HC Deb 07 June 1989 vol 154 cc343-50

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

11.45 pm
Mr. David Hinchliffe (Wakefield)

I am grateful for this opportunity to raise the proposed closure of Snapethorpe hospital. It is of the greatest concern to my constituents.

At the outset, I express my gratitude to the Minister for agreeing to meet me in a fortnight's time to discuss this important matter. This debate is about the proposed closure of the most modern hospital in my constituency. It is about the potential for the future use of the excellent facilities and environment at Snapethorpe. It is about the questionable way in which the hospital has been run down over 10 years, and the way in which local opinion about the hospital's future has been treated with utter contempt by the Wakefield health authority and the Yorkshire regional health authority.

The debate is also about the Government's policy towards medium-sized and small hospitals such as Snapethorpe, and about the Government's policy on initiatives for community care of the sort put forward by the local authority in Wakefield in respect of Snapethorpe hospital.

The formal campaign to save Snapethorpe hospital from closure has recently celebrated 10 years of existence. It would be appropriate for me to express my sincere appreciation to the many people and organisations who have been involved in that campaign over 10 years. I should like to mention especially Alice Lannagan and Penny Roberts, two former nurses at the hospital—when it was in operation—who have worked ceaselessly as chair and vice-chair of the campaign for 10 years.

I want to mention the Wakefield trades council and the local Labour party, which have continued to fight to retain the hospital; also the Wakefield community health council which has never ceased to reflect the views of Wakefield's people on this issue; and my predecessor as the Member for Wakefield, Walter Harrison, who sought vigorously over many years to ensure that the hospital was kept open and in public use. It would be remiss of me not to mention that several stalwart campaigners for the hospital in these 10 years are unfortunately no longer alive to witness this latest chapter in the fight.

The fact that, after 10 years, the district and regional health authorities have still not disposed of Snapethorpe is evidence that the campaign has been extremely effective and fully justifies the efforts made in it. The way in which the closure of Snapethorpe has been engineered is a matter of deep concern.

I do not usually read The Times, but someone drew to my attention the parliamentary sketch in that paper of 26 April, which reported health questions from the previous day, when I had raised the issue of Snapethorpe hospital. The article states: 'But Snapethorpe Hospital hasn't had a patient since 1984,' sneered Junior Minister David Mellor at a Labour back bencher, David Hinchliffe (Wakefield), who had asked about a hospital closure. Laughter followed, at Hinchliffe's expense. Only later did one reflect that Health Authorities empty hospitals before closing them. Mellor was offside. The penultimate sentence in that quotation is unintentionally highly perceptive, because the manner in which the hospital was emptied was a scandal in itself. My predecessor Walter Harrison described the Snapethorpe problem as "closure by stealth". That sums up what has happened to this important hospital in the past 10 years. The highly questionable way in which the rundown occurred merits more attention than I am able to give in this short debate. However, some important matters need to be brought to the attention of the Minister. First, the health authority has for 10 years sought the closure of the hospital but has never had the courage to face local people and admit its real intentions. Over many years we have been given all sorts of excuses for ward closures but all along we have been told officially that there has never been any intention to close the hospital. However, that is the proposal before the Minister.

Secondly, arbitrary decisions have been made by unaccountable hospital consultants who in some instances—I stress "some instances"—have been more concerned about the personal inconvenience of travelling to Snapethorpe hospital than about any issue of patient care. They have withdrawn from the treatment of patients at the hospital and have made it inoperative.

Thirdly, my constituents have been deprived of the infectious diseases facility that was valued and used over many years and relatives, without cars, of patients who suffer from such diseases face three bus journeys to the far side of Leeds to the Seacroft hospital. As a result of the closure of Snapethorpe hospital and in particular the Barden ward, the excellent convalescent facilities at that hospital no longer exist. Wakefield health authority has taken no action to provide convalescent facilities elsewhere in its area. That means that my constituents are now deprived of any form of convalescent facilities and I am especially concerned about that because I receive information about a significant number of people who have been prematurely discharged from hospital. Those people would have benefited from a week or a fortnight of recuperative care in the facility of the kind that Snapethorpe hospital used to offer.

