District General Hospital (Norwich) (Hansard, 26 January 1994)

§ Mr. John Garrett (Norwich, South)
My subject is the proposal for a new district general hospital in Norwich, and the inordinate delay in providing it.
The proposal for a new district general hospital was first considered in the late 1960s. We have since had nearly 30 years of delay and confusion in the project. In April 1973, Norwich was promised a second hospital. In October 1986, plans for an 800-bed, £48 million multi-purpose hospital at Hellesdon in Norwich were sent to Whitheall for approval. In July 1987, the then Secretary of State told Norwich health authority to consider a new site at Colney, just outside the city of Norwich. In December 1987, the regional health authority voted for Colney and performed what was, at that time, a U-turn in its policy. It is difficult to understand the status of the authority, which was able to overrule local opinion over the location of the hospital.
In February 1990, the Government approved plans for a 920-bed £104 million hospital at Colney. In April 1991, the Norwich health authority announced a complete rethink of the design and bed numbers for the new hospital, and it then became apparent that we were down to about 700 beds. In February 1992, plans were unveiled to shut the Norfolk and Norwich hospital—the main hospital at present—when the new one at Colney was opened. At that time, construction of the new hospital was due to start in 1994, with completion in 1999. In May 1993, the Government appointed a so-called regional task force to investigate whether the new hospital—now with an estimated cost of £150 million—was the best option for future acute service health care in the district.
It is estimated that, so far, £2.5 million has been poured into the scheme, which consists of a notice and a sugar beet field. The site cost is £1.5 million; the infrastructure, drainage and landscaping cost is £600,000; and thousands of hours of administrative and management time have been spent on the scheme.
The latest news is that, last summer, the business case for the development of acute services in Norwich was submitted for consideration by an ad hoc task force of regional health authority and National Health Service Management Executive officers. On 21 July 1993, we learned that the task force was unable to recommend that the business case should be considered further by the Management Executive, the Secretary of State or the Treasury.
The reasons for the task force's decision were principally that it believed that the proposed bed numbers for the future acute hospital services were to high—for two reasons: first, because the planned performance levels in some specialties were considered too low; and, secondly, because the volume of work that it was planned to divert to the primary health care sector was also considered to be too low—and that Norwich health authority, as the principal purchaser, would not be able to afford the preferred option for a single-site, new district general hospital at Colney lane, and it needed to be considered further.
After discussion, the authority reaffirmed its view that a single-site hospital at Colney lane, with in-patient services for mentally ill people as an integral part of the district 398 general hospital service, was by far the most far-sighted and sensible solution for acute services in Norwich and that this objective remained its clear policy.
The health authority then decided that the matter should be pursued, with the possible assistance of an external consultancy. Since then, there has been silence, which I hope will be broken tonight, and our health services continue to deteriorate. In September 1993, the Norwich hospitals were fined £9,000 for failing to meet the patients charter standards—with patients waiting more than two years for urology treatment, for example. Last November, a friend of mine was given his first appointment with a consultant for an awkward condition. The appointment date was March 1995. The people of Norfolk, including my constituents, deserve better. Fertility treatment, psychotherapy and cosmetic surgery have been stopped altogether.
Our local hospital services have suffered for years from chronic underfunding, with increases in allowed spending way below the growth in population, which has been among the highest in the country. They have also suffered from split-site working, with acute services based on the Norfolk and Norwich hospital, the West Norwich hospital, St. Michael's hospital and Aylsham and Cromer. Local medical consultants have written that it is unacceptable for major operations and acute medical care to be undertaken three to 25 miles from coronary and intensive care units and from the blood bank.
Norwich is the largest district in its large region and the only one not to have major new hospital building during the 1980s. Norwich consultants have developed excellent arrangements with general practice. The medical and support staff are outstandingly committed to patient care in very difficult circumstances. But it cannot go on like this. For one thing, the present arrangements on a split site lead to high-cost services and to unfair disdvantages for our acute units in today's market system.
If the new hospital has only 600 beds, it may find itself similarly disadvantaged by having far too big an overhead for the volume of treatment it carries out. The Norfolk and Norwich hospital—the main hospital—is clearly obsolete. The tower block construction is wholly unsuitable, with patients being sent up and down in unreliable lifts. There is parking for 400 cars, and every day 3,000 cars arrive. Now, there is a real problem with emergency access.
The backlog of building maintenance is £20 million, and sewage rises through the floor of the operating theatres in storm conditions, as happened not long ago. Another £20 million-worth of building work is needed for the other local hospitals. The recovery and pre-med rooms are overcrowded, and the cramming of beds makes care difficult. In the main theatre block, the conditions appear to be in breach of the Health and Safety at Work, etc Act 1974.
Pharmacy, medical records, sterile supplies and the main kitchen have no natural light and poor ventilation. All areas of the electrical system are overloaded, and the standby generator gives only 20 per cent. coverage in case of a power failure. Windows have fallen out of the main tower block—luckily, not causing casualties which might have had to be admitted to the hospital.
The need for a new hospital has been supported publicly by three Cabinet Ministers, and I assume that their welcome support has been conveyed to the Department of Health. A vigorous campaign covered by Louise Zucchi of the Evening News called Operation Transplant has failed to get any sense whatever out of the Department. When the 399 Secretary of State for Health visited Norwich in December 1993, she said that I was a prophet of gloom and doom when I suggested that the Department had little intention of ever building the new hospital.
She also said that what was needed was practical, diligent work to bring forward practical proposals—a sentence I find almost entirely devoid of meaning. She said that she wanted a state-of-the-art hospital for day surgery, and she admitted that the present split site was a problem which made it difficult to reduce the hours worked by junior doctors. At present, 20 per cent. of junior doctors are working over 83 hours a week.
I hope that the views of the Minister of Agriculture, Fisheries and Food, who is the right hon. Member for Norfolk, South-West (Mrs. Shephard), were given to the Secretary of State for Health. The Eastern Daily Press has reported that the right hon. Lady has claimed that Norfolk's health services are suffering because of the delay in giving the county a much-needed new hospital. The paper reported that she demanded an urgent answer on the issue from the Secretary of State for Health. The Minister for Agriculture, who is herself a former local health authority chairman, also said that local people needed to know where they stood. I do not know if she ever got an answer, but I have never heard of it if she did.
The Secretary of State for Health, in her flying visit to Norwich, refused an interview with the local media on the subject of the hospital. That was in a week in which the right hon. Lady found time to present a business award to a sex products firm. That also caused a certain amount of media comment. An editorial column in the Eastern Daily Press was headed "Rock Bottomley."
The paper claimed that the Secretary of State was consistent in her self-publicity, and attacked her for clearing her diary for a glitzy media presentation, but not to talk to the Norfolk public about the state of their hospital service. As an example of ministerial concern, the paper's verdict was "Rock Bottomley". We would all agree with that.
The questions I have to ask the Minister are very simple. Will the hospital ever be started? If it is intended to go ahead, when will the building start? What size will the hospital be? What on earth is the task force up to?
I have genuinely no wish to make any political capital out of the disaster for Norwich of the NHS reforms, and the two-tier system which they have introduced. I have no desire to make political capital out of the stress caused to patients and to staff by the squalid conditions which exist and by the uncertainty of the future acute services in the district. I know that the district has had changes of management, and changes in its area of coverage.
I know that the change of site was a complication. In my view, it was unnecessary. Yet the ball has been in the Government's court for more than five years. I hear that in other regions, the Government plan to close large hospitals wherever possible. But the critical need in Norwich for a major investment in acute services is agreed by all the parties in the matter—the staff, the ancillary workers, the GPs, the consultants and the local Members of Parliament.
Feeling on the subject is running high in the city of Norwich, and the stalling simply has to stop. I want plain answers to my simple questions.

