§ 2.41 p.m.
§ LORD STONHAMMy Lords, I beg leave to ask the Question which stands in my name on the Order Paper.
§ [The Question was as follows:
§ To ask Her Majesty's Government whether, in cases where the hospital capacity of a district remains inadequate, they will authorise the payment out of war damage account, of the cost of repair or replacement, of war damaged hospital buildings in that district.]
LORD ST. OSWALDMy Lords, the situation broached by the noble Lord is, I confess, a good deal more complicated than I realised when I first read his Question, and my reply cannot be as straightforward as I then hoped. The fact is that under the National Health Service Act, 1946, any payments from war damage account must be appropriated in aid of the National Health Service Vote—that is, set off against expenditure on that Vote. This means that any such payment made would be compensated by a reduction in the 1031 amount at that time available to the Service. This being so, the adoption of the noble Lord's proposal would not particularly help the Regional Hospital Boards or increase hospital building.
Until 1952, Regional Boards were allowed to claim war damage payments, but as these were appropriated in aid to the National Health Service Vote, and as the amount of building was limited by a ceiling on investment, it led to no increase in building. The procedure was therefore abandoned as wasteful of time and effort. The Government's view is that the proper course is to rely on the Regional Boards to decide the spending of their own funds, and not to give any special priority to the repair of war damage.
§ LORD STONHAMMy Lords, is the noble Lord aware that his reply confirms that nothing whatever is paid on war damage account for the repair of war-damaged hospitals, and that means that in the metropolitan areas a great disability is inflicted on many of our older hospitals which are in the worst condition? Would he therefore look at that particular point? Further, would he look at the point that the capital programme for hospitals has been fixed for the next three years, which means that, unless there is a change in the present procedure, no help can be given to hospitals which are badly war-damaged—and this does not apply to any other kind of building—and which have no help even to pull down buildings that are dangerous? Will he look at that point because, with respect, his reply is not a reply to the point I have put.
LORD ST. OSWALDMy Lords, I studied the noble Lord's Question carefully, and I think that mine was a direct reply, or as direct a reply as I am able to make, taking into account that provision of the National Health Service Act which I mentioned. I do not think it confirms the noble Lord's statement, because I had not heard that statement previously made. I think he was referring specifically to, for instance, St. Matthew's Hospital, which forms part of the Central Group of which he is Chairman. For that reason, I have looked into the condition of that hospital, and I find that one block was severely damaged during the war and made weather-proof 1032 some years ago. The interior has not been reconditioned, because the need for additional beds has never been demonstrated to the satisfaction of the Regional Board which is responsible for the planning of hospital services in that Region. I have not yet been able to find out what efforts have been made to demonstrate such a need to the Regional Board. So far as figures go, the hospital has 320 chronic sick and geriatric beds to serve a population of 145,000—that is, a ratio of 2.2 beds per thousand, which is nearly twice the national average. The yardstick of need is not the national average but the need in a given locality. I have tried to study the noble Lord's own particular area, and I cannot find that there is a case where the need for expansion is held down artificially by reference to the national need.
§ LORD STONHAMMy Lords, while I am grateful to the noble Lord for the detail into which he has gone, I was not referring to a particular hospital—indeed, I should have thought it would have been improper for me to do so. But can the noble Lord look at this matter with regard to the national position? St. Thomas's Hospital, we are informed, is to be rebuilt at a cost of £7 million, which is largely justified—and I do not dispute it—on the ground of war damage. That £7 million would resolve almost all the war-damage difficulties of almost all the hospitals throughout the country. Can the noble Lord not consider that and again have a look at the question of war damage at ordinary hospitals?
LORD ST. OSWALDMy Lords, I am sure I should be right in saying that St. Thomas's Hospital is being rebuilt on the grounds of need and not simply on the grounds of war damage.
§ LORD WILMOT OF SELMESTONMy Lords, would not the noble Lord agree that if the need is there, and it arises partly from the existing war damage, it would be a sensible thing to authorise the commencement of rebuilding?
LORD ST. OSWALDMy Lords, I hoped that I had made the point that the Regional Board in this particular case has not been satisfied that their need is greater than other needs in other parts of the country.
§ LORD WILMOT OF SELMESTONI am sorry to press the noble Lord, but that is not a very satisfactory situation. If the need is there, and the damage is there, at least the damage can be made good. The need, we know, exists all over the country, and to refer to the average does not help anybody.
LORD ST. OSWALDMy Lords, I think I did make that point myself. But the point is that somebody has to be the assessor of the need; and responsibility for the final assessment of the need, as measured against other needs in other parts of the country, devolves on my right honourable friend.