§ Motion made, and Question proposed, That this House do now adjourn.—[Mr. Mather.]
11.29 pm§ Sir David Price (Eastleigh)I am very grateful for this opportunity of raising the subject of the future of the Southampton eye hospital. I know that all my hon. Friends whose constituencies are served by that admirable hospital would wish to join me in expressing their praise and thanks to the very competent doctors and dedicated staff who practise such excellent medicine in a hospital which, we must face it, is crumbling. I also know that my hon. Friend the Member for Southampton, Itchen (Mr. Chope) wants to say a few brief words in support of my submission. The hospital is physically in his constituency, but as the senior Member of Parliament for the area I have had a rather longer association with it than he has.
My submission is simple. The Southampton eye hospital urgently needs to be relocated in a new building on a new site while at the same time retaining its independence. I shall give just two of the reasons why my submission is eminently reasonable. The Southampton eye hospital is responsible for providing the whole range of ophthalmic care, with all the latest techniques, for the Southampton and south-west Hampshire health district. We are not complaining that the current crummy Victorian building has not been equipped with lasers and so on, because it has been; it has the full range of modern diagnostic facilities. However, there is a point that is not fully appreciated, even by our regional health authority, which is in some ways conspiring—if that is not too strong a word—with us in our endeavours to get a new building for that admirable hospital. I refer to the fact that all the undergraduate teaching in ophthalmology in the Southampton medical school is carried out by that very small eye hospital. In addition, it does postgraduate work and trains nurses—those specialising and others—in eye care. There is a nurse training school for the ophthalmic nursing diploma and a number of junior doctors are in full-time training.
Therefore, I am discussing not just an ophthalmic department that is part of a general district hospital but something of a higher quality. The consultants at the hospital tell me that, although the equipment is basically satisfactory, their ability to practise the best modern techniques is restricted by the building and its layout. I, like my hon. Friends, have visited the building several times and am fully aware of that.
The hospital's catchment area is primarily Southampton and south-west Hampshire. The present population in our district is 500,000, but there is a projected increase of at least 10 per cent. by the end of the century. Therefore, the population will then be 600,000 or 700,000. In addition, there is at least a 20 per cent. cross-boundary intake of patients.
There is a point about which the region may be a little ambivalent. I am aware that the Southampton eye hospital is probably the premier eye hospital in the region. However, that is not officially recognised by the region. At this late hour I shall not bore the House with the figures, but I could do so if goaded. They show that that hospital is taking the more difficult cases from other districts within the region. In particular. it plays a large part in helping the 976 Channel Islands with difficult cases. My plea therefore is not just for Southampton and the south-west Hampshire district.
The outpatient clinic of this small hospital has been carrying more than one-third—34 per cent. is the precise figure—of the numbers of clinic patients passing through the more modern general hospital and the Royal South Hants. It has been handling about 59,000 outpatient attendances a year. The casualty department, which is open around the clock, as every good casualty department should be, deals with 30,000 patients a year. That is more than half the number taken by the grander general hospital and the Royal South Hants. I say that not to decry the larger hospitals but to show what a small hospital can handle.
Our plea is simple. The present building is a mixture of Victorian vicarage and some slightly more modern additions. I have known the hospital for 28 years. Superb medicine is practised there, but, however good and dedicated the staff are, there comes a point when the sheer inadequacy of the building must be a restriction on the ability of those in the hospital to practise their high standards of medicine. I shall give an example. The old operating theatre has no anaesthetic room, no recovery ward, no ventilation system and is adjacent to the ward's sluices and toilets. I could give the evidence, but at this late hour I shall not unduly detain the House.
We need a new hospital. The present one cannot be rebuilt on the present site because of the need for continuity. The hospital cannot be closed down for three years while a new one is being built. Therefore, a new site must be found. There are several possibilities. It could be absorbed into either the general hospital or the Roy al South Hants. There is a great deal to be said for retaining the integrity of a specialist hospital such as this. It recognises that is must co-operate with its bigger brethren where there is an overlap, and so the right answer is to locate it near the general hospital where there are other departments —I shall not detain the House be listing them—and where there is an obvious interplay between an eye hospital and other department. The most obvious examples are neurology and neurosurgery. When someone is badly injured on the motorway and has multiple injuries, including eye injuries, there are advantages in having the hospitals close together.
