§ 6.37 p.m.
§ Lord ALPORT rose to ask Her Majesty's Government whether, in view of the Report of the Army Welfare Enquiry Committee, they will reconsider the decision to close the Military Hospital in Colchester at the end of 1977. The noble Lord said: My Lords, I beg leave to ask the Question standing in my name on the Order Paper. The source of the problem which I seek to present to your Lordships starts, bizarrely enough, with a proposed extension to the Tate Gallery. When the noble Baroness, Lady Lee, was Minister for the Arts, there arose a project, which obtained her approval, to extend the Tate Gallery. It was, I understand, discovered that this could be done only by encroaching on the premises of the Millbank Military Hospital. It was eventually decided that the right solution would be to get rid of the Millbank Hospital and to build a huge general hospital which, for some unexplained reason, was to be located at Woolwich.
§ As your Lordships will recognise, there are very few soldiers at Woolwich, which is a very difficult location to reach from most of the major garrison areas in the United Kingdom, not least from the town of Colchester which, after Aldershot, is one of the largest military stations in Britain. It was decided to build a 400 bedded hospital and this is now on the point of completion. The problem then arose as to how the new hospital was to be filled. I understand that it was therefore decided to close the Royal Herbert and the Colchester Military Hospital as well as the Millbank Hospital, and maybe others as well. No thought seems to have been given to the consequences of all this for the welfare of the Army and 1268 particularly of the wives and families of those who serve in it.
§ I believe that it would be unfair of me to allege that the object of this reorganisation of the military and medical services was solely in order to provide better facilities for the public presentation of art forms consisting of the grouping of firebricks and the nets of Scottish fishermen, but there are others who may feel justified in reaching this conclusion. The fact is that the military hospital in Colchester, which has recently been equipped with the most up-to-date operating theatre and where the wards have been and are being modernised at a cost of several hundred thousand pounds, is to be closed at the end of 1977, when another £100,000 is to be spent on creating an MRS there.
§ I am not basing my case on the effect that this will have on the local civilian population. The fact is, however, that in the Colchester area we are desperately short of hospital accommodation. The building of the new Area General Hospital has disappeared into the 21st century. It is true that, because of the generous attitude of the authorities of the Military Hospital, many with only a tenuous association with the Army—retired soldiers and their dependents, civilian industrial employees at the MOD and others in emergency—have benefited from the excellent facilities that the hospital provides.
§ Her Worship the Mayor of Colchester expects to send a petition against the closure, with 50,000 local signatures, to Mr. Buck, the Member for Colchester, to present to Parliament. It is true that the relations between the garrison and the civilian population of our town have always been close and friendly. We like soldiers and we do our best to make them and their wives and families feel at home in our midst. Many soldiers in their youth seem to find attractive brides in our town, and many when they retire come and live and find employment in our part of Essex. We have indeed at the moment an infantry battalion in which the Minister of Defence himself served during the war, but I would not of course wish him to show any partiality on that account.
The case I present to you, my Lords, is not based on the civilian interests of Colchester, although they are very real.
It is purely on what I believe to be the real interests and the welfare of this generation's soldiers and their wives and families. Your Lordships would be as well versed in Kipling as I am and you will remember the poem Tommy:
We aren't no thin red 'eroes, an' we aren't no blackguards too.
But single men in barricks, most remarkable like you;".
§ But, of course, the modern soldier is not a single man in barracks, who, when he becomes a casualty, shot in the back by the IRA in Ulster, or a victim of a road crash or other accident, requires to go to hospital. Most often he has a wife and kids who, while he is away in Ulster or anywhere else, are the focus of his anxieties and the pledge to his future. If he is to serve the Queen as he and we would wish, he should have the knowledge that the wife back home and the kids, if they become ill—and this is what always haunts a young family—have ready access to immediate medical treatment.
