HC Deb 12 March 1980 vol 980 cc1487-509 11.25 pm
Mr. William Hamilton (Fife, Central)

I refer especially to the Supplementary Estimate of about £15½ million for the Health Service and other related matters in Scotland. It is not a large figure when compared with the total of £953 million. I guess that it is about 1½ per cent. However, it enables me to focus attention on one or two pressing problems of which I have given the Under-Secretary of State for Scotland notice. I shall be mentioning other matters while others I shall not mention at all.

No doubt the National Health Service will be clobbered by the public expenditure cuts. I refer to the cuts already inflicted and those to come in a few weeks' time. We shall be able to discuss the forthcoming cuts in due course. There is a Bill in Committee that we can use as a peg on which to hang some of our criticisms of the Government.

I draw the Minister's attention to what I regard as a major scandal. I am not making a party point, and I hope that the Minister will not do so. It is an issue that far transcends party politics. My criticism is directed as much to the previous Labour Government as to the present Government. The important thing is to put matters right and to ensure, as far as we can, that nothing of the sort happens again.

The scandal of the Glasgow Royal hospital for sick children must be brought into the open. The hospital is in the constituency of my hon. Friend the Member for Glasgow, Kelvingrove (Mr. Carmichael). I hope that he will be able to catch your eye, Mr. Deputy Speaker, in due course. I hope that my hon. Friend will recognise that my justification for raising the matter is that it concerns a hospital of national importance and of international repute. It far transcends purely constituency considerations. However, there are other reasons that cause me to raise the issue that I shall disclose in due course.

My hon. Friend has been active in seeking to expose what went wrong. No doubt he will put his own views on record. My attention was drawn to the matter when it hit the headlines in a two- page spread in the Glasgow Sunday Mail of 14 October 1979. The headline was "Hell Hospital". The hospital was opened by the Queen in 1971, about eight years ago. According to the article, it cost £5 million. At the time, it was supposed to be the most modern hospital in Europe for sick children. The main contractors were Richard Costain Ltd. of London.

Within a short time of the hospital opening, serious deficiencies began to show. According to the article, the concrete floors in all 12 wards are breaking up and need to be replaced. The entire plumbing system has had to be or is being ripped out. Every window is to be or is being renewed because they cannot be opened wide enough to provide adequate ventilation. The whole roof is leaking and needs to be replaced. The outside walls leak and will be completely demolished and rebuilt. Defective fire walls inside every ward will have to be taken down. All the wards will have to be closed at the same time as the entire seven-storey building is ripped apart and rebuilt.

In the article, the conditions were described by various doctors as "intolerable", "a shambles" and like trying to run a hospital in the middle of a builder's yard". The building is falling apart. It was built by private enterprise at a cost of £5 million. Taxpayers' money has been used.

I earlier described the story as a scandal. If half of that Sunday Mail story is true, it is a crime. Those responsible must be made to pay. It is estimated that the cost of repairs will be £4 million. We do not know when those repairs will be completed. Perhaps the Minister will confirm the date, given in that article, of 1981. Perhaps he will confirm also the final cost. I expect that it will cost more than £4 million if inflation continues at its current rate.

Who will pay for the repairs? Costain apparently offered no comment when contacted by the Sunday Mail. I do not know whether that firm has since commented. However, it must make some comment. There is a strange reluctance to talk about this issue. I do not wish to prejudge the matter. However, a public inquiry has been demanded. That demand should be acceded to. The truth, the whole truth and nothing but the truth must be revealed.

I do not know whether I should disclose the information that I wish to give. However, I shall take a chance. I am a member of the Select Committee on Public Accounts. When I had read the article, I took it to the Committee. I suggested that an investigation might be initiated by the Committee. It invited me to draw up a questionnaire and to submit it to the Scottish Home and Health Department. I drew up a list of 20 questions. They were sent to that Department in mid-January. I received a reply dated 21 January from Mr. Rennie, the chief accountant. He indicated that he would need some time in order to reply to those questions. He said that he hoped to reply within four weeks. I have not received any reply, although six weeks have passed. Perhaps the Minister can inform me when I may expect that reply.

I understand that extensive costings were involved. I am sure that the Department is anxious to give accurate and full answers. However, I am prepared to suspend judgment until replies have been received and until the Committee has completed its work. The investigation will not end upon receipt of those answers. That is just the beginning of our investigation. The initiation of a public inquiry should not be precluded by the Department. I hope that the Minister will be forthright on those points.

That hospital building programme is not the only one to give cause for concern, although it hit the headlines. I shall give two other examples. I have not given the Minister notice and I do not expect him to reply tonight. Perhaps he will give me a written reply or some other form of response.

