§ 10.30 p.m.
§ Mr. Neil MacFarlane (Sutton and Cheam)
I am grateful for this opportunity to raise on the Adjournment an issue of great importance to my constituents and constituency. I begin by congratulating the Under-Secretary on his appointment to the Front Bench and wish him well. I am certain that in his constituency in Rhondda he will suffer from the same problems as those which I seek to highlight tonight.
The future of the Belmont and Henderson hospital sites in the constituency of Sutton and Cheam has for some years created much rumour, concern and dissent. During the last Parliament I corresponded with the Minister's predecessor about the future of these hospital sites. The two hospitals occupy 55 acres within my constituency. They have been in existence for about 100 years and we understand that the South-West Thames Regional Health Authority is considering closing the hospitals.
These hospitals are essentially centres for therapy treatment, for treating general psychiatric disorders and for carrying out remedial treatment on people, aged between 18 and 35, with personal disorders. These people are sent there either on the recommendation of their doctors or a hospital or by the magistrates.
Over the past few months the Department of Health and Social Security has not been specific in answering my questions about the detailed timing of the closures. I understood from a letter written in July by the then Under-Secretary of State for Health—now the Minister of State—that it was likely that the closure of the Henderson Hospital would take place later this year and that the termination of the Belmont Hospital would take place as soon as alternative accommodation could be located. The anticipated date was October 1975. It is important to voice the concern of my constituents about the intentions of the 1030 Department and the Greater London Council.
There are two points to be considered. First, during August I spent some time researching in my constituency into the many problems affecting the elderly in our society. I visited old people's homes and all the day centres, and I even went out with the meals-on-wheels service. I am happy to say that for two days I served 66 mid-day meals to senior citizens. I felt that this gave me an insight into the problems from which other hon. Members must suffer in their constituencies. I am certain that this difficulty exists in the Principality. I know that the Minister will have conducted similar surveys in his constituency and I am confident that he will understand my concern about the premature closing of these two hospitals.
There is a growing requirement within my constituency and within the South-West Thames Regional Hospital Authority area for more geriatric centres. In my borough, which covers two parliamentary constituencies, there has been a reduction in the number of beds available for geriatric cases.
In reply to my Question on 19th July, the Under-Secretary of State demonstrated the enormous increase in the number of geriatric cases. Between 1970 and 1973 the number of geriatric cases in the United Kingdom rose from 170,000 to nearly 190,000. I am concerned that two hospitals may be closed prematurely when an alternative use for them could be found. Several hospitals are reducing the number of beds available for geriatrics.
I earnestly hope that the Minister will pass to the South-West Thames Regional Health Authority my suggestion that these two hospitals should not be closed but should be retained for use as geriatric centres, catering not necessarily for the London Borough of Sutton but a far far wider area within the regional health authority, perhaps going into Surrey and Sussex, which will be necessary by 1985. They would thus assist many residents over a wide area.
I accept that the cost of retaining, renovating and converting the two hospitals will be high, but by 1980 the problems of our senior citizens will be infinitely greater than they are now. It 1031 would be foolhardy for the health authority to bulldoze these two National Health Service hospitals.
There are 55 acres of land surrounding the two hospitals. We in the London Borough of Sutton are concerned about the future of the remaining land even if the two hospitals are retained. I hope that the Minister will convey to his right hon. Friend that any land which is released by the Department of Health and Social Security should first be offered to the London Borough of Sutton. There are several ways in which the land could be used. There is urgent need for more housing in the Greater London area and the availability of the land would enable the London Borough of Sutton to catch up on its housing programme for both council housing and private development.
Within the recent past we have had London overspill developments in the area. We welcome the residents who have come from the inner London area into the constituency, and we hope that they are happy there. They have settled in well, but they have placed a tremendous pressure upon the ancillary services which are so essential to society. There will be grave sociological problems if we are unable to provide all the services we require within the next ten years. The London Borough of Sutton could use the land for the erection of primary and secondary schools. We need more old people's homes and an old people's day centre. Most important of all is the inclusion of recreational facilities. I hope that all these facilities will be taken into consideration.
I earnestly hope that the Minister will convey my sentiments to his right hon. Friend the Secretary of State. It is vital that this land be clearly designated for the use of the London Borough of Sutton. I hope that the Minister will give an indication of the future timing for the disposal of any part of the 55 acres which his Department will not require and of the current plans. I cannot emphasise too strongly that we in the London Borough of Sutton, and in my constituency which covers Sutton, Cheam and Worcester Park, have heard many rumours without knowing what the precise course of action is to be. In reply to my letter seeking fuller details about the intentions for these two hospital sites, 1032 the Minister's colleague was not very specific on 11th July. They concern us greatly. It is essential that we know what the plans are.
