HC Deb 15 April 1986 vol 95 cc849-54

Motion made, and Question proposed, That this House do now adjourn.—[Mr. Lennox-Boyd.]

11.37 pm
Mr. Den Dover (Chorley)

I rise to raise a most important matter that concerns my constituency—the utterly inadequate hospital facilities at Chorley. My hon. Friend the Member for South Ribble (Mr. Atkins) may well join us, but he has a heavy cold.

The Royal Preston hospital has been built to the north of Preston at a cost of many tens of millions of pounds. Local inhabitants believe that it was built in entirely the wrong position. It might have been put there to provide some Lancaster university medical school teaching facilities, but the population growth has been to the south of Preston, in the boroughs of Chorley and South Ribble. The population in those boroughs is now more than 190,000, as compared with the town of Preston's 120,000 and the adjacent West Lancashire district council's 120,000.

We believe that the Royal Preston is in the wrong place. Spending on hospital facilities, in accordance with the Central Lancashire new town plan, should have been south of Ribble and Preston. When launching the new town, Richard Crossman said that all the basic infrastructure should and would be provided during the life of the new town, which has just been disbanded. All the infrastructure—roads, sewers, gas and electricity—is there, except proper hospital facilities in the southern part of the Central Lancashire new town.

The population in the boroughs of Chorley and South Ribble is rising, whereas it is falling in every other district health authority in the north-west. Why do we not have adequate hospital facilities in Chorley and in South Ribble? A few years ago, when we reorganised the Health Service along the lines of district health authorities, the Minister of Health was helpful and Chorley and South Ribble health authority was formed in April 1982. At that date we expected the start of the major phase 3 work at Chorley to be about now, four years later, but the current date is 1989–1990 and I have reason to believe it may have been put back to 1991 or 1992 or even later.

The new district health authority was set up against massive opposition from the north-western region which did not want us to be separated from Preston. Lancashire area health authority, a remote body, did not want Chorley and South Ribble splintered off. I have already said that our population is now more than 50 per cent. larger than both Preston and South Lancashire, the two adjacent boroughs. The Department of Health has been fair in the allocation of resources to the north-west over the last five or ten years. It has used the resource allocation working party to feed additional percentage resources into the north-west.

My complaint is about the attitude of the north-western regional health authority to the districts. Large conurbations in the Greater Manchester area have over-provision of health authority services and there is under-provision in the shire county of Lancashire. I want to speak about that imbalance. Believe it or not, in Chorley we have no medical beds. We have no orthopaedic beds, no pathology services and totally inadequate X-ray facilities.

This is a new district health authority catering for some 190,000 people. West Lancashire, which is next to us, has had all the facilities for several years and is getting a new major phase of work which is basically designed to renew those facilities. Areas in which there are no facilities should be served first before we set about renewing facilities in other areas.

As I have said, in some areas of Greater Manchester there is massive over-provision of health facilities. I should like to compare the number of beds provided per 1,000 of population. In Chorley and South Ribble, the figure is 129 beds for 190,000 people; West Lancashire, 400 beds for 120,000 people; and Preston more than 1,000 beds for the same number of people, 120,000. That is a massive imbalance. One might say that we have the Royal Preston hospital and have spent tens of millions of pounds on it. What should we do? We do not want inadequate usage of those facilities, but we should be changing its role slightly so that it becomes a regional specialty centre, perhaps moving cardiology from Blackpool to Preston. That is the sort of role that the Royal Preston should play in future, rather than asking people from Chorley and South Ribble to go through or around Preston to go to it.

Access to the Royal Preston is appalling. Many of my constituents have a round trip of up to 30 miles and that takes them two to two and a half hours by public transport in each direction. As well as the cost, especially if more than one member of the family goes there, and of course people visit every day, that is unacceptable in today's world where we are saying we want a local health service run locally for the benefit of local people.

The region has a 10-year strategy programme. That is set out in a well-produced document and on page 20 the overall aims in the 10-year programme are summarised. Two of those aims are:

  1. "(iii) To correct major deficiencies in the availability of health care
  2. (iv) to ensure a more equal access to services by people throughout the region, no matter where they live;"
I have already highlighted the inadequacy of some parts of the provision of health care. As for access, in the Greater Manchester area nobody is more than six minutes from a major hospital. That has to be contrasted with Chorley and South Ribble, where one is at least 15 to 20 minutes, at speed, away from the Royal Preston hospital, the nearest major hospital.