As I have said, the debate is also about Government policy on medium and small hospitals. On 22 May 1980 the Government issued a consultative paper entitled "Hospital services—the future pattern of hospital provision in England". That made clear the Government's belief that medium and small hospitals should play a more important role than they were playing at that time. That was a significant policy statement by the Government and it was produced by a Minister of Health who, at the invitation of Walter Harrison, visited Snapethorpe hospital and blocked a proposed temporary closure. That was unanimously welcomed by Wakefield people.

The press release that accompanied the consultative paper said: The time has come for a critical look at the giant 'super' hospital with over 1,000 beds—impersonal, complex and remote … these hospitals are frequently remote from the people they are intended to serve, also they lead to the closure of smaller hospitals which are much loved and much needed by their local communities. Perhaps when the Minister replies to the debate he will tell us what happened to those worthy expressions of concern for just the kind of situation that we have in Wakefield. In Wakefield a much loved, much needed and much valued hospital which was donated to the people of Wakefield in the 1930s by a benefactor, is to be closed because of a huge development on the Pinderfields hospital site. That site is inconvenient for vast numbers of people in Wakefield. As the Minister may know, Snapethorpe is at the centre of the local community and it can be argued on behalf of the majority of my constituents that Pinderfields hospital simply is not in as convenient a position as Snapethorpe.

It is important that the Minister responds to the clear policy statement of 1980. I am not aware of the Government formally changing their view on this matter, and the policy statement relates directly to hospitals of the kind that we are discussing. Snapethorpe is a small and valued local community hospital.

I said at the outset that we are also considering local initiatives in community care. The Minister may have been informed that Wakefield metropolitan district council has formulated detailed plans to use Snapethorpe as a focal point for community and support services for the elderly and disabled with a range of much-needed provisions, including shelter, extra care units, workshops for the disabled and a day centre.

Since I became a Member of Parliament I have had detailed discussions over a number of years with various members and officers of the local authority about its proposals, which would provide valuable facilities for the people of Wakefield, and for which there is considerable support among my constituents.

The local authority has had detailed discussions at officer and member level with the Wakefield health authority about its proposal. Wakefield council, in effect, sought the joint use of Snapethorpe hospital. It is that point that I hope the Minister will deal with tonight. For whatever reason, at the behest of the Wakefield health authority those discussions were discontinued after the removal of Sir Jack Smart as the authority's chairman.

There is a will within the district council to continue that dialogue and I am sure that that will be supported by the vast majority, if not all, of my constituents. The local authority pressed the health authority to support the continued use of Snapethorpe. I envisaged the provision of respite nursing care and the reinstatement of the much-needed convalescent facilities that had been withdrawn by the health authority. Those facilities would, if they were provided by the Wakefield health authority as part of a joint venture, fit in ideally with the local authority's provisions to form the basis of an excellent initiative which would enable people to remain within the community with support. Sadly, the minds of Health Service managers nowadays seem to operate like cash registers and Wakefield health authority has no vision of what could be achieved.

The Minister knows that I have tabled a number of questions about the performance-related pay and one area that concerns me is that hon. Members such as myself cannot discover under what circumstances performance-related pay is given to Health Service managers. But I am aware that one of the performance objectives is the achievement of hospital closures and it is likely that, if the closure of Snapethorpe is ratified by the Secretary of State, the general manager on a salary of £35,000 a year could receive a performance-related cash bonus.

It is nonsense that a person paid from public funds should receive a bonus from public funds for achieving such a closure completely against the wishes of those who pay him. The Government must look at the way in which performance-related pay operates, particularly in relation to hospitals such as Snapethorpe.

Snapethorpe has been empty for some considerable time and the officers of Wakefield health authority had no intention other than to see Snapethorpe sold as a valuable asset.

The permanent closure and disposal of Snapethorpe was discussed at a meeting of the Wakefield health authority on 22 December 1988. A report written by officers of the Wakefield health authority on the local authority's plans said: none of the proposals would have a significant direct benefit to the local health service. That made clear the officers' belief that the proposals of Wakefield district council would not have a bearing on the Health Service within the Wakefield authority.

I find it astounding that anyone looking at the proposals for community services of the kind that I mentioned earlier could reach the conclusion that those provisions would not have a bearing on the health sevices. It says something about the people who are now running the National Health Service at local level that they are unable to anticipate just how much the local health service could benefit from the kind of initiatives we propose.