Eye hospitals are almost unique in the number of their patients who go to outpatient clinics. They have fewer patients going into hospital than any other area of medicine. Therefore, I suggest to my hon. Friend that the right answer is to retain the independence of the hospital but to locate it near the general hospital. There are a number of suggestions on how that might be done. I do not wish to say more than that. My hon. Friend the Member for Itchen may wish to say a few more words if he catches your eye, Mr. Deputy Speaker, because the hospital is in his constituency.
There is a broad case in favour of relocating the Southampton eye hospital in a new purpose-built building on a site close to the general hospital while retaining its independence. My submission is supported not only by the staff of the hospital but by the district and the local branch of the British Medical Association.
§ Mr. Michael Colvin (Romsey and Waterside)My hon. Friend has not mentioned one very important person—the ghost. When listing the assets of the 977 Southampton eye hospital, he must include the ghost. The building was a vicarage and it is very ancient indeed. The ghost is an important asset. What my hon. Friend said about the catchment area of the hospital is important. He did not mention that 75,000 patients go there from around the region. A difficulty that the hospital has found in regard to capital investment is that it has been treated as a district hospital—as a hospital of the Southampton and south-west Hampshire district—when it is not a district hospital; it is in effect a regional hospital and, for investment purposes, should be treated as such.
§ Sir David PriceI thank my hon. Friend for his intervention. As I said, at least 20 per cent. of patients come from outside the district. But the region has not recognised it as such and part of my submission is that it should be so recognised. If that were the case, I believe that the capital allocation involved would be containable within the regional budget.
As I said when speaking in the debate on the National Health Service last Thursday, unlike counties, regions are not independent authorities. They are creatures of the Department at the Elephant and Castle. They have no independent financial sources, although they have a degree of independence. The Minister would therefore be right to say that this is in effect a regional hospital. It is a referable hospital from other districts within the region, but, again, it is not recognised by the region.
I am aware that within the other districts of the region—my constituency traverses more than one, so I am not speaking only for Southampton; I speak for Winchester too—there is a feeling that the Southampton district has had more than its fair share of the capital allocation. This has arisen because Southampton is a designated district for the teaching hospitals. This is important to the region, but it has, in a way, made other districts feel that Southampton has had more than its fair share. I do not believe that to be the case.
I hope that the case for rebuilding this eye hospital, which in cost-effective terms is one of the most effective hospitals in the country, will be looked at in its own right. I know that the Minister is totally sympathetic to the case I have made and that he will respond with that sympathy and understanding that can come only from somebody from Oxford.
§ Mr. Deputy Speaker (Mr. Paul Dean)Do I understand from what the hon. Member for Eastleigh (Sir D. Price) said that he and the Minister are agreeable to the hon. Member for Southampton, Itchen (Mr. Chope) intervening in the debate?
§ Sir David PriceYes, Mr. Deputy Speaker.
§ Mr. ChopeI thank my hon. Friend and the Minister for allowing me to participate in the debate. The eye hospital is in my constituency, although it has a significance which goes far wider.
I was pleased to be able to visit the hospital in August and see for myself the cramped conditions in which a dedicated team of staff must work. They take enormous pride in their work and, although it is tempting on an 978 occasion such as this to say that the conditions there are terrible, the standard of care being provided for the patients seems to be of the highest order. Our plea tonight is that this should not be taken for granted and exploited in a way that would prevent progress from being made and the new development taking place.
I have with me a copy of the draft 1984 health district plan. Unfortunately, it contains a reference on page 132 to the fact that the eye hospital is unlikely to be redeveloped within the next 10 years. As my hon. Friend the Member for Eastleigh (Sir D. Price) said, a feasibility study is being undertaken by the regional health authority, which is looking at three possible alternative sites, one of which is not owned by the health authority. There is reference in the district plan to the fact that if that turns out to be the preferred site, it may be necessary for the DHSS to make an interim contribution.