I hope that the Minister will be able to convince the South-West Thames Regional Health Authority of the genuine need in the borough and outside my constituency for some consideration to be given to the problems of old age and our senior citizens who by 1985 will require more and more treatment. There is also the need for greater training facilities for nursing staff so that the affliction of old age and problems associated therewith can be tackled.
§ 10.42 p.m.
§ The Under-Secretary of State for Health and Social Security (Mr. Alec Jones)
I am grateful to the hon. Member for Sutton and Cheam (Mr. MacFarlane) for his kind words at the outset of his speech. I am flattered that my interest in the welfare of old people in the Rhondda should be known as far afield as Sutton and Cheam.
I agree that the hon. Gentleman has shown great energy and persistence in pursuing this matter. I have studied the letters, the parliamentary Questions, and the papers available in the Department. The hon. Gentleman has raised three major issues which are related but which have a distinct pattern—first, the present position and the future of the two hospitals; secondly, the general provision for geriatrics in the area; and, thirdly, the future of the site.
The hon. Gentleman referred to rumour, concern and dissent. I will do my best to deal with that and I will be as forthright as I can be. The hon. Gentleman will realise as I proceed that it is not possible to be absolute in giving times for closures of hospitals when we have to deal with such complicated matters as the site now occupied by the Belmont and Henderson Hospitals.
We must remember that Belmont Hospital was established in 1853 as an orphanage. It became a workshop. During the First World War it served as a prisoner-of-war camp. It then became an industrial colony. During the Second World war it was an EMS hospital and then a specialist unit dealing with neurosis.
1033 I understand that, as long ago as 1969, the former South-West Metropolitan Regional Hospital Board decided that there was a need to replace the buildings at the Belmont Hospital as part of the development of long-term plans for psychiatric services in this area. This hospital, as of course the hon. Gentleman knows, deals with the treatment of general psychiatric conditions, and has traditionally taken patients from a fairly wide catchment area—patients who have been drawn to it by its reputation.
The Belmont Hospital buildings are themselves now scheduled to be closed following the completion and commissioning of the nearby Sutton Hospital's new psychiatric unit; and the South-West Thames Regional Health Authority, which has assumed the former board's responsibilities, anticipated that this unit of 120 beds and 120 day places will be operational during the next five months. The Belmont Hospital part of the joint site should therefore be emptied early next year. Therefore, the Belmont Hospital, having rendered a variety of services in its time, is to move to new and pleasant surroundings. I trust that the staff and patients will be happy in their new surroundings and that there will be a greater degree of efficiency.
This unusual and impressive unit tackles a spectrum of mental and social illnesses which have been shunned by many hospitals. It thus offers a valuable service to phychiatrists, social services departments and the Home Office. An enthusiastic and capable staff have fully developed the team approach to treatment.
This experiment was set up by Dr. Maxwell Jones, and the fame of the hospital is world wide, particularly in the psychiatric world. It has accommodation for 48 male and 20 female patients and its bed occupancy seldom exceeds 50. The regional hospital authority has been considering the former regional hospital board's plans to move the hospital to a separate building in the grounds of Ban-stead Hospital. Unfortunately, at Ban-stead there have been slight structural defects and it is not now expected that the move can take place for at least two years.
§ Mr. MacFarlane
The Minister referred to the impressiveness of the Bel- 1034 mont and Henderson Hospitals. Having made a couple of visits to the latter, I think the hon. Gentleman is looking at the hospital with a degree of optimism. I can only assume that the hospital has not been inspected recently. It is not an impressive unit. It is an antiquated building and in a condition of severe dilapidation. It is a cause for concern in my constituency because of the law-breaking activities of many patients. I wish to emphasise that the Henderson hospital is far from impressive.
§ Mr. Jones
I was not trying to convey the impression that all is right with the physical buildings of the Henderson Hospital. I was trying to emphasise the importance in the psychiatric world that is attached to the type of work being undertaken in the Henderson Hospital. It was in that sense I made use of the word "impressive".
Inspections have been carried out. The regional health authority believes that patients should be encouraged to keep their environment clean, both as part of their treatment and in order to help them to lead a natural life in future. They are encouraged to keep their accommodation in reasonable condition and to carry out minor decorations themselves. I understand that large-scale redecoration of wards is currently planned. On the assumption that the hospital will not be moving in the immediate future, the health authorities will also be considering replacement of a number of items of furniture. There is an awareness of the physical problems attached to the hospital.
