HC Deb 17 December 1974 vol 883 cc1537-48

12.22 a.m.

Mr. Guy Barnett (Greenwich)

I am grateful for this opportunity to raise the subject of the future of the Miller Hospital, in my constituency, for two reasons —first, because there are matters with regard to the handling of those affairs which are open to criticism and, secondly, because I believe that there are lessons to be learned from the story of the Miller which may have wider implications.

I want to be brief, because I want to allow my hon. Friend the Member for Woolwich, East (Mr. Cartwright) to make a short intervention in this debate before the Minister replies. I do this because he is chairman of the local community health council in whose area the hospital is situated.

I want to refer to the history only briefly because this debate is concerned with the future and not with the past. It is worth remarking that for many years the Miller Hospital commanded a loyalty unequalled in my experience amongst hospitals of this kind. It has a devoted staff, who sincerely love the place, despite its inconvenience and the poor environment in which it is situated.

Just over a year ago my right hon. Friend the Member for Deptford (Mr. Silkin) and I attended a meeting of the staff, called to protest about the closure, and we were both deeply impressed by the loyalty which they showed to the Miller as an institution. Neither of us was surprised when a petition against the closure attracted 12,000 signatures. This was evidence that the hospital has its roots deep in the community which it has served for well over half a century. The Secretary of State for Social Services knows that I regret the decision to close the hospital in January of next year. I remain unconvinced by the arguments that have been advanced. Nevertheless, as the Member of Parliament for the area, I have now to accept it as a fact, and my main purpose is to discuss what is to happen to the building and its contents after January.

The first suggestion which I heard was that the land would be sold to the highest bidder by the regional health authority. That, it seems to me, would be an appalling decision, and I am glad that we have heard no more of it. Secondly, I have been told that the first option would go to the local authority and that a scheme had been worked out whereby the local authority would acquire the site in exchange for other sites which the health authority requires for the construction of health centres in other parts of the authority's area.

What worries me about both these proposals is that neither appears to recognise that the community possess buildings which are still a consderable asset and for which an alternative use should have been found well before the closure Does this mean that after January these buildings will be boarded up, allowed to deteriorate and be objects of vandalism until somebody decides what to do with them? I hope the Minister will be able to prove me wrong on that.

The figure of £600,000 has been put as the cost of bringing the building up to standard. If that is a realistic figure it seems to me to reflect very ill on the old regional hospital board, but I have reason to believe that it is not realistic, and relates only to the continuation of the hospital as a general hospital.

This debate takes place against a background of severe economic stringency, when money for new projects will be extremely short, especially for health centres. The Miller is situated in an area of great deprivation, where there are mounting figures of homelessness and where the proportion of elderly people is well above average. According to the census figures the borough of Greenwich has 3.1 per cent. of males and 6.7 per cent. of females over 75 years of age. A large proportion of these elderly people live in the immediate area of the Miller Hospital, and many more live in Dept-ford, which is a stone's throw away. Does not this make it urgent that we find a use for these buildings which are furnished, equipped and heated and which could be so relevant to the needs of the community which has supported it so well over the years? Has a feasibility study been made or planned? I think it should be.

I want to deal briefly with a number of needs which the Miller might meet. Even if I were competent to do so I do not have the time to evaluate them, but could not the Miller, for instance, provide student accommodation for those who study at Goldsmith's College or other institutions in the area, or has it not a role for single medical personnel? Incidentally, I am glad that the nurses' home is to be saved. Perhaps my hon. Friend will confirm that point. There are other sorts of people in the area who find accommodation extremely difficult to get. Teachers are one example, and skilled workers are another. Apprentices might be a third.

Two years ago I took part in a debate in the House on the subject of single homeless people and the tragic inadequacy of the provision we make for them. This matter lies within the responsibility of my hon. Friend's Department and I wonder whether it has been discussed. There are numerous other examples, but I am particularly interested in the possibility of the Miller being used for geriatric purposes, knowing, as I do, the area which it serves. Already, geriatric accommodation both for residential and day tenants is seriously overstrained in my constituency.

