HC Deb 09 December 1980 vol 995 cc898-906

Motion made, and Question proposed. That this House do now adjourn.—[Mr. Cope.]

11.17 pm
Mr. William McKelvey (Kilmarnock)

I welcome the opportunity to debate the question of the protracted delay in the building of the North Ayrshire district general hospital, and I am particularly glad to see among my Scottish colleagues those of my colleagues from Ayrshire. I hope, Mr. Deputy Speaker, that in the course of the debate my hon. Friend the Member for Central Ayrshire (Mr. Lambie) may catch your eye.

This project for a new 700-bed hospital was initiated by the former Western region hospital board and design team that was appointed in March 1965. Work then started on the site in August 1972, and the projected date of completion was to be around May 1977. However, on 19 March 1979 the local health council requested the Secretary of State to hold a public inquiry into the delay in hand-over and commissioning of the North Ayrshire district general hospital.

The response from the Scottish Home and Health Department of 4 May 1979 was that a public inquiry can elicit much information, but its proceedings are likely to be protracted and might not directly assist (indeed, might even prejudice) the Health Board's chances of recovery of excess costs from offending parties. The Board has given priority to ascertaining what is technically wrong at the hospital and to finding means of putting the problems right, while at the same time attempting both to establish responsibility for the problems and to maintain as far as possible, their rights to appropriate legal action. In these circumstances, it is not considered appropriate to consider further the question of a public inquiry at this stage. I believe that a similar type of reply was given to my hon. Friend the Member for Central Ayrshire when he asked a parliamentary question on 23 May 1979.

Those requests had been prompted when, on 27 November 1978, the Ayrshire and Arran health board issued a press release announcing that there would be at least a six-month delay in the hand-over to the North Ayrshire district general hospital. The main reasons for the delay were identified as involving two areas. First, there were serious plumbing problems in the form of unacceptably high levels of lead and copper in the water supply. I understand that the technical reason for that was that earlier plumbing had been dealt with and some solder had got into the water supply. I am glad to say that that was cured by the perpetual running of water over a period of some months.

The second and more serious problem concerned the ventilation system to the main five-storey ward block and to the main theatres. At that time, Mr. Carson — the area health board chairman—stated: The Board cannot accept a building which has identifiable problems of such a worrying nature. No one could blame him for that. Indeed, we share his concern. The problems were much more serious than had first been envisaged.

On 28 September 1979, the Ayrshire and Arran health Board issued a press release indicating that it would be at least 18 months before the North Ayrshire district general hospital was commissioned. In fact, the health board hoped that the remedial work required and some additional work would be carried out at the same time, thereby, it was hoped, reducing the time lag, then estimated at three years, to 18 months.

Again, there was a press release dated 17 April 1980. It stated: It was seven months ago when the Board announced it would be 18 months to three years before the hospital would take its first patients.

In July, the first part of the hospital complex, the college of nursing and the administration blocks, were handed over and brought immediately into use. The new hospital was to serve North Ayrshire and would allow the closure of Torrance House — a small hospital with limited resources — and the closure of Kilmarnock infirmary, which has a capacity, at present, of about 130 beds. It is well over 100 years old and is totally inadequate and unsuitable by modern standards.

Since the new hospital was expected to open in 1977, few or no improvements have been made to the deteriorating and overcrowded conditions that prevail in Kilmarnock infirmary. Consequently, the entire staff are valiantly struggling against mounting difficulties in order to maintain a reasonable standard of patient welfare. One can imagine the despair felt by these dedicated people in such conditions. Since further delays will affect them, they will not move to the new hospital for about three years. Since the Government have embarked on an all-out austerity programme, they have little hope of any money being spent on improving the conditions at Kilmarnock infirmary. It would be particularly unwise to spend large amounts on that area, because a fairly short period of time might be involved.

It is a scandal that we should play on the fact that such workers are prepared to put up with intolerable working conditions because they are responsible for their patients. They put the welfare of their patients before their own. Among the workers and all the senior staff in Kilmarnock hospital, there is growing concern that out-of-date machinery is beginning to break down. That gives rise not only to serious concern about the patients in Kilmarnock infirmary but to delays for those waiting for treatment or operations.

The main design fault was apparently in the ventilation system, which proved to be inadequate and did not comply with the necessary high standards of today. The extensive remedial work will mean that this brand new building will not be fully operational until March 1982. It is almost five years behind schedule. It is an indictment of the original designers that the capital building costs of £9 million have obviously soared during the delay. I shudder to contemplate what the final bill will be. I am not sure what the present estimate is. As a result of inflation, I am sure that several millions of pounds have been added to the bill.

