BEARSTED MEMORIAL HOSPITAL

HC Deb 20 December 1974 vol 883 cc2098-107

3.30 p.m.

Mr. David Weitzman (Hackney, North and Stoke Newington)

I am grateful to have the opportunity of raising on the Floor of the House the matter of the threatened closure of the Bearsted Memorial Hospital. This is the only Jewish maternity hospital in England. It deals with 800 to 1,000 births a year, a considerable percentage being non-Jewish cases, but its main object is to serve the needs of the Jewish population in the centre of a Jewish community.

The hospital had its humble beginnings in the East End of London. The present site in Stoke Newington was acquired and plans were made in 1937, but it was not until October 1945, because of the war, that permission was given to enable part of the hospital—for 32 beds—to be erected. Very considerable sums of money were raised by the Jewish community. A large amount came from the pennies of Jews in the East End of London, and substantial support was provided by Lord Bearsted and his family. An annex was opened at Hampton Court to meet the need pending the completion of the hospital in Stoke Newington.

The hospital was taken over under the National Health Service. On 25th July 1952 the Minister gave an undertaking that it would be extended and that the annex would be closed down. On 25th February 1954 I raised the matter in the House. That undertaking was then reaffirmed. It was said to be part of a long-term project. Twenty-two years have pased since 1952, but that promise has not been kept and apparently it has now been abandoned. In 1969 the annex was closed.

I want to remind the House of the legal position. Under Section 7(7) of the National Health Service Act 1946 regard must be had to the objects of the endowment. Under Section 61 of that Act, where the character and association of any voluntary hospital transferred to the Minister is such as to link it with any particular denomination, regard must be had to that in the general administration.

In defiance of these legal obligations, the Enfield and Haringey Area Health Authority has issued an order to close down the hospital at the end of this year. It has done this in the most disgracefully dictatorial fashion, at short notice and with no consultation of any kind. Notice of closure was given to the matron and staff on 27th November—five weeks ago. The Community Health Council was then informed and was assured that the individual staff had given their approval after full consultation and had accepted the need for the closure. That was untrue. I have seen them and I am satisfied that it was untrue. In fact, the consultant obstetrician of the hospital, when he heard of it, wrote in protest. The consultant staff were informed only on 9th December—ten days ago.

In a letter dated 11th December, the chairman of the Tottenham Hospitals Medical Staff forwarded to the Secretary of State two resolutions passed by the medical staff. They were as follows: 1. This meeting deplores the decision of the Enfield and Haringey Area Health Authority to change the use of the Bearsted Memorial Hospital without any consultation with the consultant medical staff in the hospitals involved and finds the manner of the initiation totally unacceptable. The Area Health Committee is requested to halt the implementation of its decisions at once so that full discussions may take place. 2. This meeting believes that minority interests of the local Jewish community should take precedence over administrative convenience. The Town Clerk of the London borough of Hackney wrote to the Secretary of State saying that he was instructed by his council to protest against the decision taken without consultation, that the area health authority could not be fully informed of the needs of residents of the borough, that the facilities of the maternity hospital were of unique value to the local Jewish community and that the loss of these facilities would have a serious detrimental effect on the local community.

There has been complete disregard by the authority of the circular issued by the Department. In Appendix 5(1) of Circular HRC(74)4 the relevant area health authority is told to consult community health councils about their plans and intentions. In paragraph 32 a duty is placed upon the authority to see that such councils in particular are advised and are consulted about the opening of a new service or, as in this case, the closure of an existing service. That was not done.

I attended a meeting of the area health authority last Monday. The reason given by the chairman for the closure was that the hospital could not continue without the tutor midwife and that the Central Midwives Board could no longer treat the hospital as a teaching unit. The truth of the matter is that in August last, and indeed at the beginning of the year, the authority knew that the tutor would be retiring in the middle of December. It had ample time to secure a replacement. It placed a badly-worded advertisement in the Nursing Mirror. It did not advertise in any other nursing journal or in any Jewish periodical. It told the matron in October last not to engage any further staff. In fact, without advertisement, applications for posts were received by the matron but she was under orders to refuse them.

