HC Deb 09 November 1988 vol 140 cc459-66

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

2.47 am
Mr. Michael Latham (Rutland and Melton)

In September, the Leicestershire health authority put forward a series of drastic proposals for public consultation. They affect all hon. Members with Leicestershire constituencies, and I have already advised you, Madam Deputy Speaker, and my hon. Friend the Minister, that any Leicestershire Member who seeks to catch your eye will have my agreement to take part in this short debate.

Before that, I record the presence of my hon. Friend the Member for Loughborough (Mr. Dorrell). As a Whip, he is not allowed to speak but I know of his tremendous commitment to the Health Service in his constituency. The hon. and learned Member for Leicester, West (Mr. Janner) and my hon. Friend the Member for Bosworth (Mr. Tredinnick) are away from the House on important business, but have sent their good wishes; my hon. Friend the Member for Harborough (Sir J. Farr) is, alas, unwell and awaiting an operation, but he has always been a tower of strength in lobbying for Leicestershire and he telephoned his good wishes from his sick bed.

The health authority is short of cash, especially the extra money needed to open phase 2 of the new Glenfield district hospital in 1990–91, and phase 4 of the Leicester royal infirmary in 1991–92, together with two small schemes in Loughborough and Hinckley. Those schemes alone will produce a deficit of more than £4 million. If the authority proceeds with other desirable improvements the deficit will be nearly £8 million, and by 1994, if nothing is done, it will have risen to £21 million.

The authority is trying to achieve savings by completely closing eight hospitals, transferring some wards between the various city hospitals and closing all four rural maternity units. Two of the hospitals scheduled for closure—Framland and Catmose Vale—and two of the maternity units—at St. Mary's, Melton Mowbray, and at Rutland memorial hospital—are in my constituency.

Leicestershire health authority has long been underfunded. When I was a new Member in 1974 Leicestershire received only 75 per cent. of national average NHS funding. With all the other county and city Members of Parliament at that time I went to see Mrs. Barbara Castle, the then Secretary of State. We urged her to improve Leicestershire's share of national resources and to permit the proposed new Glenfield hospital, at that time threatened with the axe, to be built. As a result of sustained all-party pressure and the good effect of the resource allocation working party, Leicestershire now gets 96 per cent. of the NHS national average, which is still not enough, but better than 75 per cent. The new Glenfield general hospital has been open for a couple of years, and funding phase 2 of it constitutes part of our financial problem.

I am delighted to see my hon. Friend the Minister here, even at 2.48 am, but I must press her, first, to defend the RAWP formula. It is essential to Leicestershire, and we must proceed to 100 per cent. average funding as quickly as possible. Some people, perfectly honourably, have suggested mothballing the new Leicester units. I cannot support that, having pressed for almost 15 years for them to be built. Many of my constituents will benefit from them. I press my hon. Friend to ensure that some of the new money announced for the NHS by the Chancellor in his autumn statement be urgently directed to Leicestershire to help it cope with its immediate cash crisis.

Several of the hospitals scheduled for closure were announced as long as over three years ago in the authority's 1985 strategic plan. Both Framland and Catmose Vale hospitals in my constituency are old hospitals. Splendid care of the elderly takes place at both units and I pay tribute to the staff. However, I do not oppose their closure, and nor do many of my constituents. We merely demand that some of the large sums released from the sale of the land be ploughed back into adequate provision of extra beds for the elderly in other hospitals in Melton and Oakham and into really effective community care. It will not be adequate to rely solely upon the private nursing homes, although they have an important part to play, and it will be wholly unsatisfactory to take maternity beds at the Rutland memorial hospital for the purposes of geriatric care. Rutland people expect additional provision to be made for the elderly at Rutland memorial hospital, with the use of some of the money from the sale of Catmose Vale, as was specifically promised in the 1985 strategy document. The elderly patients and the splendid staff deserve better than the health authority's present proposals, which seem ill thought out and inadequately related to the local needs of elderly people, who need to be visited by their families and friends.

Let me deal with the shameful proposal to close the rural maternity units at Oakham and Melton Mowbray. In my view, this proposal shows a complete lack of concern for the wishes of ordinary people in rural areas. In 1987, there were 296 maternity beds in seven hospitals throughout Leicestershire, providing for 10,789 deliveries. The new proposal is for 220 beds in two hospitals, both in Leicester city, for 11,000 deliveries, with the remaining five units being closed down.

