§ Motion made, and Question proposed, That this House do now adjourn.—[Mr. Lang.]11.42 pm
§ Mr. Jack Straw (Blackburn)
The debate is about the capital building programme for the Queen's Park hospital, Blackburn. I emphasise that the programme affects all the people in the Blackburn, Hyndburn and Ribble valley constituencies and boroughs. I am glad to see the hon. Member for Hyndburn (Mr. Hargreaves) in his place. There is concern in Accrington about the future of the Accrington Victoria hospital and its relationship with the main hospitals in Blackburn, but, as I believe the hon. Member for Hyndburn will say, there is unanimity of view throughout the district health authority area that the rebuilding of parts of Queen's Park hospital and the implementation of new facilities for child health must take place urgently.
Queen's Park hospital and the Blackburn Royal infirmary provide the district general hospital services for the district health authority area. Facilities exist at Queen's Park hospital for medical, psychiatric, geriatric, maternity and paediatric services. The buildings at Queen's Park hospital were formed from the old Blackburn workhouse and need to be rebuilt. The site suffers from being on a slope; it is high up and windy. The need to rebuild was recognised by the regional health authority many years ago, and that led to the preparation of a four-phase capital building programme. Phase 1 was to be the paediatric unit; phase 2, the geriatric unit; phase 3, the maternity unit and phase 4 was to be the unit for the mentally ill.
In 1980–81 the health authority proposed that work on the paediatric unit should begin in October 1981, on the geriatric unit in 1983, on the maternity unit in December 1984 and on the mental illness unit in 1986.
The rebuilding of the paediatric and child care units came first as the need there was the greatest. The children's wards at Queen's Park hospital are appalling. Ward CH3 can accurately be described as a shed.
Should the Minister have thought that I might exaggerate the position, I sent him a collection of photographs showing the cramped and inadequate facilities used to treat the sick children of Blackburn, Hyndburn, Rossendale and the Ribble valley. I hope that those photographs confirm to the Minister the view of the medical members of the technical advisory group on child health which, as long ago as 1969, when they visited the hospital, said that ward CH3 at Queen's Park hospital should not be used for the care of children.
Twelve years later the paediatric consultants, in a submission to the health authority, listed eight major problems with the facilities. They said:The main Paediatric Ward … at Queen's Park Hospital is totally isolated and lacks any connection other than transport to necessary supporting medical services. All Children who (some of them being critically ill) require x-rays have to be taken to the x-ray Department by ambulance … The ward design of CH3 is such that it does not allow flexible use of the available bed space. The indoor play facilities for children are totally lacking. The main ward is used for nursing children, for play and also for providing a makeshift dining room. There is no provision for piped oxygen or suction on ward CH3. The treatment room is so small that it can barely accommodate more than two people at a time. There are no facilities for parents, such as a waiting room or a quiet room for parents to retire, especially when they have a critically ill child in hospital. All day-case investigations are 385 being carried out in the main ward area, thus disrupting the smooth running of the ward … The school-room is totally inadequate as it is such a small room.When it became apparent in 1980 that the starting date for phase 1 and the later phases for the maternity and geriatric units had slipped, many representations were made. The then Minister for Health, the hon. Member for Reading, East (Dr. Vaughan) visited the hospital on 13 June 1980. Subsequently, the Minister wrote to me saying that phase 3—the maternity unit—was to be included in the RHA's capital programme for 1984–85. That letter carried the clear implication that the earlier phases would begin before then.
The regional health authority confirmed this in a letter to the consultants. It stated:As regards the scheme's timing, the current anticipated start date is March 1983 … Based on these target dates the Unit should become operational in September .1985.I visited the hospital again in March this year and was horrified to learn not only that phase I was not to begin in March this year but that the approval in principle submission had not been formally male to the Minister.
I then wrote to the chairman of the health authority. He replied on 26 April telling me thatMinor technical delays have occurred in the first phase of development … but these have now been overcome … It is possible, therefore, that both Phase I and Phase III may be delayed to some extent, although it is hoped that a start will be made on the earlier phase before the end of the current financial year.He went on to say that the first two sections of the approval in principle submission had been made to the Department on 23 March.
