Ormskirk General Hospital (Hansard, 16 March 1984)

§ Mr. Kenneth Hind (Lancashire, West)
The subject of this Adjournment debate is the construction of a new and modern hospital wing at the present Ormskirk general hospital in west Lancashire.
The Ormskirk general hospital is the main acute ward, operating, emergency and accident centre for west Lancashire and is based upon Ormskirk and Skelmersdale, and covers the large area of surrounding agricultural villages.
Until 1982, the plans that had been in force for many years to construct a new hospital at Ormskirk had been one of the priorities of the North-West regional health authority, and, until 1983, it was planned to construct the hospital in 1986–87. It is now being reconsidered under the capital programme for that region, and is likely to slip back in terms of date of construction and priority behind a hospital that it is proposed to construct at Chorley. This is not satisfactory, and I wish to explain why the hospital is necessary for the region in future.
The Ormskirk general hospital is the main general and surgical hospital for an area stretching north-south from the river Ribble, in the north, to Rainford on the outskirts of St. Helens, in the south, and from Southport and Formby in the west" to the outskirts of Wigan. It takes into the area two small towns, and a population of well over 100,000. It is the main emergency and accident centre for that area, and it is ill-equipped to provide the kind of services which it is called upon to provide.
The major problem with the hospital is that the major acute wards are situated in nissen huts, built in the early 1940s for the treatment of wounded service men who at that time were taken to what was then a cottage hospital on the outskirts of Liverpool. Those nissen huts were built with a temporary life of about 10 years. They have reached the stage where their repair is far beyond justifiable cost.
An acute patient at Ormskirk general hospital is taken from one of those nissen huts in an electric wagon, which looks very much like a milk float with solid steel sides, to the operating theatre along a small road that passes through the centre of the hospital. When the patient has been operated on, the reverse process is carried on.
This hospital is one of the few remaining hospitals which have such wards. Surely in 1984, some 33 years after the construction of these hospital wards, this cannot be an acceptable way to conduct health care. The fact that these wards will be very costly to replace is supported by the district health authority and the responsible works officer. The operating theatre at the hospital is some 50 yards from the wards, and the patients must travel on these carts come rain, hail, shine or snow. Whatever the weather, they have to experience this unsatisfactory procedure.
The operating facilities at west Lancashire, although very adequate, are not suitable for an area of this size as a civilian emergency centre, which is the role they are called upon to carry out. In recent years, the M58 was constructed through west Lancashire. If more than a handful of people are involved in an accident on the M58, and require surgery, they will have to be taken to Preston, which is 16 miles away. That cannot be acceptable. Their 681 chances of survival must be much more limited than if a proper hospital, capable of providing the necessary accident and emergency facilities of sufficient quality, were built at Ormskirk.
The third problem, which is not often considered, is the position of the staff and consultants at the hospital. They took their posts on the understanding that in future they would work in a modern, properly furbished hospital. It does their morale no good if their new hospital slips beyond the targets originally planned for 1986–87.
The answer to all those major problems is to provide a hospital wing that is capable of providing operating theatres, acute wards and proper medical facilities for the treatment of acute patients, all of which are associated with a modern civilian emergency centre. That is what was planned for the Ormskirk hospital in the third phase of its development, to be built in 1986–87.
I and all those living in west Lancashire urge the regional health authority to reconsider its position. New facilities would provide more than 130 acute beds, eight intensive care beds, children's beds, 17 adult care beds, five operating theatres, an accident and emergency unit, fracture clinic, six X-ray rooms, a plaster theatre, an anaesthetic department and various administrative and ancillary facilities.
The history of the hospital is simple; it goes back to the early 1950s. The then Liverpool regional hospital board prepared to extend facilities at Ormskirk to provide the services needed. That was abandoned in the 1960s when the new town of Skelmersdale was built a few miles away. It was proposed to build a new hospital in Skelmersdale in 1974, but that plan was abandoned because the population of Skelmersdale did not reach the projected 80,000. It has not yet reached 43,000, and there is no sign of its doing so. The regional health authority reconsidered its position and in the mid-1970s planned to build a general hospital at Ormskirk, in three phases.
Phases 1 and 2 were to be at Ormskirk, and phase 3 would be a community hospital at Skelmersdale providing a number of acute beds and various facilities. Having planned that, and given it priority, that plan then slipped back. When the International Monetary Fund was called in in 1976 by the then Labour Chancellor of the Exchequer, the right hon. Member for Leeds, East (Mr. Healey), £1,000 million was cut from the hospital building budget.