That is the mentality of the NHS production line: grab them in and shove them out again and never mind about the wishes of the mother and the family. Those crude proposals have aroused immense anger in my constituency—anger that I share. They are dressed up as being good for mother and baby, allegedly because the birth will take place in a modern, hi-tech general hospital. The proposals ignore the fact that the two units are safe and friendly and, above all, accessible to women living in rural areas.

The NHS has been closing rural units for far too long. I can best illustrate that point with a personal example. My eldest son James, who is nearly 13, was born in November 1975 in Corby maternity unit, four miles from my home in Gretton. My younger son Richard, who is 9¾, was born in Kettering general hospital, 13 miles away, in February 1979 because the Corby maternity unit had closed in the intervening years. My wife went into labour with Richard, my younger son, in the middle of a massive snowstorm. The ambulance just got her out of my village before lunch, and she was the last person out of the village that day. I could not get out because I had to look after James at home. I did not see Richard until 24 hours after he was born and the roads had been cleared by snow ploughs.

That is the miserable prospect that awaits my constituents—except that the distance from some of the Rutland and Vale of Belvoir villages to Leicester is over 30 miles, often along poor roads and perhaps in fog, ice or snow. No, thank you very much. That simply is not tolerable, and I will not let it happen, especially when any financial saving from such closures would be negligible, and the inconvenience, expense and worry for my constituents quite unacceptable.

I have great personal affection and respect for my hon. Friend the Minister. I shall make her an offer that she cannot refuse. If she wants my support for her conduct in the House of the NHS she will tell Leicestershire health authority here and now that the rural maternity units must be saved. If she does not, I promise her that I will make her ministerial life a misery until the units are saved. My constituents are simply not to be treated in that cavalier and unreasonable manner by the health authority. My hon. Friend the Member for Harborough has said the same. He has told the authority of his complete opposition to the closure of the maternity unit at Market Harborough cottage hospital. His wisdom, experience and knowledge of his constituents over nearly 30 years in the House deserve respect.

Finally let me say a word to the Leicestershire health authority, to which I shall also make an offer that it cannot refuse. I have a letter from the chairman, Mr. George Farnham, who is an old and valued friend of mine. It is a stick of political dynamite, and I intend to explode it now. He wrote to me 14 months ago on 8 September 1987, referring to maternity services in Melton and Rutland: There is no question in my mind or in the minds, to the best of my knowledge, of our Gynaecologists about the retention of the peripheral maternity units; they will be retained as presently constituted. I hope this puts your mind at rest on this matter. Mr. Farnham is a man of honour. I am sure that he will now tell his colleagues and staff in the health authority that the proposals cannot proceed. The maternity units must be saved forthwith and the battle should be won tonight.

I now invite other hon. Members from Leicestershire briefly to express their constituency concerns.

2.56 am
Mr. Keith Vaz (Leicester, East)

I am grateful to the hon. Member for Rutland and Melton (Mr. Latham) for the opportunity to take part in the debate. I congratulate him on the impressive stand that he took in the debate on the imposition of charges for eye and dental tests which we both agree will deny many people, especially the elderly, the right to medical services.

It is appropriate that we should discuss the Health Service in Leicestershire because a sickness is spreading through it. The root cause is, of course, resources. When my day began at 9.30 am yesterday I attended, with many mothers and babies from the constituencies of the hon. Member for Rutland and Melton and the hon. Member for Leicestershire, North-West (Mr. Ashby), who is also present in the Chamber, a lobby of the health authority in Princess road, Leicester. The object was, of course, to protest against the closure of the eight hospitals. Two have already been mentioned. The others are the Ashby and district hospital, Blaby hospital, Fielding Johnson, Higham Grange centre, the Regent hospital and the Roundhill maternity home. When one adds to those the proposed closures of wards at Groby road and Leicester general hospital in my constituency and the possible closure of the Towers hospital in 1992, one realises that the Health Service in Leicestershire is in crisis.