There are, I believe, 4,500 children and over 4,000 adults in our married quarters. Most of these will, after the end of next year, become an additional responsibility on the civilian medical resources in our town. Of course, in the case of Colchester they will get the best we can provide, but as we cannot provide what is needed for our own civilian population, they will have to take their turn if the Military Hospital is closed. Here I should like to quote from the report of the Army Welfare Inquiry Committee, paragraph 413 and subsequent paragraphs. It says this:
In written evidence, the Society of Community Medicine said that they saw Army families at a disadvantage in comparison with similar civilian families in the fields of health, education and welfare. They considered that families of junior ranks were most affected …
It goes on:
They also mentioned that no priority or preference was given to service families who must take their place in the queue for medical specialist facilities and services, unless they had access to a military hospital, and that when their turn came they often had either already moved on or were about to do so. Frequent posting meant that health records sometimes were lost in the pipe-line, to the detriment of the wife or child; and isolation from parents and parents-in-law might be particularly damaging to the increasingly younger wives and mothers now found in the Army. For wives, they considered that separation often meant long periods of boredom and loneliness, usually aggravated by the constraints imposed by young children; in extreme cases reactions were said to be almost as desperate as widowhood. They also
emphasised the fact that separation was no easier to bear on second or subsequent occasions, and related this to what they considered to be an increase in psychiatric morbidity, such as anxiety states and depression.".
I may say that all our major units serve regularly at intervals in Ulster. The report goes on:
All these comments were echoed in similar measure during our visits by local medical authorities, doctors, health visitors, and other witnesses.
It goes on:
… many Army wives complain to us of difficulties in reaching doctors' surgeries and of transport problems in visiting their sick husbands in military hospitals, often at some distance from the unit location and particularly if it meant making arrangements for someone to look after children; in changing prescriptions; in getting dental treatment; in getting continuity of treatment in cases where medical records had not been transferred in time; and in getting adequate family planning facilities.
Finally, it says:
Our postal surveys show that family illness features very high on the list of problems en-countered by wives.
§ My Lords, the knowledge for both the young soldiers and for their wives that family health receives special care in the Army from the military medical services and through a military hospital is a con-solation for the problems which they face in their family life. Let me say that I have a pretty shrewd idea what the noble Lord will say in reply when the time comes for him to answer this short debate. He will start by saying that there are important reasons of economy. The original decision was not made for reasons of economy. That was an argument in its support which has been imported at a much later stage; and I would remind your Lordships that the loss and waste of resources and the existing facilities of the military hospital at Colchester are in my view very serious. He will then argue the advantages of training for RAMC officers in a big general hospital as against those of a smaller one like Colchester. But we have had for many years past a first-class postgraduate medical centre in Colchester with which the medical officers of the RAMC at the hospital have been associated, and it helps provide the additional training they require if they want to increase their professional careers. Of course there could be, and there is at the present moment, very considerable co-operation between the civilian medical profession and the RAMC.1271
§ Then the noble Lord will argue that there is a shortage of RAMC officers and nursing officers which requires a concentration of resources at somewhere like the Woolwich Hospital—the Queen Elizabeth Hospital. I am absolutely certain that just as in the case of Millbank, additional civilian specialist help could be given locally to the Military Hospital to help out if there was a shortage of specialist resources available for the Military Hospital in the future. We have been under a very great debt—doctors and civilians alike in Colchester—to the Military Hospital in the past, and it is a price which I am sure would be well and happily paid in order to help to maintain in our midst the facilities which the hospital provides.
§ Finally, the noble Lord will argue the advantages that a big modern hospital can give, with better facilities for the treatment of cases that are sent to it. But I think that idea is already out of date. I think I would be right in saying that it is now generally agreed that the large central hospital does not have the advantages from the point of view of treatment of patients which are available in a small, local hospital, in easy access to the nearest and the dearest of patients during their period of sickness and recovery.