Moreover I am reliably informed—this information has been conveyed to the chairman—that one agency can supply a State certificated midwife on 30th December and another one on 6th January and that another agency can provide an unlimited number of certificated midwives and nurses upon request from an official body. It is obvious that the reason put forward by the chairman is spurious and the hospital can continue and should continue fully equipped as it is today.

Perhaps the real reason for the proposed closure is that given by the district administrator on 28th November last. He then told the non-nursing staff that the reason was that there was a large surplus of maternity beds in the district because of the new maternity wing in the North Middlesex Hospital. Indeed, this excuse is reinforced by reports circulated in the constituency that it is the intention to replace Bearsted by a geriatric hospital or by a rehabilitation centre for juvenile offenders.

As the Town Clerk of the London borough of Hackney stated, Bearsted is of unique value to the local Jewish community. Not only this, but it serves the whole of the Jewish community in London. It is conducted in accordance with strict dietary laws. The Jewish mother has the attendance of the mohel for circumcision purposes. Jewish services can be held. The requirements of the Jewish holy days are observed. The attendance of the requisite 10 men to form what is called a minyan can be achieved in the present location.

The mere supply of kosher food from the kitchens of North Middlesex Hospital would be insufficient. North Middlesex is situated in a district where it would be impossible to hold Jewish services and, because of the walking distance, husbands and relatives would be unable to visit there on the Sabbath or on holy days.

I sent to the Minister a petition signed by over 2,000 local people protesting against the closure. I have received hundreds of letters from mothers in London, and particularly from my own constituency. The Board of Deputies of British Jews, the Chief Rabbi and the Jewish Chronicle have all protested in no uncertain terms. Over 50 Members have signed the motion I tabled protesting against this action.

If this hospital is closed it will inflict a severe blow on the Jewish community and will remove a well-needed service from the general community, because it is used, of course, to a considerable extent by the general community. It cannot be replaced by any transfer to the North Middlesex Hospital. I have heard it suggested that this hospital might be kept open in skeleton fashion and then its re-opening might be considered. Another report is that it will be open for three months. I hope that these reports are untrue. If the hospital is at any time reduced to a skeleton staff. I feel sure that it will never be reopened, and there is absolutely no reason why it should not continue as it is, serving the needs of the community.

I protest in particular as strongly as I can at the scandalous manner in which this decision was made. There was no consultation with the bodies or people who matter. There was, in my view, a manufactured ground to support an unjust proposal in order to fill the North Middlesex Hospital. There were broken promises with regard to Bearsted and there was a complete failure to recognise the need for and the importance of this hospital, situate where it is.

I ask the Minister to reject the manoeuvres—I use that word deliberately—of this area committee and to allow the hospital to remain open and to function fully. At the very least, I trust that if he cannot give me that assurance today he will at any rate say that no decision will be taken until there is the fullest possible consultation on this matter.

3.41 p.m.

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

I would not wish to join in a legal battle with my hon. and learned Friend the Member for Hackney, North and Stoke Newington (Mr. Weitzman) for obvious reasons. He has equipped himself throughout his life with far greater talent than I have in this field. I could not agree with the strong words which he used, though I understand his reasons for doing so.

I prefer to begin by quoting to my hon. and learned Friend a statement made in the House by our late friend and colleague, Dick Crossman. He said on 21st April 1969, referring to this hospital and its problems: 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 Region 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."— [OFFICIAL REPORT, 21st April 1969; Vol. 782, c. 224.] I assure my hon. and learned Friend that it is our intention to see that that undertaking, given in this House by a former Secretary of State, will be honoured.

May I now explain to my hon. and learned Friend why the threatened suspension of admissions to the Bearsted Memorial Hospital from 1st January has arisen? It is a primary duty of the statutory health authorities to have proper regard for the safety of the patients in their care. At the Bearsted Memorial Hospital a situation has arisen in which, through a crucial staff shortage, that safety which is dependent upon nursing care and supervision cannot be guaranteed. In consequence, the area health authority has had to make urgent contingency plans for the admission elsewhere of patients who were to have been accepted into the Bearsted Memorial Hospital after 31st December this year.