I pay tribute to the work that has been done by parents and staff and by unions such as NUPE and COHSE to oppose the closures. There are currently 8,500 people on the hospital waiting list in the Leicestershire district. There are 600 people waiting for orthopaedic operations; and it will take 60 full days of surgery to clear the urgent list, the only definition of urgency in such cases being that of indescribable pain. In Leicestershire it takes months or even years to get a hearing aid approved and fitted.

The morale of staff at local hospitals is at an all-time low. On Saturday 12 nurses came to my surgery at the Coleman neighbourhood centre. Sister Sandra Burgin has been working for more than 20 years as a theatre sister at the general hospital. Last week her managers announced to her that she would be receiving a pay rise of 38p per week. She says that that is a disgrace, and I agree. Ancillary workers at the hospital are being denied a pay rise of just £1.50 per week. The Government have robbed the Leicestershire health authority of more than £20 million in the past five years, and it will be a further £8 million short this year.

So far, 34 right hon. and hon. Members have signed my early-day motion opposing the closure of the eight hospitals. It must be pointed out, however, that the health authority still wastes a great deal of money. For example, in the general hospital in my constituency the health authority has decided to undertake a scheme called QED, resulting in hundreds of large red feet stickers being spread all over the hospital in an attempt to save money. That scheme has cost several thousands of pounds.

We all know where the blame lies and who is responsible. We know who has betrayed the county and who has robbed the people of Leicestershire of a decent Health Service and turned it into a jumble sale. I gave notice before the debate informing the Chancellor of the Exchequer, the right hon. Member for Blaby (Mr. Lawson), that I should be talking about him. I describe his attitude and conduct as hypocritical. Blaby hospital is in his constituency, but he has not lifted a finger to prevent its closure. This morning a petition of 10,000 signatures was presented to save the hospital.

Last week in the House of Commons the Chancellor promised £2 billion for the Health Service. I should like to know what will be Leicestershire's share. The Chancellor should be ashamed of himself because, as a Leicestershire Member of Parliament, he has taken part in a conspiracy to deny the people of Leicestershire their fair share of services. We want the cash, and we want it now.

3 am

Mr. David Ashby (Leicestershire, North-West)

I am grateful to my hon. Friend the Member for Rutland and Melton (Mr. Latham) for initiating this debate.

We have just heard something of a political tirade from the hon. Member for Leicester, East (Mr. Vaz). He was not a Member in 1983 and so would not remember the hard work of my hon. Friends the Members for Rutland and Melton, for Harborough (Sir J. Farr), for Loughborough (Mr. Dorrell), the hon. and learned Member for Leicester, West (Mr. Janner) and myself to ensure that Leicestershire received a fair share of the national RAWP average. It was down to 92 per cent. and the position was acute. It is now up to almost 97 per cent. That is not good enough—we want 100 per cent.—but there has been a definite improvement. I am grateful to all those who worked so hard to achieve that.

We can appreciate the difficulties in which the Leicestershire health authority finds itself. In 1979 it had old hospitals, but all plans were put on the shelf because the previous Government had failed to provide sufficient funding for the NHS. Leicestershire health authority was desperate. It had to dust the plans off the shelf and try to provide the services that Leicestershire needed. It did not have sufficient acute services. Since 1984 there has been £18 million of new investment and a vast increase in the services required, above and beyond those that could be readily appreciated. As a result, the health authority is in some difficulty. It is not of its own making or that of the Government; it is simply a fact.

There has been enormous investment in Leicestershire, and we should be grateful to the Government for that. Leicestershire has centres of excellence. If I were to be desperately ill, I would rather be ill in Leicestershire than anywhere else. A new hospital was opened recently at Coalville. It provides much-needed services for the elderly. Because the population is becoming older, there is a need for those services. The hospital includes what I believe to be a very important service, the general practitioner beds. They are vital to the community. Many families who look after elderly relatives need some relief for a short time. Often one elderly person looks after another who is seriously ill, and he needs to have a few days break every six weeks or so.