§ I therefore offer these conclusions. From the medical point of view, opinion is changing from the concentration of treatment in large units to the need for accessibility to patients by their families and friends in local hospitals. Big is no longer beautiful in medical hospital terms. From the administrative point of view, the large sums spent on the modernisation of the Colchester Hospital will be wasted if it is now to be put in moth balls, as is the present intention. This is by far perhaps the most important point of all: from the military point of view, the loss of the amenity which it provides for families serving in our garrison would have a very serious effect on recruiting, on the number of trained men with families who will sign on for further service. And let me put it to the Minister quite bluntly: it could lead at some later stage to a situation in which a married man, or even a unit, feels that the duty to his family overrides his allegiance to the Crown. My Lords, the Directorate of Medical Services would 1272 have no right to inflict such pressures on Service men and their families, and if anything were to go wrong the responsibility would be very great indeed.
§ My Lords, let me sum up. The military medical advice locally in Colchester is against it, and in some cases passionately against it; the views of senior commanders and unit commanders are, as far as I know, strongly against it; the decision is deplored by the ranks of the 26 Army units stationed in Colchester; it is a cause of anxiety, amounting to fear and deep resentment, among the wives of soldiers in the garrison; it is opposed by the civilian medical opinion, as represented by the Colchester Medical Society; many thousands of military and civilians have signed the petition against it which the chief citizen of Colchester has organised; it has been the subject of a debate in the House of Commons introduced by Mr. Buck, the Member of Parliament; and the Minister, Mr. Brown, has had a deputation representative of local interests wait upon him, of which the noble Lord, Lord Greenwood of Rossendale, and I were members. To this, I must record, he read an answer which seemed to us to have been drafted before the delegation assembled at the Ministry, and which did not seem to me or to those who reported it to me to really understand the root problem with which we are trying to deal. Now, my Lords, we have the report of the Army Welfare Inquiry Committee to give official backing to the views which all of us have pressed on the Ministry of Defence: that a vital element in the welfare of the modern soldier in peace-time, particularly those who are serving frequently away from their families and their home bases, is the availability of medical attention for his family when they fall ill.
§ Many times in these last years I have heard your Lordships refer with pride and gratitude to the services rendered by the present-day Army, especially in Ulster; and we have heard it said by the Minister within the last few minutes. So far as our garrison is concerned, as I have said, all our major units serve in Ulster; and I remember not very long ago attending an occasion in the garrison in the evening following an afternoon when three young fusiliers were reported as having been shot and killed in Ulster. I know the effect that it had upon the wives and the men with whom I happened to be at that 1273 particular time. What is more, our units go on separate service frequently, for we are the station of the Air Transportable Brigade, which is the "fire brigade" which is available at any time at short notice for duty anywhere.
§ Surely the morale and contentment of these troops is of importance to the Ministry of Defence. As it is, by what seems to me and to those who are associated with me in this to be a stubborn adherence to an administrative decision which is wrong from a military and a medical point of view; which involves economy only in the sense that it gives some substance of justification to the existence of a medical "white elephant" at Woolwich, while involving a lamentable waste of resources where they are needed, in Colchester; which is in conflict with the whole weight of evidence as we can see it—still the Colchester Military Hospital is to be closed in 12 months' time.
§ My Lords, I and all of us here know something of the problems that involve Government Departments when decisions like this have been made, sometimes, as in this case, some years previously. But let me put to the Minister, if I may, this compromise, and I ask him seriously to consider it together with his right honourable friends. In three years' time the Ulster troubles, we hope and pray, may be over, and therefore separate, unaccompanied service will be less characteristic of the Army. In three years' time the Health Service in North-East Essex may have greater resources; we hope so. In three years' time the economy of the United Kingdom (this, after all, is the Government's promise in the light of their policies and the hopes from North Sea oil) may be far stronger and able to provide the resources which are needed to maintain facilities for the local population and, perhaps, additional facilities for the Army as well. I ask the Government, therefore, to postpone the closure of this hospital, the Colchester Military Hospital, for a further two years, until the 31st December 1979.