The point is well illustrated and confirmed by a case which I took up recently. The Greenwich Hospital senior administrator, in reply to a letter I sent to him, wrote, We all know that there is a great strain on the accommodation in Old People's Homes and if the hospital had always to wait for vacancies we should soon reach saturation point, blocking beds and so depriving other awaiting patients of hospital treatment. I should be the last to suggest that the Miller is the perfect answer to a desperate situation of shortage of places for short-stay and recuperative facilities, but it is surely better than none at all. At a time of too much vandalism, and when we are perhaps too ready to resort to the demolition men, with their battering rams, is it not at least relevant to think in terms of skilful adaptation of old buildings that become surplus to needs?

I believe that there is room for imagination here. It might be no bad thing if we were to place on public authorities a statutory duty to consult in good time about the future use of buildings that are surplus to their immediate needs. Two of the buildings of the Miller are listed. I wonder whether the Department or the regional health authority know that. I wonder what plans they have for those buildings, in view of that fact.

Among people in the area there is an immense fund of good will towards this hospital. I wonder whether any attempt will be made in the future to capitalise on the good will that the institution has earned—on the sort of voluntary help that has been given and is being given to the hospital from people who live in the area and are associated with the Friends of the Miller.

Not only in the health field but in education and the social services we are all too often apt to think in terms of the single-purpose institution. Is it not time we more readily examined the possibility of the multi-purpose institution? It might be feasible for part of the Miller to be a sanctuary for battered wives, who could live there rent-free on condition that they gave help and support to elderly, short-stay patients. I should like to see such suggestions examined. Whatever the situation, working out the sort of suggestion I have just made, with the assistance of voluntary patients, we might be able to maintain our social services at less of the enormous cost which labour-intensive institutions are bound to involve. With the assistance and co-operation of the community, institutions such as the Miller could be adapted to have a value and use to the community for many years.

I hope that in the light of these points my hon. Friend the Minister will be able to give me some indication of the thinking in his Department and tell us what he has been able to glean from the regional health authority. If there is not much thought, I hope that the fact that I have raised the subject will provoke it.

12.32 a.m.

Mr. John Cartwright (Woolwich, East)

I am grateful to my hon. Friend the Member for Greenwich (Mr. Barnett) for allowing me time to take part in the debate, particularly as I do not entirely agree with his case for the Miller.

My interest in the matter is twofold. I am chairman of the community health council which took the decision earlier this year to approve the closure of the Miller, to the everlasting regret of my hon. Friend. Secondly, until recently I was leader of Greenwich Borough Council, which is now casting covetous eyes at the land on which the hospital stands.

I acknowledge the sincerity with which my hon. Friend made his case for the continued use of the building, but the community health council was strongly influenced in deciding to approve the closure by the outstanding maintenance work needed on both the Miller and the nurses' home. This was high, because work had been delayed for some time pending a final decision on the future of the hospital. My hon. Friend may be right in saying that the figure of £600,000 that we were given is not accurate, but those members of the health council who have been over the hospital have been depressed by its general condition.

Any of the uses suggested for the building would involve substantial spending on maintenance. Continued use as a hospital would involve running costs of about £780,000 a year, although that figure would not apply with the other uses my hon. Friend suggested. In its present form the Miller is an expensive building to run.

I have mentioned the Greenwich Borough Council interest in the site, which is over 2½ acres, in an area of considerable housing need. There is a high demand for one-bedroom units— a use for which the site is eminently suitable. The supply of building land in Greenwich, as in many other inner London boroughs, is fast runing out. The site could provide a housing gain for the borough council.

I recognise the problem about the listed buildings, but the borough has considerable experience and some expertise in the matter of dealing with such buildings.

There would not just be a housing gain; discussions have been taking place at officer level between the area health authority and the borough council about a straight exchange of land, under which the Miller site would be provided for housing and the borough council, in return, would provide sites for health centres in areas of proven need in other parts of the borough. In that way the whole community would gain. The discussions are at an early stage, but I hope that my hon. Friend the Minister will say that the Department will look kindly at the principle.

