§ Mr. Michael Shersby (Uxbridge)
I am grateful for this opportunity, at extremely short notice, to raise the question of the proposed closure of Uxbridge cottage hospital. I realise that the Minister will be in some difficulty in replying in detail to some of the points in view of the fact that I was able to give notice of this Adjournment debate only half an hour ago. Nevertheless, this is an invaluable opportunity to deploy the arguments that are being discussed in great detail in my constituency and which are causing a great deal of alarm and distress to my constituents.
Uxbridge cottage hospital, situated in Harefield Road Uxbridge, has been in existence for many years. It is a pleasant 24-bedded cottage hospital which, throughout my lifetime, has provided excellent care for the sick in the community. I was a patient of the hospital as a child when I had my tonsils removed. I can claim an intimate knowledge of the hospital. The fact that I am still standing today and that I am in good voice demonstrates that the expertise of the surgeons in those days was of a high order.
The reason I am raising the proposed closure of the hospital is that the Hillingdon area health authority submitted proposals a year or two ago to close the hospital and to relocate the patients who would normally be treated there in what is known as the Uxbridge cottage hospital ward at Hillingdon district hospital. The main reason for the proposal was financial.
It cost at the time of the proposal—I speak from memory—about £103,000 a year to run the cottage hospital but only £40,000 a year to run the same number of beds in the Uxbridge cottage hospital ward at Hillingdon district hospital. One has to realise the difficulties of Hillingdon area health authority and the fact that we live in times when there are severe financial constraints. Nevertheless, the proposal aroused considerable opposition locally. Many people felt that the Hillingdon area health authority, if it had tried hard enough, could have found the money to keep the cottage hospital open as a separate entity.
The proposal went ahead. The Hillingdon area health authority submitted proposals that would have resulted in Uxbridge cottage hospital being used as the headquarters of the Hillingdon area health authority. In other words, it proposed to turn the 24-bedded hospital into an office block to accommodate the administrators who run that fine health authority. However, this proposal also fell on stony ground because many people in the community could not reconcile themselves to the possibility of their cottage hospital being lost in this way and the fact that the 24 beds that were in existence for the care of the sick and the elderly would disappear.
The Hillingdon borough council, for its part, indicated that in no circumstances would it be prepared to grant planning permission for the proposed change of use and the proposal was dropped. Time went by. Other proposals were submitted to the Hillingdon area health authority that would have enabled the 24 beds to have remained in use for the benefit of the community. I shall return to that point later.
The Hillingdon area health authority decided that, in view of the fact that its earlier proposal to turn the cottage hospital into an office block had been refused, it would 521 submit new proposals, contained in a consultation paper, whereby the cottage hospital would be used as residential accommodation for the nursing staff, serving the other hospitals in the Hillingdon area.
I fully recognise the difficulties which all area health authorities experience, including my own health authority in Hillingdon, in finding suitable accommodation for nursing staff. However, it is a very serious matter to propose the closure of a cottage hospital and to contemplate the loss of 24 beds which could otherwise be used for the care of the sick and the elderly. Nevertheless, the Hillingdon area health authority has proceeded with the proposal, which has been considered also by the Hillingdon community health council. Both the Hillingdon area health authority and the Hillingdon community health council approved the proposal that the hospital should be used as residential accommodation for nursing staff.
Last week, the North West Thames regional health authority considered the proposal, and it, too, approved it. It is now on its way to the desk of my hon. Friend the Minister for Health. This evening, therefore, I shall point to some other aspects of the matter which may not have appeared as fully as I—and perhaps my constituents—would wish in the papers that have been prepared by the Hillingdon area health authority and by the Hillingdon community health council, and which my hon. Friend will consider in due course.
There has been a long tradition of public support for Uxbridge cottage hospital. That can be demonstrated by the fact that for many years there has been in existence an organisation known as the League of Friends of the Cottage. In fact, it has been in existence for 25 years. That organisation has done a great deal to support the hospital. It contains many local people who live in Uxbridge and who believe that the hospital should continue to be used for the care of the sick and elderly.