The capital spending allowances in Chorley and South Ribble are inadequate. It has the lowest revenue budget expenditure per 1,000 members of the population. Last summer, the region changed its priority criteria and said that it would allocate capital spending if districts are able to make revenue savings. We cannot do so. Chorley and South Ribble has the lowest revenue budget of all. It would do so if it could, but it is impossible for it to make savings.

A summary of the situation shows that in the last seven years since this Government came to power the starting date of 1984–85 or 1985–86 has been pushed back to 1991–92. That shows that, every seven years, the starting date is being deferred by seven or eight years. If those trends are projected forward, by the year 1992–93 the starting date for the major upgrading, phase 3 works, costing about £20 million, will have been put back to the year 2000. In other words, the works may not start until the next century.

The people of Chorley and South Ribble will not accept that. There have been marches of 20,000 people and petitions galore. There have also been all sorts of hospital crusades. I applaud the efforts of those who have complained about the lack of facilities. The casualty service is now open each day from 9 o'clock in the morning until 8 o'clock at night, but Ormskirk and the Royal Preston are open for 24 hours a day. This imbalance in hospital services is unfair.

After the Minister for Health visited the north-western region last July, he wrote a letter to the regional chairman in which he said: You told me of your planned capital developments which are fundamental to resolving the problems of equality of access and confirmed that the capital programme has this as a prime objective. As a back-up—paragraph 2(iv)—he said that the region was going to Submit a full 10 year Capital Programme reflecting the policies and priorities contained within the Regional Strategic Plan and in particular show how this will take into account the need to address the current imbalance of service provision to facilitate equality of access. I have referred to the unfortunate imbalance in access and to the lack of facilities. They are the matters that I am raising in this debate.

One might say that it is up to the region to allocate priorities between its various districts. I accept that but, as in so many other aspects of a Member of Parliament's job, there are appeal procedures. Every time that these matters are raised with the region, we face the same brick wall, the same stone wall, the same nil response. An officer from the Department of Health and Social Security should take a look at this as an independent observer. Chorley and Ribble could give evidence and the region could give evidence. I am sure that the observer would accept what I have said this evening and would say that something should and must be done about the lack of medical facilities and the lack of reasonable access.

As a fall-back, the provision of private funding ought to be looked at. Too often we say that this must be met by Government spending—in other words, by the taxpayer. Is it right and proper that although many Government Departments rent office accommodation throughout the country, the private sector is not allowed to provide buildings and rent them to us? Something happened a few years ago in Sussex. Perhaps Chorley should follow that model.

We will do everything possible to achieve the earliest possible starting date for the Chorley upgrading work. I hope that the Under-Secretary of State will at least keep an open mind and not turn down the possiblity of somebody coming along and taking an independent look at the problem.

11.49 pm
The Parliamentary Under-Secretary of State for ealth and Social Security (Mr. Ray Whitney)

I am glad to have the opportunity to respond to my hon. Friend the Member for Chorley (Mr. Dover) and to congratulate him on using the possibilities of the debate to bring before the House the problem of the expansion and upgrading work of Chorley hospital. My hon. Friend's assiduity in pursuing the interests of his constituents, particularly in the health sphere, is well recognised, and it was certainly well demonstrated in his remarks tonight.

It will not be possible for me to respond in detail to all the points that my hon. Friend has made, because it would not be fair to him for me to give an instant response particularly to one or two of the interesting proposals that he has made. However, I assure him that I will consider them most carefully in conjunction with my right hon. Friend, and carry them further in due course.

I recognise the justified concern which my hon. Friend has about the delays in starting work on phase three of Chorley district general hospital. Phase three is a major development which is likely to cost something of the order of £21,295,000 which will transform Chorley hospital into what we all understand as a proper district general hospital.

As my hon. Friend has told the House, at present his constituents in Chorley and south Ribble district have to look to the new Preston royal hospital for acute services. This is a fine £22 million hospital which was opened in 1983 by Her Royal Highness the Princess of Wales. This arrangement remains since before 1982 when Preston, Chorley and South Ribble were one district. My hon. Friend understandably wants Chorley to have its own hospital and for his constituents to enjoy the same access to health services as people in other parts of the region which are undoubtedly better provided for.

