§ Lord DENHAMMy 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 on what system of priorities single-bed rooms in National Health Service hospitals, made available by the phasing out of the private sector, will be allocated.
§ Lord WELLS-PESTELLMy Lords, the separation of private in-patient practice from National Health Service hospitals will release for National Health Service purposes generally the facilities, services, and staff. previously used by private patients. Single rooms and all the other facilities provided in National Health Service hospitals are already available for National Health Service patients and this will continue. After the phasing out of pay beds the National Health Service will be able to widen the provision of privacy for those who need it or desire it. The Area Health Authorities control the allocation of National Health Service resources in their areas, but the use for individual patients of particular facilities provided in a hospital is under the clinical direction of the consultant concerned.
§ Lord DENHAMMy Lords, are Her Majesty's Government aware that very many people of slender means have for years been subscribing to private insurance schemes, not because they want to jump hospital queues, not because they want to buy special medical skills that are not available to everybody, but purely because they want to ensure their comfort and privacy if they are taken ill? Are Her Majesty's Government further aware that a large proportion of these people will not be able to pay the very much higher premiums needed to cover the cost of a room in a new clinic or hospital built in times of inflation, and will therefore lose the benefits they have earned through years of thrift? Do Her Majesty's Government appreciate that, as they will he solely and deliberately responsible for this deprivation, they will have the highest possible moral responsibility to see that those private rooms whose allocation is 526 not justifiable on medical or psychiatric grounds do not become the object of privilege?
§ Lord WELLS-PESTELLMy Lords, the moral responsibility on this Government, and presumably on any other Government that this country may have, is to serve the needs of the greatest number, and to prevent people from jumping a queue because they have the financial means to do so. This is precisely what. is happening at the present moment. The Government are not unaware that certain people may be placed in some difficulty in so far as they may not be able to get what they want, but everybody will be able to use the National Health Service facilities, and those who are deemed by their consultant to need some sort of privacy will be provided with it.
§ Baroness LEE of ASHERIDGEMy Lords, is the Minister aware that privacy is a precious necessity for some patients, but that privacy is a punishment for other patients? May I venture to ask Members of your Lordships' House—
§ A Noble Lord: No, the Government.
§ Baroness LEE of ASHERIDGE—to read a chapter in In Place of Fear, written by the creator of the National Health Service a quarter of a century ago, in which he stated quite clearly that the Health Service patient who needed privacy for either physical or psychological reasons would have an amenity ward at his disposal, so that there need be no conflict at all between a National Health Service patient's needs and the provision of privacy? May I further add that the attack on one of our Ministers in the other House—who is the last person in the world who would ask for privacy—by sections of the Press has been absolutely disgraceful.
§ Lord WELLS-PESTELLMy Lords, I am indebted to my noble friend for her comments and observations. I should like to make it clear, in repeating what I have already said, that with the phasing out of pay beds, facilities will be provided as they are provided at the present moment, in that people who, for various reasons, may need privacy will, in fact, receive that privacy.
§ Lord TREFGARNEMy Lords, instead of berating the "queue jumpers " 527 with some venom, why do the Government and the noble Lord not do something about the queue?
§ Lord WELLS-PESTELLMy Lords, I am sorry if noble Lords think that I have been berating anybody. Phasing out pay beds will bring into the National Health Service nearly 5,000 more beds, and therefore something will be done in respect of the queue.
§ Lord AMULREEMy Lords, can the noble Lord give us an undertaking that none of these bedrooms, when they are given up from being used for private patients, will be turned over to the administrative side and used as offices?
§ Lord WELLS-PESTELLMy Lords, I would not, with great respect, like to give that assurance—
§ Lord WELLS-PESTELL—for the simple reason that I just do not know, and I will not make a pronouncement on something of which I am not absolutely certain. However, I should be most surprised if that were to happen.
§ Baroness SUMMERSKILLMy Lords, is it not a fact that no change at all has taken place in the policy, except of course from the point of view of people who desire to pay a large sum of money for their beds? Is it not a fact that anybody who needs privacy will be able to obtain a private bed, just as he or she has been able to do in the past, on an amenity basis?
§ Baroness LEE of ASHERIDGEExactly.
§ Baroness SUMMERSKILLThe amenity basis is, of course, the one that is decided by the physician or surgeon, and surely that seems to be absolutely fair.
§ Lord WELLS-PESTELLThat is so, my Lords, and I thought I had made that quite clear.
§ Lord AVEBURYMy Lords, apart from any medical or psychiatric need for private beds, is the noble Lord aware that there is also the consideration, which appeals to the hospital authorities, that, when a well-known person goes into hospital and the Press or television people 528 may wish to make importunate inquiries about his or her condition, that is seen by the hospital authorities as a very good reason for putting such a person into these private facilities, whereas from the ordinary patient's point of view this looks like an extension of privilege to people who arc not paying for it?
§ Lord WELLS-PESTELLMy Lords, I think that may well be so.
Lord WALLACE of COSLANYMy Lords, is the Minister aware that the only guarantee of privacy should be for medical need determined by the doctors in charge of any individual case, and that apart from that no other question should arise?
§ Lord SEGALMy Lords, would my noble friend not agree that the rate of bed occupancy is far more important than the addition of a few hundred or thousand beds, and that the one overriding criterion ought to be the interests of the patient—to get him well as rapidly and efficiently as possible?
§ Lord WELLS-PESTELLI do not know that I would go all the way with my noble friend. It is perfectly true that Area Health Authorities are currently authorised to make 4.574 pay beds available within the National Health Service, and the average daily occupancy of those beds amounts to 2,383.
§ Lord PLATTMy Lords, without wishing to take any sides in this matter at the present time, and as one who was very much in favour of the amenity bed scheme when the National Health Service came in, may I ask the noble Lord to say whether Her Majesty's Government realise that in a number of hospitals there have just not been the amenity beds to offer to the many people who would have liked to have them and who would have paid something for their use? Also, will Her Majesty's Government take into account, when they are considering the question of queue jumping, the fact that medical necessity is not always the only criterion? Perhaps I may be allowed, when asking a supplementary question, to give an example. For an ordinary working man who is to have a non-urgent operation, it perhaps does not matter very much exactly when he goes into hospital, and he gets a postcard saying, "A bed will be available tomorrow."
§ Several Noble Lords: Too long.
§ Lord PLATTMy Lords, if that were to happen to a Cabinet Minister, would that not be a reason, a non-medical reason, for him coming in on a certain date?
§ Lord WELLS-PESTELLMy Lords, I can only repeat what I have already said; that is, that the acid test will be in respect of those who need privacy for a variety of reasons, some of which may be medical, and those who desire privacy.
§ Baroness MACLEOD of BORVEMy Lords, is there a charge for amenity beds and, if so, how much is it?
§ Lord WELLS-PESTELLMy Lords, there is a charge, and I think I am right in saying that at the moment it is about £2 a day.
§ Baroness MASHAM of ILTONMy Lords, will the National Health Service be given any more money to supplement the money lost from pay beds?
§ Lord WELLS-PESTELLMy Lords, I am not the Chancellor of the Exchequer, so I cannot say. I really cannot give the House an answer to that supplementary question.
§ Lord HAILSHAM of SAINT MARYLEBONEMy Lords, does not the noble Lord answer on behalf of the Government and is it not the tradition of this House that, when an answer is given on behalf of the Government, a comprehensive answer is given covering any Department which may be affected?
§ Lord WELLS-PESTELLMy Lords, the noble and learned Lord will know that I was asked whether the Government would provide the National Health Service with more money to meet this kind of situation. I said that at the moment I just do not know.