It is much more difficult to estimate the social cost, which cannot be measured in pounds. People will undoubtedly be in difficulties. Patients who need the facilities of the new hospital will be denied them for some time to come.

I should like to ask a number of questions, which I hope will be answered tonight. I begin with what is virtually a plea from the local health council, which asks when, oh when, the North Ayrshire district general hospital will be open to accept patients. Fears are now being expressed that it may be as late as the autumn of 1982 before patients will be admitted. Some people feel a growing concern that by the time the hospital is open the estimated cost of running it will be more than £12 million a year. There might well be no cash available to open it, so in 1982, when eventually—five years behind schedule—we have this fine hospital, there may well be no money to staff it. Then we shall have to return to the almost Dickensian conditions in Kilmarnock infirmary and try to make some improvements there.

Secondly, why were the problems in the ventilation system in particular not recognised until after the due completion date of May 1977?

Thirdly, it is understood that the area health board will be going to litigation. Indeed, a writ was served on the consulting engineers in September. Why has it taken so long for this action to be raised?

Fourthly, what part, if any, has the Common Services Agency played in this long-drawn-out affair? Who in that body is responsible for overseeing the condition of the project? The agency is evidently the scrutineer of any plans or projects such as the North Ayrshire district general hospital.

Fifthly, will the Secretary of State hold a public inquiry into the whole affair? If, for reasons previously stated, this might in some way prejudice the health board's chance of getting back some of the money spent because of the errors, will the Secretary of State be prepared to set up a commission to investigate hospital building, not only at the hospital in question but throughout Scotland?

There has been a catalogue of disasters in new hospital building. It is passing strange that in this age of technological advance we seem, particularly in Scotland, unable to produce consulting engineers who can design and build a proper facility. We have had trouble at Ninewells, Inverclyde Royal, the sick children's hospital in Glasgow, which some people say is virtually falling apart, and the hospital that we are debating.

I look forward to the Minister's reply.

11.27 pm
Mr. David Lambie (Central Ayrshire)

I am grateful to my hon. Friend the Member for Kilmarnock (Mr. McKelvey) for allowing me to take part in this short debate. I am glad to see that my hon. Friend the Member for South Ayrshire (Mr. Foulkes) is also present, because, as an Ayrshire Member, he is concerned about the delay in finishing the North Ayrshire district general hospital, which will serve the whole of Ayrshire.

I should like to add my voice to the demand for a public inquiry, not only into the delay in completing the North Ayrshire district general hospital but into hospital building in general in Scotland. My hon. Friend mentioned the Ninewells hospital in Dundee, which took 10 years to build. The original estimated building time was four years and the initial cost was estimated to be £10.2 million. The final cost was £19.5 million. The tremendous delay has resulted in increased public expenditure, which the Undersecretary is always telling us the Government want to cut.

The twenty-fifth report from the Committee of Public Accounts for 1979–80, dealing with the Royal Hospital for Sick Children in Glasgow, told us that the site works there started in July 1968. The planning team started work in November 1965. That hospital should have been commissioned in 1971, but remedial work is still being carried out. The Committee carried out an investigation and took oral evidence on the reason for the delay.

Following the evidence that was given to the Committee, we were told that the original cost was £4½ million. The repair cost is £7¼ million, nearly double the initial cost of the project. That is why people in Scotland are becoming disturbed about what is happening to hospital building in our country.

Much the same comments apply to the hospital that is the subject of the debate, and we have raised these matters because of pressure from local people and the local health council. No one seems to know what is going on. The Minister must tell us tonight what is going on so that not only do we know what is happening but the information is available to our constituents and the health council.

In February 1976 the cost of this hospital was estimated at £9½ million. What is the estimated cost now? A press statement issued by Ayrshire health board on 17 April 1980 carried a statement by the chairman of the board, Mr. Carson, a friend of my hon. Friend on the projected programme of corrective and post-contractual work. It said: Mr. Carson emphasised the boldness and imagination of the proposed scheme, and went on: 'We have reached this stage only with the willingness and co-operation of everyone concerned—the design teams, the main contractor and the engineering sub-contractors, the Common Services Agency and our own staff. No one should underestimate the complexity of integrating the various works'. That statement was made eight years after the commencement of the hospital, and now we are getting this great enthusiasm about what is to be done through cooperation. The Minister should tell us why there was not this co-operation eight years ago. Why has the design team been sacked? Mo one knows that the design team has been sacked. Everyone is afraid to say that that is the case. I am laying tonight that the original design team has been sacked, and the Minister has to verify that statement.