I refer first to the North Ayrshire district general hospital, where for new works, alterations and additions the pretender estimate was £1.963 million. The revised estimate for 1979–80 was £2.523 million. For the works in progress at that hospital before 1977–78, the pretender estimate was £8.3 million. The revised total cost for 1979–80 is £15.8 million. There may be good reasons for the difference. It may be due simply to inflation. I should be glad of a detailed answer at a later time.

The second example concerns phase 1 of the Merchiston hospital. The pretender estimate was £3.34 million. The revised total cost for 1979–80 is £5.17 million. If the difference is merely due to inflation, it bodes ill for the future building programme, with the current rate at 20 per cent. Inflation is unlikely to come down in the short term. All the signs are that it will remain at that level for quite a time. That rate of inflation, plus cash limits, is bad news for the Health Service.

I understand that my hon. Friend the Member for Dunfermline (Mr. Douglas) will touch on other aspects of the National Health Service, and I shall merely mention briefly two other problems that concern me—mental illness and handicap and geriatrics. The Minister knows that I have an amendment down in Committee on the Health Services Bill, which we shall be dealing with upstairs. Suffice it to say that in the next few years of financial stringency the most acute suffering will occur with regard to mental illness and geriatrics. I believe that the Minister accepts that.

I can cite examples all over the United Kingdom of man's inhumanity to man. If we treated animals as we treat geriatrics and the mentally ill, there would be an uproar. If a donkey is flogged or there is cruelty to sea beasts in Japan, an early-day motion is put down. I wish that we could get as indignant about geriatric patients and the mentally handicapped in our hospitals.

I received a reply today from the Minister on how much is spent per week per patient on food in psychiatric hospitals. On average it is £5.61 a week, which is 80p a day. Looking at the Minister, I doubt whether he would survive for more than a week on 80p a day. The situation is worse than that. The low figure that the hon. Gentleman gave me was £4.47 a week, which is 64p a day. I should like to know, and the House has a right to know, which hospitals provide for their psychiatric patients in that way. It is not a party point. The answer that I received from the previous Minister was similar. The provision for the inmates of Belsen could not have been much less.

In the Daily Record on Thursday 14 February, a couple of weeks ago, there was the headline "Wards of Shame". The newspaper quotes from a report of the Scottish Hospital Advisory Service. It speaks of old men in some of these geriatric hospitals sharing a shaving brush, a bath towel, even underwear. It is difficult to know how they do that, but they do, according to this report. The report says: It is still possible to find the open stall type of WC without a door and with a battery of WCs open to view. These are old men and women, eking out the last few days of their lives in the most indecent indignity. We all ought to be ashamed that we tolerate conditions of that kind.

What do the Government intend to do about such a state of affairs? In a few weeks, they are to cut those services still further. There is a Bill before the House, to which I have referred. What are they doing in that Bill? They are to extend private practice. That will help the geriatrics an awful lot. That will help the mentally ill and mentally retarded an awful lot. They are to allow the area health boards and the local health councils to raise cash by organising bazaars, whist drives, bingo sessions and, perhaps, strip shows and flag days and God knows what. It is spelt out in clause 4 of the Bill. It would be laughable if it were not so idiotic, obscene and irrelevant to the great problems currently besetting the Health Service in Scotland and the rest of the United Kingdom.

In the coming weeks, in the Budget and the public expenditure White Paper, there will undoubtedly be further vicious cuts in this supremely Christian service. More and heavier charges, perhaps new charges, are more than likely. I do not know how much longer our people will tolerate in silence the continuous onslaught on their standard of living at a time when the Government are talking about spending over the next few years thousands of millions of pounds on nuclear submarines, nuclear defence equipment and the rest. It is the most un-Christian, the most absurd sense of priorities I have ever met in a lifetime of political experience. I hope that the Government are thoroughly ashamed of what they are doing. The people will very soon rise in rebellion against it. It cannot be tolerated a day longer.

11.43 pm
Mr. Neil Carmichael (Glasgow, Kelvingrove)

I am grateful to my hon Friend the Member for Fife, Central (Mr. Hamilton) for giving me the opportunity to say something about the Royal hospital for sick children, which lies within my constituency, outlining the problems that have beset this hospital over the years. I have not raised the matter officially with the Under-Secretary who now has charge of health matters in Scotland, the hon. Member for Aberdeenshire, West (Mr. Fairgrieve).

I emphasise, as did my hon. Friend the Member for Fife, Central, that this is not a party political matter. I received extremely unsatisfactory answers on the issue from my hon. Friend the Member for Stirling, Falkirk and Grangemouth (Mr. Ewing), who was the Minister with health responsibilities in Scotland in the last Labour Government.

