CLOSURE OF SMALL HOSPITALS (Hansard, 25 February 1965)

§ LORD ABERDARE
My Lords, I beg leave to ask the Question which stands in my name on the Order Paper.

§ THE PARLIAMENTARY UNDERSECRETARY OF STATE FOR COMMONWEALTH RELATIONS AND FOR THE COLONIES (LORD TAYLOR)
Yes, my Lords. But there are many other relevant factors besides local difficulties of communications which have to be considered by my right honourable friend the Minister of Health or the Secretary of State for Scotland before making a decision on a proposal for the closure of any small hospital.

§ LORD ABERDARE
My Lords, I should like to thank the noble Lord for that reply. I must declare an interest in the particular circumstance of the Lady Aberdare Maternity Hospital at Mountain Ash. May I ask him whether he is aware that in this case the plans for its closure would entail patients and visitors in certain circumstances having to travel from one valley to another valley for treatment in a new hospital at Merthyr Tydfil? Is he aware that this road is a very winding, mountainous road? Is he aware that it is often closed by snow in the winter? Moreover, is he aware that there is no railway there any more? Also, is he not in general sympathetic with this case, and does he not feel that there are geographical difficulties which might well influence the Minister to look with some favour on this small hospital?

§ LORD TAYLOR
I was aware of only some of those factors, my Lords. But 917 I think that the real issue is not the Merthyr Tydfil Hospital but the Aberdare General Hospital, where the increase in obstetric beds planned is from 14 to 44, and it is this increase which is giving rise to the question of the future of the Lady Aberdare Hospital. However, the future of the Lady Aberdare Hospital will not be finally decided, I understand, until that increase has taken place.

§ VISCOUNT LONG
My Lords, having been a patient in one of these local hospitals, may I ask the noble Lord whether he is aware of the shortage of nurses in the main hospitals? Is he further aware of the wonderful attention that patients in the local hospitals get from part-time nurses? Before the Government do away with these local hospitals, where the attention, the food and everything else are magnificent. will the noble Lord ask his right honourable friend the Minister of Health to have a local inquiry in all these areas, as the doctors are all against doing away with these local hospitals?

§ LORD TAYLOR
My Lords, there is by no means unanimity inside the medical profession about the future of these small hospitals. The difficulty is that sometimes they are technically less efficient than larger hospitals.

§ VISCOUNT LONG
They are not.

§ LORD TAYLOR
My Lords, the noble Lord cannot have been a patient in the Lady Aberdare Maternity Hospital. This small hospital, which I have no doubt has many qualities, has in fact a lower number of deliveries per bed than the Aberdare General Hospital. One does not say that that is necessarily wrong, but it does mean that factors of economics and factors of medical efficiency have to be considered, as well as factors of communication. Nobody is denying for a moment the value of part-time nurses.

§ VISCOUNT LONG
My Lords, is it not a fact that in many areas the medical profession are dead against the closure of these local hospitals?

§ BARONESS SUMMERSKILL
My Lords, is the noble Lord aware that the medical profession at the centre are opposed to these local hospitals, because they know that a good bedside manner 918 —even a good part-time nurse—is not a good substitute for an efficient medical staff? Despite the difficulties of communication between the valleys, it is absolutely wrong to keep open these hospitals which instil confidence in a patient—confidence which may be misplaced.

§ LORD TAYLOR
My Lords, without careful consideration, I would not commit myself to the quality of the service in any local hospital. But I would agree that the final test must be the safety and welfare of the patient.

§ LORD BRECON
My Lords, as the original Question had some bearing on Wales, perhaps we can go back to it. May are remind the noble Lord that I asked him a supplementary question on December 8 last, about the closing of small hospitals in Wales, and about who would have the authority. He said that he would consult with his right honourable friend on this matter. Can he now tell us whether the final decision upon the closing of a small hospital in Wales will be made by the Minister of Health or by the Secretary of State for Wales?

§ LORD TAYLOR
My Lords, my memory is defective. I must confess that I had forgotten the noble Lord's question. In my opinion, the decision will be taken by the Minister of Health, because I think the Welsh Hospital Board is responsible to the Minister of Health. But I am not absolutely certain, and I speak subject to correction.

§ LORD BRECON
My Lords, this is not carrying out the promise of the Government which they gave to Wales, that all these managerial matters would be looked after by the Secretary of State for Wales. He was to take over the responsibilities of the Ministry of Health and now he is not going to do so. I hope that we shall know before long exactly what the Secretary of State proposes to do.

§ LORD TAYLOR
My Lords, if the noble Lord will put down a Question specifically, we will see that he has an authoritative Answer.

§ LORD GRIMSTON OF WESTBURY
My Lords, returning to the question of the opinion of the medical profession, is the noble Lord aware that there are a 919 great many general practitioners in country areas who wish the small hospitals to remain open? When I was in another place I had more than one deputation to that effect from the local G.Ps.

§ LORD TAYLOR
My Lords, the noble Lord is quite correct about this, and one has great sympathy with these local general practitioners. As a matter of fact, in the Aberdare General Hospital, where the extra beds are to be provided, there will be fourteen general practitioner beds among the extra beds, and the effect of those extra beds has to be taken into account when the fifteen general practitioner beds in the Lady Aberdare Hospital are considered.