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

§ Mr. Hind
Yes. I am obliged to my hon. Friend for pointing that out. The hospital that was desperately needed slipped back in time. The Government are attempting to restore the capital building programme and recently asked the regional hospital boards to look at their programmes.
Since 1981, when the Chorley district health authority was created, Chorley began to be given priority over Ormskirk by the North-West regional health authority. The arguments must be examined. In the late 1970s, a magnificent new hospital was built in Preston for the patients of that area. At that time, Chorley was included in the Preston area. The people of Chorley can still go to their hospital and benefit from its facilities.
The arguments about Ormskirk have not changed. The facilities remain the same and the hospital remains the 682 same. The pressing need has not changed, but the regional health authority has changed its mind. The authority should have another look at the matter.
I hope that when my hon. Friend the Under-Secretary of State for Health and Social Security is asked to approve the regional health authority's capital programme, he will consider whether it is satisfying the needs of patients in west Lancashire when it is not providing them with what would surely be expected in every other town and city — a proper hospital with acute beds and a sufficient number of wards.
Money has been spent in west Lancashire, plans have been made and the hospital is just about ready to be built. The slippage means that all the time, effort and resources put into developing a modern hospital for Ormskirk are in danger of being wasted. That is not acceptable.
The patients of Chorley will not be harmed by waiting a few more years for the development of their hospital. The patients of Ormskirk have waited for 20 years, and that is long enough. It is time for reality to take over and for proper facilities to be provided for patient care.

§ The Under-Secretary of State for Health and Social Security (Mr. John Patten)
I congratulate my hon. Friend the Member for Lancashire, West (Mr. Hind) on the eloquent way in which he put the case for the proposed hospital in his constituency and on the vigorous way in which he has pressed the case on my Department. I have met him to discuss the matter.
My hon. Friend put his finger on the problem when he traced the difficulties in the Ormskirk area back to 1976, when the IMF had to come in. The resultant swingeing cuts were the biggest cuts in the capital programme that the NHS has ever known. That was the root of the problem. We are battling to put right the consequences of those cuts.
I am happy to tell my hon. Friend that we are building and designing more hospitals in the NHS capital programme than at any time since 1948. I hope that his remarks and the reasonable desires of his constituents can be set against the generally good picture of vigorous action by my Department, though I recognise the strong feeling in west Lancashire that the new hospital should be built there.
My hon. Friend eloquently described the problems in the existing hospital. I shall not bore the House by going over that ground or attempting to refute my hon. Friend's powerful descriptions of what goes on there. We certainly recognise that the accident and emergency department is overcrowded.
Not unnaturally, many people travel outside the district for treatment, mainly to Liverpool, thereby continuing the link that existed before reorganisation in 1974. However, they are more than offset by the numbers who travel into the district to use its hospitals.
Conditions at the hospital are certainly difficult and the care provided in the face of those difficulties is a tribute to the skill of the medical, nursing and other staff. I should like to pay a tribute to the ancillary staff who play such a great part in keeping the hospital going under difficult conditions when patients have to be moved around the hospital campus. No one doubts the need to improve hospital facilities in west Lancashire. Indeed, successive managing authorities in the area have rebuilt the hospital several times on paper, and I can well understand how 683 frustrated my hon. Friend's constituents feel at those paper edifices. They want to see the building — in bricks, mortar, concrete or in whatever form it is to be built.
My hon. Friend has already mentioned that before the 1979 strategic plan there were plans to give the district a new general hospital at Skelmersdale new town. I think it was that also which led to some delay in the project. The new town was then planned to grow into the district's major population centre. It did not actually happen. Skelmersdale did not expand to that size, and the old market town of Ormskirk—which I have not visited but look forward to visiting on some occasion in the future —remains the district's main town.
Consequently, in 1979 the North-West regional health authority proposed, quite reasonably and logically, to redevelop Ormskirk hospital as the district general hospital and to build instead a community hospital at Skelmersdale, more in keeping with the community pattern that has grown up in the area. Optimistically, a start date for building at Orkskirk was set for 1986. I say "optimistically" because the region has had to look again at its plans in the light of realities. For several years the North-West regional health authority has had a capital programme considerably in excess of what it could realistically expect to undertake. At the annual accountability review that we held with the north-west region about 18 months ago, we set the region the task of having a more realistic capital programme, recasting its capital strategy. I shall return to the question of resources in a moment.
I should like to pay a public tribute to the excellent new chairman of the North-Western regional health authority, Sir John Page, who has addressed the task of capital planning with the characteristic vigour that he brought to his life in business.