I have visited this hospital frequently and have talked regularly to members of staff, many of whom I know on a personal basis. There is nothing I could say about this hospital, and the building work within it, which would be an exaggeration. The entire standard of building is appalling. I will say that the concept, the design of the hospital and the architectural layout are extremely good. I Dive full marks for that. It is a well-laid-out hospital. The concept is good. However, the building and construction work is absolutely unbelievable.

Over the years, I put questions to the Ministers in charge. It is interesting to read some of the answers. As far back as May 1977, I received an answer from the then Under-Secretary of State, my hon. Friend the Member for Stirling, Falkirk and Grangemouth, which referred to extensive remedial works which have still to be undertaken and for which the relevant tender documents are now being instructed or are in course of preparation."— [Official Report, 25 May 1977; Vol. 932, c. 1393.] I should like to know how far forward is this process and whether all the documents for remedial work have now been produced.

The question of arbitration and litigation has bedevilled the repairs to the hospital. We have elevated the legal aspects of this matter beyond a joke. It is much more important that we find out what went wrong with this hospital and why there are so many defects than to discover who will pay for them. That can come later. I repeatedly asked for a public inquiry. There must be such an inquiry. I hope that my hon. Friend the Member for Fife, Central, having raised this matter tonight, will help to persuade the Department to hold a public inquiry.

Until recently, nurses at the hospital were required to carry drinking water. The plumbing was so bad that when the taps were turned on black water came out. Drinking water had to be carried to the patients on the various floors. I saw the exposed drains. The relatively new clerk of works—he has been there a few years now—has pictures and a black museum illustrating what happened at the hospital. There are drains and soil pipes going nowhere. They run down to the ground but do not lead to the main sewer. That would be bad enough anywhere, but in a hospital it is terrible. The plumbing is appalling. The facing of the building is coming off. It was very badly done. It is dangerous and must be renewed.

Anything that the Sunday Mail said about the hospital was true. This may sound surprising, as tabloid newspapers usually exaggerate. However, anything said by the Sunday Mail about the hospital and the workmanship was an understatement.

When I asked questions about the matter, I continually received the same answer. The Under-Secretary of State said: I am advised that a public inquiry held in advance of arbitration or litigation could prejudice the Board's chances of recovery."—[Official Report, 15 February 1978; Vol. 944, c. 252.] The Minister should examine this matter and say how much longer we must wait for a public inquiry. It is not sufficient merely to go to court. A complete examination of exactly what went wrong is required.

I understand that the main buildings were accepted serially by the hoard during the period March to August 1971, enabling the first patients to be admitted in October 1971. Formal handing over of all the buildings was completed in March 1972. Surely, the Department did not accept those buildings without certification by the architects and quantity surveyors that they were built to specification, that their standards were up to scratch and that they were perfectly suitable for the work.

Almost two years ago, I was told that since the hospital had been opened in 1972 48 beds had been out of use continually. Between February 1972 and February 1978, more than 15,000 bed weeks had been lost—and this in a part of the West of Scotland where beds are at a premium. Perhaps at a later date the Minister can tell me whether the number of bed weeks has been further reduced.

This may be unparliamentary, but I am quite prepared to repeat it outside: there has been considerable neglect by the professional people involved. The architects' fees of £185,000 have been discharged in full, as have the quantity surveyors' fees of £130,000 for work on this hospital. The specific jobs of these people were to see that the client was given full value for money and that the building was properly equipped to do the job it was commissioned for. What were the architects and quantity surveyors doing for the £325,000 they got between them? They were supposed to supervise and see that the job was properly done. I believe that we need a public inquiry.

I have some knowledge of building work, and I have spoken to many people who were involved in this hospital. I have said repeatedly in the House that every tradesman and every professional man who had anything to do with this hospital had some responsibility for the result. The workmanship was appalling and the supervision was appalling—and that applies to departmental supervision as well. I am sure that the Property Services Agency must have had overall control of this, and it, too, has been negligent in its job.

I do not know whether the Minister has visited the hospital. Its story is one of utter horror. I hope that the Minister will be stimulated by the debate into taking a look at the hospital and seeing just how bad it is. I raise this matter tonight because we must not let such a thing happen again. Everyone who was involved in this job bears a responsibility —and it is an appalling one. Rather than hide behind the law and say that we cannot have an investigation because it would breach the legal process. I think we should admit that things have gone well beyond that stage.