I turn to the general question of geriatric provision in the area. I compliment the hon. Gentleman on the visits that he has made and the work that he has undertaken for the old people in his constituency, for I am fully aware of his admirable interest in the development of facilities for geriatric patients. I assure him that consideration of the needs of psychiatric and geriatric patients—in other words, of those patients currently using this site and those whom he might wish to see there—has been amongst the highest priorities for early consideration by the Merton, Sutton and Wandsworth Area Health Authority in whose area these hospitals lie.
The total number of geriatric beds in this area is, I understand, approximately 1035 930 or 9.9 per 1,000 of the population over 65 years of age. That compares favourably with the national average of 8.83. Moreover, by 1981 the population of the area is likely to have fallen by 50,000. No reliable population estimates are available after 1981, but it can be assumed that the population in London is unlikely to increase in the following decade. I have no doubt that the relevant authorities will be carefully planning the proper spread of bed provision in this specialty and the maintenance of proper standards in both district general and other hospitals.
§ Mr. MacFarlane
It is all very well to suggest that the population of Greater London will decline over the next decade, but the problem facing the outer London boroughs is acute and critical. Unless the Department has made some accurate projections over the next 10 to 15 years I feel that it will be ignoring the depth of the geriatric problem up to 1990. I should be interested to know—perhaps the hon. Gentleman could write to me—what the projections are and the numbers of beds being planned and prepared for geriatric cases in the next decade.
§ Mr. Jones
I cannot give the detailed answer that the hon. Gentleman would like. The Department's recommendation is that five beds per 1,000 population over the age of 65 should be provided in, and five more outside, the general hospital in each district. It is on that basis that planning is taking place for the provision of geriatric places in this area.
The hon. Gentleman will be pleased to learn that Sutton and West Merton, in which district the hospitals that we are now considering lie, has been amongst the first districts in the country to set up what will become a geriatric "health care planning team". It is therefore energetically considering all forms of geriatric provision. I will convey to this body the suggestions that the hon. Gentleman has made tonight. I am sure that it will take account of his views in considering provision for geriatric cases.
I should like to comment about the future of the site on the assumption that both hospitals will at some stage be closed. Obviously this site, whether of 49 acres, according to my information, or 1036 55 acres, according to the hon. Gentleman, is of considerable value. Its acquisition is an attractive proposition to many bodies, including the Sutton authority and others who may be interested. Obviously we must ensure that whatever we do this valuable site is used for good social reasons.
As my hon. Friend the Minister or State explained to the hon. Gentleman in answer to questions earlier this year, the regional health authority still has to make sure that it does not require either the existing hospital buildings or any part of the site for other hospital or, indeed, any health purposes once the Belmont and Henderson hospital buildings are vacated. After tonight's debate, of course, the authority may be further influenced to retain parts of that site for geriatric use.
The hon. Member will be only too well aware of the demands being made on this authority, as on each of the newly-established health authorities, not only in terms of plans to be made but of resources with which to fulfil these new demands. In this particular case, the possible uses to which part at least of the site could be put include that of a site for its own or for the district management team's administrative offices.
The hon. Member will appreciate that, in view of the large number of unknowns, it has not been possible to determine what should be the future of this site in the event of the health authorities not requiring it all. The Secretary of State has now been asked for formal approval to the closure of the buildings but we are awaiting the outcome of discussions between the South West Thames Regional Health Authority, the Merton, Sutton and Wandsworth Area Health Authority and the newly-set up Community Health Council which must now be consulted. Obviously, the reorganisation of the health service has played a part in the delay here.
Should the buildings and site indeed be declared surplus to National Health Service use, then the usual procedure will be followed. The regional health authority must first establish whether there is a local authority need for a personal social service function. If there is, then this will take precedence over any other non-health use. Otherwise 1037 offer of the property must, in accordance with the rules for disposal of Government land, go first to other Government Departments, then to the London Borough of Sutton and to the Greater London Council, both of whom have urgent housing needs and both of whom have expressed an interest in it.
I end by assuring the hon. Gentleman that the health authorities and my Department share his concern that we 1038 must not only ensure an effective geriatric service in this area but also, if this land is no longer required for health purposes, must ensure that it is used for the maximum benefit of his constituents and all concerned.
§ Question put and agreed to.
§ Adjourned accordingly at three minutes to Eleven o'clock.