§ Motion made, and Question proposed, That this House do now adjourn.—[Mr. Lang.]1.58 am
§ Mr. Max Madden (Bradford, West)
It was 10 April, just a few weeks before the local elections, that the Minister for Health announced that Thornton View hospital in Bradford was to close and that Shipley hospital was to remain open as a community geriatric unit and not as a community hospital. The Minister's decision to close Thornton View hospital was bitterly resented by the people of Bradford. Support for the hospital has been magnificent from the relatives of the elderly patients who praise the care that is given by the hospital, and from the staff and their supporters, who, since last August, have occupied the hospital and mounted a round-the-clock picket to ensure that patients are not removed.
In Shipley, there has been mounting concern after the initial reaction of pleasure that the hospital had been saved. The Minister's decision to close Thornton View hospital, which, in his own words, providesa caring and homely environment much appreciated by the patientsand to keep Shipley hospital, but to change it into a community geriatric hospital, came as a considerable surprise. Surprise, however, turned into astonishment at the end of May, when confidential minutes of a meeting between a deputation from Bradford district health authority and members of the Yorkshire regional health authority were leaked. They revealed thatthe DHA had considered the possibility of redesignating the hospital for geriatric use, but it had been concluded that it would not even be possible to achieve the RHA's minimum standards for the care of elderly patients within the confines of Shipley Hospital and that the facilities would be worse than currently available in other geriatric hospitals within the District.Yesterday, Bradford district health authority considered a motion that noted the district health authority's view that it would be impossible to achieve the region's minimum standards for the care of the elderly at Shipley, that the cost of upgrading Shipley hospital was unkown, that the projections for the elderly population had been underestimated previously, and that the Minister's decision would result in a net loss of 46 geriatric beds in Bradford. The motion concluded by callingUpon the Minister to fully explain and reconsider his decision".It was lost by just seven votes to six. The district health authority, which was previously in favour of closing both hospitals on the ground of economy, came within an ace of joining the many other people in Bradford who are in favour of keeping open Thornton View hospital.
In Bradford, 30,000 people signed a petition that was presented to the DHSS, urging that Thornton View hospital be kept open. It has the support of Bradford community health council, Bradford city council, the three political groups represented on it, and the relatives of patients. The hospital has been supported and visited by the leader of the Labour party, several members of the shadow Cabinet, the general secretaries of the health unions—the Confederation of Health Service Employees and the National Union of Public Employees — and many other individuals and organisations.
An early-day motion signed by more than 100 Labour members, urging that the hospital should remain open, has been on the Order Paper for several months. A large 1047 deputation representing all these viewpoints and others met the Under-Secretary of State in January, and presented an extremely powerful case for the hospital staying open. The members of that deputation were very disappointed, as I was, that Ministers were unable to accept several invitations that were extended to them to visit both hospitals before they announced their decision. I, and others, were extremely disappointed that those visits were not made, because we felt that it was vital that Ministers should see for themselves and talk to those who directly support those hospitals, so that they could ascertain the views and strength of feeling that exists in Bradford over the future of both of those hospitals.
We are entitled to ask why the Minister decided to announce the closure of Thornton View hospital, which, to use his words again, has provideda caring and homely environment much appreciated by the patientsWhy did the Minister decide to change Shipley hospital from a community hospital into a community geriatric unit? What commonsense, clinical or compassionate reasons were in the Minister's mind, given the advice that I assume that he was given last July by the Bradford district health authority—whose chairperson is a Conservative county councillor living in Shipley—that facilities at Shipley would be worse than currently available in other geriatric hospitals within the district?
If we need to inquire into those reasons—reasons that were in the Minister's mind—we find an intriguing explanation in an article in the New Statesman on 3 June,written by Phil Cohen, in which he wrote:The government was warned by local Tory MP Marcus Fox of a widespread grassroots revolt which would have endangered his seat if Shipley closed. Leafy Shipley, with its large detached houses, is a stronghold of the rich and middle classes. Thornton View, however, is the poorest constituency in Bradford—a Labour held seat—and has the highest immigrant population.Dr. Clive Tedd, a GP who serviced the 30-bed GP hospital, said: 'The Minister knew he would lose a Conservative MP at the next election. I was secretary of one of the wards of the local Conservative Association and it was made quite clear to me that was what would happen. I think Mr. Clarke is happy to see Thornton View close because the mixture of people trying to keep it open is totally different. It is seen as trade unionists, NUPE members and to a lesser extent relations of elderly patients'.That was the view of an active member of the Conservative party.
