ASHFORD HOSPITAL (SITE) (Hansard, 27 February 1970)

§ Mr. W. F. Deedes (Ashford)

I begin this short Adjournment debate with apologies to the Joint Under-Secretary. It is very inconvenient for a West Countryman, even a Minister, to be present here at 4 o'clock on a Friday. I regret the necessity for this.

To a degree, we are both victims of a curious concatenation of circumstances. Negotiations about the site for Ashford Hospital have been going on for about four years. On 9th February I addressed a Parliamentary Question to the Secretary of State to ask whether there was a decision. On 12th February the right hon. Gentleman told me that, although he agreed that a decision was urgently needed, one was not yet available.

On 16th February, having reached a point of exasperation, I asked for this Adjournment debate. This was granted on 20th February. On Monday, 23rd February, after the weekend, the noble Lady, the Minister of State, sent me the decision. All this must have been pure coincidence, of course, but it was a very interesting coincidence and it is what has led to the Joint Under-Secretary being here today for this little debate.

For several reasons, and one rather serious one, I thought it right to continue this debate. For a start, there are one or two small subsidiary questions arising out of the decision which has now been taken. I am sure that the Joint Under-Secretary will be able to answer them. First, there were strong agricultural objections to the site which has been chosen. Can I take it that these objections have now been over-ridden or disposed of and will not cause further delay? Second, I understand that there were also objections by the vendor—the owner of the land. I should like to be clear whether they have been cleared up or whether we may have to face a compulsory purchase order.

I do not want to indulge in recriminations about the delay which has occurred. I will not recite the course of negotiations since February, 1966, 1643 though they make pretty melancholy reading. The hospital is urgently needed for at least three reasons. First, we have an increasing population—not only in Ashford, but in the area. Much of this relates directly to the Government's policy for London overspill.

Second, the two main present hospitals are so inadequate as to impose an intolerable strain on nursing and medical staff. Third, it is imperative to try to hold together the medical teams who are in the area and who are looking forward to the facilities a new hospital will provide. If it is deferred, from their point of view without hone for the future, we may well lose them.

My main concern is whether we can now expect to get started and to finish this hospital in accordance with the South-East Metropolitan Hospital Board's programme. We are now at March, 1970. Does this rule out a start early in 1972, which was the original hope and objective? It seems to me extraordinary that it should need two years from this point to the actual start of work; but accepting that this is the period needed, can it be done now by early 1972?

The really crucial question I want to raise is: can we be sure that the hospital board will now be free to go ahead as fast as it may wish? Can it count on a fair wind from the Department of Health and Social Security? The hon. Gentleman will probably say that it is now largely up to the board. He will know that there is more than one way in which central Government policy can speed or delay works of this kind. I want for a moment to dwell on this aspect—it is, indeed, my main point—for the benefit of the hon. Gentleman's Department, although I stress that I do not expect him to reply to it now.

One cannot be a Member of Parliament and reasonably close to the progress of public work, without realising that a new factor is now operating, and may well operate in respect of the new hospital. An an instrument of deflation and economic policy the Government are now selectively and effectively operating a go-slow in their activities. They are deliberately lengthening the course of negotiations or processes and, where 1644 possible, entering fresh obstacles which slow down the start of certain work. When public authorities have cleared the routine course, as we have done in this case, and obtained planning permission, loan sanction, and the rest, and when the way should be clear, they find increasingly that they may encounter small but distinct obstacles, such as inexplicable delays in getting a reply from Whitehall, or, perhaps, more sophisticated methods by which small questions are raised in Whitehall which delay the start of the work.

The Minister will no doubt demur, or will even deny this, but I am sure that many of those in the building industry will confirm that this is happening, and that they are experiencing it. It has become much more apparent in the last 12 months. In effect, and this is my main source of concern for the hospital, the Treasury has called in aid an invisible but highly effective brake. I suppose that it has always operated in the past to some extent, but it is operating sharply now, in respect not only of hospitals but of roads and housing and public works of all kinds. The more slowly a rolling programme rolls, the less it will cost in the financial year in question.

I am determined that, if I can help it, this factor will not operate against the work on the new hospital. We are already late with this urgent project even now that the site has been determined. What is needed is acceleration, not this brake mechanism. In all friendliness, I can tell the hon. Gentleman that I propose from now on to keep a very close eye on progress. This sophisticated system of go-slow will not deceive me, and if it is operated against the hospital I will take further steps.

