HC Deb 15 February 1990 vol 167 cc553-60

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

2.36 am
Rev. Ian Paisley (Antrim, North)

My Northern Ireland colleagues and I wish to put on record our appreciation of the remarks made today by the Secretary of State and, from the Opposition Front Bench, by the hon. Member for Wigan (Mr. Stott) about our late colleague, Harold McCusker. All hon. Members from Northern Ireland will miss his contribution to our counsels. We salute his memory as a gallant Ulsterman.

A good case does not require long argument. It can be put concisely. The need for acute hospital services in the Ballymoney, Moyle, Ballycastle and Coleraine areas is beyond dispute. I should make it clear for the record that Moyle hospital is not in the Moyle district council area. It is in Larne, and I give my wholehearted support to the campaign to keep that hospital as an acute hospital, just as I should like the Waveney hospital in Ballymena retained as an acute hospital.

In 1987 there was a population of about 88,000 people in the Ballymoney, Ballycastle and Coleraine districts. That was estimated to rise to about 94,000 by the year 2002. At the height of the tourist season, the population peaks at more than 150,000. It is agreed that 320 beds, plus psychiatric provision, are urgently required.

The history of coming to grips with meeting the hospital requirements of the area is tragic. Promises have been made and broken. Decisions have been arrived at after long debate, only to be overturned and overruled, sometimes in an unconstitutional way. But the time has come to take a new step forward to meet the need, and that is what this debate is about.

We need unity. All the past rivalry between members of the medical profession in Ballymoney, Ballycastle and Coleraine districts has been laid to rest. A Northern health and social services board resolution, which was supported by 41 votes to two, support the building of a new, purpose-built acute hospital to replace the workhouse buildings on the Route hospital site in Ballymoney and the piecemeal development on the Coleraine site.

The councils in the areas concerned have now also united and the Ulster Unionists, the Democratic Unionists, the SDLP and the Alliance parties have given their wholehearted support, as have the Churches.

The present proposal is to spend £20 million on the Coleraine hospital. After visiting that hospital, the Under-Secretary of State, Lord Skelmersdale, said that it was a shambles. We do not want to be involved in the partial rebuilding of a shambles. The proper course is to build a brand new hospital to meet the urgent need. The cost of doing that, according to data in the report of Ceefa Services Ltd.—that report was prepared by the board and the Department of Health and Social Services—would be only 10 per cent. more than the partial rebuild of Coleraine. The board has now decided on an option reappraisal. Talking about money, the Eastern board has been over-funded by £14.75 million, while the Northern board has been under-funded by £8.5 million. Some money is owing to the Northern board.

Therefore, we call on the Minister to ensure that the DHSS in Northern Ireland will back the board and its administrative officers and, recognising the acute hospital requirements of our districts, will join us in promoting their urgent development in accordance with the wishes of a united community and in keeping with decisions that have already been made in favour of building a new hospital.

The infrastructure of the Coleraine, Ballymoney, Ballycastle district will remain incomplete, and at times dangerously inadequate, until the new acute hospital has been constructed. The year 1997 must become the target for completion and cease to be put forward as a tentative date for commencing the new hospital which we so badly need. Tonight my hon. Friend the Member for Mid-Ulster (Rev. W. McCrea) will contribute to the debate and make other important points.

2.40 am
Rev. Martin Smyth (Belfast, South)

I support the plea that the Department of Health and Social Services might give its backing to the Northern board in developing a new hospital in the north-east of Ulster and particularly in the Northern board's northern area. As I come from the Eastern board area, naturally I would not suggest that it was over-funded, because it has the problem of regional specialties. However, I recognise that planning has gone on for a long time. It is said that he who pays the piper calls the tune, and one is always suspicious of consultancies and appraisals which produce what the Department might want.

The harsh reality is that, five years ago, the then Northern Ireland Consultative Assembly advised that money should be given to the Northern board to develop that hospital because it was badly run down. The rivalries that normally exist between small towns that want to maintain their own hospitals have been resolved by the community coming together and plumping for a central hospital that is more convenient to the population. That in itself is a reason why the Department and the board should consider not having another appraisal but getting on with the job.

The tragedy is that, if the board had finally decided to go ahead with the updating of the Coleraine site, there would be no demand for another reappraisal which is a waste of money. With the modular plans now available for the Antrim hospital, there is no reason not to proceed with the development of the basic hospital in a green-field site.