Yesterday, the chairman of the Bradford district health authority was unable to say what sort of community geriatric unit Shipley hospital would become. He has been quoted as saying that all that was required was the addition of a toilet and a day room. Many of us found that an unconvincing explanation of the required facilities at Shipley hospital. Yesterday, it was also announced that the hospital's attic would be required to be brought into use.
No clear guarantee was given at the meeting that the beds at Shipley would become long-stay geriatric beds.Indeed, a disbelieving group of Bradford people attending the meeting were told that there was no one on the geriatric waiting list in Bradford. If Thornton View closes, and even if large amounts of money are spent on bringing Shipley hospital up to standard, there will be a net loss to the district of 46 geriatric beds.
Elderly people—and the number of elderly people over 85 in Bradford will go up by more than a third in the next 20 years, and by more than 77 per cent. in the Yorkshire region in the same period—are in urgent need of residential hospital care. Bradford's social services are 1048 under enormous pressure, and that is not helped by tuts in rate support grant and threats of other action by the Government to reduce the finances available to the city.
The flourishing private nursing home sector in Bradford—heavily subsidised by the taxpayer—is clear evidence of the increasing need for care for the elderly. As beds in places such as Thornton View are lost, it makes the provision for the elderly, especially those who do not have much money or well-off relatives, that much harder. As hospitals close, as council homes and services are axed or cut, it means more elderly people are compelled to seek help in their homes, with relatives living with or visiting them or having to go to live with relatives. Such community care imposes severe and unnecessary strains and sacrifices on wives, daughters, mothers and sisters. It is women who are paying the cost in physical, emotional and financial terms for the political philosophy of this Government, which dictates that welfare services must be cut, and the choice of care diminished to those whose purses or wallets are not fat enough to provide private care.
I am grateful to the Minister for his reception of the deputation in January, but I must tell him that, as I speak, there are pickets at Thornton View hospital, and the occupation will continue. Only two weeks ago, staff voted overwhelmingly to continue the occupation, and there is no way that they will allow patients to be removed from the hospital. With thousands of unemployed in Bradford and thousands of people living in deepening poverty, an epidemic of dysentery — a disease of poverty — now shows the depth of poverty in the area. In those circumstances, the loss of arty public medical facility is unacceptable and will not be tolerated. Bradford urgently needs more help. It needs more resources to give our people better health care, better housing, better education, more jobs and some hope. The elderly, who created the wealth in the past, are clearly entitled to an increasing share of present-day resources to ensure that in their remaining years they receive the best possible care that our supposedly civilised society can give them.
Closing Thornton View hospital is not in the best interests of the elderly people of Bradford. No explanation has been given to the people of Bradford which might justify the closure of that hospital or the translation of Shipley hospital from a community hospital to a geriatric unit. I have to say that the stench of corruption hangs over the Minister's decision. I say that with considerable regret, but it is the view of many people in the city. That is the conclusion that many people have been forced to reach after the series of events which occurred both before and after the Minister's decision of 10 April this year.
The Minister can remove that stench of corruption by announcing today that all the decisions will be urgently reconsidered and by announcing in the very near future that he has no plans to close Thornton View hospital but that that hospital will be kept open and that Shipley hospital will remain a community hospital as the citizens of Shipley wish. That is the obligation facing the Minister today. He has a clear opportunity to reassure the people of Bradford that these badly needed medical facilities will be reprieved. I appeal to him to tell us as clearly and unequivocally as possible that Thornton View hospital will be kept open and that Shipley hospital will continue in the role that it has performed hitherto.
I hope that the Minister can see his way to making that clear commitment today. If he cannot do that, I am afraid that the great concern that has existed since the occupation 1049 began last August will continue and intensify. No one, including the district health authority, is satisified with the explanations given so far, and I join those who pressed the health authority yesterday to call upon the Minister to reconsider his decision. I hope that he will do that and that he will announce that intention today.
§ Mr. Deputy Speaker (Mr. Paul Dean)
Order. Does the hon. Gentleman have the permission of the hon. Member for Bradford, West (Mr. Madden) and of the Minister to intervene?
§ Mr. Fox
I take an exception to the hon. Member for Bradford West (Mr. Madden) devoting so much time to the affairs of Shipley. He is a newcomer to Bradford, never mind Shipley, and he has no right to speak for my constituents, who are delighted at the Minister's decision to keep our hospital open. It is not being changed from a community hospital into a geriatric unit. It maintains most of the services that it had before, but the beds will be better used. We wanted to keep a community hospital, we have achieved that aim, and we are grateful.