It would assist me if the hon. Gentleman could give some idea of the prospective programme now that the site has been determined. Can he give the Ministry's view of the likely date of start, and any information about the phases which the building of the hospital may take; whether it will be built in one phase or in several phases? Can he say anything about his Minister's general approach to the current hospital building programme that would assist us to know what our prospects are? Finally, will he take back to his Department the word that its go-slow tactics have been 1645 rumbled, that those concerned may save money by this and by other means elsewhere, but not with respect to Ashford's new hospital?

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

I must, first, thank the right hon. Member for Ashford (Mr. Deedes) for his kindly opening words. It is true that when one has a constituency in West Cornwall 4.30 p.m. is not the ideal time to begin the House on a Friday.

However, I can well understand his concern about the delay there has been in deciding on a site for this very important project, the proposed new Ashford hospital, in Kent, and I am grateful to him for giving us this chance to discuss it. The right hon. Gentleman has taken a keen interest in this question and I can assure him that we, too, have been anxious to resolve the many problems that have arisen in this difficult case. As my noble Friend the Minister of State explained in the letter she sent earlier this week, a decision has now been reached that the Lacton Green site should be that chosen for the new hospital.

It may be helpful, however, if I were to sketch out first a few general considerations which apply to the selection of a site for a large multi-million pound project for a district general hospital such as is envisaged at Ashford. We are here considering a project which will eventually cost something of the order of £7 or £8 million, and its magnitude is such that it will need an area of some 30 acres to accommodate it. In trying to find good sites, we attempt to secure as good a balance as we can between the different factors we need to consider where is the best site for access by the patients concerned, we must take into account the varying costs of different possible sites and also consider how we can most easily ensure efficient internal working of the hospital itself, and, equally important, coordination with supporting services outside. This is somethig we are looking at more and more in planning hospital services. The selection of the site itself has to take into account the size, shape and nature of the area; the contours, sub-soil an natural features on it, since these all have a direct bearing on its suitability for development; its choice also depends on its accessibility to the local centres of 1646 population and to the necessary traffic routes; on the nearness to major roads which might call for sound proofing—this would add considerably to the cost; on the local availability of staff and recruitment prospects; on the facilities for integrating the new hospital with the existing services and last, but not least, on the ease with which the land can be acquired if it is not already owned by the Crown. This is a point raised by the right hon. Member, but as I do not like to cross bridges before reaching them. I do not think that at this stage I can say anything about any problems which might arise with regard to the purchase of land. However, I do not think that there will be insuperable difficulties.

It will be apparent from the history of the case that all the factors I have mentioned have played a part and have contributed to a greater or lesser degree to the time needed to reach a decision. To meet all the criteria I have described, time-consuming investigations and discussions are often essential. I do not think I need go into the early history of the case before the hon. Member, together with the Member for Folkestone and Hythe (Mr. Costain) who led a deputation of doctors from the Folkestone area—discussed the situation with my noble Friend the Minister of State in September last. My noble Friend explained at that time that the regional hospital board and the Department accepted the need for a start as early as possible on the new hospital. The regional hospital board had been requested by the Department to undertake a survey of the principal sites in question at Godinton and Lacton Green so as to discover the relative cost of constructing the new hospital on the alternative sites.

The need for this comparative survey arose partly from the fact that the originally preferred site at Godinton had, as the hon. Member knows, fallen within an area which became the subject of a public inquiry, which then went on appeal to my right hon. Friend the Minister of Housing and Local Government, and which he decided could be used for housing purposes. This meant that an alternative site further back from the road had to be found which in turn meant a possible increase in building cost. My noble Friend also explained that the survey would be completed by the end 1647 of October and that she hoped for a decision as soon as the facts had been evaluated together with the various social and economic problems which she mentioned.

The costing survey was produced as programmed by the end of October and discussed with representatives of the South East Metropolitan Regional Hospital Board in early November. The Department reached the agreed conclusion with the board that on the evidence produced there was no significant difference between the cost of developing the sites in mind at Godinton and Lacton Green and that therefore the question of cost no longer affected the choice between them.