Mr. Weitzman rose—

Mr. Jones

I shall give my hon. and learned Friend the latest position, news of which we received less than half-an-hour ago.

May I emphasise that there are two completely separate issues which I should like the House to recognise? The first issue is the likelihood of the immediate temporary suspension of admissions to the Bearsted Memorial Hospital due to an acute staff shortage. The second issue is that of the long-term future of this hospital in relation to the previous assurances given in this House to the Jewish community.

I should like to deal with the long-term future first so that this issue no longer confuses the question of a temporary suspension of admissions which may or may not take place. A survey was made in October of this year by the area team of officers of the Enfield and Haringey Area Health Authority of the maternity beds available in the two districts of the area. This survey showed very clearly that the area would be over-provided with maternity beds for the trends in population revealed by the statistics over the last few years. The maternity provision required for the area can readily be given from March 1975 by the two new maternity facilities at the district general hospitals in the area.

A paper was prepared on the findings of this survey and was to have been presented to the area health authority after consideration by the district management teams and the consultants for their comments. This paper was prepared and circulated for comment and in that paper change of use of the Bearsted Memorial Hospital was proposed. It was intended that the area health authority should consider the proposed change of use of the Bearsted Memorial Hospital after the informal discussions had been completed. Had the area health authority then agreed with the proposals, permission would have been sought from my right hon. Friend the Secretary of State to proceed with formal consultations with the community health councils, Jewish representatives and other interested bodies with a view to making proposals to the Secretary of State for her final decision. This formal pattern of consultation towards a final proposal has still to be made and has not been arbitrarily dispensed with by the area health authority, as seems to be the view of my hon. and learned Friend.

I now turn to the other and more immediate issue, which is the possibility of a temporary cessation of admissions to the Bearsted Memorial Hospital and the possibility that that might take place from 1st January in order to secure the safety of the patients.

The Bearsted Memorial Hospital is recognised by the Central Midwives Board as a teaching establishment for pupil midwives. It has an establishment of two tutors. The first of those tutors left earlier this year, and on 31st August the second tutor gave notice to leave at the end of the year. No fewer than 15 advertisements for replacement tutors have been placed in nursing journals since the beginning of the year, and no satisfactory applicant has yet been found. There is a shortage of midwifery tutors in this area. In direct consequence, in November the Central Midwives Board withdrew its recognition of the Bearsted Memorial Hospital as a teaching institution, so that, with effect from the withdrawal of the second tutor, which is due to take place on 31st December—

Mr. Weitzman rose—

Mr. Jones

If I am not able to give my hon. and learned Friend all the information for which he has asked, he will have only himself to blame.

Mr. Weitzman

I hope my hon. Friend listened to my speech, because his suggestion that certificated midwives could not be obtained is absolutely untrue. I have quoted chapter and verse showing that they could have been obtained. The hospital finds itself in its present position because of delay and negligence, which I say is deliberate, on the part of the area board, in not making a proper attempt to recruit midwives. It can be done.

Mr. Jones

I understand my hon. and learned Friend's annoyance. However, the chapter and verse which he has given are not those on which I was advised. If there are differences on this matter, possibly we can discuss them later on. However, what I am saying is said in just as much good faith as that in which my hon. and learned Friend has expressed himself.

My hon. and learned Friend will appreciate that among the first to be made aware of a possible decision to close the hospital should be the staff, upon whose good will and morale so much depends. However, it was inevitable that this emergency decision should become public knowledge and should be interpreted by many as an arbitrary and authoritarian decision to close this Jewish hospital without any consultation, without due warning and without concern for any previous undertakings given in this House to the Jewish community.

These difficulties existed, certainly, and we have sought right up to the last moment today to overcome them in the best interests of my hon. and learned Friend's constituents and of the whole Jewish community of that area. It is because of our determination to ensure that the interests of the Jewish community are not forgotten that we pursued this matter at another meeting this morning.