Rather than worry about who is to repay the State for the deficiencies in this hospital, there is need for nothing other than a full, public inquiry. This would be for the good of the building industry and for the good of professional organisations in Scotland. I have seen the black museum. There is plenty of evidence to show how appalling was this job.

I hope that the Minister will forget about trying to recover relatively small sums of money and get on with the job of trying to find out what went wrong. This would perhaps help when costlier jobs are undertaken in the future. While it may be painful at this stage, we could be proud of the fact that we had been honest, had examined the matter without fear or favour and had produced a report that would be a guide to the building industry and to the professional industries in Scotland for many years to come.

Mr. Deputy Speaker (Mr. Richard Crawshaw)

Before calling the next hon. Member, I should explain that not everyone present was in the Chamber when Mr. Speaker indicated that debates on items Nos. 13 and 14 were limited in scope. As the extra money is only a small amount in relation to what was originally granted, the debate does not extend to the whole of the Service. It should be related only to the purpose for which the extra grant is asked. I have allowed hon. Members to mention specific hospitals. I have no knowledge of whether those hospitals fall within the grant. This is not a general debate on the National Health Service in Scotland. I recognise that it is difficult to keep the matter within those confines. I hope that hon. Members will realise that the House is not debating the previous money that was given. The debate relates only to the extra money now being given.

Mr. William Hamilton

On a point of order, Mr. Deputy Speaker. I have taken part in many of these debates. I looked carefully at Class XI, Vote 4. You are right, Mr. Deputy Speaker. It is a matter of £5½ million, as I indicated. But it covers a multitude of activities. It covers the capital expenditure of the health boards, which affects all hospitals. We could speak on all hospitals in Scotland. We do not know which particular hospitals are concerned with the global sum.

Anyone, in my humble submission, would be in order in referring to any hospital, because all are controlled by the health boards. There is a specific sum—an increase of about £3 million—for the health boards. Similarly, there are references to other parts of the National Health Service, including research and charges, and the supply of artificial limbs and hearing aids. It is a very wide debate.

Mr. Deputy Speaker

The hon. Member for Fife, Central (Mr. Hamilton) is quite right. It is difficult to know exactly what is specified. The hon. Gentleman made an attack on the general Health Service more related to the original Estimates. These are additional Estimates. It is difficult to keep within those confines. I think, however, that the matter should be brought to the attention of hon. Members.

11.58 pm
Mr. Dennis Canavan (West Stirlingshire)

There should be no fear on your part, Mr. Deputy Speaker, about having to call me to order on this matter. I should like to endorse briefly what my hon. Friends have said. I hope that the Minister will say specifically how these extra moneys, if they can be called extra moneys, given to the health boards will affect the Government's plans to increase fee-paying opportunities within the Health Service.

As the Minister knows, he and I served on the Standing Committee that dealt with the Education (No. 2) Bill, setting out the Government's plans for an assisted places scheme. As the Minister responsible for health matters in Scotland, can the hon. Gentleman tell us whether the Government have plans to introduce a similar scheme of assisted places for pay beds and what effect that would have on patients who cannot afford pay beds? The Minister and the Prime Minister are on record as saying that the Government are not cutting public expenditure on the NHS. They are playing with words. They may argue that they are not decreasing expenditure, but they are certainly reducing the planned growth in the NHS that they inherited from the previous Labour Government.

When detailed plans are published in the White Paper, we shall see a further decrease in expenditure on the Health Service and on other essential services.

The Government are not just cutting public expenditure but are redistributing expenditure and the opportunities for social services so that those who benefit most will be those with money to pay for the services. One of the basic principles of the NHS when it was set up more than 30 years ago was that health services should be available to all, irrespective of the money that the patient had in his pocket. It was agreed then that the only criterion for deciding a person's place in the queue was his health priority. The person most in need on health grounds should be at the head of the queue. The Government are undermining those principles in their public spending programmes.

Mr. Iain Sproat (Aberdeen, South)

The hon. Gentleman is being ridiculous.

Mr. Canavan

The hon. Member for Aberdeen, South (Mr. Sproat) is the biggest witch-hunter An Scottish politics and is probably creating a great deal of fear, not just among the poor people who are claiming benefits but among those at the end of the NHS queues, which are far too long.

Mr. Sproat

Does not the hon. Gentleman realise that under the system operated by his Government three-quarters of a million people in this country were waiting for operations that they could not get? That is how the NHS deteriorated under his Government, and that is what the present Government are trying to put right.

Mr. Canavan

I have never been a member of a Government or been in a position to form a Government.

Mr. Sproat

Thank God.

