§ 2.31 p.m.
§ Sir David Renton (Huntingdonshire)I wish to refer to the need for a new general hospital at Huntingdon, a hospital which is many years overdue. My constituency is one of the fastest growing in the whole country. But hospital facilities at Huntingdon, St. Neots, St. Ives and more than 50 surrounding villages have grown scarcely at all in the past 100 years. The present hospital was built over 100 years ago and had about 50 beds serving a population of around 20,000. Now it has to serve over 100,000 people with only 62 beds.
997 Improvised arrangements give us an operating theatre, an X-ray department, an outpatients department and one or two other services. However, the antiquated and cramped conditions of the hospital are utterly unacceptable and have long been acknowledged to be so by all concerned. The nearest other hospitals are 20 miles away in three different directions —at Cambridge, Peterborough and Bedford. To collect people from some of our villages or from the Great North Road, where accidents occur, and take them to one of those hospitals often involves a round trip of 50 miles. Visiting becomes a great burden for relatives.
During the past 16 years I have made frequent requests for a new general hospital to be built at Huntingdon. This is my maiden speech on that subject although it could conceivably have formed the subject of my maiden speech 33 years ago. It has been accepted that we should have a new hospital. The land for it has been available for many years, at Hinchingbrooke, in the park. There we have, I must concede, a fine new geriatric hospital which replaces an old Poor Law institution for old people. That is not the same thing as our need for a new general hospital. Three times we have been promised an early starting date for the hospital. The last occasion was last November when I took a deputation of hospital workers, local representatives and the leading doctor concerned with the hospital to see the Minister of State, who received us most sympathetically.
It was then agreed between the East Anglian regional health authority and the Cambridge area health authority that preliminary planning for our new hospital should start at once. That was with a view to providing 204 new beds in this hospital by 1982 and increasing it to 450 after that. But, of course, both those figures can be achieved only if the preliminary work started when it was said that it would start, last November, and if the programme was adhered to.
Last month, to our great dismay, we had the frustrating news that only 56 beds were to be built by 1982. This is fewer than we have in the present, obsolete, hospital. We were also told, incidentally, that we would have to keep the old hospital going and that there would have to be further improvisation in those cramped conditions. This is not good 998 enough. The reason that we have so far been given is that the Department of Health and Social Security and the health authorities have failed to agree upon the plans for the new hospital.
There is no question of difficulty over cash. It was accepted last winter that the hospital was within the cash limits and within the budgets of the area health authority and regional health authority. There is no problem of finance, as is so often the case when projects are delayed. It is said to be failure by the authorities concerned to agree upon the plans. I do not know who is to blame. Perhaps the Minister can offer some explanation. It may be that he will gladly accept some responsibility on behalf of his Department. I do not know.
It is disgraceful that there should be this delay. Administrators at every level should now stop arguing among themselves and get on with the job. My constituents are fed up with these postponements and excuses which we have had to suffer for so many years. I hope that the Under-Secretary will tell us that he will knock some heads together and let us know when the building of our much-needed hospital will at last start.
§ The Under-Secretary of State for Health and Social Security (Mr. Eric Deakins)I am grateful to the right hon. and learned Member for Huntingdonshire (Sir D. Renton) for giving me an opportunity to set out the exact position relating to the development of Hinchingbrooke hospital at Huntingdon. In view of the somewhat misleading statements which have recently been made in the local press I can appreciate the concern felt by the right hon. and learned Member and his constituents, and I hope that in the time available to me I can go some way to allay his fears on this matter.
I can assure the right hon. and learned Member that the East Anglian regional health authority and the Cambridge area health authority (teaching) which are responsible for the provision of health services in Huntingdon are fully aware of the need for an early completion of the proposal development of Hinchingbrooke hospital. As the right hon. and learned Member is aware, the first two phases of the development, comprising the residential accommodation and 112 geriatric beds were completed in March 1976 and were occupied later that year. Space for 999 a further 56 beds is at present being used to accommodate the geriatric day hospital and service departments, and cannot be bought into use until these are reprovided.
The decision to make an early start on phase III of the development is a relatively recent one. In July 1977 the regional health authority's proposals included financial provisions for a start in 1985–86 with completion in 1988–89. The area health authority, in reviewing the area needs, gave first priority to a new unit at Addenbrookes hospital, Hills Road, Cambridge, the completion of which would provide beds to permit the closure of the old Addenbrookes hospital at Trumpington Street, Cambridge, in or about 1982. The regional health authority considered, however, that the proposals put forward by the area health authority for this development could not be completed in time to permit the closure of Trumpington Street in 1982. It concluded that the most that could sensibly be encompassed in the next stage of development in Hills Road was a block containing a geriatric department, together with 28 beds for general acute purposes.
In order partially to offset the loss of beds in Cambridge, and in order to redress the existing inadequate facilities, in Huntingdon—and there is no dispute between us and the right hon. and learned Gentleman that they are grossly inadequate—it was also decided, in November 1977 that, in parallel with the Hills Road development, a start should be made on phase III of the development at Huntingdon, possibly by adapting a "best buy" scheme to the site.
The merits of this proposal lay in the immediate availability of prepared plans and the fact that the "best buy" hospital was devised to suit a catchment area broadly similar to that which looks to Huntingdon for basic health services. The availability of suitable prepared plans would, it was hoped, allow the hospital to be designed and built as rapidly and economically as possible, and before the closure of the Trumping-ton Street hospital.