§ It is not asking much, in the light of the importance of this matter in the lives of thousands of wives and children of soldiers serving in the garrison at Colchester. It might avoid, I suggest, for the Army Medical Directorate, responsibility for a grave error of judgment which will be 1274 bitterly regretted; and it would show that the Ministry of Defence is not completely insensitive to the welfare in this respect of the Servicemen and women and their families. It would show, particularly, to local civilian opinion, that the Army today can think beyond the narrow limits of administrative convenience and accept the weight and sincerity of the advice tendered to it by those who, whether or not they have been soldiers, have very much at heart the welfare of the young men and their wives and families who are, for the time being, our fellow citizens in our ancient military town, and in whom we take an especial interest and pride.
§ 6.55 p.m.
§ Baroness ROBSON of KIDDINGTON
My Lords, I join briefly in this debate as someone interested in the National Health Service and its administration, because the health services provided by the Ministry of Defence and those provided by the National Health Service are very closely linked. I would plead for a much closer liaison between the National Health Service and the Ministry of Defence or the RAMC. I am quite happy to admit that the National Health Service, as a whole, have been the gainers in the past. I believe the average figures are something approaching 22,000 National Health Service patients looked after in military hospitals in a year, and only about 5,000 defence personnel looked after in the National Health Service hospitals. So your Lord-ships can see that the proportion is very much in favour of the National Health Service; and, in the past, this has taken place without any money changing hands, so to that extent the National Health Service have been even greater gainers. But I think the Ministry of Defence would admit that the admission of National Health Service patients into their hospitals has helped enormously in providing training facilities for their medical personnel over a wider range than would have been the case without them.
I should like to say something about military hospitals in particular. They are not all the same. Although I quoted the figures that I did to your Lordships, the amazing thing about the Colchester Military Hospital is that there they have been caring largely for military personnel. The average daily civilian attendance as inpatients in 1974, out of 114 beds, was 28. 1275 So they have been more concerned in many ways with looking after military personnel than many other military hospitals. Incidentally, I am told that they intend to retain out-patient services for acute care, psychiatry with X-ray and physiotherapy services in an extended medical centre. Your Lordships may assume that the National Health Service would be delighted to take over the Colchester Military Hospital in order to extend the bed complement, which is highly-needed in that part of the country. Unfortunately, because of the situation of the hospital, which is in the middle of the military barracks, it is not particularly accessible to the general population of Colchester; and I believe that, in the present economic climate of the National Health Service, the capital expenditure necessary to upgrade the hospital is such that this cannot be undertaken by the Health Service.
I want to relate this question to some-thing which the noble Lord, Lord Alport, mentioned, and that is the building of the Military Hospital at Woolwich. It seems quite fantastic that the liaison between the NHS and the military hospitals has been such that the Ministry of Defence has built a large, brand-new hospital in an area which is already over-bedded and has not had enough communication with the National Health Service to see that it might have been better to spend that money somewhere else. This is exactly the position that existed in the past between the board of governors of the teaching hospitals and the Regional Hospital Boards. There was no liaison between the two planning bodies.
I believe that we are approaching a better attitude in this sense, but it is in many cases too late and I am afraid will not help to save Colchester. I have, in my own region, an example, the Cambridge Military Hospital, where negotiations have been going on for something like ten years between the local NHS and the military hospital for the rebuilding of that hospital. They provide about 70 acute beds for the community in which they function. The local health authority would be quite happy to accept 60 acute beds in the rebuilt hospital, should it be rebuilt, and, perhaps, some additional maternity beds. The area would be quite happy to pay to the Ministry of 1276 Defence the equivalent cost of running DHSS beds. On the other hand, I think the question would be quite different—because we have already built the Frimley hospital, a brand new district general hospital—if we were asked to contribute a capital sum, something which I believe the National Health Service could not afford at the moment. What is important is that it has obviously been wrong in the past that the NHS has benefited to too great an extent from beds in the military hospitals without making any contribution. It may be that this, to a certain extent, has caused the problems facing the hospitals.
