§ Mr. Tim Brinton (Gravesend)
I beg to move:That, having regard to various decisions and proposals of the South East Thames Regional Health Authority, particularly the funding arrangements for Medway, proposals to discontinue radiotherapy at St. William's Hospital, Rochester, to close St. James' Hospital, Gravesend, and the lack of representation from these districts on the regional health authority, this House asks the South East Thames Regional Health Authority to review the funding of health services in these high population areas of Kent, and affirms that, if St. William's Radiotherapy Unit is to be closed, major discomfort would be caused to patients if the only radiotherapy treatment for this part of Kent were to be placed at Pembury near Tunbridge Wells.Time is not on my side in discussing a subject that could occupy a fair length of time, although I appreciate the importance of the previous debate. I shall try, in the short time available, to do some justice to the grave health care problems that are faced in Kent. I wish to refer to four particular subjects: the Dartford and Gravesham health district that forms part of my constituency; the representation on the South East Thames regional health authority; the funding arrangements for Medway; and the radiotherapy treatment at St. William's hospital, Rochester.
It may help my hon. Friend the Under-Secretary of State to know that I am not asking for extra taxpayers' money to be poured into meeting the problem. I do not believe that this is necessary. I should, however, like him to urge the South East Thames regional health authority to accelerate the moves that it has already made towards rationalisation of the health services in that region. The Medway district particularly has been under-funded for some years.
I pay tribute to my hon. Friends who have been waiting most of the day to contribute to the debate and also to my hon. Friend the Member for Rochester and Chatham (Mrs. Fenner), who has worked so hard for this cause but who, in her elevated status as a Minister, cannot take part in private Members' debates.
The Dartford and Gravesham health district is not, I understand, complaining about under-funding. What is happening there may be due to the reorganisation of health districts. I am, however, concerned about the rumours that abound in public in the locality about various dramatic changes. The one that I have specified in the motion refers to the possible closure of the hospital for the elederly, St. James' hospital, Gravesend, which is a very old hospital. I am the first to recognise that modern premises would be desirable. There is, however, concern about the possibility of patients being moved to hospitals near Dartford.
Elderly patients inevitably tend to have elderly friends and relatives. Patients are frightened that if they were moved eight to 10 miles to Dartford, many of their friends and relations would not be able to visit them in hospital. I hope that my hon. Friend will be able to help in that connection.
Another story circulates about an overspend last year caused by the introduction of the 37½-hour week for nurses at a cost, I understand, of £300,000. This would seem to present the new authority with considerable problems when it takes over on 1 April. Again it is my hope—bearing in mind reorganisation, new brooms and so forth—that something can be done to help.
659 I turn from seeking reassurance for those in Gravesend and Dartford to the issue of representation on the South East Thames regional health authority. It is amazing, bearing in mind the problems of health care that exist in this area of Kent, that not one member of the regional health authority comes from that area. In other words, we do not have a voice. It would be a great reassurance, when appointments come round, if that voice could be heard at regional level.
I wish to refer now to the under-funding of the Medway health district. This is regrettably not a new story. Almost exactly four years ago, on 3 March 1978, my predecessor in Gravesend introduced a debate similar to this one. The under-funding was freely admitted. This is not a party political issue. It is something that is historically true of the district.
For reasons that are tied, I believe, to the fact that the region includes three large London teaching hospitals, the funding in the outer parts of the region has inevitably been distorted. The growth of population in Rochester, Chatham and surrounding areas has been fast and furious over many years. The deprivation—that is the word that I think one has to use—is perhaps exemplified by comparing Medway district and its funding. If increased by 3 per cent. in real terms this year, this will, I understand, rise to 70 per cent. of the resource allocation working party target. The next lowest funded district in the area is Brighton, which has a smaller population. I understand that Brighton's funding will be about 90 per cent., and thus closer to the average.
I accept that, with an average, some must be below the average and some above it. However, although there has been progress during the four years since that debate, I maintain that to be 30 per cent. below the average in health care these days is something which the region should consider seriously and that it should accelerate the improvement that we urgently need.
I use Brighton again in the next comparison. Another way to describe the problem is that, although the two populations are similar, the number of medical beds in Medway is 152, while in Brighton it is 332. We have 226 geriatric beds, whereas Brighton has 423. In June 1980, the total number of full-time staff in Medway is 854 per 100,000 people, whereas the national level is much higher—1,573 people working in a district for 100,000 people. I hope that those brief illustrations will drive home the message that I want to convey, that Medway has 54 per cent. of the national average staffing levels—lower than the 70 per cent.
§ Mr. Roger Moate (Faversham)
Does my hon. Friend agree that, deprived as Medway is of about £12 million this year, it will be about 20 years before we reach our RAWP target? Is it not appropriate for the Government to consider giving a form of direct supplement to help deprived districts which are within an otherwise over-provided region? Otherwise it will be difficult to achieve the sort of solution that we all want.