Strangely enough, at times the Department can pull money out of the hat like a conjuror. At one stage, the board was told that £11 million would be available for upgrading. When it was considering a green-field site, it was told that £20 million could be made available for the upgrading of the "shambles" site—I use that term in tribute to Lord Skelmersdale, who is responsible for health matters in Northern Ireland, and who described it as a shambles.

The harsh reality is that the site is too narrow, too confined. The work necessary to upgrade it would result, in the long run, in a situation similar to that which arose in south Belfast, where work on a confined site took many years. I plead that time be not wasted, that a decision be taken to go for a green-field site, where work on putting in the modules could start now. The Route and Coleraine sites could then be sold, to the financial benefit of the Health Service.

2.45 am
Rev. William McCrea (Mid-Ulster)

I support my hon. Friend the Member for North Antrim (Rev. Ian Paisley) in his efforts to have a new acute hospital for the Coleraine-Ballymoney-Ballycastle area erected. In 1977, the Northern health and social services board, with the approval of the Department of Health and Social Services, decided that a new acute hospital should be built in this district. Thirteen years later, we have outdated hospitals in Coleraine and Ballymoney and uncertainty as to the future of hospital services in the northern section of the Northern health and social services board area. As a former member of the Northern Board, I am absolutely convinced that the only rational way to ensure the highest standards of acute services in the area, with its widespread rural hinterland and extensive coastline, is by the provision of a purpose-built acute hospital on a green-field site between Coleraine and Ballymoney.

For many years, the attempts to rationalise acute services in this vast area were wrecked by factional wrangling, rivalry and conflicting interests. However—much to the credit of the medical profession, with its vision, and of elected representatives—a united approach, in the best interests of all, has been forged. The lead given by the medical profession is overwhelmingly endorsed by the community, which, as my hon. Friend has said, is united in its demand for the rejection of workhouse buildings on the Ballymoney Route hospital site and the piecemeal development on the site of the Coleraine hospital.

It is essential to have all hospital services on one site if there is to be proper provision of patient care, if increasingly expensive and sophisticated technology is to be properly used, and if there is to be concentration of professional expertise. There is therefore a unique opportunity to achieve a cohesive hospital service for the whole district.

Throughout the community in the Northern board's area, there is great concern lest the Government force upon it a second-rate acute hospital programme that will not meet present needs, never mind the challenge of the 21st century. The current service is inadequate and inconvenient. The partial-rebuild option ignores the fact that the population is expanding, as well as the Northern health and social services board's commitment to the area 13 years ago.

The good will that would be engendered in the Coleraine-Ballymoney-Ballycastle area by the provision of a purpose-built hospital would hold out exciting possibilities for the future. The patch-quilt approach will never give the north-east corner of the province up-to-date medical facilities such as are enjoyed by the people of the areas covered by the other boards. That is why I join my colleagues in the call for proper hospital provision in the area.

The option appraisal must be carried out as a matter of urgency. I trust that the Minister will regard 1997 as a target date for completion of this new hospital. Money earmarked for the provision of acute services in the district must be carefully guarded to ensure immediate action on the erection of a new acute hospital on a green-field site between Ballymoney and Coleraine. I know that the Minister will have the whole-hearted support of this House if the go-ahead is given. The group campaigning for a new hospital has stated: A new hospital is now a practicable consideration, and not an impossible dream. Like my hon. Friends, I urge the Minister to grasp the nettle. If he goes ahead with the provision of this hospital he will be remembered as someone who was forward-looking, someone who did not favour continuation of what Lord Skelmersdale called a shambles.

2.49 am
Mr. William Ross (Londonderry, East)

You, Madam Deputy Speaker, will appreciate from the fact that four Northern Ireland Members have spoken that we all have an interest in the debate. Large chunks of my constituency and of that of the hon. Member for Antrim, North (Rev. Ian Paisley) are served by this hospital. The new green-field site hospital will almost certainly be situated in my constituency.

Hospitals are important. I wish that we had more time to debate them in depth. They are necessary to provide the health care that the community needs. Such care is costly, so money must be spent to the best advantage. That means that the location of their most costly items must be at key points. Those locations are primarily decided by geography and population. The Northern Ireland framework, after much debate and argument, was decided long ago. I believe that the relevant geography is the most distant point from the hospital, not the distance between hospital and hospital, which is sometimes used.