To get the matter into perspective, I shall quote briefly from an article which appeared in the Uxbridge Gazette recently. It stated:Hillingdon Community Health Council has appealed to the Minister of Health, Dr. Gerard Vaughan, to come to a quick decsion over the future of Uxbridge Cottage Hospital.Mrs. Shirley Court, chairman, told a meeting of the CHC last week that she had written to Dr. Vaughan immediately after the area health authority meeting at which it was decided to continue to house Uxbridge Cottage Hospital in Uxbridge Ward at Hillingdon Hospital.She referred to the letter from the Minister to Uxbridge MP Michael Shersby promising that he would look into the future of the hospital before a firm decision was made.'We are desperately concerned that the former Uxbridge Cottage Hospital patients should not have to wait any longer for their present accommodation in Uxbridge Ward at Hillingdon Hospital to be upgraded,' Mrs. Court told Dr. Vaughan.In response to the report of Mrs. Court's letter to my hon. Friend, a letter was written this week to the Uxbridge Gazette by Mr.H. J. Ingle, who for many years has been honorary treasurer of the league of friends. I shall read the letter, because it is relevant to the matter:I was surprised to see in your issue today, that Mrs. Shirley Court, Chairman of the CHC, stated that the opposition to the closure of our hospital, came from a small group only, 'the same four who attended today's meeting'. May I suggest this is only due to the long wearying time in which I, for one, have been involved in this campaign. The interest is still intense.May I, as honorary treasurer of the League of Friends of the Cottage, for twenty five years claim to have considerable knowledge of the whole problem, and continuing evidence of the 522 overwhelming opinion of Uxbridge people, in favour of reopening the Cottage hospital for full nursing services and minor operations. My reasons are as follows:I quote that letter because Mr. Ingle has been associated with the hospital for 25 years. The fact that 6,264 people were involved in petitioning the former Minister, the right hon. Member for Norwich, North (Mr. Ennals), shows the substantial public opposition that exists in Uxbridge to the closure of such an excellent hospital.
- 1. In October 1976, a formal consultation paper was issued calling for comments on the subject of the proposed closure of Uxbridge Cottage hospital. This resulted from many meetings on the matter. Our members compiled a paper, of which I have a copy, detailing thirteen good reasons why the hospital should remain open, and sent it to the HAHA.
- 2. Following a large Public meeting, held about the same time, attended by Mr. Michael Shersby, our Member for Parliament; the prospective candidates of the other two parties; the Chairman of the Cottage Hospital Medical staff committee; myself, and about one hundred citizens, a campaign was slatted to bring our views in favour of the retention of the hospital to the attention of the Health Authority.
- 3. In furtherance of this meeting, I organised a petition, in which I was assisted by many local citizens, who took turns sitting in the local Public Library, for two weeks, taking signatures. The result was that I presented lists containing 6,264 names, to the Minister, Mr. David Ennals, MP. As no further action followed, we presumed and hoped that we had been successful.
- 4. All was quiet for two years, until October 1978, when the hospital was closed for installation of a new lift and re-decoration. I was then given to understand that it would re-open in the New Year for all nursing services and minor operations. Since then the bureaucratic machine has been grinding away, and the position has become so confused, it has been difficult to keep in touch, but not due to lack of interest. I feel guilty for fading into the background, recently, but I am an old man. I hope it is not too late for some young energetic people to take up the torch, and save the dear old `Cottage'".
With great respect to the dedicated and excellent people who form the Hillingdon area health authority and the community health council, they are not elected by the people. Consequently they have no mandate from the people of Uxbridge to recommend the hospital's closure. I mention that because, in sharp distinction to their views, Hillingdon borough council, which, after all, consists of the elected representatives of the people, has resolved that it does not agree with the hospital's closure. Therefore, the unelected representatives of the Minister and of the other organisations that nominate people to serve on area health authorities and on community health councils take one view and the elected representatives of the people—Hillingdon borough councilors—take another.
As a result of that sharp difference of opinion, Hillingdon borough council will hold a public meeting on the evening of 14 January to discuss the matter in detail and to submit its views to my hon. Friend the Minister. Whatever view my hon. Friend may take when he considers the issue in detail, I hope that he will give: me an assurance tonight that he will not take any decision until he has received and considered the views of Hillingdon borough council, which represents the people of Hillingdon.
I must declare an interest, because I am president of the Abbeyfield West London Society Ltd. and of the Abbeyfield Uxbridge Society. Throughout the period that the Hillingdon area health authority and the Hillingdon community health council have considered the hospital's closure, issued consultation papers and eventually made recommendations to the North-West Thames regional health authority and to my hon. Friend the Minister, the Abbeyfield West London Society has put forward a 523 proposal to acquire Uxbridge cottage hospital from Hillingdon area health authority at an agreed figure and to set up Uxbridge cottage hospital as an extra care society. It would provide the extra care that people need when they can no longer care for themselves in an ordinary Abbeyfield house. One possibility was that the West London society would act as an umbrella society so that those from other Abbeyfield homes in the Hillingdon area could go there when they were no longer able to care for themselves.
Another idea which has been canvassed recently but which has not been specifically put to the Hillingdon area health authority is that we should form an Uxbridge Abbeyfield cottage hospital extra care society. In other words, we should form an extra care society which would operate for the benefit of Uxbridge people exclusively, at no cost to the Hillingdon area health authority, and which would operate with Government grant and public support to keep those 24 beds in operation for the care of the sick and the elderly.
It has been suggested in the local press that the Abbeyfield project is no more and no less than a nursing home, but of course Abbeyfield, as my hon. Friend well knows, is not an organisation which operates in such a way that its activities can be described so narrowly as that of a nursing home. Abbeyfield societies are run by local societies which operate throughout the country. The concept of the Abbeyfield extra care house arose from the increasing need to provide care for the residents of ordinary Abbeyfield houses who, whilst not hospital cases, had become so frail that they required more constant attention than the busy housekeeper could be expected to provide.
