HC Deb 19 December 1983 vol 51 cc248-54

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

9 am

Mr. Allan Roberts (Bootle)

The South Sefton area health authority, which covers my constituency, lies within the same regional health authority as does Liverpool — the Merseyside regional health authority which recently instructed all its area health authorities to make cuts in services and health provision throughout Merseyside.

On 9 November 1983 the House debated the cuts being imposed through the Liverpool area health authority when my hon. Friends who represented the people of the city of Liverpool pointed out the devastation that was taking place in their area.

My constituents in Bootle, Litherland, Seaforth and Waterloo and the remainder of those who live in the area covered by the South Sefton area health authority are hit not only by the cuts being imposed by what seems to be their area health authority, South Sefton, but by those made by the Liverpool area health authority where the Newsuan general hospital is being run down and will be closed, Princes Park hospital is to lose 100 beds for the elderly, 24 beds are to go at Alderhey children's hospital and the St. Paul's eye hospital will close a ward, despite its long list of about 600 patients awaiting eye treatment. The catchment area of this and the other Liverpool hospitals suffering cuts, run-downs and closures is the whole of Merseyside. These cuts hit South Sefton, including my Bootle constituency, as well as Liverpool. On top of these cuts in the city centre hospitals and health service, there are imposed on the people of South Sefton the cuts of the South Sefton area health authority. These are tragic, and in some cases devastating. They are made against the background of central Government cuts in the total Health Service budget, the Government's hidden manifesto which they denied at the general election but which is now being revealed step by step, stage by stage.

I have here the consequences of the cuts being imposed by the Government on the South Sefton area. The fateful meeting of the South Sefton area health authority which considered and implemented these cuts took place on 28 October this year. I remember it well. It was my fortieth birthday, and the meeting provided me with a rather tragic birthday present. I have here the report that was considered. It is printed on pink rather than blue paper. The report to the South Sefton area health authority said: When the allocations for the current year were announced in February, 1983, we received no additional funding for growth … This meant we had to reduce our expenditure by £637,000 in 1983–84, and the Authority's approved economy package reflected this position. In that economy package we looked for savings on revenue account of £637,000 in 1983–84 to be followed by savings of £865,000 in 1984–85. Following the Chancellor's statement in July, the Authority produced an Action Plan which gave substance to a further saving of £496,000 in the financial year ended 31st March, 1984. That is a total saving of £1,133,000 in all in 1983–84. The Secretary of State also announced manpower reductions, and in this financial year we need to shed 87 whole time "equivalent posts … The District Management Team are, therefore, monitoring manpower for three main reasons:

(a) To meet the figure of 87 as above"— those were staff cuts— (b) To observe the vacancy control requirement derived from the the economy package". That is a euphemism for not filling vacancies that may arise, including nursing vacancies. In continues, (c) To assist the District Nursing Officer with her overspending on nursing posts in the General Division at Fazakerley hospital. There was great anxiety at Fazakerley hospital about that, because it will mean a reduction in nurses in that already under-staffed hospital.

Those were the proposals and the figures before the South Sefton area health authority meeting on 28 October. The authority took several decisions, including cuts in gardening at hospitals, especially Fazakerley; cuts in boiler house staffing in hospitals; reduced stocks of medical and surgical equipment; at Walton hospital, which serves our area, a withdrawal of night attendents at the residence; and cuts in administration cover. The authority decided to review patients' feeding menus, which meant that patients would not get the proper food that is so essential in the nursing care process. At Fazakerley hospital, cuts were proposed in catering and domestic services, so that standards of food and hygiene will deteriorate. There will be reductions in porters. Instead of the porters taking patients round the hospitals, and to the operating theatres, patients will now be left lying around for much longer. There will be administrative cuts in the community units and a withdrawal of the caretaker at the clinic.

Even more serious are the compulsory redundancies to achieve a reduction in staff of 87, which will start on 31 December 1983—a strange Christmas present to those in need of health care in that area. Waterloo hospital is to close, which is probably the greatest cut in the area. It is a small, family hospital that is regarded in the entire area as a caring community facility. It provides a minor injuries unit, chest clinic, X-ray service, renal dialysis unit, community haematology, and chiropody and physiotherapy services. It is a local district nursing base, and a centre for hearing aids. All those community-based services will be closed or transferred away from the local community. A massive campaign is being mounted, not least by Bootle and Crosby Labour parties, which has received the support of the whole community. A massive petition has been organised, and demonstrations and packed protest meetings have taken and will continue to take, place to oppose this tragic closure.