In the meantime, we have a stop-gap scheme, a two-year programme for the years 1983–84 and 1984–85. That was published to enable certain essential schemes to go ahead. Some schemes at Ormskirk were, as my hon. Friend knows—he did not have time to mention it in his speech — included in the capital programme; in fact, about £13 million has been spent by the region on capital works in Ormskirk over the past 10 years. So some money has been spent, although I am the first to admit that the new hospital has not even appeared on the horizon. The two-year interim plan does not mean that plans for the hospital have been abandoned. I have already said—and am happy to repeat—that the need for the hospital and for the redevelopment is not in doubt. The only issue is timing and money.
I said a moment ago that I would return to the question of resources, and I shall do that now in a little more detail. I hope that what I have to say will be of interest to my hon. Friend's constituents in west Lancashire. Under this Government, great strides have been made to reduce the inequalities between regions which have existed since the inception of the NHS. As my hon. Friend will be aware, we have built on what the Labour Government began in 1976 with the process of the regional reallocation of funds within the NHS.
Our plans are largely to complete a redistribution of health resources between the relatively well-off and the relatively deprived regions over the next 10 years. In order to do that we are obviously shifting money around the 684 country as fast as we possibly can and as fast as it is feasible to move it from the over-provided to the under-provided regions.
Next year, when resources to the NHS as a whole will be increasing by 1 per cent. in real terms, taking inflation into account—a sum of £850 million in all—the northwest region's increase will be slightly above the national average. It will be 1.3 per cent., bringing an extra—and, I hope, welcome — injection of cash 'into the region, the particular problems of which we appreciate. This means that the region itself will have one of the highest allocations per capita of capital money in the National Health Service in the year 1984–85. In the next financial year, the North-West regional health authority will have more than 11 per cent. of the total capital money available to all 14 of the regional health authorities in England. That is a fairly reasonable slice of the capital cake available. If it is of interest to my hon. Friend's constituents, that works out at £14.35 precisely for every man, woman and child in the region.
We do not look only to regions to fund capital projects from extra money that we can find through taxation. We also look to authorities to enhance their resources positively with savings from genuine and sustained cost improvement programmes which can be used to improve services. I pay tribute to Ormskirk, which has shown the way in this respect to other district health authorities—and there are 191 of them. It was spending far too much on energy, especially heating. It introduced a vigorous energy conservation programme and, as a result, it has been possible to provide funds for a brand new intensive care unit. That is a model for how other district health authorities should be seeking to make savings, whether in energy, catering, supplies or transport. Two weeks ago, for instance, we published a report which demonstrated that the National Health Service had more vehicles than drivers to drive them. District health authorities have a very important role to play in making savings so that those savings may be devoted to patient care, whether in the development of services or in the development of hospitals through capital works such as my hon. Friend is pressing upon me today.
We must expect regional health authorities to have realistic programmes to get the best use from available funds. We will not know—certainly I do not know—what the region's intentions are for the capital programme. I understand that an announcement is to be made towards the end of April. Despite the magnitude of the task and the different pressures facing Sir John Page and his colleagues, I am sure that they will produce a capital programme for the whole region that is very realistic.
I stress that the decisions about hospital programme building at the planning stage and about the order in which various projects should come on stream are rightly matters for the health authority. The authority has the necessary knowledge of local needs and conditions which we at the Elephant and Castle do not have. Ministers are not in the business of overturning decisions that the region makes on its capital programme. Therefore, I hope that my hon. Friend will understand if I cannot give him a start date for redevelopment at Ormskirk. That is a matter for the regional health authority, with its detailed local knowledge.
I do not believe that the man from the Elephant and Castle knows best. Sometimes we do; on other occasions we do not. Probably the people of Ormskirk and west 685 Lancashire would be the first to complain if all their decisions were second-guessed or taken from the centre. However, we are as eager as my hon. Friend to see progress in the constituency as soon as possible.
I can promise that when, in the next few months, the Department receives the regional health authority's plans for Ormskirk hospital, if they are forthcoming, they will be dealt with as soon as possible. There has been criticism in the past of the slow way in which the Department has 686 handled some of these projects. I assure my hon. Friend that that phase is dead and buried. We are determined to press ahead as fast as we can.
If there are no major problems, I see no reason why the scheme should not be approved in principle within 12 weeks of the Department receiving the region's submission. That will enable the proposals to go ahead, subject to the usual building control procedures, when they have a place in the capital programme. I am happy to give that clear pledge.