A draft programme presented to the regional health authority in January 1978 made provision for phase III at 1000 Hinchingbrooke to start in September 1978 and to comprise half the "best buy" hospital, containing 210 beds. The estimated contract period was 36 months, and the estimated total cost £10.6 million.
It may be that, in their eagerness to complete this development before 1982, the health authorities were setting themselves too tight a schedule. As the right hon. and learned Member will appreciate, a scheme of this nature cannot be settled without full consultation with all concerned. In this case, a Hinchingbrooke working party was appointed to deal with the detailed content of the development, and was given the task of examining the feasibility of matching the proposed half "best buy" package to the specific requirements of the area health authority and the university.
Provisional requirements were received in April, but the final proposed allocation of beds to specialties was not agreed until 23rd June, when it was suggested that, of a total of 204 beds, 56 should be allocated to general medicine, including paediatrics; 84 to surgical specialties including paediatrics, general surgery, orthopaedics, urology and gynaecology; 14 to general practitioner obstetrics; 28 to adult psychiatry and 22 to psychogeriatrics.
In the meantime, however, because of the complexities of the discussions, the steering committee which had previously dealt with the Cambridge study team report of December 1975, which set out projected requirements for future hospital services in Huntingdon, had been reconvened. At a meeting of the steering committee held on 28th June, regional officers intimated that they now had doubts about the suitability of a "best buy" hospital at Hinchingbrooke. Factors leading to this view were as follows.
First, the latest appraisal of the regional capital programme gave some cause for concern around the year 1981–82 due to changing timetables of a number of schemes in progress, for reasons outside the control of the regional health authority.
Secondly, they considered that the changes which had been proposed locally in the content of the hospital suggested that a "best buy" design was now perhaps less relevant for the planned development.
1001 Thirdly, they felt that the Department would prefer to see a nucleus design adopted at Huntingdon in preference to "best buy". Perhaps I should explain for the benefit of the right hon. and learned Gentleman and other hon. Members that "nucleus" is the latest standard planning guidance issued by the Department and is based upon the use of standard modules of accommodation, with the provision of the essential nucleus of hospital facilities in the first phase and a capability of subsequent expansion of bed numbers and Departments to form the total hospital.
I should further explain, for the benefit of all hon. Members who are having new hospitals contemplated in their areas, that the nucleaus design is an extremely good one; it is a very efficient method of hospital building, not merely from the point of view of cost control, planning and construction, but from the point of view of flexibility for future expansion and development. It is a design that we are trying to market, and with some success, in overseas countries where there are much bigger hospital building programmes than we have.
Basically, it is the sort of design—and without a diagram and model I cannot explain this too well, not being a technical expert—whereby one can tack on modules one after the other because it is not based on the idea of building an enormous tower block, a design which is much less flexible if one wants to change the future use of the hospital to accommodate the changing needs of the population for which health care is being provided. By and large, my Department has a very high regard for the nucleus concept of hospital design, which has been developed by architects in the Department. I have been overseas with them selling the idea to other Governments, so we are very much enamoured of it.
While it is true that the Department is encouraging the use of "nucleus", I think I should make clear that my officials had never been asked to give views on the relative merits of "best buy" or "nucleus" in relation to this project. The regional health authority had written to the Department in November 1977 seeking an assurance that the principle of "best buy" was acceptable, and the Department confirmed that we did not object in principle to its using 1002 well-tried plans which it found acceptable.
We warned, however, that the timetable appeared to be very tight and that we would want reasonable assurance that the proposed starting date of September 1978 was realistic before we could rule out alternatives to the "best buy" design, such as "nucleus". It was suggested that the realism of the timetable seemed crucial in this respect, and an assurance was given that the Department would do all it could to help.
The steering committee asked the working party urgently to consider the possibility of using a nucleus design or some alternative form of development, and proceed on the basis of the bed content as previously agreed. It was asked to prepare, for consideration by 12th July, a planning programme which would not be substantially different from that proposed for the modified "best buy" development. The working party responded later that month with a report which concluded that, although it would be feasible to design an alternative development most of which could be based on nucleus, the consequence—serious from the right hon. and learned Gentleman's point of view—would be to delay the start on site until 1981 and completion until 1984. I make this point because that is a serious factor which the Department had to take into account as well However, there have been further developments since then.
Regional officers discussed the various alternatives with departmental officials yesterday, and the right hon. and learned Member will be glad to hear that the proposal for a "best buy" design will now be pressed ahead by the regional health authority with all possible vigour. Work is expected to begin on site in June 1979. with commissioning in the autumn of 1982.
§ Sir D. RentonI am most grateful to the Minister for that latest news. It offers much greater hope. But will the Minister say whether that is a plan for the first instalment of 204 beds as originally intended?
§ Mr. DeakinsYes, indeed. I can assure the right hon. and learned Gentleman on that point. There may have been arguments about the precise number of beds but I do not think there has been 1003 any argument about the scale. The right hon. and learned Gentleman, in his opening remarks, made a very powerful case for this development taking place as quickly as possible. Now, with the backing of the regional health authority and the area health authority—it had to fit in with plans which had to be changed in Cambridge—I am sure that the right hon. and learned Gentleman and his constituents will get the new hospital facilities to which they have long looked forward and which I am sure they deserve.
In the light of what I have said, I hope that the right hon. and learned Gentleman is satisfied that the hospital has not been dealt a death blow, as has recently been reported in the local press. Far from it. There is no question of planning being restarted from scratch, nor was there any question of the hospital being a "bits and pieces" hospital, as was also reported. Huntingdon will receive a hospital built to a well-proven design at as early a date as is physically possible.