One matter on which I agree wholeheartedly with my hon. Friend is the risk of delay in reaching conclusions about the use of the Miller building. The community health council has already stressed to the regional health authority the need for urgent decisions. In our view it would be a disaster if the building were left unattended and empty, since it would provide an invitation to vandals.

The reply we received from the regional health authority is not particularly encouraging. It says that the Authority has no plans for the further use of this site for their own purposes. We hope to be able to dispose of it as soon as we have confirmed that the proceeds will come back to the Authority.' The letter also indicates the interest of the London borough of Greenwich. It goes on to say that other Government departments and Local Authorities do have certain degrees of priority given to their claims. As soon as the question of our obtaining the benefit from the sale and the degrees of priority have been resolved, we will be in touch with the Borough Council at Greenwich to re-open the question. I may be doing the regional health authority an injustice, but that does not sound to me like a very speedy or rapid process.

I hope that in his reply my hon. Friend will reassure us on that point, because we want to be assured that decisions about the future, both of the site and the building, will be taken rapidly so that the site can be put to the best possible community use with the minimum of delay.

12.36 a.m.

The Under-Secretary of State for Health and Social Security (Mr. Alec Jones)

We are indebted to my hon. Friends the Members for Greenwich (Mr. Barnett) and Woolwich, East (Mr. Cart-wright) for the contributions they have made to this debate.

For a long time my Department has been aware of the considerable interest shown by my hon. Friend the Member for Greenwich and my right hon. Friend the Member for Deptford (Mr. John Silkin) in this hospital.

I am grateful for the opportunity afforded me by my hon. Friend in raising the question of the future of the Miller Hospital, Greenwich. This hospital has been in existence for nearly 100 years. If we are talking about the ending of this hospital we should at least place on record our appreciation of the work done there by generation of doctors, nurses and supporting staff.

I well understand the strength of feeling, affection, and loyalty of local people which led them to support the petition to the extent that about 12,000 of them signed the petition to save the Miller Hospital. Both my hon. Friends have accepted—in one case reluctantly—that the closure of the hospital was necessary in the light of the present situation. This was not a decision taken lightly or easily; it caused my Department and Ministers a considerable amount of disquiet. In the document, "Democracy in the National Health Service" we attach considerable importance to the role that should be played by community health councils. The Government decided to give to those councils immediately the delegated responsibility for agreeing to hospital closures, where they accepted the recommendations of health authorities. The case of the Miller Hospital was referred to the Greenwich Health Council, of which my hon. Friend the Member for Woolwich. East is the chairman. That council had the major interest in the closure of the hospital, and it accepted the recommendation of the area health authority and that of the regional health authority made at their meeting on 14th June 1974. I make that point merely to show that we have, as a Depart- ment, carried out not only what we ought to have done but what we believed was desirable in consulting all authorities about the decision to close the hospital.

It is clear to me that the facilities being provided at the new Miller wing are, as is to be expected, a superior replacement of those which the Miller Hospital has provided, but there were two other major considerations which led to the decision. One was that the cost of running the new wing could not have been met by the health authority if the Miller had stayed open. It was a matter of redeploying both finance and manpower resources efficiently, and to improve the quality of the service. The other consideration was that the fabric of the old hospital has, understandably, been slipping into a state of decline. When we remember that the hospital is nearly 100 years old, it is understandable that the fabric of an institution of that age would be slipping as I have described. It would have been imprudent on the health authorities to spend large sums on a building which they had had for many years clearly announced plans to close, and both my hon. Friends will realise that the closure decision was not a recent one.