We hope that the Government's long overdue response to the Griffiths report will be made before long and that they will consider proposals of the kind being put forward by Wakefield. They should be supported by the Government because they are about ensuring that people remain in the community and do not enter institutional care that they do not require. The council's proposals would ensure that many people who would otherwise be hospitalised will remain in the community with day care, with day support, and with the help of the other initiatives proposed, rather than end up in long-term institutional care. If that does not have a direct bearing on the local health services, I do not know what has.

I want to give the Minister adequate time to respond to my comments. I am sure that he is well briefed. Although these are early days in the hon. Gentleman's role as Under-Secretary of State for Health, he is certain to have had already his fair share of grief from Back Benchers such as myself fighting for much loved local hospitals. I know that the hon. Gentleman will have to respond to another Adjournment debate later this week, and I sympathise with him for having to remain here until such a late hour to deal with such issues.

By comparison with the arguments advanced by other right hon. and hon. Members, not all can boast, as I can, the proud history and excellent potential of Snapethorpe hospital. Not all can boast of formal objections to the proposal to close the hospital not only from the constituency Member of Parliament but from hon. Members representing surrounding constituencies. They include my hon. Friends the Members for Dewsbury (Mrs. Taylor), for Leeds, Central (Mr. Fatchett), for Hemsworth (Mr. Buckley), for Pontefract and Castleford (Mr. Lofthouse), and for Normanton (Mr. O'Brien). They have all, without prompting, but knowing of the strength of feeling about Snapethorpe, objected formally to the health authority.

Not all right hon. and hon. Members can boast the support of all political parties at local level for the future of their hospitals. Wakefield Conservative party fully supports the future of Snapethorpe. It does not say very much about the matter except at election time, but it does support the hospital's future. Had I been defeated at the last election, I would fully have expected the elected Conservative Member, God forbid, to be making a plea for the hospital's future in my place, because I know that the Conservative candidate shares my concern.

Not everyone can boast that their hospital has been visited by two Health Ministers and by at least three shadow Health Ministers, all concerned about its threatened closure. And not all right hon. and hon. Members can boast petitions containing the signatures of 100,000 local people supporting their hospital's future. Surely none can boast the level of local commitment that has enabled the fight to retain Snapethorpe hospital to continue for more than a decade.

Snapethorpe has a future in the hands of local people. There are clear proposals to ensure that it will have a future of use to the community; a future of carrying on the good work that it has performed as a hospital over many, many years. I appeal to the Minister to block the proposed permanent closure so that the hospital may enjoy that future.

12.4 am

The Parliamentary Under-Secretary of State for Health (Mr. Roger Freeman)

The hon. Member for Wakefield (Mr. Hinchliffe) is a doughty fighter for his constituency causes. I pay tribute to him for his energy and his relentless efforts in pursuit of his constituents' interests. That must be right and I make no complaint about it, however many parliamentary questions, Adjournment debates or letters there are. It is his duty and his responsibility and I respond with enthusiasm and a willingness to reason with him. Ultimately we have to exchange argument and discussion on the basis of reason and what is in the best interests of his constituents who are patients of the National Health Service but within limited resources. Resources were always limited. They were limited under the Labour Government and they are limited under the present Administration in any one year. We have to make the best use of the resources available.

I have nine minutes to address some of the points that the hon. Gentleman has raised. One of his key points was about community hospitals. The Government firmly believe that community hospitals have a role to play in the National Health Service. I am bound to say that the argument in support of community hospitals is stronger in rural areas than in urban areas.

I do not know the borough of Wakefield. I have passed through it but I have not visited it. I am sure that the hon. Gentleman will appreciate that in an urban area, or a comparatively densely populated area, the argument for having several separate community hospitals is very different from that in the sparsely populated areas of Norfolk where I was last week, when it was put to me that very sophisticated, high-technology medical equipment was not so important and could be provided in the provincial cities and towns, but it was important that commmunity hospitals should remain to provide non-acute services. That is an important policy and we stand by it, but, as I am sure that hon. Gentleman will agree on reflection, it is more relevant to rural areas than to urban areas.