Mr. Canavan

I was constructively critical of various aspects of the NHS under the previous Government, but the present Government are making things worse. We should be extending opportunities to people irrespective of their ability to pay. The hon. Gentleman's Government are turning the clock back to an elitist two-tier health service where those with the ability and willingness to pay will get priority of access to treatment and the vast mass who do not have the inclination or the ability to pay will have to wait in a long queue. The queues will get longer, not shorter, and that is completely alien to the principles and traditions of the National Health Service.

That alienation will be felt even more strongly in Scotland because, whatever the merits or otherwise of the pay bed system in the United Kingdom as a whole, the number of pay beds in Scotland has been very low. It now appears that the Government are trying to increase the number of pay beds, thereby decreasing the opportunities for the vast mass of the population of access to an adequate health service. That is obscene and it discriminates against the people who are most in need. No Government, irrespective of party, can justify that.

12.6 am

Mr. George Robertson (Hamilton)

This has been a valuable debate, and I commend my hon. Friends the Members for Fife, Central (Mr. Hamilton) and for Glasgow, Kelvingrove (Mr. Carmichael) for bringing the matter to the attention of the House.

My hon. Friends have concentrated on the problems of the Royal hospital for sick children in Glasgow, and I would not seek to minimise them. I hope that some solution of the problems being experienced there by patients and staff will soon be found.

Since we are considering the Supplementary Estimates and the money necessary for this part of the public sector, it is all the more relevant that we should highlight the statements of the Minister that the National Health Service is being protected from the swingeing attacks on the public sector that we have experienced in so many other areas of public spending under his Government.

The Minister and the Government are saying that this protection is something in which they can take pride. The reality is very different. On the surface, the figures suggest an increase in expenditure in the Service this year as compared with last year. That is merely an apparent protection of the NHS not afforded to other public services. However, in the hospitals and in the ambulance service, where it really matters, inflation, encouraged and supervised by the Government, means that the gross amount of money available has decreased.

The Minister knows that one of the first acts of his right hon. and learned Friend the Chancellor of the Exchequer was to increase VAT. In the short time that it took him to present his first Budget, the Chancellor almost doubled VAT and drove the first nail into the coffin of the NHS by placing an enormous burden on a service faced with existing cash limits.

Cash limits are now being used to cut back the services to the public, and the Minister can rely on the fact that the wider public do not yet understand the full impact of the cash limits on the National Health Service in Scotland. If the public understood the situation, the Minister's assertion that the National Health Service was somehow being protected from the effects of public expenditure cuts would sound very empty. Administrators in the Service are now experiencing grave difficulties because cash limits have not been increased to keep pace with the inflation that the Government are so recklessly supervising.

Some health boards are considering solutions that they would not have considered before. The Inverclyde hospital has about 70 beds which are no longer available as a direct result of expenditure pressures. There is open talk in Scotland that some of the beds, abandoned because the health boards do not have the money to use them, will be used as pay beds. That is happening in a part of the country which has not had much experience of private medicine within the National Health Service.

The Minister will say "Oh, no", but the Health Services Bill gives more than simple encouragement to pay beds in the National Health Service. It is an open invitation to use spare resources to encourage private medicine. The Government are encouraging, openly or surreptitiously, the use by private medicine of such resources as are unused because of cash limits.

A researcher in the Library asked some of the administrators of the health boards how cash limits were affecting them this year. He spoke to the treasurer of the Highland health board, who said that the health boards were requisitioning cash on a daily basis from the Scottish Home and Health Department about two months ahead. He said: On February 6th the Highland board requisitioned the cash it needed for the remainder of the year up to March 31st. There are some indications that all this money may not be forthcoming. That experience is not confined to the Highland health board. It is the experience of many Scottish health boards. The direct consequence is that services are being curtailed and patients are not being treated in the way that medical authorities would wish. The Government are conducting a policy which on the surface appears to protect expenditure but which is cutting the money available to treat patients in medical need. If the National Health Service is weakened, the Government will have a heavy burden to carry when they are finally cast out of office.

12.13 am
The Under-Secretary of State for Scotland (Mr. Russell Fairgrieve)

We are grateful to the hon. Member for Fife, Central (Mr. Hamilton) for raising the problems of the Health Service in Scotland. We are also grateful to the hon. Members for Glasgow, Kelvingrove (Mr. Carmichael), West Stirlingshire (Mr. Canavan) and Hamilton (Mr. Robertson) for taking part in the debate. It may have gone a little wider than we envisaged, but we are pleased to have had the opportunity to debate the subject.

The hon. Member for Fife, Central advised me that he wished to mention the Royal hospital for sick children. That part of my reply will be formal for the sake of the record. The hon. Member and his colleagues went a little wider than that in parts of their speeches, and I shall have to comment more politically on those aspects.