Not only has the original design team been sacked, but, as Mr. Carson said on 17 April, a new design team has been appointed. Everyone is enthusiastic now and they will get on with the hospital, but when will it be opened? On the last occasion on which the House dealt with Scottish questions, in reply to a question that I asked about the-completion date I was told that it was hoped to open the hospital in the autumn of 1982—10 years after the start of the hospital.

I ask the Minister to deal with the matters raised by my Ion. Friend. The Common Services Agency's building division is concerned with the design, building and commissioning of new hospitals. It acts as agent for both the Secretary of State and the health boards. It is supposed to provide information, advise the health boards and build projects. It can supply architects, design staff and so on on it may appoint private firms to do the work. It does all that, but major building projects must be authorised by the Scottish Home and Health Department.

The design team has been sacked. That was necessary and should have been done years ago. I want to know, as did certain members of the Public Accounts Committee, who in the Common Services Agency is responsible for what has been done. My hon. Friend the Member for Fife, Central (Mr. Hamilton) asked about the chief architect in the CSA. Has he been sacked? Has anyone else been sacked for this catalogue of disasters? Has anyone in the Scottish Home and Health Department been sacked? There has been a tremendous increase in the costs of these projects. Money has been wasted. People have been paid for doing jobs that they did not do. Have any of the people concerned in the Scottish Home and Health Department been sacked?

Is it not possible to ask the Select Committee on Scottish Affairs to take evidence on the activities of the CSA in regard to this hospital? The Minister has a tremendous responsibility in this matter. Public money has been wasted in Dundee and Glasgow, and now in Ayrshire. He must speak up and give us answers that we can give to our constituents.

11.35 pm
The Under-Secretary of State for Scotland (Mr. Russell Fairgrieve)

I am grateful to the hon. Member for Kilmarnock (Mr. McKelvey) for giving us the opportunity to discuss briefly this evening the problems that have arisen at this hospital. I am also glad that the hon. Member for Central Ayrshire (Mr. Lambie) has caught your eye, Mr. Deputy Speaker.

As the hon. Member for Kilmarnock will know, I have had the pleasure of visiting the hospital. It is not yet opened, but it is a most beautiful and attractive hospital. It is far from obvious to the outsider why it cannot be occupied at once. It is regrettably true, however, that the problems with the ventilation system do not permit this. The air conditioning, for that is what we are talking about, is just not up to the job, even when turned to full power: and when that is done the noise level in the wards is intolerable.

There is a lot that I should like to say in the limited time available to me in this debate, but I feel I am duty bound to answer first some of the questions put to me. Thereafter, I may try to make some general remarks about the hospital.

I will try, first, to answer the questions put to me by the two hon. Members. Obviously, the questions overlap. I, as a layman, have asked time and time again why it is taking so long to get the wards open at this hospital. The clinical considerations govern the doctors' views of when the theatres should be opened. They do not want the wards opened with patients there before the theatres are ready. We are quite correct in that regard in thinking of early 1982, although the nurses' section and the administrative block are open now.

As regards costs, I am glad to say that in respect of this hospital the final cost in real terms is coming out at some £21 million and the remedial works themselves are expected to cost only about 1 or 2 per cent. of this figure.

Why were not the problems with the ventilation discovered earlier? Those of us who have had a Jot of experience in industry—it is rather like building a car or anything else — know that until the whole thing is switched on one does not find out the faults. Until the whole lot was switched on, it was not found that the ventilation was not working. I am glad that the hon. Member agreed that: in the case of the water what was needed was turning the taps on and letting them run. It was not a question of late action. Action was taken immediately the faults in the ventilation system were discovered.

The CSA came into the picture only in 1974, long after the hospital had started to be planned and built, when the reorganisation took place. The CSA is an advisory body and not an executive body.

Mr. George Foulkes (South Ayrshire)

I do not think that it is so easy to gloss over the role of the Common Services Agency so lightly. Does not the Minister think that it might be much simpler for health boards to deal with the design team and the builders direct without the intervention of the CSA and that the intervention of that third arm causes confusion, delay and difficulty? Will he take account of that?

Mr. Fairgrieve

I shall take account of that. However, I cannot accept the argument. The CSA is there to help. Health boards are dealing with the design team and the subcontractors direct. The CSA is there for advice if so required. The CSA is not part of the Department. It is part, basically, of the Health Service. The health board is not dissatisfied with the role that the CSA has played in this matter. Therefore, I suggest that the hon. Member take up the question of the CSA with the health board itself.