I thought that as a result of my representations and that letter the building would at least go ahead before the end of this financial year, but on 24 May I learned to my horror that it was to be recommended that phase I should be dropped altogether from the capital building programme for this year and that there was no guarantee that it would be included in the programme for next year or the following year.
Following representations from me, the regional health authority instructed the capital programme panel at its meeting on 24 May to re-examine the schemes. At the regional health authority meeting on 28 June, however, it was finally decided that the scheme would not go ahead this year, and there was no guarantee that it would be included in next year's programme.
I appreciate that the regional health authority makes decisions within the overall capital allocation provided by the Government, but I have called for this debate and a reply from the Minister for three reasons. First, the regional health authority is a creature of the Secretary of State. Secondly, the Secretary of State is responsible for the financing of the health authority. Thirdly, the Secretary of State is ultimately responsible for the good administration of health authorities.
I realise that there are many hospital schemes in the pipeline competing for limited resources, but the conditions for children at Queen's Park hospital are scandalous. They would not be tolerated for a moment in any of our major cities and they should not be tolerated for the people of Blackburn, Hyndburn, Rossendale and the Ribble valley. The staff achieve astonishingly good results in conditions in which no one should expect them to work.
I hope to hear from the Minister in more concrete terms than I have obtained so far that decisions will be made to ensure that the schemes go ahead. I also hope to learn more 386 about the reasons why the schemes have been so seriously delayed, as no satisfactory explanation has ever been given. There is the strongest suspicion that it is not just a matter of limited resources, but that technical and administrative delays have contributed to the slippage.
If the scheme was due to go ahead in March this year, as the chairman of the regional health authority said in his letter of December 1981, why was the approval in principle submission not put in to the Department until 23 March this year, and why has the third section of that submission—the preferred option submission—still not been made? If the technical delays have been sorted out, as I have been assured, why did the chairman of the capital programme panel, councillor Mrs. Patricia Case, tell the Lancashire Evening Telegraph last week that, even if the money was available, the scheme could not go ahead before February next year?
I hope that the Minister will also throw some light on the continuing rumours that the dealys are due to design difficulties, due to a sloping site, and tell us why those difficulties have only now arisen when it has been known for many years that the site has slope characteristics? Why were those problems not sorted out in all the years of preparation?
Decent hospitals for our sick children are the least that we expect and demand from a civilised and relatively wealthy society, such as ours. Facilities for the care of sick children in the Blackburn and Hyndburn area are neither satisfactory nor adequate.
I know that the Minister will treat our worry seriously, and I hope to hear of Government action to match that worry.
§ The Under-Secretary of State for Health and Social Security (Mr. John Patten)
The hon. Member for Blackburn (Mr. Straw) has pursued this issue with vigour since he was first returned in 1979. I am glad that he has had the opportunity to do so again today. I am also glad to see my hon. Friend the Member for Hyndburn (Mr. Hargreaves) here. I congratulate him on his election victory. He is taking a close interest in the affairs of his constituency and the related problems of the Victoria hospital in Accrington. No doubt I shall hear from him about that hospital by letter or in person. As he is nodding assent, I see that he will not refuse that invitation.
Nobody questions the need for development at Queen's Park hospital, Blackburn. I do not dissent from the hon. Gentleman's succinct resume of conditions there. If we were in a court of law rather than the high court of Parliament, the hon. Gentleman would want to introduce as evidence the large photograph album of views of the hospital that he was kind enough to send me recently to demonstrate conditions there. I have not had a chance to visit it, as did the then Minister of Health in 1980, but I know from my inquiries that the picture the hon. Gentleman has given is accurate.
The issue is not about the need for development but about its timing. I have had detailed inquiries made into the history of the development. In the short time that is available, I hope to answer many if not all of the questions that the hon. Gentleman has asked. If I fail to answer any of them in detail, no doubt he will remind me of them afterwards and I shall write to him.
In the 1979 strategic plan, which is an important document, the North-Western regional health authority 387 reported that the first phase of development of about 100 beds, including a paediatric unit, was being designed. That phase was provisionally planned to open in June 1984. The mental illness unit and the maternity unit were provisionally programmed to open during 1988. Since then, all four phases have, as the hon. Gentleman reminded us, slipped in the capital programme from year to year. I must report that the first phase could not start before April 1985. I regret that I cannot at the moment give a categoric assurance about when they are likely to start —I can only give the earliest conceivable dates.
