hospital should cease. This decision leaves the future of the Ethel Hedley Hospital uncertain. The building is not, as I have said, the property of my right hon. Friend the Secretary of State but belongs to the Ann Hedley Trust which, it is understood, is anxious that it should continue to be used for a community purpose. The hon. Member mentioned that. It is important to remember the words it used "used for a community purpose", because here has been some confusion in some people's minds between hospital accommodation and what would be normally regarded as welfare accommodation.

My right hon. Friend the Secretary of State realised the sense of loss which the closure of this much loved hospital would cause to the local community. In deference to their feelings, and because he felt that the building could serve some useful community purpose, he made known to the trustees of the Ann Hedley Trust his desire to continue children's orthopaedic work at the Ethel Hedley Hospital for a period of six months. This was in order to give time for a suitable community use to be found for the building. Already informal discussions have taken place to try to find such a use for the building and the hon. Member for Westmorland has been asked to assist by referring to the trustees any suitable bodies which he, with his local knowledge, might be aware of as needing such premises.

I understand that one suggested use for the premises is under consideration at present but this should not stop any suitable body being referred to the trustees.

Mr. Jopling

Can the Minister say by whom?

Dr. Dunwoody

It would not be appropriate.

The consultations taking place are confidential at the moment and I do not think it would be helpful if I were to say in debate in the House between whom they were taking place. We would welcome it if further suggestions were made for the future use of this building on an atractive site, and I hope that this debate will serve to bring this about.

Question put and agreed to.

Adjourned accordingly at nine minutes past Eleven o'clock.