It is also ludicrous in the extreme for the hon. Gentleman to quote extracts suggesting that my seat is marginal when I have a majority of 11,400.
Thornton View hospital really should close. Half of it was closed in the 1960s. Those of us who have spent our lives in Yorkshire and in the area around Bradford in particular know a great deal more about these matters than the newcomer who now represents Bradford, West. The hon. Gentleman is far more at home down here in the south and as ex-director of the Labour party publicity machine. His Adjournment debate today shows exactly what he stands for
§ The Parliamentary Under-Secretary of State for Health and Social Security (Mr. John Patten)
I am grateful to my hon. Friend the Member for Shipley (Mr. Fox) for speaking with characteristic force about these matters. I listened with sorrow to some of the remarks of the hon. Member for Bradford, West (Mr. Madden) about Shipley and some of the allegations about actions taken by my right hon. and learned Friend the Minister for Health and myself, and I utterly reject those allegations.
I cannot oblige the hon. Member for Bradford, West. Neither I nor my right hon. and learned Friend the Minister for Health intend to reopen a decision that has been properly taken, the reasons for which have been clearly and properly promulgated. If the hon. Gentleman or his constituents want to know why the decisions about the Thornton View and Shipley hospitals were taken in that form by my right hon. and learned Friend, they need go no further than the letter in which my right hon. and learned Friend announced his decision.
It is unfortunate that the title of the debate and some, although not all, of the hon. Gentleman's powerful speech, reflecting his strong feelings about this issue—I respect those feelings—were concerned with the future 1050 of Thornton View hospital. The modern Health Service is concerned, not with buildings, but with patients—the best arrangements for the present and potential patients of Thornton View hospital and elsewhere in the district. Those are the people about whom we should be concerned—not the future of any particular building in Yorkshire. We should properly be concerned also with the future of the people who work in the hospital. I appreciate the hon. Gentleman's strong views on that matter.
I shall make three pledges about the hospital, its patients and those who work in it. First, as the hon. Gentleman knows, no patient has yet moved from Thornton View hospital, nor will any patient be moved until it is absolutely clear what pattern of moves, determined in the light of the individual needs of patients, will be in the patient's best interests. I know that the district health authority will work to those ends.
My second pledge refers to the staff. All permanent staff working at Thornton View hospital will be offered alternative employment. I repeat: all permanent staff working at the hospital will be offered alternative employment. It is important for those in Bradford, however strongly they feel about the future of Thornton View hospital and its patients, to realise that that is the fact of the matter.
The hon. Member for Bradford, West spoke often and freely about Shipley hospital, which is in the constituency of my hon. Friend the Member for Shipley. My third pledge concerns nursing staff at that hospital, and I hope that my hon. Friend will take my remarks back to his constituents. The pledge is that nursing staff at the Shipley hospital will qualify in future for what is known as a geriatric lead payment when the beds are redesignated. That is an important point for those who work so hard at Shipley hospital.
I do not want to debate tonight the rights and wrongs of the occupation of hospitals. The hon. Member for Bradford, West supports such a move. I believe that is totally wrong, but it is counter-productive for the House to begin tonight to debate the rights and wrongs of whether people should occupy NHS property or any other form of property in the pursuit of their aims.
I do not intend to do more than make passing reference to what I believe was a totally misplaced Labour party political broadcast which featured Thornton View hospital and specifically suggested that the closure of the hospital would cause its residents to be turned out on to the streets. That is disgraceful. By all means fight the political argument fairly, but it is wrong to make completely unfounded and unsupportable allegations about what might happen to individual elderly people, causing them and their relatives great upset.
I ask the hon. Gentleman to do four things tonight. First, I ask him to condemn, with me, the numerous cases of actual and threatened violence that has surrounded the closure. If he does not do that, he is doing his constituents a grave disservice. Secondly, will he join me in condemning the fact that at one stage a large deputation of opponents to the closure—they have the right to be heard—forcibly detained the regional chairman of the Yorkshire regional health authority, the regional administrator and the regional information officer? I cannot believe that the hon. Gentleman thinks that that was correct.
Thirdly, I call on him to condemn the threatening telephone calls that have been made to some of those 1051 involved in taking the closure decisions. If the hon. Gentleman thinks that democracy and the interests of his constituents are forwarded by threatening telephone calls, he is sorely and sadly mistaken. Fourthly and lastly, I hope that he will condemn the fact that the car of the chairman of Bradford health authority has been vandalised in its garage as a protest.