The Department also took the opportunity to review the several changes in circumstances since August, 1968, when the Department itself was in favour of Godinton. The major changes were that the revised hospital catchment area proposed by the regional hospital board included a greatly increased population from the coast that would find Lacton more convenient, and that we knew more about the route and access to the proposed Channel tunnel motorway. This information meant that noise from the motorway and access problems would no longer be an adverse factor in respect of the Lacton site.

We therefore came to an agreed conclusion with the hoard that from the hospital service point of view there were no compelling arguments for choosing one location in favour of another. We appreciated that reasons not connected with the hospital service might well affect the choice between Lacton and Godington, and while we did not want unnecessarily to take agricultural land or interfere with housing development, it was important from our point of view that one or other of the sites should be made available quickly.

At this stage the question was referred to the Ministry of Housing and Local Government in preparation for a meeting which that Ministry was arranging with representatives of the local authorities, the regional hospital board, the Ministry of Agriculture, Fisheries and Food, Ministry of Transport and my Department. The object of the meeting was to enable views to be exchanged and dis- 1648 cussed on the planning merits of the various sites under consideration so as to reach a conclusion as quickly as possible.

At this meeting, which was in November, there was a very full and valuable exchange of views. The sites at Godinton and the one at Lacton Green were discussed, as well as a site opposite the Willesborough Hospital and other possibilities. After the meeting the Department was asked, amongst other things, to reconsider the possibility of using the Willesborough site and to consider a variation of the site at Lacton Green to minimise interference with good agricultural land. The regional hospital board thought it desirable to employ consulting engineers to confirm its earlier opinion on the unsuitability of the Willesborough site.

The outcome was that, because of the physical conditions at this site, additional building costs would amount to well over half a million pounds, and there was also a possibility of further sums having to be spent if, after investigation, piling was found to be necessary.

As regards the proposed variation of the Lacton Green site it was found that costs would be significantly increased if the site was varied as suggested.

All this was discussed at a meeting of interested departments. It emerged that the alternative site at Godington Park possessed great amenity and recreational value as part of the very attractive wooden area of parkland around Godinton House and that damage to amenity from using this site would be grave. On the other hand the site at Lacton Green consisted of land having a high agricultural value within part of the productive farm unit.

After balancing these considerations, and taking into account as well the change in the catchment area, the conclusion was reached, as I have already mentioned, that on the information available Lacton Green was to be preferred. The regional hospital board has been so informed by my Department and the local authorities by the Ministry of Housing and Local Government. Now that a conclusion has been reached that the new hospital should be built at Lacton Green, it will be necessary for the regional hosof the land for the purchase of the site, pital board to negotiate with the owner 1649 At the same time, planning of the hospital can proceed.

It has taken a long time, I accept, to choose the most satisfactory site from all points of view, but I understand that if no further major difficulties arise it should he possible to meet the original date of 1972–73 for starting work on the new hospital.

This brings me to the point that the right hon. Gentleman has raised about the timing and phasing of the hospital development. It is not possible to make firm plans on how a hospital should be developed on a new site until it is known for certain where the site for it is going to be. Now that this has been decided at Ashford, the regional hospital board can press on with the next stages of planning. In practice, this means that the regional hospital board will be considering in more detail the site factors at Lacton Green, the selection of the building shape and the cost and phasing of the project with a view to agreement with the Department on these matters.

The hon. Member suggested that there was some question of a deliberate go-slow. He realised that I would deny that, and I do. The Government's record in hospital building during the last five years suggests that the contrary is, in fact, the case. We are this year spending £100 million in capital development on the hospital service, which is double the amount being spent five years ago. We 1650 attach considerable priority to hospital building and realise the urgency of improving hospital provision in many parts of the country, Ashford certainly being one of them.

The board has already done a certain amount of work on all these problems but the detailed phasing will depend very much on the board's financial resources in future years for hospital building in the region and their assessment of priorities in the light of the needs of the Ashford area compared with the other areas. It is right that regional boards should exercise discretion in considering priorities within their own regions which they often know so well.

There will inevitably be heavy calls on the board's allocations in the coming years for development elsewhere in the region. Moreover, programmes are reviewed from year to year. But I am able to assure the right hon. Gentleman that in the provisional capital programmes from 1972–73 the regional hospital board has earmarked some £5 million for the first phase of the Ashford District General Hospital which is expected to contain some 350 beds and supporting departments. I hope that the hon. Member appreciates that at this stage I cannot say more.