We are told that the building will be retained. A letter that I received stated that the future of the hospital will be reviewed when it has been closed. What nonsense Ministers and the area health authority talk. Surely they do not expect the local people to fall for that one. They realise that, once Waterloo hospital closes, it is highly unlikely ever to be reopened, especially if this Government are in power.

Who is sitting on this non-democratically elected area health authority, and taking the decisions on cuts in the Health Service? One member of the board is the partner of a doctor who owns a private nursing home at 57 Albert road, Southport. It is registered in his wife's name, Mrs. Niadoo. People such as that doctor have a vested interest in cuts in state provision, and on all the evidence provide sub-standard care, are involved in making undemocratic decisions and in pushing through cuts. The cuts are partly implemented. on the Government's admission, to defend the private sector.

The Under-Secretary of State for Health and Social Security (Mr. John Patten)

The hon. Gentleman is making serious allegations about the conduct of one member of the district health authority. He alleges that that person provides sub-standard care. I hope that he is prepared to repeat those allegations outside the House.

Mr. Roberts

There is an investigation into the home to which I referred. I am sure that the evidence will be brought to the attention of the Minister in due course.

The Government have a vested interest in the private sector. Even people on the boards of area and regional health authorities are trying to destroy our National Health Service so that the private sector can develop. However, they will never destroy it completely, because the private sector feeds on the Health Service. Consultants and others will always favour certain cuts, but want the NHS as they have a vested interest in waiting lists at state hospitals. People pay to see consultants— not to get better care, but to jump the queue.

The people of south Sefton suffer twice, because of the cuts imposed on them by the Government through the area health authority and because there is the meanest Tory council in the country in Sefton. It is cutting community health and social service care. I shall give some examples of services that are being destroyed in our area, or which are hardly meeting current need. I took up with the St. Helens and Knowsley health authority a constituent's problem, and received a letter from the chairman, in which he said: It is indeed desirable for your constituent to be provided with day care when he is out of hospital. Unfortunately, there are no local authority day places available for the mentally ill in the South Sefton Health District. This deficiency has been brought to the attention of the South Sefton Health Authority and to the Director of Social Services for Sefton by the Psychiatric Div:sion of Walton and Fazakerley hospitals, but to date it has not been possible to remedy the situation. That is a glaring example of a massive gap in provision, which should be filled, and cuts should not be imposed. I received a telling letter from four speech therapists, working on Merseyside, appealing to you for help.

In 1972 a government report (Quirk) recommended that South Sefton Health District should have fourteen speech therapists On 1st December 1983 we will have only three full-time posts. With this provision we are supposed to cover Walton and Fazakerley General Hospitals, five schools for the mentally and physically handicapped, three units for children with learning difficulties, two training centres for the mentally handicapped adult, and evening group plus eleven health clinics and a domiciliary service. In these settings we alone assess, diagnose and treat all disorders of human communication in both adults and children.

In our district there are children failing at school and adults who will never speak again because we are unable to provide a service which meets the needs of this community. Without speech therapy, patients with severe speech and language disorders will never be able to participate fully in society. I received a letter from an elderly gentleman, Mr. Atkins of 11 Park avenue in Crosby, saying: I doubt whether you will know a great deal about this subject. I didn't either until I needed the service. I am nearly 78 years old, and suffer from arthritis and poor sight. Action is needed right away by caring people, not in three years but in three months. Mr. Atkins talks about the chiropody service at the Thornton health clinic in Bretland road, which appears to be being deliberately run down. It has been hopelessly undermanned for years, with patients having to wait three months between visits. He graphically illustrates the difficulties faced by the elderly in my constituency and in the area round south Sefton and Merseyside, who are trying to get a chiropody service. It is inadequately staffed and in dire need of help and assistance.