The plan states that the results of this appraisal may require the acquisition of land a considerable period in advance of a capital development commencing, which would require approval from the DHSS. I do not know whether that is true, but I hope that it will not be that long before development takes place. I hope also that my hon. Friend the Minister will be able to give some indication that the Department is sympathetic to the redevelopment.
It is worth praying in aid in a debate about the Southampton eye hospital the fact that we are fortunate in Southampton in having a district health authority which is constructive in dealing with its priorities. There is very little bickering on the authority, and its members get down to the business of ensuring that there are value-for-money savings. Efficiency savings are part and parcel of the budget every year. It is the intent of those who work in the authority to ensure that money is available for new revenue developments. That is why I hope that the new eye hospital in my constituency, or in Southampton, will be a reality sooner rather than later.
§ The Under-Secretary of State for Health and Social Security (Mr. John Patten)I am grateful to my hon. Friend the Member for Eastleigh (Sir D. Price) for raising an issue that is important to him, his constituents and to my hon. Friends the Members for Romsey and Waterside (Mr. Colvin) and Southampton, Itchen (Mr. Chope), whose voices have also been heard during the debate. I am especially glad to have heard the voice of my hon. Friend the Member for Itchen. I missed his maiden speech, which I understand was formidable. I am glad that I now have evidence of his formidable debating powers.
The main issue that my hon. Friend the Member for Eastleigh has chosen to raise is the need for a new eye hospital. As he undoubtedly knows, the Department has had the views of consultants drawn to its attention, notably by my hon. Friend the Member for Southampton, Test (Mr. Hill), who forwarded a letter to us in July from one of the distinguished consultants at the hospital, Mr. M. J. Absolon. I am grateful for that letter and the information that it gave. However, I am much more grateful for the full additional information that my hon. Friend the Member for Eastleigh has provided tonight along with the local flavour. I am sure that his constituents and those of my other hon. Friends are grateful for the interest that their Members of Parliament are all showing in the fate of the hospital.
979 The provision of such a new facility has long been recognised as desirable in Southampton. That is recognised in Southampton and at the Elephant and Castle. However, it is sometimes difficult to turn recognition into reality. I shall set out some of the background to the difficulties that the district health authority, the regional health authority and the DHSS find themselves in because of the present economic and financial climate, which means that it is not possible for us to proceed as fast as we would wish with many of the things which seem desirable. However, I remind my hon. Friends—I dare say that they do not need reminding—that a record number of hospitals is being built and designed. The number is greater than at any other period since the inception of the NHS. My remarks tonight should be set against that background.
Unfortunately, there are competing priorities for limited resources and difficult choices have to be made. I am sure that my hon. Friends regret that last week the Leader of the Opposition, the right hon. Member for Islwyn (Mr. Kinnock), failed in his speech on the NHS to give any clear recognition to the fact that there will always be competing priorities in the NHS, as that distinguished predecessor of his, Mr. Richard Crossman, observed so often when he was the Secretary of State for Social Services. My hon. Friend the Member for Eastleigh made a notable contribution to the debate on Thursday. It can happily be said that it is recognised by many who occupy the Opposition Benches, although they are untenanted tonight, that there is a need to replace old and unsuitable buildings.
The DHSS recognises that the Wessex regional health authority is significantly more deprived than most regional health authorities. We have long recognised this, and we are striving, as we have done for many years, to put this right. In recognition of this fact, Wessex has been receiving a higher share of the national annual capital sum. This means that in recent years there has been an extensive capital programme, the majority of which has been concentrated in Southampton, which I am sure my hon. Friend would be the first to recognise.
From 1974 to 1981 about 40 per cent. of the total capital spent by the regional health authority in the whole of this very large region was spent in Southampton. Over the next 10 years, Southampton can expect to receive 9 or 10 per cent. of Wessex's capital allocation. Much of that is committed to the Royal South Hants hospital which, of course, provides a maginificient service in the area.
§ Mr. ColvinAnd teaching.
§ Mr. PattenI am glad that my hon. Friend the Member for Romsey and Waterside has intervened. When I was in my previous accommodation at Stormont castle, I thought of the waterside as being somewhere in Londonderry. I must now think of it as being located on the south coast.
