National Health Service (Structure)

HC Deb 05 November 1979 vol 973 cc14-6

9. Sir Anthony Meyer

asked the Secretary of State for Wales what proposals he has for the reorganisation of the National Health Service in Wales.

10. Mr. Best

asked the Secretary of State for Wales what plans he has for further reorganisation of the health services following the report of the Royal Commission.

14. Mr. Ray Powell

asked the Secretary of State for Wales what are his proposals for the area health authorities in Wales.

Mr. Wyn Roberts

Before the end of the year, the Government will be issuing a consultation document on the major issues of structure and management on which the Royal Commission reported. The document will refer to National Health Structure in Wales. I do not want to anticipate this, but I can say now that I shall need a lot of convincing that in Wales any change in the present pattern of areas would be justified, since the area health Authorities generally are comparable to the district authorities contemplated for England.

Sir A. Meyer

Is my hon. Friend satisfied that the family practitioner committees are well constituted and effectively carrying out their function in every case? Can my hon. Friend give me an assurance that there is a continuing role for community hospitals, and that nothing is projected that will diminish or delay the programme for the construction and maintenance of these community hospitals?

Mr. Roberts

The family practitioner committees are, on the whole, operating successfully. I know that my hon. Friend has a problem in his authority, but my right hon. Friend cannot intervene in that matter. With regard to the closure of community hospitals, where new hospitals are built and take over the functions of outdated smaller hospitals, some closures are inevitable, but generally our policy is to build on to the role of small hospitals. We shall certainly not close small local hospitals which provide a valuable service to their communities, provided that resources are available to keep them open. If a closure is proposed, I shall need to be satisfied that there is no better course open to us.

Mr. Best

I greatly welcome that statement by my hon. Friend, but is he aware that, in order to ensure that the resources are available for these small hospitals and that they do not close, the people of Wales are looking for a saving in the bureaucracy and the administration of the Health Service—rather than a cut in services to the patients—where these savings can be effected?

Will my hon. Friend lay once and for all the bogy about cuts in the Health Service? Will he explain to the House exactly what the Government are doing in regard to the Health Service, since much has been said by Labour Members that is greatly misleading to the people of Wales?

Mr. Roberts

I assure my hon. Friend that the Government plan to maintain spending on the National Health Service in Wales for 1980–81 at the level proposed by the last Administration. With regard to the Royal Commission report and the later consultation, we want to streamline the Health Service as much as we can and get the best value for the money that we spend on the Health Service in Wales.

Mr. Powell

I am pleased that the Minister has said that there will not be any reorganisation of the Health Service, but I recently read a document about a reorganisation taking place in the Ogmore area, particularly affecting one hospital, Blackmill hospital. I wonder whether the reorganisation will include this hospital. If there is to be consultation, I hope that the consultation with staff will be far more wide ranging than the last consultation, when you reorganised the service in 1973. As a new Member, I ask whether you would be prepared to apologise, on behalf of the last Tory Government, for the hash you then made of the Health Service.

Mr. Speaker

Order. I am prepared to do many things. The hon. Gentleman kept saying "you". The word "you" in this House refers to one person only, and he does not like it.

Mr. Roberts

In any organisational changes that may take place, the staff interests will, of course, be properly safeguarded. Districts within Welsh area health authorities do not have the same autonomy as in England. There are, nevertheless, criticisms of existing management arrangements, and there is a case for re-examining them. We hope to be able to strengthen individual hospital units and sectors.

Mr. Geraint Howells

I am sure that the Minister is aware of the last Conservative Government's assurance to the people of Mid-Wales that the second phase at Bronglais hospital would be built within five years. Here we are, 10 years later, and the assurance has not been fulfilled. Has the Minister any plans to build the second phase at Bronglais hospital within the next five years?

Mr. Roberts

I should require notice of that question. Of course, there have been delays in capital programmes, largely because of a deficiency in resources. I shall look into the matter raised by the hon. Gentleman and write to him.

Dr. Roger Thomas

I fully appreciate that the Ministers at the Welsh Office are very busy, but I wonder whether one of them has had time to read the lecture given at the Liverpool Institute recently by my right hon. Friend the Member for Plymouth, Devonport (Dr. Owen), a former health Minister, in which he suggested that we should make haste slowly over the reorganisation of the Health Service, and take perhaps until 1992 so that this time we get the organisation right and do not have a complete mess, as in 1974.

Mr. Roberts

I agree that we must take time over any further reorganisation of the Health Service. In answer to the original question, I suggested that the Health Service in Wales does not need a great deal of change. That also suggests that the Health Service reorganisation carried out by the last Conservative Covernment was indeed a very good one and has stood us in good stead.