I hope that the hon. Gentleman condemns those four forms of action. I do not see him dissenting from that condemnation. I do not seek to put words in his mouth—
§ Mr. Madden
This has been a litany of the most extraordinary allegations, all of them, except the last, completely new to me. I should have thought that there was no sign of who was responsible for damaging the car. The Minister appears to be setting up a smokescreen to obscure matters and to allow him to leave the debate without answering the questions which are central to it. What will happen to the patients at Thornton View hospital? What money is being made available to modify Shipley hospital? Will the Minister confirm that, if Shipley hospital becomes a community geriatric unit, it will result in a net loss of more than 40 beds in Bradford district? They are the questions that the people of Bradford want answered rather than to hear the Minister indulging in hearsay allegations and making remarks of the sort that he has, which are wholly unfounded. If there is evidence about any of the matters to which he has referred, surely police inquiries should have been made and those responsible found, brought to court and convicted if guilty.
§ Mr. Patten
To talk of smokescreens and unsubstantiated allegations is a case, if I am guilty, of the pot calling the kettle black, given the dreadful smears that the hon. Gentleman chose to read out about the conduct of my right hon. and learned Friend the Minister for Health, myself and my hon. Friend the Member for Shipley. It is clear that the hon. Gentleman sings one song in the House and another in his constituency. In the five minutes that I have available let me address myself to the points that the hon. Gentleman made.
Services provided by the health authority for the elderly in Bradford are chiefly concerned with the prevention of long-term illness and disability, and quite correctly. It is the health authority's policy to ensure that old people are maintained in the best possible health, whenever possible at home, and to avoid unnecessarily prolonged stays in hospital. It will be the aim of the authority in future years to increase the number of beds of district general hospital sites, thereby making specialist services available for the acute care of the increasingly elderly and frail to whom the hon. Gentleman referred.
The quality of hospital provision for the elderly has improved considerably in recent years in Bradford. In January 1983, for example, a 30-bed ward for the 1052 assessment of elderly patients was opened at St. Luke's hospital, increasing the number of geriatric assessment beds to 88 at that hospital. There are improved staffing levels and facilities for rehabilitation and assessment.
The change in service philosophy that has occurred in recent years has resulted in a decrease in demand for geriatric beds. We serve patients and their demands, not buildings and the demands o f those who work in them, nor indeed the demands of Ministers. In Bradford there has been a decrease in demand for geriatric beds that is clearly demonstrated by occupancy levels.
§ Mr. Patten
The decrease in demand is at the root of the hon. Gentleman's arguments. Between 1977 and 1982, there was little overall change in the number of beds available to geriatricians for the treatment of their patients, yet that period saw an increase of over one quarter of the number of geriatric in-patients treated, while the average number of geriatric beds occupied fell by one eighth. To put it another way, despite the greater services being delivered, the average number of empty beds in the district increased from 21 to 82.
Not just services for the elderly provided by Bradford area health authority have undergone a substantial improvement. When considered in relation to resident populations of more than 64 years of age, the Bradford health authority had more geriatric beds than any other district in the Yorkshire region, with more than one and a half times as many geriatric beds as the national average. Similarly, it has many more nursing staff than other districts, nearly one and a half times as many district nursing staff as the national average helping to look after elderly people. I shall not use emotive phrases like "over-provision". All that I am saying is that Bradford is pretty well provided for in comparison with Yorkshire, as well as in terms of the national averages.
We all know that, while pressure is put on the health service from demographic trends there is a need to look ahead and consider their implications with care. The position at Bradford is not the usual one. Contrary to the pattern found in most localities, the set of population projections in general use for planning in the Yorkshire region shows a reduction of 4 per cent. in the number of Bradford health authority residents who will be over the age of 65 in the next few years. Rather than a population explosion in the next few years, the picture shows the reverse.
Against that background, my right hon. and learned Friend the Minister for Health took the decision about Thornton View hospital. It needs replacing and patients deserve better accommodation, despite the attentions of the staff to provide a homely and caring atmosphere. It was against that background that my right hon. and learned Friend took the decision about Thornton View and Shipley hospitals. I thank my hon. Friend the Member for Shipley for his courtesy in attending the debate tonight.
§ Question put and agreed to.
§ Adjourned accordingly at twenty eight minutes past Two o'clock.