There are two elements to what I acknowledge is a most unsatisfactory position. The first is the delay in completing the design and the second is the uncertainty about the programming of the phases. The hon. Gentleman highlighted that in his characteristically lucid speech.
I am advised that three factors have contributed to the delay in completing the design of the relatively modest phases. They are rather modest, each consisting of a little more than 100 beds and the associated services. That is not enormous by NHS standards today. The design is a variant of a new regional standard design and has run into several developmental problems that are typical of any prototype. I hope that the hon. Gentleman understands that, inevitably, there are teething problems with new designs.
New and more rigorous guidance on building and fire regulations was issued while the design work was in progress, and some revisions were needed to achieve new standards. I hope that the hon. Gentleman will not dissent from the statement that the new regulations are needed for the hospital. There may be a lesson for all district health authorities in the fact that this district health authority asked for some modification of the content of phase 1 of the scheme at a relatively late stage, which caused many problems and needed further redesigning. The delay was caused by a design problem, compounded by three separate, but interrelated, factors.
However, to come up to date, I am glad to report that the design stage of phase 1 is complete. The regional health authority expects to be able to seek the necessary approval from my right hon. Friend the Secretary of State soon, and informal discussions on a draft approval in-principle submission have already taken place between my officials and regional staff. No major problems have been identified. Provided that no unexpected problems arise —they have arisen in the past with this design—there is no reason why the region's proposals for the first two phases at Queen's Park should not be approved within 12 weeks of the Department receiving the submission. I shall take a hand in ensuring that the Department deals with the submission as quickly as possible.
I must also mention the programming of the first phase, and of any subsequent phases. For several years the North-Western regional health authority has had a capital programme considerably in excess of what it could realistically expect to undertake. At the review meeting last autumn, we set the regional health authority the task of recasting its capital programme on reasonable assumptions about future resources. I shall return to the 388 division of the cake, and how much money is available to the region in capital terms, in a moment. However, I understand that the work is well advanced, and we hope that the regional health authority can announce its revised programme later this month. At this stage, I cannot say what priority the regional health authority will afford to the various phases of the Queen's Park development. That is a matter for the authority, as the hon. Gentleman knows. However, overall the region's programme last year was over-committed by nearly one quarter, and many schemes will have to be delayed. In revising the programme for the current financial year, half of the 66 schemes originally planned to start this year have been delayed, including the phase 1 scheme. However, I should be surprised if the new paediatric unit at Queen's Park did not figure quite near the top of the region's priorities for next year. In any event, I shall ensure that the hon. Gentleman is advised immediately the regional health authority goes firm on its programme.
The hon. Gentleman hinted, with great delicacy, that inadequate resources might have contributed to the delays on the schemes. Nationally, the capital programme has increased by 17 per cent. in real terms during the past five years, and only last week we announced that it will continue at roughly the present high level for the next decade. It is indisputable that the North-Western regional health authority's capital allocation has been the largest in the country. Its allocation for the next period will be substantial and in line with the planning assumptions notified to the regional health authority by the Labour Government in 1978. So we have clear guidelines laid down by a previous Administration — in this region, with successive Conservative Administrations—matching planning assumptions not with promises but with cash.
The regional health authority has perhaps been slow in recent years to recognise the unreality of the assumptions on which its capital programme was based. As a consequence, many people in the region—not just in Blackburn but in other areas, such as that represented by my hon. Friend the Member for Hyndburn — will, understandably, feel let down as hospital schemes announced with provisional completion dates are delayed.
There is much to learn from that experience, not only in the north-western region but in the other 13 authorities throughout the country. I believe that under the new regional health authority chairman, Sir John Page, this lesson will be well taken and that the new capital programme, when finally announced, will be totally realistic in its approach.
Words from me will not mollify the hon. Gentleman and his constituents. Actions speak louder than words and I expect that over the next year or so, under the leadership that Sir John is giving to the regional health authority, the hon. Gentleman's confidence and that of his constituents, and of others in the north-western region, in the management of the National Health Service will be increased.
Question put and agreed to.
Adjourned accordingly at six minutes past Twelve o'clock.