The constant talk about the National Health Service being clobbered goes a little over the score. The hon. Member for Fife, Central knows the history of the Health Service as well as I do. The idea that it is being clobbered is ridiculous. I shall return later to the clobbering that took place under the hon. Gentleman's Government and the lack of clobbering that is taking place under the present Government.

There have been references to the remedial work that is having to be carried out at the Royal hospital for sick children, Glasgow, which was rebuilt between 1968 and 1971 to replace the earlier hospital on the same site. As hon. Members know, the subject is at present engaging the attention of the Public Accounts Committee, and my Department is about to submit to the Committee detailed answers to some 20 questions that the Committee has posed.

The first point that I should make is that the Greater Glasgow health board has now embarked on arbitration proceedings with a view to obtaining restitution of the large amount of expenditure —I regret to say that it is far more than the hon. Gentleman mentioned—that must be undertaken at the hospital. To this end, an arbiter was approved last July, and the present position is that the board's legal advisers are just completing a formal statement of claim. This is subject to extensive consultations between the board and its advisers. The sum being claimed has now been fixed at £7.25 million.

The cost of remedial work is being met in the first instance from Exchequer funds by way of capital allocations from the Scottish Home and Health Department to the health board. The House may be assured that the public interest is uppermost in my Department's approach to the claim, though the necessary action is primarily for the health board.

To pursue these matters by means of a public inquiry, as the hon. Gentleman suggested, would serve no useful purpose at this stage, as ii: could prejudice the attempt to obtain restitution by legal means from the parties held to be liable for defects that must now be remedied.

Mr. Carmichael

I can see the point. I have heard this answer a number of times. The hon Gentleman said "at this stage". We spend much more on public works in Scotland than the £7.25 million. We need more than that; we need to find out what happened and why. Important though the return of the money is, without a public inquiry it is not sufficient. I hope that the hon. Gentleman will accept that.

Mr. Fairgrieve

I accept it up to a point. When the present arbitration has taken place and the legal position is remedied, when—as we hope—we win our case and obtain restitution, the lessons must be gone into very seriously. But the main point now, for the sake of the public purse, is to obtain the return of the money that has been disgracefully spent in this way. That is the exercise in which we are involved. Thereafter, we must look at the lessons.

I need say no more about that matter, because it is virtually sub judice. The Department is watching it very closely. We shall look at the whole question of supervision of building materials, quality control and all the other matters that this unfortunate circumstance raises.

The hon. Member for Fife, Central went on to refer to the description "Hell Hospital". At least, he was honest enough to say that this was under both Governments. He said that it was built by private enterprise. I do not know whether there is any significant point there, but it was put out to public tender, so let us be fair about that. We hope that those responsible will be made to pay. I have already given the figures involved and have spoken about the public inquiry and what we do in the Public Accounts Committee.

The hon. Gentleman also mentioned other problems with hospitals—for example, the North Ayrshire district general hospital and Merchiston, phase 1. I shall write to him about the questions that he posed.

In many ways, we have over-democratised our method of building hospitals. When you think—

Mr. Canavan

indicated dissent.

Mr. Fairgrieve

When you think, if you can think—

Mr. Canavan

On a point of order, Mr. Speaker. Is it in order for the Minister to ask the person in the Chair if he can think?

Mr. Speaker

The Minister used the word "you", but I do not think that he was referring to me.

Mr. Fairgrieve

I shall be more careful of my response in future. Some of the hospitals that are coming on stream could have been started 16 or 17 years ago, when, under another Government, there was a growth in the economy and there was the advantage of lower fuel costs. We expected a continuing higher standard of living and a prosperous country, and the hospitals were designed with that in mind.

When I said "over-democracy", I meant that our planning procedures for hospitals take much longer than those in other countries in Western Europe and North America. At one time we reached a stage where, before we built a broom cupboard, the cleaners had to be asked whether it was the right size. As a result, many years passed between the conception of a hospital and its commissioning.

That has happened in hospitals in North Ayrshire, where, if we were planning them today, the design would be quite different from the point of view of fuel consumption, meals service and privacy given to patients. The hospitals would be very different if considered in the current economic climate.

I turn to the questions of mental illness—raised by the hon. Member for Fife, Central—geriatrics, financial stringency and man's inhumanity to man. The hon. Member raised the emotive question of whether I could live on 80p per day for meals. Could he live on that? I assume that he included himself in his figures. He tabled a question today about the weekly cost of food per patient in psychiatric hospitals and the comparable figure for other hospitals. My answer was quite clear. The latest figures available show that the average provision in a psychiatric hospital is £5.61 per patient per week and £6.62 per week in other hospitals. The averages conceal a wide range of costs to individual hospitals, from £4.47 to £7.49 for a psychiatric hospital and £3.94 to £11.92 for other hospitals.