Recently the Department published its guidance on the provision of community hospitals. I can understand that there is a real attraction in the notion of keeping the Miller Hospital as a going concern in this way, but I draw my hon. Friend's attention to a sentence in paragraph 21 of that document, which says that where existing or projected district general hospitals fully cover the hospital needs of the district it would be inappropriate and wasteful to provide community hospitals in addition That is the situation which the health authorities have in Greenwich, in addition to the impossibility of running both the Miller wing of the new hospital and the old Miller Hospital itself. The Miller wing was all but complete, and the contract for the final plan of the new hospital was about to be let. The health authorities had at one time considered a further deployment of hospital beds which would have involved a fresh though temporary phase of activity for the Miller. That they abandoned this idea was for the reason to which I referred above—the physical condition of the building. They were advised that the cost of redeveloping or adapting the existing fabric for health purposes would be at least £600,000 and they concluded—and I support them in their conclusion—that it would certainly be an uneconomic proposition. I think I should make the point at this juncture that these considerations relate to the hospital building itself and not to the nurses home nearby, which I understand will continue in use.

The transfer of hospital in-patients to the Miller wing has now been accomplished, and I should like to pay tribute to all the staff who have made this transition so smoothly and with so little inconvenience to those in their care. The remaining health activity at the Miller consists of one out-patient clinic which will, I understand, be transferred to another local hospital in the next few weeks. I understand, therefore, that the building will be empty by the end of January next year.

I appreciate the points made by my hon. Friend about the possibility of vandalism in this area, and it would not be my wish, nor that of anyone with any responsibility in this matter, to do anything other than prevent the vandalising of buildings such as these which might be put to use for students, apprentices, the single homeless, battered wives, and so on. I am sure that there are a host of people who might use them.

We shall certainly bear much in mind the point made by my hon. Friend that if the building were vandalised there would be no possible future for it. I shall refer to the appropriate authorities the need for carrying out the most protective measures possible to ensure that this hospital building, which may have a use for the area, does not suffer from vandalism.

The future use of the buildings and site is to be considered by the local joint consultative committee for Greenwich and Bexley, which, I understand, has recently been set up. That committee brings together the health and social services interests.

Should the buildings and site be declared surplus to National Health Service use, the usual procedure for the disposal of surplus Government land will ensue, and in our proposals for disposing of surplus Government land I think we could honestly say that we were taking into account the views expressed by my hon. Friends.

If the joint consultative committee established that there was a local authority need for a personal social services function, this would take precedence over any other non-health use. Otherwise, property or land which is declared surplus to National Health Service requirement must be offered first, at current market prices, to other Government Departments; then to the London borough of Greenwich—this was the interest of my hon. Friend the Member for Woolwich, East; then to the Greater London Council and to the Housing Corporation, and, finally, to other interested bodies.

I think, therefore, that taking into account the order of precedence, as it were, that we have established as to the disposal of surplus Government land, one can be reasonably reassured that the use of this building and site ought well to be in favour of the people who live in the area.

My hon. Friend the Member for Greenwich made the specific suggestion that the building might well be used for geriatric services. While I am not in a position to say whether it would be suitable or whether that could be done—the decision is certainly not mine or that of my Department but is for the health authorities concerned—I assure my hon. Friend that I shall make a special point of drawing the attention of the relevant authorities to his suggestions, not only for geriatric services but for the whole range of possibilities he has put forward tonight concerning the future use of the site and building.

I end by assuring my hon. Friends that the health authorities are well seized of the importance of ensuring that a decision about the future of the Miller building and site should be effected as soon as possible for the maximum benefit of their constituents and of all concerned. The closure of any hospital is bound to cause considerable concern to the locality. Many hospitals such as the one we are discussing tonight have almost come to the end of their day as a useful part of the National Health Service. When we talk of the Miller being nearly 100 years of age, this clearly indicates the problem we are facing.

I shall, however, make sure that any suggestion that the Miller can and should be used for other social services in this year of 1974 will be brought to the attention of all the relevant authorities. It would not be the wish of myself or my Department to fail to do anything to ensure that these buildings and site were not protected against vandalism which might prevent their use for appropriate social services such as my hon. Friends have suggested tonight.

Question put and agreed to.

Adjourned accordingly at ten minutes to One o'clock.