I received a letter from another constituent, Mr. Peter Boyle of 22 Gardner avenue, Bootle, who says: As one of your constituents and a supporter of your re-election"— that is nice to hear— … I should be grateful if you would use your position to make known the disgraceful state of affairs, as a result of a shortage of money at Clatterbridge hospital, Wirral, Merseyside. The situation was brought to my attention by a close relative who is currently a patient there. As you know, much of the work carried out at the hospital depends on the use of X-ray equipment for the treatment for cancer patients. Radiographers and other staff are frustrated by constant breakdowns of dated equipment and patients are kept waiting for hours on end for a treatment which itself takes only minutes. Some wait from early morning, with little to pass the time, until late at night, and staff work through the night to get machines working and complete the day's quota of treatments. There is no over-time paid, just time off in lieu, which some never take because of staff shortages and dedication to the patients. is hospital needs is new, modern equipment now, so that it can continue the wonderful work it has carried out in the past. For many cancer sufferers in the north-west it represents the only chance of prolonging their lives. What better reason for public expenditure. What better justification could there be for the arguments put forward by the Opposition against cuts in the Health Service.

What has been the reaction of the Crosby constituency Liberals to our campaign against the closure of Waterloo hospital and the cuts in the services imposed by the Government, the area health authority, and the local authority, the Sefton Conservative council? They wrote to me suggesting alternative measures to the closure of the Waterloo hospital.

The Crosby constituency Liberals said: Having consulted with various interested parties, we feel that such alternative proposals can be made so as to satisfy the demands of the Health Authority and so preserve this amenity". meaning Waterloo hospital. The Liberals seem to support the cuts providing they can decide them.

The persons whom I represent are opposed to all Health Service cuts in the south Sefton area and want to see greater expenditure, not cuts, to provide a better and not a worse Health Service in Bootle, south Sefton and throughout Merseyside. I could continue at length, but I want the Minister to reply.

We are dealing with a matter of principle which divides the two main political parties. The Conservatives do not regard the Health Service as worth defending at all costs. We regard the Health Service as a major exemplification of what Socialism and our Labour party policies are all about. The Conservatives hate Socialism, and they hate Socialism that works more than that which does not. Because the Health Service works and is caring in action — it is Socialism in action — they are attacking the Service and many people are suffering including some who voted Conservative at the general election.

9.17 am
The Under-Secretary of State for Health and Social Security (Mr. John. Patten)

This has been an interesting night of debates, and the Adjournment debate has been equally interesting.

I begin by refuting utterly the comments of the hon. Member for Bootle (Mr. Roberts) about my Government's attitude towards the National Health Service. If we had such an attitude, it would be a curious reflection of it for us to spend more rather than less in real terms next year. Next year will see the Government's attitude towards the NHS expressed.

The hon. Gentleman's comments reflect the excellent debate that took place a few weeks ago when, to my surprise, and certainly to the surprise of many hon. Members, the Adjournment debate lasted almost four hours instead of half an hour. That gave us the opportunity to have an in-depth look at health provision in Liverpool and Merseyside.

I shall refrain from discussing in great detail the points that we discussed at length on that occasion concerning health provision in Liverpool. Instead. I shall address my comments to the specific points that concern the hon. Gentleman. I appreciate his concern about what is happening in his constituency and in the Sefton district health authority. I wish to put into perspective some of the comments about the alleged savagery of the cuts. It is peculiar to hear talk of cuts when more money rather than less is being spent nationally.

The first point to bear in mind is that the resource allocations below regional level are the responsibility of the regional health authority. Money is distributed to it, and thereafter resource allocation is its concern. The Mersey regional health authority, under its excellent chairman, takes the view that when adjustments are made to the level of available resources they should be applied on an equal basis.

The RHA does not believe that any one district should be protected from the adjustments at the expense of other districts within the region. The South Sefton district is virtually at its RAWP target for the late 1980s. I do not need to remind the hon. Gentleman that the RAWP process began in 1976 under the last Labour Administration. It is a mechanism by which resources can be progressively, gradually and slowly redistributed from over-provided and funded parts of Britain to under-provided and funded parts. We see that process in action within the Mersey regional health authority.

There will certainly be a decline in population in the area, which may lead to some interesting redistribution of parliamentary boundaries, but that is in the lap of the Boundary' Commission.

Mr. Eddie Loyden (Liverpool, Garston)

When the Minister considers the redistribution of resources in the NHS, is due regard given to the levels of unemployment and the consequences of that on the health of people in the area?

Mr. Patten

We certainly take into account the issue mentioned by the hon. Gentleman, and also other issues such as relative deprivation and the social standing of certain areas.