In regard to the north-west as a whole, my hon. Friend recognised that we have, indeed, increased massively the health services in the north-west region as a whole under this Government. It is better funded and managed, and treating more patients than ever before. Since 1978–79, health service spending in the region has increased from £380 million to £809 million in 1984–85. That in real terms represents a growth of 19.6 per cent. Taken together with the region's allocation for 1985–86 and 1986–87, the current financial year, the expenditure in real terms in the region is forecast to rise by some 21 per cent.

As regards capital allocation, there is a good story to tell. I recognise the point that my hon. Friend makes about allocation within the region, but it is important to set that in context. The north-west region has the second highest capital allocation in England, amounting in 1986–87, the current financial year, to £71.52 million. On a per capita basis, the region's basic capital allocation works out at £14.89 for every man, woman and child in the region compared with an English average of £12.70. However, the problems and inequalities exist.

My hon. Friend drew the attention of the House to the question of access. In this respect, his constituents in Chorley and the people in South Ribble fare poorly compared with the better-off districts in the north-west region, notably Manchester and Trafford. I have to say that that they are not the worst off, and their access rate for all surgical specialties is slightly above the regional average because of their closeness to the new Preston royal hospital.

The region says—with which I hope my hon. Friend will agree—that it must build to make it possible for people to have better access. Hospitals have to be in the right place. Over-bedded districts must yield up resources for developments in deprived districts. I believe that this is happening and that, recognising as I do the disappointments, across the region great progress has been made. In particular, acute beds are being rationalised from Manchester. Indeed, Ministers are openly supporting the authorities in Manchester who are carrying through this change so that all the people, no matter where they live in the region, can have more equal access to health services.

The key to the whole process is making better use of existing buildings. But the region has found that in order to do this it will need to build in some already comparatively well-off districts. If the new buildings are cheaper to run than the old and if revenue and capital resources will be released, this makes sense. This is why, when the capital programme was drawn up last year, the highest priority was given to schemes releasing a considerable level of revenue savings, at least £100,000 per annum. So, the region has been told that Ministers will agree to such developments only if, first, it can be shown that the resources released will benefit deprived districts and, second, it is monitored by the region and the Department. The region has accepted that.

I can appreciate my hon. Friend's concern, as phase 3 at Chorley appears to have slipped back in time. I understand that what has happened is that the region's capital programme was drawn up with some over-commitment built into the early years. The regional health authority took the view that for planning reasons over-commitment can act as an incentive to progress and assist in ensuring that the regional health authority can respond to slippage, so that maximum use is made of capital allocations. On this basis, the date previously shown for Chorley's hospital was the earliest possible date, if other things did or did not happen. I understand that everybody at Chorley, and in other districts, appreciated that there was over-commitment in the early years.

After a year's experience Sir John Page, who recognises fully the problems and concerns voiced so well by my hon. Friend, decided that this was not sound resource management or the best way to cope with slippage. Instead, the region is now to publish a 10-year programme which is affordable and realistic and in which the over-commitment will be eliminated as far as practical. The regional health authority is shortly to consider a new capital programme on this basis. Phase 3 is now proposed for 1990–91. I understand that this does no more than confirm the realistic starting date for the scheme, were there to have been no slippage under the old programme. I am assured that my hon. Friend now has no need for further conjecture on future delays—there is no question of it being the year 2000. Chorley phase 3 has a fixed priority in relation to other schemes which will not be changed.

To complete the picture, I should say that my officials are considering with the Treasury the region's plans for phase 3. This is a clear indication of the regional health authority's commitment to the scheme. I assure my hon. Friend that no unnecessary delays will stand in the way of formal approval in principle for the scheme.

What I have been able to say will by no means have satisfied my hon. Friend, but I hope that he accepts that the north-west region and Ministers have a deep concern to establish a capital programme soundly based on the regional strategy. That strategy is committed to reducing the inequalities of access throughout the region. My hon. Friend should recognise that, to achieve this, resources must be released from comparatively well-provided districts to facilitate developments in relatively deprived districts. That is happening. I assure my hon. Friend that we shall continue, in co-operation with the regional and district health authorities to ensure that that progress continues. I shall study the proposals which my hon. Friend has made to the House and will be in touch with him shortly.

Question put and agreed to.

Adjourned accordingly at two minutes to Twelve o' clock.