§ 4. Mr. Peter Bottomleyasked the Secretary of State for Social Services if he will make a statement on the proposed cuts by hospital authorities in the four Thames regional health authorities.
§ 9. Mr. John Huntasked the Secretary of State for Social Services if he will make a statement on the proposed cuts by hospital authorities in the four Thames regional health authorities.
§ Mr. EnnalsProposals for closure in the current year arise mainly from the duty of authorities to keep expenditure within notified cash limits. I shall shortly decide what allocation will be made for next year in the light of consultation on the report of the Resources Allocation Working Party. I remain firmly convinced that redistribution of resources in favour of deprived areas is right and necessary. But it must essentially be a long-term process depending partly on the total resources available to the NHS, but also on the over-riding need to proceed at a pace which allows adequate time for careful planning and full consultation on rationalisation proposals. Press reports of wholesale butchery among leading, teaching hospitals in London are totally unfounded.
§ Mr. BottomleyWe can gather from that answer that we are on a touchy subject. Would the right hon. Gentleman agree that area health authorities should provide cost justification proposals to close hospitals like the Eltham and Mottingham General Hospital? Will he build the conurbation factor into the 669 plans for denuding many parts of London of their NHS hospitals?
§ Mr. EnnalsIn relation to the problems of Greenwich and Bexley AHA, there are proposals for the closure of four small hospitals, including the Eltham and Mottingham hospital. These closures are designed to rationalise the over-provision of hospital facilities in the area as a result of there now being two large new hospitals in the area—Greenwich Hospital and Queen Mary's Hospital, in Sid cup. It is a natural consequence. People will always resist the closure of any hospital, but if we are to go ahead and build new hospitals with better facilities, inevitably the planning must include the closure of some small uneconomic hospitals.
§ Mr. LiptonDoes my right hon. Friend really think that this country is going to be saved from economic disaster by closing the children's ward at Bart's over the weekend and sending the children either back home or into adult wards, where they run the risk of cross-infection? Will he also have a look at what is happening at the Maudsley Hospital in Denmark Hill.
§ Mr. EnnalsAt Bart's, to keep expenditure within the cash limits in the current year there are proposals—and they are only proposals as yet—to close temporarily two general wards and, at the weekend only, one children's ward. No decision has been taken, but if areas are to live within their cash limits and within their budgets, they have to have some programme of rationalisation. That is inevitable. The only other consequence would be for the Secretary of State of the day to bail out regions which are over-expended or to take the money from funds in other parts of the country.
§ Sir George YoungWill the Secretary of State now give the House a categorical assurance that in no circumstances will he authorise the closure of the newly-constructed Charing Cross Hospital in Hammersmith, or the Hammersmith General and North-West London Hospital in West London?
§ Mr. EnnalsYes, I give that assurance. The reports of proposals to close one or more of any of the teaching and specialist hospitals in the North-West Thames region—and that includes Charing Cross and Northwick Park—are 670 absolutely without foundation. They lack reality. I can give that denial. The heavy concentration of teaching hospitals in the inner London area of the region poses some problems for the regional health authority. I have not yet received the plans of the region for the future, but I repeat that the pace at which change can be introduced needs to be carefully considered, to avoid putting at risk important services and teaching commitments.
§ Mr. Michael StewartIs my right hon. Friend aware that what he has said about the Charing Cross and Hammersmith hospitals is encouraging? Nevertheless, does he agree that if the imbalance between the London regions and the rest of the country is to be corrected, it has to be done on a time-scale that will allow the other regions to make use of any new money that may be available to them?
§ Mr. EnnalsThe problem is not whether other regions which have been deprived over many years can use their resources, although, of course, there is great concern about the situation in London. The real problem is that we are suffering from a failure to plan the use of our health resources over many years. I believe that it is the responsibility of the Government to seek to adjust that balance. I fully agree with my right hon. Friend that it can be done only at a speed which does not damage centres of excellence, and which does not damage the teaching hospitals and the main structure of our NHS hospitals, on which our Health Service is based.
§ Mr. Patrick JenkinIs the Secretary of State aware that the Opposition entirely accept in principle the general proposal for reallocation over a period? Will he equally accept that in a period when the real resources going to the National Health Service are at best static, and perhaps in real terms declining, he must proceed along this path with the most extreme caution if he is not to do unacceptable damage to health centres in the declining areas?
§ Mr. EnnalsThe implication of extreme caution might be that I should not proceed at all. However, I can assure the right hon. Gentleman that I shall proceed with very great care. Since so many rumours are floating around, I 671 should add that it must be recognised that health authorities have been required to submit to my Department, by early next year, plans for the rationalisation and development of services over the next 10 years. In doing that, there are inevitably some proposals for closures, but it must not be assumed that because a plan has been put forward for consultation that will happen, let alone that it will happen next year.