The need for a hospital of a high standard in Coleraine was recognised and accepted as a vital component in the framework of hospitals for Northern Ireland. It was understood by people in the area to be served that there would be a queue for capital resources and that Coleraine would have to wait for a while. We expect our place in the queue to be honoured, and in all fairness Coleraine should be at the front of it.

No one denies the need for better facilities at Coleraine. The argument is about whether to rebuild on the existing site or on a green-field site. An option appraisal will decide which is best, and that appraisal should be restricted to those two possibilities.

I am amazed that appraisal is necessary, after so many years of debate. The list of facilities needed, and the detailed cost of such facilities, should have been defined years ago.

Three things need to be decided: first, what facilities; secondly, the area of land needed for the hospital; and, thirdly, the comparative cost of new build and rebuild.

Will the Minister ensure that the option appraisal will be made quickly and in depth, and that its conclusions will be definitive? Will he undertake to accept those conclusions and make the funding available, so that the hospital can be completed by 1997, or at least so that it can be a long way down the road to completion?

The endless delays in hospital provision in Coleraine are making many people wonder whether the Government intend to avoid building an acute hospital there. They are wondering whether this large, important and growing area of Northern Ireland will be discriminated against in regard to the life-saving facilities that it so sorely needs.

My constituents and I are fed up with waiting; it is a time for action.

2.52 am
The Parliamentary Under-Secretary of State for Northern Ireland (Mr. Richard Needham)

I add my support to the tribute paid by the hon. Member for Antrim, North (Rev. Ian Paisley) to the former hon. Member for Upper Bann, Mr. McCusker.

After four years as Minister with responsibilities for health in Northern Ireland, I am glad that at last we can agree that a major acute hospital is necessary in the northern area of the Northern board. That is a welcome change from the past arguments about Antrim. I noticed that the hon. Member for Antrim, North had not altered his position on Waveney and Moyle hospitals, but it was welcome to hear that other hon. Members now accept the need for a major new acute hospital, without which we cannot concentrate services and do all the things that I have been trying to persuade hon. Members to accept for most of the past four years.

I am equally delighted that the hon. Member for Antrim, North is now arguing so strongly for a green-field site at Coleraine, which he so bitterly resisted for Antrim. It tends to lead me to the belief that politicians are not the best guardians of these decisions.

As the hon. Gentleman said, 1977 was the time when a decision was taken by the Northern board on what to do. It was decided at that time that Antrim would come first and that there would then be a redevelopment of Coleraine. We have followed that decision since.

Rev. William McCrea

Will the Minister not accept, however, that he is on very dangerous territory when he refers back to what happened concerning the Antrim hospital? He will have to confirm that in fact the Northern board, of which I was a member, made certain decisions one day, and then, because they did not suit the Government at that time, went around to find out what deals it could do to get the Antrim hospital accepted. I think it would be far better if the Minister stayed away from the history of that, because it is certainly very muddy water.

Mr. Needham

I regret having given way. We have a great new hospital at Antrim, which is always first in line for the Northern board's capital scheme, and we are now talking about what we intend to do at Coleraine. As I say, the decision made in 1977 is now being followed.

The hon. Member for Londonderry, East (Mr. Ross) made the point, quite rightly, that we have to consider money in all this. The reason that Ceefa Services Ltd. was taken on was to do an appraisal of the two options—the green-field site and the redevelopment of Coleraine—and see which was best in value-for-money terms. If hon. Gentlemen were part of the devolved administration they were talking about earlier, I am sure that they would have done nothing different from the Government to make sure that the money that was being proposed was being properly spent. CSL found that the green-field site would cost some £40 million, whereas a redevelopment of Coleraine would cost some £11 million.

Rev. William McCrea

Nonsense.

Mr. Needham

I have found some nonsense in a document I have received recently, to the effect that the difference was only 10 per cent. According to the analysis, the green-field site would be £1 million more per year in annual equivalent cost—that is, 10 per cent. per year for every year of the life of the project.

Having said that, I understand that the board voted for the green-field option and to enter into a discussion with the Department of Health and Social Services to consider the green-field option. The Department quite rightly told the board that, if it felt that the CSL findings were to be set aside because they were, as the hon. Member for Mid-Ulster so eloquently put it, nonsense, it would have to show evidence of that.

It seems to me to be slightly inconsistent when the argument is made in this document that the CSL option appraisal is a lightweight report—a statement that I do not accept—and then the next statement is that we do not need another appraisal. We cannot have it both ways.