The hon. Member for Bootle rightly highlighted the suggestion that a major hospital in his constituency should close. He was referring to the Waterloo hospital. It would be premature of me to comment in any detail on the points that he raised, and I must confine myself to factual background comment. The suggestion that the hospital should close is properly subject to a consultation process which, as he knows only too well, has only just begun. The hon. Gentleman's constituency Liberal party has already made some interesting suggestions. He obviously suffers from the irritations of the Liberals in his constituency as much as I do in mine.

The consultation period will not end until February 1984. If, at the end of that period, the community health council — which does good work in the hon. Gentleman's area—objects to the proposals, the matter will come to us for a final decision, but not until it has been fully considered by the RHA. Should it come to us, I shall bear in mind the points made by the hon. Gentleman.

The hon. Gentleman will be aware that acute in-patient facilities were withdrawn from the hospital in 1974 as a consequence of the commissioning of new facilities at Fazakerley. Over the years there have been a number of in-depth investigations on environmental grounds and also by firemen and engineers. These have shown that the property requires major capital investment to bring it up to standard. Since 1974 the health authority—the preexistent authority and the present authority—has used the hospital as a community hospital. It has provided a number of clinics, a minor injuries unit, a satellite unit for renal dialysis and support facilities, including an outpatient department. I pay tribute to the work of the staff.

I should say a word in passing about manpower changes in the area. As the hon. Gentleman has said, the south Sefton district is scheduled to lose 87 posts. So far, some 52 posts have already been suppressed and the district is confident that it will be able to reach the target of 87 without any impact at all on the level of patient care. I hope that the hon. Gentleman is reassured by that, especially as, historically, employment in the Health Service is higher than it has even been since the inception of the NHS.

As the hon. Gentleman knows, the health authority has considered the future of Waterloo hospital on several occasions, on each of which it has drawn back from curtailing services there because of the strong community feeling in the area. It has been decided to close the hospital temporarily in advance of full consultation because the authority decided that it must live within the cash limits that are a statutory enjoinment on it. Successive Governments have always recognised that there may be circumstances, including financial pressures, which justify acting in that way, but before closure can be made permanent the full consultation to which I have referred must be undertaken and is now taking place.

The health authority has given close consideration to the future of services now provided at Waterloo. I am sure that the hon. Gentleman is familiar with the authority's plans for relocation of those services, so I shall not comment on them in detail today.

In addition to the closure of Waterloo hospital, which the authority estimates will result in savings of about £200,000 in a full year. the authority has agreed to a temporary reduction of 20 long-stay geriatric beds at Fazakerley hospital. That reduction is being linked with the future use of other wards at Fazakerley when the authority will receive 93 of its own patients currently in hospital in Liverpool. There will thus be a certain amount of transfer back as a result of the Liverpool health authority's long-term strategy proposals if and when they are considered and approved. South Sefton will certainly receive a regional adjustment from the Mersey regional health authority for accepting those patients and that important issue is still being considered.

The outlook for Waterloo hospital is not all doom and gloom, as the hon. Gentleman suggests. The Mersey regional health authority's capital programme contains provision for a 20-place day unit for the elderly severely mentally infirm at a cost of more than £561,000 at present prices, to start in January 1986. That highly important development will add to and not detract from hospital provision in the area. Although a declining population is projected for the south Sefton district there will be a proportionate increase in the number of elderly people, some over 75 and many over 85. It is critically important to make adequate provision for that important client group of the National Health Service.

In conclusion, I can say little more because of the consultation process now taking place, but I repeat my utter refutation of the hon. Gentleman's opening remarks about the Government's attitude to the NHS. It would certainly be most peculiar to favour cutting the NHS while deploying a historically large amount of money in real terms on it and employing a historically large number of people in it.

I hope that I have reassured the hon. Gentleman, and, through him, his constituents, and perhaps even the troublesome Liberals to whom he referred, that there is indeed a future for the Waterloo hospital. The development envisaged for it will represent a substantial advance within the context of a modern Health Service, providing for client groups such as the elderly, infirm and confused who have hitherto not had a fair deal from successive Governments. Within that framework of a modern Health Service the Waterloo hospital will continue to have a role.

Question put and agreed to.

Adjourned accordingly at half-past Nine o'clock am.