Since the meeting of the area health authority on 25th November other meetings and discussions have taken place with representatives of the community health council, consultants of local hospitals and representatives of the Jewish community. Particularly as a result of representations made by my hon. and learned Friend, all efforts are still being made to avert this threatened temporary suspension of admissions to the Bearsted Memorial Hospital.

Urgent attempts are being made to recruit sufficient agency staff. An attempt is being made to find a suitable midwifery tutor through the Jewish community. Consideration has been given to the possibility of obtaining assistance from the North Middlesex Hospital by the provision of a tutor or staff. But there is a local shortage of midwifery tutors, and the North Middlesex Hospital is already below establishment. That means that no assistance can be obtained from that direction. However, appeals for help have been made to the area health authorities of the neighbouring areas of Camden and Islington and of the City and East London. Unfortunately, to date, neither authority has been able to assist with staff or with a tutor. Should sufficient staff be recruited—and I am told that a minimum of seven nurses is required to allow even a reduced service—the hospital will continue to admit patients or resume service should a temporary suspension have become necessary.

In the meantime, plans are being made for the welfare of Jewish patients in other hospitals. The occupancy of the Bearsted Memorial Hospital by Jewish patients was of the order of 18 per cent. of the total bed availability, so that only about six beds were occupied by Jewish patients at any one time. I am assured that the provision of kosher food from the Hospital Kosher Meals Service can be made to Jewish patients in any hospital in the region. The North Middlesex Hospital can provide facilities to allow ritual circumcision, and the provision of similar facilities at other local maternity hospitals is being considered.

I come now to the most important part of what I have to say. This morning at a meeting with Lord Fisher and representatives of the Board of Deputies of British Jews, my hon. Friend the Minister of State gave a firm undertaking that a decision to cease admission to the Bearsted hospital would be delayed as long as possible—in fact until Monday 23rd December—to allow the most thorough attempts to recruit staff to be made. In addition to the nine pupil mid-wives who must be withdrawn to continue their training elsewhere, the hospital is short of seven other nurses. I am told that seven nurses, all of whom must be midwives, would be required if a temporary closure were to be avoided and even a reduced service maintained.

At 3.15 this afternoon the position was that we had received promises from certain agencies which would give us a total of seven midwives, one staff nurse with part I midwifery, and two nursing auxiliaries. The situation therefore appears very much more promising than it was even when we met Lord Fisher and his colleagues this morning. Of course, these promises have not yet reached firm commitment.

My hon. Friend the Minister of State further assured the meeting that the hospital will be kept open at whatever level the staff recruitment will allow, and that no unnecessary limitation will be placed upon the services given while formal consultations are held. I believe that my hon. and learned Friend can be as assured as it is in my power to make it that we are taking the advice and guidance of Lord Fisher and his colleagues.

We have pursued the question of the vacancies; we have taken advice as to where suitable nurses might become available; and we have made the promise that, provided the level of staffing which I have mentioned materialises, the hospital, or at least some part of it, will be kept open—and kept open so as at least to allow a breathing space in which long-term plans can be devised with the cooperation of all the people in that area.

Mr. Weitzman

I am satisfied that my hon. Friend will do everything he can in this case, but he has not said a word about what I consider to be the most disgraceful aspect—the complete lack of consultation with the powers and bodies which ought to have been consulted.

Mr. Jones

We can argue at length about the degee of consultation that should take place, but I must remind my hon. and learned Friend in this context that the health authorities during the past year have been subjected to reorganisation on such a scale as to make consultation extremely difficult. It is my impression, from my reading of the situation, that the urgent problems facing the Jewish community in that area are such that we should now concern ourselves not so much with an argument about past consultation but with trying to keep open either the whole hospital or as much of it as we can. That is the order of priorities, and that is the nature of the undertaking which my hon. Friend the Minister of State gave this morning.

Mr. Walter Johnson (Derby, South)

I beg to ask leave to withdraw the motion.

Motion, by leave, withdrawn.