From the Government's and the public's point of view it is very important to ensure that we make the right decision and do it on the basis of the best value-for-money option. My noble Friend Lord Skelmersdale said that the Coleraine site is at present a shambles, but no one is suggesting, least of all him, that if it were to be adequately and properly redeveloped it would not be able to provide as good a quality of service as any green-field site.

I must make the point that, if the capital costs are to be compared, Coleraine would have to rise to over £30 million before the green-field site became a viable alternative. Having made its decision for the green-field site, the board rightly decided that it should go for an appraisal and that it should appoint some consultants who were capable of doing that. I believe that we can all agree—the board would certainly wish me to say this—that everyone accepts that matters should proceed as speedily as possible.

As Minister responsible for health, I was the person who decided that the debate on the hospital should be brought forward. It had always been agreed that Antrim would go first and that Coleraine would follow. If it had not been for me bringing the debate forward, we should not have started talking about the Coleraine redevelopment until 1993. I welcomed the fact that we brought the debate forward, and we should now try to reach as speedy a conclusion as we can to decide which site to choose. However, we must make certain—most importantly, it is the board which must make certain—and show the Department and the public that if there is to be an alternative, it is properly costed and worked out.

From the capital programme that is available to the Department, it would be possible to start redeveloping the existing Coleraine site in 1993. It seems extremely unlikely, if not impossible, that we could start a brand new, major project post-Antrim until 1997. In any event, I accept that all of us must work as fast as we can to come to a speedy conclusion so that we can do away with the current uncertainties.

Mr. William Ross

Is the Minister not aware that, at an early stage, before he arrived in the Department, it was understood that Antrim and Coleraine would go ahead at the same time? It was only because we came down to money problems that Antrim was allowed to go ahead at that time. Can he further assure me that the criteria that are now being applied to Coleraine have been applied to every other hospital that has been built in Northern Ireland?

Mr. Needham

I am afraid that I do not agree with the hon. Gentleman's comments. I accept that he was there and I was not, but I have looked back through all the papers. The 1977 board decision clearly stated that Antrim came first and Coleraine second. We have proceeded on that basis ever since. As I said, we are now debating this case because I decided, when I became the Minister responsible, that it was right that we should bring the debate forward to try to get on with the matter and to get the problems out of the way as quickly as possible.

Mr. Roy Beggs (Antrim, East)

Does the Minister accept that the difference between Coleraine, Ballymoney, Moyle, Ballycastle and the Antrim hospitals is that there is unanimity on the new provision at Coleraine? I support those who seek to achieve a new hospital on the green-field site. Will the Minister concede that there is not, was not and is unlikely to be agreement about an imposed decision on hospital provision with regard to Antrim hospital? I assure the Minister tonight that we in Larne want a hospital in Larne. We shall have our own appraisal to present to the Minister shortly on acute services for Larne.

Mr. Needham

That is a ludicrous argument. What we have to provide in the Northern board is not an imposed decision. We have to provide proper acute care in the most modern facilities, using the very best staff with the most up-to-date equipment. It is ridiculous to suggest that, just because there is no agreement in the south of the Northern board area, Coleraine gets the facility that it requires and that such a facility does not exist in the southern part of that area because an agreement does not exist between the politicians and the medical profession.

Our job, as it is for anyone in the Government, is to ensure that we achieve the highest possible quality of care in the southern part of the Northern board area, in the northern part and anywhere else in Northern Ireland. That is what we have done up to now, and what we shall continue to do.

Rev. Ian Paisley

Will not the Minister look forward? I could say many things. It was promised first that Waveney hospital would be an acute centre, and that was overlooked. As the constituency representative, I cannot forget that. I sympathise with the hon. Member for Antrim, East (Mr. Beggs), because I used to represent his area, and still do in another place. The Minister should realise that we need to move forward quickly with the provision of proper actute services in the Ballycastle-Coleraine-Ballymoney area. The medical profession says that there should be a new hospital. Should we not move with the professional men who are supported by the whole community?

Mr. Needham

The board has to reconsider the option appraisal. That is the right way forward for the board. I agree with hon. Members that we should do what we can to get a new acute hospital——

The motion having been made after Ten o'clock and the debate having continued for half an hour, MADAM DEPUTY SPEAKER adjourned the House without Question put, pursuant to the Standing Order.

Adjourned at five minutes past Three o'clock.