§ The Parliamentary Under-Secretary of State for Health (Mr. Tom Sackville)
I am glad to have the opportunity to answer the debate initiated by the hon. Member for Norwich, South (Mr. Garrett) on this important topic. The subject of a new hospital for Norwich has been raised on many occasions. It has been raised by my hon. Friend the Member for Norwich, North (Mr. Thompson) in an Adjournment debate and on other occasions. I note with interest the presence in the Chamber of my right hon. Friend the Member for Mid-Norfolk (Mr. Ryder), who has taken a strong interest in the matter on behalf of his constituents.
I also see that my hon. Friend the Member for Great Yarmouth (Mr. Carttiss) is here. He is noted for his championing of the cause of the James Paget hospital in his constituency. I have also heard from other colleagues, including the Member of the European Parliament, Mr. Howell, who has taken an active role in the matter. I have heard often from him on the subject. So I am fully aware of the strength of feeling on the matter and how important it is to people living all around Norfolk.
The description given by the hon. Member for Norwich, South of the hospital and the local health service did not give due credit to it. He quoted my right hon. Friend the Secretary of State as calling him a prophet of doom, and today he gave us a gloomy picture. He gave no credit for all the successes of the hospital or to the thousands of people who work for the health service in the area. That was remiss of him, but I am afraid that it is typical of him and his colleagues and of their approach to the health service.