The hon. Gentleman knows perfectly well that, when an organisation is catering for many people, to divide the costs and pretend that the result is true for one person is ridiculous, irrelevant and unnecessary. To use the emotive question of whether anybody in the House could feed on 80p per day is a total distortion of the facts. We are talking of the costs of feeding people in hospitals. The hon. Gentleman knows that patients in our hospitals in Scotland are not suffering from lack of food, which is the inverted inference of his remarks.

I do not think that the hon. Gentleman expects me to talk about wards of shame. He knows of the terrible, frightening, looming picture of the geriatric problem facing this country. It is a problem with which none of us knows how to deal. On balance, we prefer to deal with the geriatric problem in the community rather than in hospital. We are short of the necessary resources. How wonderful it would have been to have come into Government last May as the Minister of Health in West Germany or France, countries which, because of their productive efficiency, have a higher standard of living and can spend more money per head on health and pensions and on longer holidays and better benefits than are available in Britain. But that is the lot with which we currently have to deal. The Government hope and intend to get us out of that.

Mr. Canavan

They are taking a long time about it.

Mr. Fairgrieve

Ten months is a better record than the hon. Gentleman's Government's five years, which saw unemployment doubled and the value of money halved, with inflation brought to new and greater levels. Of course, we do not wish to tolerate such conditions and we shall do all we can to change them.

The hon. Member for Fife, Central, started again on the old theme of the bingo clause—clause 4 of the Health Services Bill, in the Standing Committee on which we are both members—with flag days, the rattling of tin boxes and all that. Is there anything wrong with letting people who want to help their local community do so? It is a permissive, not a mandatory, clause. We are allowing people who so wish to contribute to their hospital or to other causes. The sinister suggestion by the hon. Member that we were clawing away at the principles of Aneurin Bevan's Health Service is baseless, and I think that he knows that. There has been no question of new Health Service charges being introduced.

In education, housing and health, Labour Members do not seem to be concerned to hit at the rich, the people who can buy their own homes and can pay for their health care and for their children to be educated. They hit at the people who want to make a contribution, at the person who wants to get an aunt into a private ward, to send his child to a school for which he can make a contribution, or to get a mortgage to buy a house. It is Labour Members who are divisive. It is they who want to create two nations—the rich and the poor. They do not like the bridge or the ladder.

Mr. Canavan

Does not the Minister realise that most people make a contribution to the Health Service? But for the taxes people pay and the contributions that are made through national insurance, the Health Service would not exist.

Mr. Fairgrieve

I am aware of what the taxpayer pays. I am merely saying that if a person, after having paid his taxes, rent and rates, decides that rather than have a holiday in Majorca he would like to spend his money on health or education, he should be entitled to do so.

Mr. Canavan

He can buy a place in the hospital queue.

Mr. Fairgrieve

Consider what is being done by the trade union movement in other countries—in Europe and America. Consider what Frank Chapple has done for his members by taking them into BUPA. If matters such as these were considered by trade union leaders rather than politicking on behalf of their members, which does not necessarily get them very far, wage earners and everybody else in the country would benefit.

Mr. Canavan

Buying privilege.

Mr. Sproat

What about you?

Mr. Fairgrieve

Before I leave the hon. Member for—[Interruption.]

Mr. Deputy Speaker

Order. We cannot have this conversation going on across the Chamber. The Minister is addressing the House. I hope that hon. Members will pay attention to him.

Mr. Fairgrieve

I am sorry that I was slow to sit down, Mr. Deputy Speaker. I realise that you had a problem with sedentary interjections on my right and on my left. But I note that, with your usual aplomb, you have the House well under control again.

I do not propose to comment, in a debate on health, on the final remarks by the hon. Member for Fife, Central about spending on health rather than on nuclear defence equipment. I would make to him the comment that was made to me in reply to a question that I put to the Labour Government when we were in Opposition. If this country would spend the same proportion of its GNP on defence as Russia, I should ask no more, no less. I leave it at that. There is no need to argue that point any further.

I turn now to the remarks made by the hon. Member for Kelvingrove. I realise that he was concerned basically with the hospital statement. I have not given as long a reply as I might have done on the Glasgow sick children's hospital, but perhaps I may write to him about that matter in more detail, and the hon. Member for Fife. Central, will, of course, get a copy. I am grateful that he made some complimentary remarks about planning under both Labour and Conservative Governments.

