§ Lord SEGALMy 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 which hospitals are being considered for closure during the next three years.
§ Lord WELLS-PESTELLMy Lords, information of the kind requested is not available centrally. The responsibility for considering possible closure or change of use of hospitals rests primarily with the Area Health Authority concerned.
§ Lord SEGALMy Lords, while thanking my noble friend for that reply, so far as it goes, may I ask whether it would be possible to keep these buildings on a maintenance basis so that they may be reopened when happier times arrive? In cases where closure is inevitable, could not these buildings be retained for community use, as hostels for old people or for the mentally handicapped, instead of being sold to the highest bidder?
§ Lord WELLS-PESTELLMy Lords, in general, hospitals would not be permanently closed unless it was clear that they had no future place in the long-term plans for the Service. If temporary closure was decided upon, a hospital could, as my noble friend suggests, be placed on a care and maintenance basis, and this is often done. With regard to the second part of his question, the rules for the disposal of National Health Service property provide that they are first considered for other NHS use. If none is foreseen, they are then offered to local authorities, with whom there is already close co-ordination through the joint consultative committees, for possible use in the personal social services. Only—and I 604 want to stress this—when these aspects are cleared, are premises first offered to other Government Departments, then to local authorities for use other than in the personal social services and then, finally, for disposal on the open market.
§ Lord WADEMy Lords, can the noble Lord give an assurance that, in considering these matters, no bias will be shown against small hospitals merely because they are small?—since there are many which are valuable to the National Health Service and arc much appreciated by some patients.
§ Lord WELLS-PESTELLMy Lords, I think the first acid test is their contribution to the needs of the community, and, secondly, there is a cost-maintenance test. I do not think there are any other considerations that would militate against them.
§ Lord AUCKLANDMy Lords, would not the noble Lord agree that his statement will give widespread concern to a number of workers in the National Health Service? Would he give an undertaking that cottage hospitals, which serve an enormous need in the community, particularly in rural areas, will get special priority when it comes to keeping open hospitals which really matter?
§ Lord WELLS-PESTELLMy Lords, I do not accept what the noble Lord says; that is, that any statement that I made will cause widespread alarm or concern. I went so far as to say that hospitals are not closed unless there is a very good reason, and there are a number of procedures that have to be gone through before they can be closed. If I may deal with the matter relating to staff which I think the noble Lord touched upon, all closures involve a planning process with extensive consultation at all stages with those who are concerned, including the staff; then there is a considerable gap of something like six months before any action is taken, so that the needs of the staff and those who serve the hospital can be fully explored.
Lord INGLEWOODMy Lords, would not the noble Lord agree that, so far as cottage hospitals are concerned, the important thing is not only the convenience of the staff but also the convenience of the patients, frequently elderly and not acutely ill but to whom 605 visits from their families are very valuable. While it may be a great deal more convenient for consultants to have all patients where possible put into ambulances and carried long distances to a few centres, it is extremely unfortunate for many elderly people whose relations have neither the transport nor perhaps the time to go a distance to visit them. This can add greatly to the loneliness and unhappiness of old people.
§ Lord WELLS-PESTELLMy Lords, I find it very difficult to believe that noble Lords feel that there is such indifference to the needs of the patients and their relatives that we just shut down cottage hospitals and other hospitals simply because we have a whim to do so. All these matters are considered very carefully.
Lord INGLEWOODMy Lords, following on that point, may I ask whether the noble Lord is aware that I would not have put it so forcefully if he had not laid all the stress on the convenience of the staff but not mentioned once the patients?
Lord WALLACE of COSLANYMy Lords, is my noble friend aware that the opening of a large, modern, fine new hospital involves the closure of some smaller units which are either uneconomical or not necessarily able to give the finest possible service. Although I disagree with the reorganisation of the Health Service, is he also aware that considerable consultation is had with community health councils and their views obtained before any attempt is made to draw final conclusions about closures?
§ The Earl of CROMARTIEMy Lords, would the Government agree that we are talking only about England? I am talking about the North of Scotland where one may have to bring a mother who is going to have a baby hundreds of miles to Inverness. Our local hospitals —what other noble Lords may call cottage hospitals—are extremely valuable—
§ Several Noble Lords: Question!
§ The Earl of CROMARTIE—and give excellent service.
§ Viscount HANWORTHMy Lords, I should also like to support what has been said—
§ Several Noble Lords: Question!
§ The MINISTER of STATE, DEPARTMENT of INDUSTRY (Lord Beswick)My Lords, may I suggest that we stick to questions? It might be for the convenience of the House if my noble friend the Minister were enabled to answer them occasionally.
§ Lord SEGALMy Lords, could my noble friend say how many beds are likely to be lost to the National Health Service through closure of the hospitals which are now under consideration?
§ Lord WELLS-PESTELLMy Lords, that is another question, but, frankly, I do not know the answer.
§ Baroness MACLEOD of BORVEMy Lords, is the noble Lord aware that there is a village in Sussex which does not subscribe to the criteria set out today by the Minister? Is he further aware that they have disagreed with the Ministry, and have now bought back the cottage hospital for their own use?
§ Lord WELLS-PESTELLMy Lords, if the noble Baroness, Lady Macleod of Borve, is in any sense aggrieved by the situation and she will let me have particulars, I will try to let her know the reasons for the action that was taken.
§ Lord HAILSHAM of SAINT MARYLEBONEMy Lords, would the noble Lord, Lord Wells-Pestell, be good enough to answer the question posed by my noble friend? Even though it was not in interrogatory form, it could easily be translated into the words, "are not" instead of "are".
§ Lord WELLS-PESTELLMy Lords, if I understood correctly the noble Earl, Lord Cromartie, what he was saying was that cottage hospitals in his part of the country are of supreme importance to the community. I was not aware that he was complaining that any of them had been closed.
§ Viscount HANWORTHMy Lords, is my noble friend really certain that full weight is given to the importance of these local cottage hospitals, whether or not they are viable?
§ Lord WELLS-PESTELLMy Lords, I am certain, and for this reason. A hospital cannot be closed unless the Community Health Council approves. If the Community Health Council disagrees after going into every aspect the matter then has to be referred to the Secretary of State.
§ Lord PARGITERMy Lords, would it not be desirable to take into account the expressions of sympathy opposite on the question of the Health Service and, equally from the same side, demands for cuts in public expenditure?