It was felt that the local Abbeyfield society could contrive to provide such care if their frail, elderly residents could be grouped together, on an area basis, in suitably designed houses with special equipment and kind and experienced staff. This purpose has been well explained by the national Abbeyfield Society, and it should be well known to the Hillingdon area health authority and to the Hillingdon community health council, and I am quite certain that it is well known to my hon. Friend the Minister.
The Abbeyfield West London Society is very interested in acquiring Uxbridge cottage hospital, and it would be willing to raise the necessary funds by public subscription, not just in Hillingdon but elsewhere, and it would seek grant aid in the normal way. I mention that as only one possibility for the alternative use of Uxbridge cottage hospital if it proves impossible for it to continue in use as a cottage hospital because of financial stringency.
I must make it absolutely clear that not everybody in Uxbridge agrees with the idea that the cottage hospital should be used as an Abbeyfield extra care house. There is a body of opinion among local general practitioners that in some way the cottage hospital should be kept open for its traditional use. On the other hand, there are general practitioners and members of the Hillingdon area health authority who feel that it should be closed. Whatever may be the variation of opinion, it seems to me that one thing is clear. It surely must be a very serious matter for any area health authority, or any regional health authority, or any Minister of Health, to contemplate snuffing out 24 beds in 524 a splendid hospital on which a great deal of money has been spent only recently, and instead using those premises for residential care for nursing staff.
§ The Minister for Health (Dr. Gerard Vaughan)
I am very glad indeed to have been able to listen to this debate and to reply to it. My hon. Friend the Member for Uxbridge (Mr. Shersby) is right to have brought this matter before the House. It is of great importance to his local community. He has put the situation clearly and persuasively, and it has been helpful to me to have his further views.
My hon. Friend declared his possible interest in an alternative proposal that he has put to the House, and rightly so. I hope that his constituents will hear of the debate and will appreciate not only the way in which he has brought the subject to my notice previously, but his sense of timing in bringing the debate to the House tonight. The papers arrived at my Department only this morning—indeed, I have not yet had an opportunity to go through them—but on the same day my hon. Friend is pressing his views in an Adjournment debate.
As my hon. Friend rightly reminded us, we are discussing a small general practitioner hospital of 24 beds. The Government are very keen to support the continuation of small general practitioner hospitals of this kind whenever possible. We think that they perform a very important local function in the community. When we discuss possible closures with the various authorities, we always suggest that they should look not only at the medical reasons and, if necessary, the financial reasons, but at the community implications of any closure.
My right hon. Friend is right in saying that the hospital was temorarily closed on financial grounds. At that time the patients were moved into beds in a separate, identifiable ward in the Hillingdon district general hospital. The health authority has every right, under the Health Acts, to close down some parts of the service temporarily if there is a major financial problem, but it is not intended that any facility closed in this way should remain closed indefinitely.
A proposal was brought forward fairly quickly that the hospital should be turned into offices for the area health authority. That is not the sort of step that I could welcome, and we have made clear our view that buildings that are for services to patients are not to be converted, unless there are very strong grounds for it, into administrative accommodation. So that proposal was abandoned, the hospital remained temporarily closed, and now there is a fresh proposal to confirm the closure and to use the building for staff accommodation—particularly accommodation for nurses.
I understand that there are possible plans that the hospital might later be reopened as a community or psychiatric hospital, but we all know that once a hospital has been closed for clinical purposes and is then put to some other quite different use—even though it is within the National Health Service—it is very difficult to reestablish it as any kind of working hospital. My hon. Friend spoke to me about it a little while ago. At that time he put the local views very strongly. I was persuaded not only by his argument but by the understanding that perhaps the community health council might not have been able to take all the factors into account when it came to its conclusions.
525 Therefore, I thought it right to take a rather unusual step, which was to call in the whole proposal and look at it myself. I was very reluctant to do that. We do not do it very often. We are reluctant to do so. We feel that decisions of this kind ought to be made locally, because the various needs of the service are best understood locally. We feel that it is not right for the Government to keep interfering in local matters. However, I felt that in this instance it would be right to do so, and the papers, as I have already mentioned, arrived today.
It is also wrong for a health authority that will be replaced in April next year by a new district health authority to make decisions that might pre-empt the new authority, which may have a different view. When such decisions arise they should be put off if possible until the new district health authority is fully established and can reconsider the matter.
Those were our general reactions to the matter, as a result of which I believed it right to call the matter in. The matter is now with me, but it would be wrong to raise local hopes because I am considering it. It may well be that it is in the interest of the local community that the hospital should remain permanently closed, although not for financial reasons. It would not be satisfactory if short-term financial problems led to the closure of a hospital which, in the longer term, may be required. However, by closing the hospital a better local service can be provided by Hillingdon district general hospital.
My hon. Friend has put forward an interesting alternative proposal, which I shall be glad to consider and to take into account before coming to a decision. I assure him that no decision will be taken before the meeting to which he has referred.