As regards the public inquiry, time and time again we have explained that the object of the health board, the people in Ayrshire and the Department is to get this hospital commissioned as soon as possible. A public inquiry would definitely cause delay. It would also prejudice the action that we have already taken so that those who have caused this problem can be brought to some form of justice — which will be done. We have issued a protective writ, so we are not time barred.

Mention was made about hospital building being a catalogue of disaster. I must deny this. There have been far more problems south of the border than we have had in Scotland. There have been only three, shall we say, disasters: the one that we are discussing, Ninewells at Dundee and the sick children's hospital, Glasgow.

Mr. Lambie

That is more than enough.

Mr. Fairgrieve

As a proportion of the number that we have built since the Second World War, it is not bad going for the course. Every one of these can be put down to trying to take short cuts. Dundee was design and build, for political reasons. Yorkhill's problems arose out of political reasons—"We must build it immediately." The problem in this instance was not a mistake but, as we have said, a fall-out within the design team.

The design team has not been sacked; it has been changed.

Mr. Lambie

Disappeared.

Mr. Fairgrieve

It has not disappeared. Three-quarters of the design team members are the same. There have been changes in the design team. Some of its members are no longer with the team. The team has not been sacked; it has been changed by up to one-third of its members.

Let us get the facts right before we go rushing round in various devious channels which are not always strictly factual. I have mentioned the public inquiry and Dundee. I have also referred to what is going on. I regret that the hospital will not be open to receive patients until 1982. I have made inquiries.

There is no question, as has been suggested, of the hospital not being able to be run by the board. The finance is available. The board is at the top end of the Scottish health authorities' revenue equalisation programme. The hospital has no problem of not being fully commissioned. Therefore, that gets another canard out of the way.

Having answered the questions that were put to me, I think that I am now entitled to make some remarks on how we are progressing.

Mr. Lambie

What about the Select Committee?

Mr. Fairgrieve

I have been asked whether there could be a public inquiry into the whole principle of hospital building in Scotland. I have already given our fine record compared with the rest of the country and the reasons why we have trouble in three hospitals. The Secretary of State asked for a seminar in the Scottish Office, during which he spent three hours looking into the whole question of hospital building, commissioning and so on in Scotland. A very detailed exercise was carried out on that score. I hope that hon. Gentlemen are satisfied on that point.

After we changed the design team, it was necessary for the firm to look into the whole problem, find out what was there and what was wrong with it and make recommendations on how to put it right. This may be old hat to Opposition Members, but I still think that we should put it on the record. The health board was aware that this was likely to be a lengthy process and was very keen to make an early start on using the hospital. Hence, it agreed that there would be a phased hand-over with departments being transferred to the board for commissioning and subsequent bringing into use as necessary remedial works were completed.

The first departments—this is often forgotten—were handed over on schedule. That was not mentioned by the two hon. Gentlemen who spoke tonight. These were the administration block and the college of nursing, and they have now been in use for some months. Thereafter the design team found it necessary to revise its original handover programme. As I said earlier, the board members insisted on meeting the design team and the CSA building division to discuss the problems and the reasons for the slippage. They were most concerned to know whether there would be any further slippage. Those meetings duly took place. The consulting engineers naturally felt unable to give any absolute guarantees but satisfied the board that, in their opinion, the majority of the problems had now been diagnosed and that the new timetable would be met. This envisages the ward blocks being handed over to the board in February and April 1982.

It is not for me to say, but we are trying to do everything that we can to advance that date. A period of commissioning is then necessary, but the hope is that the first patients can be admitted some six months thereafter. I should like to mention at this point that current indications are that good progress is being made and that the timetabling is being kept. I can assure hon. Members that the health board is pressing vigorously for the work to be completed as soon as possible. It had been struggling for this for some time, and it is its wish that this fine new hospital, which I have had the pleasure of going round, should be brought into use as soon as possible.

There is absolutely no truth in the suggestion that the board has been dragging its feet because it considers that it cannot meet the running costs of the hospital.

Mr. McKelvey

Will the Minister deal with the question of Kilmarnock infirmary and the fate of the patients and staff there?

Mr. Fairgrieve

I cannot possibly go into that question tonight. It is a separate matter. There will be no problem about dealing with patients in the area, if that is what the hon. Member is asking.

The board is quite determined in due course to pursue those who are judged to be at fault. It has taken certain legal steps to prevent the possibility of any actions which might be found necessary being time barred.

I conclude by emphasising the positive situation. All concerned are pressing on as hard as they can with getting this excellent hospital put to rights and into use. They deserve every encouragement that we can give them. For those reasons, if for no others, I am grateful to the hon. Member for bringing up the subject for debate tonight.

Question put and agreed to.

Adjourned accordingly at fourteen minutes to Twelve o'clock.