§ Mr. Brinton
I thank my hon. Friend. I started by saying that my purpose was not to ask for extra money from the Government. I stick to that, because I believe that the problem can be contained within the region.
There are over-provided areas in south London, as was demonstrated four years ago. Slight progress has been 660 made. For instance, there has been considerable progress with London university—I sit on the court of London university—in rationalising the teaching side of teaching hospitals. It is urgent that the hospital side of teaching hospitals should also be rationalised. I shall probably return to that matter in a moment, when I refer to St. William's hospital and the radiotherapy treatment there, because it is all part of the same story. I hope that I have succeeded in outlining, albeit briefly, the funding problems of the Medway health district.
There is a proposal by the region to rationalise the radiotherapy services of St. William's hospital in Rochester and in the whole of that area of Kent, running from Hastings to Rochester in the north, and out to the Isle of Grain, which is a fairly remote part of my constituency. Many people heard that news with great alarm. In fact, I have received more letters on this matter than on any other subject during the past two and a half years.
§ Sir Frederick Burden (Gillingham)
This was first proposed three years ago, when I resisted it strongly. I understand that the regional health authority is referring the matter back. That is not enough. This matter must be settled quickly to remove the strong and understandable fears of many peole in the Medway towns and surrounding areas who may be suffering from cancer—that dreadful and debilitating disease. In my view, the Government should, if necessary, step in to ensure that the radiotherapy unit at St. William's continues, and that cash limits are not allowed to prevail over the continuation of treatment of this dreadful disease. I have received more than 485 letters in condemnation of this suggestion. I hope that my hon. Friend will be able to do something about it.
§ Mr. Brinton
I thank my hon. Friend for his intervention.
The problem is immense. If, for instance, at the end of the deliberations, the only radiotherapy treatment were more than 25 miles away at Pembury, near Tunbridge Wells, many hundreds of people would have to drive all that distance, by ambulance or other means, to receive radiotherapy treatment. At the end of that treatment, as I well know, having been acquainted with people with that dreadful disease, one does not feel like undertaking a long journey.
In my haste to put my case I may have been slightly hard on the South East Thames region, because I have not congratulated it on its decision to confirm the 3 per cent. rise in real spending for Medway; I believe it had a meeting yesterday about it. However, it is not enough, and we need more.
As my hon. Friend the Member for Gillingham (Sir F. Burden) has said, it has agreed to include at least the Medway district hospital site as one of the three options in a feasibility study for a site for radiotherapy treatment.
§ The Under-Secretary of State for Health and Social Security (Mr. Geoffrey Finsberg)
I do not want to prevent the development of my hon. Friend's argument, but he will appreciate that I shall not be able to respond this afternoon. I undertake that the points my hon. Friends have raised will be covered by me in correspondence with them.
§ Mr. Brinton
I am grateful to my hon. Friend. I was hoping to give him time to reply, but I am sure that a reply in writing will be received gratefully by my hon. Friend as well as by myself.
661 The strategy of the region ought to be examined closely. By taking this chunk of Kent and Sussex from Hastings up to Rochester, as I understand it, the region wants to achieve the best treatment for cancer by radiotherapy that it can get. It believes that the right way is to have one centre for the whole area. I plead with the region to consider the other side of the coin. While it is vital to have the best treatment, it is also vital at that stage of the illness to give the patient as much comfort and social help as possible.
Therefore, I plead with the region to consider the option of two centres. It is equally cruel to suggest that people from Hastings who have cancer should travel all the way to Maidstone or Rochester, That is as far as people have to travel the other way.
Rochester has a huge number of people. Gravesend, Rochester and Gillingham together have a population of more than 500,000. St. William's hospital, which has become a great friend and a great succour in a personal way to many people, has a high reputation for particular sorts of treatment for cancer. It treats 1,500 new patients a year. In every way its energy and its vitality—having been round it that is the word I would use—are to be commended.
§ Mr. Brinton
As my hon. Friend has said, there is also its compassion.
The hospital also has the virtue of massive voluntary subscriptions. This shows that the people like the hospital; they own it and are part of it. I must point out to some of those people who may read about the debate that we have to be rational in our thought at a difficult time.
I believe that the feasibility study and the whole operation will take years. It may be that as time goes on we shall find that a more modern site is needed for more modern developments in treatment, in which case I am sure St. William's can be adapted to be used in many other ways. But let us look at the Medway district hospital site, because it is the site in the middle of the mass of the population. I look upon that as the objective to help people. It is forecast that as the years go by many more people will get the disease. We must help them in every way possible.
I thank my hon. Friend the Under-Secretary of State for his attention. I await his reply with great interest and look forward to improvements in the funding of Medway—
§ It being half past Two o'clock, the debate stood adjourned.