The hon. Member for Fife, Central gave me notice of the matter that he was going to raise, but, as I have explained, we are not dealing with the question of a public inquiry. I have visited many hospitals in Scotland and I shall continue to do so. Apart from my personal interest, if I thought that it would serve a useful purpose—I am in Glasgow fairly often—I should certainly visit the hospital.

The hon. Member for Hamilton made a political speech—

Mr. Canavan

Disgraceful!

Mr. Fairgrieve

—which he is entitled to do, and I am entitled to reply in similar vein. [Hon. Members: "Hear, hear."]

As regards protection from cuts, the hon Gentleman knows as well as I do that in the current year spending on the Health Service has been maintained but that it has been eroded by three factors. The first is inflation, which is half the Labour Administration's legacy and half ours. The second is the Clegg award, which the previous Administration did not build into this year's financing. The third is VAT under this Government. Therefore, I am being absolutely fair in saying that the present stringency in the economic position of the health boards in Scotland this year is basically the result of the policies of both Administrations, and we have been in office for only 10 months.

As the hon. Member for Hamilton knows, we have built in a 2:6 per cent. increase in real terms for next year. Therefore, he must wait to see whether we do what we have said we will do before putting forth any ideas about cuts. The Labour Party, when in office, doubled unemployment, halved the value of money and caused the greatest inflation in the history of this country. So it comes ill from the hon. Member for Hamilton to talk in the way that he did about this Government when we have been in office only 10 months.

Mr. Canavan

This Government are making things worse.

Mr. Fairgrieve

As regards the Inverclyde hospital and the Argyll and Clyde health board, we have again heard emotive remarks about the closing of a ward. I remind hon. Members that the withdrawal of that ward merely brings the hospital beds under the control of the board to the same level as the national figure for the rest of Scotland, which is 2.5 beds per thousand population. Therefore, this area now has the same proportion of hospital beds as a result of the withdrawal of this ward as the rest of Scotland.

A point was made about encouraging private medicine. Is there anything wrong in doing that when people are prepared to contribute, if it takes the weight off the National Health Service, cuts down the waiting lists and makes beds available more quickly? Is there anything wrong in that?

Mr. Canavan

Does the Minister realise that it does not cut the waiting lists? Introducing an element of fee-paying into the Health Service does not provide one extra doctor or nurse. It merely enables a privileged minority to jump the queue. That is what is so disgusting and obscene about it.

Mr. Fairgrieve

That is absolute rubbish. When people are taken out of the queue, they do not jump it. The queue is shortened. The hon. Member for West Stirlingshire will not accept that, because he does not like practical facts. He is too taken up with dogma. I do not believe that there is much that I can conclude from the kind of contribution that we have come to expect from him. He again went on about extra moneys and—

Mr. Canavan

The Minister should go to the House of Lords.

Mr. Fairgrieve

I do not think that that would be a suitable place for either myself or the hon. Member for West Stirlingshire. There is no question of this Government cutting back on expenditure or of the redistribution of expenditure. The hon. Gentleman knows that.

During the five years when I was in Opposition, I heard many speeches from Labour Members and never once did I hear anything about the creation of wealth. They continually talked about spending and the distribution of wealth. I only wish that we had the wealth that there is in West Germany or France. In those countries, pensions and wages are higher and the amount per head spent on health is higher. The reason for that is that productivity is higher. I would love to be able to stand at this Dispatch Box and say that the Government will spend more on health, but that cannot be done. Unfortunately, the people of this country do not realise that until we increase our productivity such matters must go by the board.

As I said earlier, if those within the trade union movement would come out of the political arena and go into the industrial arena, half our problems would be cured.

Mr. Canavan

Like the miners.

Mr. Fairgrieve

I have tried to the best of my ability to answer some—

Mr. Canavan

Which is not very much.

Mr. Fairgrieve

From a sedentary position, the hon. Member for West Stirlingshire says that my ability is not very much. That may be so. But my ability is a little better that the hon. Gentleman's continued blinkered dogma. He sees nothing more than his own case and he understands nothing other than his own pathetic beliefs about what he thinks is correct. He knows that it is he and people like him who have dragged this country down from the position we were in 15 years ago when we had the highest standard of living in Western Europe. Today, we have about the lowest standard of living in Western Europe.

I shall be replying in more detail to the question about the Royal hospital for sick children in Glasgow, but I thank the hon. Member for Fife, Central, who has been in the House a good deal longer than others who have taken part in the debate. For the past few minutes he has had his hand under his chin wondering whether we have elevated the debate to the level he would have wished.