Although I am pleased about the opening of Coalville hospital, it has placed the Ashby district hospital at risk. It has been in existence for more than 100 years and is very much loved. It has a maternity unit, but the difficulty is that there are only 3.4 births per week in the unit. Bed occupancy is only 33 per cent. Only easy births take place there; difficult births take place at the royal infirmary. The average stay is live days. I have spoken to the experts—not the doctors, but the nurses who run the unit—who say that they can never predict whether a birth will be easy or difficult. One in 10 is difficult and the patient has to be rushed to a major hospital. The nurses feel that the mothers are too much at risk. That is just one view and there are others. Mothers say, "Mothers are entitled to choose", but it is often those who have had an easy birth who say that. Those who had a difficult birth say, "Thank goodness we have these centres of excellence in Leicestershire."

Those are the two sides of the argument, which is a sad one. We must look at the overall picture and appreciate the difficulties of the area health authority. We must stress that it is providing excellent NHS facilities for the critically ill for the whole of Leicestershire.

3.5 am

The Parliamentary Under-Secretary of State for Health (Mrs. Edwina Currie)

I congratulate my hon. Friend the Member for Rutland and Melton (Mr. Latham) on winning the ballot. He takes a great interest in the welfare of his constituents and health care nationally. I took seriously his threat to make my life a misery, but I have to tell him that so long as I hold this great office of state and see daily many marvellous examples of good care in the NHS and outside, my life is a joy and nothing that he can do can dent it, even at 3 am.

I welcome my hon. Friend the Member for Leicestershire, North-West (Mr. Ashby) who is my neighbour. I join in his delight at the new Coalville hospital which has been welcomed and enjoyed by his constituents. I hope to see it before too long. I am sorry that our hon. Friend the Member for Harborough (Sir J. Farr) is unwell and I hope that my hon. Friends will convey to him my good wishes for a successful treatment and speedy recovery. If there is anything that I can do to help I should be glad to make myself useful, but I am sure he is being extremely well looked after at home.

I also note the presence of my hon. Friend the Member for Loughborough (Mr. Dorrell) in his place on the Front Bench. That surprises me because I have in front of me the profile of Leicestershire district health authority produced by my Department and dated 31 October 1988 in which he, with his majority of 17,648, is recorded as a Labour Member. I think that that is a mistake and I am glad to have his support tonight.

I note also what the hon. Member for Leicester, East (Mr. Vaz) has said and shall comment on his points as I proceed.

Trent regional health authority has benefited enormously from Government policy in recent years, as all present acknowledge. Ten years ago, when the party which the hon. Gentleman supported and probably still supports was in power, the authority was receiving £369 million. Last year it rose to just over £1 billion—an increase of about 14 per cent. in real terms—and Trent's initial cash allocation for this year was increased by 6.3 per cent. to over £1,050 million, which is well above the national average increase of 5.7 per cent. That shows both how much we care about the region and the tremendous improvement, particularly in the position of the regional health authority in relation to RAWP.

As I said on Monday night when my hon. Friend the Member for Derbyshire, West (Mr. McLoughlin) was drawing attention to issues on health care also covered by Trent regional health authority:

We should not underestimate the impact of the Trent regional health authority or of the National Health Service generally on local life. More than 660,000 in-patients were cared for in Trent hospitals last year and total employment in the regional health authority stands at about 75,000 whole-time equivalent staff. The amount of money contributed to the local economy by the health authority is considerable."—[Official Report, 7 November 1988; Vol. 140, c. 149.] Leicestershire health authority is the biggest district in the country. It looks after a population of about three quarters of a million. It is a major centre for teaching and health care. It looks after about 100,000 in-patients a year and nearly 600,000 out-patients, with over 12,000 staff. In the past four years there has been an increase of more than 500 in front-line manpower—doctors and nurses. That is hardly the picture of misery that was painted by the hon. Gentleman. This year its capital allocation, for example, plus estimated income from the sale of land, will come close to £20 million.

When I became a Member of Parliament, Leicestershire heath authority was receiving £116 million a year. Last year it was £162 million and this year it is £177 million, which, as my hon. Friend the Member for Leicestershire, North-West said, demonstrates the improvement service and funding. Indeed, it gives the lie to what the hon. Gentleman said. So much for Government robbery. If that is robbery, most local people would rather have more of it than less. The development of services in Leicestershire was described in the strategic review which Leicestershire health authority recently produced. I understand that it is out for consultation, so hon Members will realise that I am constrained in what I can say.