The hon. Gentleman raised the specific issue of Snapethorpe hospital. As he said, he, I and a delegation are to meet on 20 June. It is somewhat unusual to have the Adjournment debate before the meeting. Nevertheless it will serve as a benefit in putting the hon. Gentleman's comments on record for the Department and the district health authority to study beforehand. I shall certainly study them before the meeting.

It might be helpful if I spent three minutes putting on record the sequence of events which has led up to the current proposal for the permanent closure and disposal of the hospital. I shall try to deal with the hon. Gentleman's two main points.

Snapethorpe hospital opened in 1933 and originally had a complement of 103 beds. The benefactor of the hospital, as the hon. Gentleman has pointed out in a recent series of questions in the House, was a Mr. Benjamin Sykes. The hospital site and buildings were later vested in the Secretary of State under the National Health Service Act 1946, free of any trust.

The transfer of services at the hospital to elsewhere in the Health Service occurred over a period of years, culminating in its temporary closure in April 1984. That has been the situation since then. For the past five years it has been relatively unused; only one service remains—the sterile supplies unit. This state of affairs has been the result largely of clinical and not administrative decisions.

As long ago as 1978, the consultant in charge of the infectious diseases unit based in Elgin ward decided that he could no longer provide a fully comprehensive service at the hospital. Over the three preceding years the average bed occupancy of this 12-bedded ward had never exceeded 50 per cent. At that time the seriously ill patients were always transferred to Seacroft hospital in Leeds. The service was subsequently transferred completely to Leeds together with the resources.

Further clinical decisions to return Dewsbury chest patients to their home health authority and to close a pre-convalescent ward showing a negligible bed occupancy resulted in only one ward remaining in use. Both decisions received community health council approval. The remaining ward, Barden, stayed open to provide a chest service to Wakefield.

In July 1980, the health authority commenced consultation on the closure of Barden ward, along with other proposals for the closure and change of use of facilities within the district. Closure was opposed by the CHC and the matter was referred to Ministers for a decision. In 1981, full closure was deferred pending a further review of services. In April 1984, the then Minister of State, my right hon. and learned Friend the present Secretary of State, agreed to temporary closure. The hospital has remained closed since that time.

In November 1987, the health authority resolved to consult again on permanent closure. The consultation process has now been completed and because of the continued opposition of the community health council, the matter has again been referred to Ministers. I assure the hon. Member for Wakefield that Ministers will wait until the meeting is held so that we can take full account of the representations that he and others will make.

The health authority has considered the possibility of providing acute services at Snapethorpe, but the hon. Gentleman is aware of the hospital at Pinderfields in which £25 million is to be invested to enhance the capacity of that excellent hospital to 700 beds. Acute services are more sensibly located at the district general hospital.

I am advised that the buildings at Snapethorpe are not suitable for the long-term care of elderly people and would have to be rebuilt. I am further advised that they are not suitable for refurbishment, but if they are perhaps the hon. Gentleman will so advise me at the meeting. Back-up services would be located four miles away at the district general hospital. Mentally handicapped people are provided for in Wakefield, and other plans and facilities are available for mentally ill people.

I am advised that, within limited resources, the district health authority has decided that providing further services on site, bearing in mind that the buildings could not sensibly be used in their present state and would have to be demolished, is not top of the list of its priorities.

The hon. Member for Wakefield referred to a joint venture with the local authority. We welcome joint ventures with local authorities. The Department of Health has not issued any instructions about joint ventures and encourages them. When the Government have announced their conclusions following the review of Sir Roy Griffiths' report into community care—an announcement will be made soon—doubtless district health authorities and local authorities will reconsider the provisions of facilities in the community for the different client groups that the hon. Gentleman cited.

At present the health authority believes that it would be in the best interests of the patients it serves for the site to be sold and for the proceeds to be used now to the benefit of the patients in the area. That is not to say that in the future, with more resources or different priorities, the health authority could not decide, perhaps jointly with the local authority, to provide additional services on a different site within the urban area. Surely it is better, after five years of planning blight and the facilities lying empty, for the uncertainty to come to an end, the site sold and the proceeds reinvested immediately to the benefit of patients in the area.

I look forward to meeting the hon. Member for Wakefield and his delegation shortly.

Question put and agreed to.

Adjourned accordingly at thirteen minutes past Twelve o'clock.