§ Mr. Garrett
That simply is not true. I went out of my way to congratulate the medical consultants, the local GPs and the people who work in the hospitals in Norwich, under the most difficult conditions, most of which are due to the Government's policy.

§ Mr. Sackville
If I may return to his words on the subject of the planning of the hospital, the hon. Gentleman is right to say that plans were put forward for the hospital which have proved to be unsuitable and inappropriate. The plan known as Norwich 2 was a very large scheme for a hospital of more than 1,000 beds at the high cost of almost £150 million. It is not surprising that the task force from my Department and others who examined the plan found that some rather optimistic projections had been made.
In the light of the changes that are taking place in the health service—especially the rapid growth in day surgery and the transfer of many services to the community and to primary care—we are not likely to see hospitals of that size in the future. That is not to say that there should not be redevelopment in Norwich. I am sure that a good case can be made for that.
The hon. Member mentioned the visit of my right hon. Friend the Secretary of State to Norwich. His description of it was somewhat selective. The quotes that I have include one from an editorial in the Eastern Daily Press entitled "Golden Virginia". It praised my right hon. Friend for giving a strong suggestion that it should be possible to consider sympathetically any practical and realistic scheme for a hospital development. She said: We are sympathetic to the provision of a new hospital so long as it is well planned and well founded. 401 My right hon. Friend is quite right, because, given some of the changes that I have enumerated, a new hospital in Norwich might prove too large for the job that it must undertake. In a few years, if there is too much capacity in the hospital, the health authority will be left with an extremely expensive building and facilities. It will have to cope with all the revenue consequences of that, which will impact on the services that it is able to offer patients. It is important that we get it right.
As the hon. Gentleman said, the Norwich 2 plan was withdrawn. I am informed that, should my right hon. Friend decide that the acute unit should become a trust, the health authority, in tandem with that trust, will put together a business case for a hospital development appropriate to the needs of the local population. It is important that they assess that case correctly and that whatever is built is economic and efficient and can optimise the resources available to the local health authority.
It would be unwise to be too pessimistic about that. Many people try to claim that the health service is 402 underfunded and short of resources, but I must remind the hon. Gentleman that, for next year alone, the Treasury has allocated £1.5 billion for capital developments in the health service.

§ Mr. Garrett
Will we get any of that?

§ Mr. Sackville
If the business case is, as my right hon. Friend said, well planned and well founded", there is no reason why a development should not take place in Norwich. There are problems with the current acute services, but the hon. Gentleman's description of them was extremely ungenerous. Money is available for developments appropriate to local patient needs.
I have no reason to suppose that any business case that is submitted will not be sympathetically considered. I hope that it will reinforce and continue the tradition of excellent health care that already exists in Norfolk.