In 1984, the health authority started thinking about future services. The strategic plan was approved following wide public consultation and published in 1985. A number of the health authority's present plans were not in the plan published in 1985. The intention is to provide a first-class acute specialist service from three general hospitals—the Leicester Royal infirmary, Leicester general and Glenfield hospital, which are all in Leicester—but at the same time to redevelop smaller hospitals around the county into a series of community hospitals mainly concentrating on the care of elderly people, in which the growth of need is likely to be sharpest in the next few years.

I heard what my hon. Friend the Member for Rutland and Melton said about geriatric services, but we cannot escape the fact that there will be a rapid increase in the number of elderly people. They will increasingly need our help in the future.

In the short time that I have left I shall concentrate on maternity care. I heard what my hon. Friend the Member for Rutland and Melton said about maternity care, but I hope that he will think that his criticism of the big hospitals was somewhat over the top. I shall not rehearse my obstetric history, but I had both my children at a major teaching hospital in the midlands, and I am glad that I did. I was booked as a low-risk mother, as most people with my background and housing would have been. I was not low risk and experienced problems, and I was extremely glad that everything was on tap. My baby was delivered in a slightly less than usual way, but she is fine. Had I had these problems elsewhere, we might have formed part of the statistics to which I shall refer in a moment. Throughout the country, hundreds of women receive excellent care in the major hospitals and it is not appropriate to infer that because a hospital is big it cannot give kindly care or that the quality of care is diminished. I hope that that is not the case, and I am certain that it is not in Leicestershire.

My hon. Friend the Member for Leicestershire, North-West drew attention to something that is of significance in the papers prepared for consultation by the district health authority. The number of occupied beds for maternity care at Ashby hospital in the year ended 31 March 1988 was 5.9. That is quite a reasonable occupancy, but it suggests that there is a gap. At Roundhill there are 30 beds, of which 15 are unused, and the number of occupied beds is only 6.1. At St. Mary's, Melton, there are 10 beds, of which only five are used. At Rutland Harborough there are eight beds, of which three are used. At Loughborough there are eight beds, of which six are used. By "used", I mean the average number of occupied beds. The number of births per bed per year in those hospitals in 1987 ranges between about 32 or 33 at St. Mary's, Melton, and 11 at Market Harborough.

I accept that in the strategic plan, the four small hospitals—particular reference has been made to the GP maternity beds—were regarded as remaining in use until the end of the planned period. My hon. Friend the Member for Rutland and Melton was right to draw attention to that, but it should be noted that the health authority decided in May 1987, following consultation and with agreement, that the total number of GP maternity beds in Market Harborough, Oakham and Melton Mowbray should be reduced from 56 to 31 in view of the significant under-use. The rate of use of some of those beds after that reduction is still less than half. Their main use is for out-patients, and that will remain so. Wherever babies are being born in Leicestershire, they are not, on the whole, being born in the small maternity units.

I am told that ante-natal care will be provided at each of the four hospitals and the accommodation released is intended for a variety of uses, most of which will require accommodation for geriatric patients, additional support services and out-patient clinics.

In a question to my right hon. Friend the Leader of the House, my hon. Friend the Member for Rutland and Melton said that he wanted no generalities and expected to hear that the proposals to close all rural maternity units have been dropped?"—[Official Report, 3 November 1988; Vol. 139 c. 1189.] The proposal has not been dropped. The health authority has not finished consultation on the matter. The proposal has not come before Ministers. That will probably happen next spring, but only if there is failure to agree locally. Whatever decision is taken it will be in the interests of the patients, and that includes unborn children. I carry the burden of knowing that 45 women in the United Kingdom died in childbirth last year. Although we announced yesterday that we have the lowest infant death rate on record, in comparison with other countries Britain has a worse record. The death rates in other countries of tiny babies have tended to fall faster.

I am grateful for this opportunity to listen to the views of my hon. Friends. The debate has shown again their interest in their constituents. I hope that they will take on board that we are trying to provide the best service that we can. I hear the commitment that my hon. Friend the Member for Rutland and Melton has made to the small maternity units and we shall ensure that his views, those of his constituents and other hon. Members are taken into Account.

Question put and agreed to.

Adjourned accordingly at fifteen minutes past Three o'clock.