The district health authorities find themselves in a difficult position. They recognise—I believe that they have stated it publicly—that this new eye hospital is at the top of their priority list for service development in the district. They must consider that priority against other competing priorities. Undoubtedly I am only telling my hon. Friend the Member for Eastleigh that which he already knows, but the need to improve non-acute services for the elderly the mentally ill and mentally handicapped —the priorities groups—to whom we try to give greater 980 attention is as pressing in that area as it is in my constituency and in other districts. The districts do not have an especially easy task.
§ Sir David PriceMy hon. Friend is right in talking about the needs of the elderly. One of the problems with using the present building as an eye hospital is that it is inadequate for the elderly. As my hon. Friend knows, I am especially interested in the disabled, and some of the elderly tend to be disabled. For example, the lavatories are wholly unsuited for anyone in a wheelchair.
§ Mr. PattenI take my hon. Friend's point. I would not seek to disagree with him for one moment. We all know of his long-standing interest in the problems of the disabled. I have not visited the hospital. I do not know it at first hand, but I have heard such graphic descriptions of the conditions that I almost feel that I have seen it.
In recent years, the district health authority' s capital development programme has been dominated by the major programme of work which was initially planned in the 1960s to provide facilities to enable Southampton to fulfil its functions as Wessex's teaching facility, and obviously Southampton benefits considerably.
As my hon. Friend the Member for Romsey and Waterside pointed out, this hospital, like other hospitals in Southampton, provides valuable services to the whole region. The decision to designate Southampton as a teaching district meant that the acute hospital services development programme had in the first instance to reflect the priorities of the medical school. Certainly, the Southampton general hospital was at one stage identified as the firm location for the major development of student and clinical accommodation, including possibly a eye hospital. Replacement accommodation for the eye hospital was to be provided within the development programme.
Current clinical views are not as clear. Clinical views are not always consistent. From my short period at the DHSS I have found that we do not always get unanimity of views from senior and distinguished clinicians. I am advised that current clinical views have questioned the suitability of the original location and have suggested up to three locations. Of course, the district health authority is the authority that is enjoined with the job of deciding local priorities. I should not want to take issue with my hon. Friend on any issue, but I might always take issue with him on the suggestion that regional health authorities are our creatures. Sometimes, as I look around the country, I wish that they were our creatures. We have a system of 14 regional health authorities and 192 district health authorities which are enjoying spending formidable sums on hospital and community services. In the first instance it is up to them.
It must be a matter of pleasure to my hon. Friend the Member for Eastleigh to realise that the district health authority and the Wessex regional health authority recognise the need to replace the eye hospital. It remains for the district health authority to accord it the priority that it feels right within its annual district plan, and, in the light of that, to discuss with the regional health authority the question when necessary capital to commence this desirable plan can be made available from the not inconsiderable sums of money available to the region.
I understand that there are feasibility studies for three possible sites. There may be more. There may be different ways of helping the rebuilding of the hospital. The 981 regional health authority will take into consideration the views put forward by the ophthalmic consultants and others about the relevant merits of the different sites. When one has heard two such measured but impassioned pleas it is difficult to put the other side of the case. There are, happily from our point of view, many of our hon. Friends in other parts of the Wessex regional health authority area and other right hon. and hon. Friends who wish to see capital schemes developed there. They look, not with jealousy but with a slightly jaundiced eye, when large and expensive capital developments are concentrated in one place.
We all know that with high technology medicine such concentrations are often necessary, particularly to provide the splendid teaching facilities that we see in Southampton. At the same time, it has to be recognised that the region and the DHSS must consider the spread of service developments throughout Wessex.
982 Some districts have had to wait a long time in the queue while a substantial number of developments have been concentrated in Southampton. That is not to say that I am not completely sympathetic to the case raised by my hon. Friend, which has attracted such interest. Nonetheless, it is incumbent upon me as a Minister to mention the competing needs in other parts of the region.
I hope that my hon. Friend will accept assurances from me that the regional health authority and the district health authority will, as they have advised me, provide as soon as possible for the building and replacement of this hospital, which is recognised by all as desirable. My only regret is that I cannot give my hon. Friend firmer news, which is what I would have wished to be able to do.
§ Question put and agreed to.
§ Adjourned accordingly at three minutes to Twelve o'clock.