I am told that there is a Working Party or committee in the Department of Health preparing a Paper on the planning criteria for the National Health Service and the Ministry of Defence hospitals, so that in future we shall avoid problems such as Colchester and Woolwich. I think that in some areas—although I would not say this applies to Colchester where there is a shortage of beds—there is no reason at all why the military services should not use National Health Service hospitals, except that there is this fear that the training of the RAMC could not be taken care of in the same way. I believe that it could. There is no reason at all why Ministry of Defence doctors or consultants should not be employed on an honorary basis in the NHS and their salaries paid by the Ministry of Defence.
My Lords, the other argument that is put against this is that they will not get experience in the type of unfortunate and tragic accidents that tend to happen in the Army; but, if to a large extent, they worked in the accident and emergency departments in NHS hospitals I cannot see that there is much difference between the results of a ghastly motorcar accident and the results of even more unfortunate incidents happening, perhaps, somewhere in Northern Ireland. I believe that with good will we could work together to a much greater extent than in the past and could help to avoid the mistake of Woolwich and the tragedy of Colchester, and that, between us, we could help save the nation money as well.
§ 7.3 p.m.
§ Lord LYELL
My Lords, we on these Benches would, I am sure, wish to associate ourselves with the comments and the 1277 excellent speech of the noble Lord, Lord Alport, and we are all very grateful to him for raising this subject which he has explained in great detail and in regard to which the noble Baroness, Lady Robson, was of such assistance. We are glad that the noble Lord, Lord Winterbottom, is to reply for the Government because all of us know how highly the noble Lord considers all aspects of the defence forces and their dependants. Many of us will remember the sympathy and knowledge displayed by the noble Lord when the House was considering the provisions of the Armed Forces Bill during last summer, and especially when we considered a more reasonable system of courts to deal with civil misdemeanours committed by the dependants of Servicemen who happened to be stationed in the British Army of the Rhine. Of course, in that Bill there were other provisions which dealt with juvenile problems, and all of us were struck by the detailed knowledge and clarity and the effort that the noble Lord made in helping us with questions that we had on that Bill and in seeing that the Bill brought up to date the whole framework of military law. That is why we are so pleased that he is speaking tonight for the Government. We know how highly he rates welfare as an element among the general benefits of the defence forces.
It seems that many of us still think of defence problems as mainly in the area of combat forces. Nevertheless, the Servicemen and women are required to take an increasingly wider interest in welfare; and this is so at all levels. Indeed, the report of the Committee chaired by Professor Spooner draws attention to this aspect, I think in paragraph 480 and the following paragraphs—this particular aspect of Army dependants who live, as the report puts it rather crudely but effectively, in what they call "cantonments" which can do much to foster corporate life and welfare in the garrison or unit. As we have heard from the noble Lord, Lord Alport, there are 26 separate units of varying sizes in and around Colchester.
All of us who are able to go on visits to Service establishments learn when we do so of the vast amount of time and trouble taken by the wives of Servicemen, by housing officers and by the padres; and many of these tasks are undertaken voluntarily in addition to other duties which may be or are performed by such people.
1278 Noble Lords will agree that it is very sad indeed to find these problems occupying the minds of our Armed Forces personnel; because the House will agree that we are asking more and more of our Servicemen. They have to become proficient in all sorts of different tasks and these particular tasks have changed out of all knowledge—certainly in my own case since I left the Army on completion of two years' National Service, 17 years ago. I have kept in close touch with all arms of the Services and I am most impressed and embarrassed by the amount of technical knowledge that all arms of the Services and all ranks require to have. As the noble Lord, Lord Winterbottom, and all other Members of the House will be aware, soldiers in particular are now liable to be flown, moved or ferried from the United Kingdom, or back here, at short notice, even at as little as 24 hours' notice. These movements may he to Europe or to Northern Ireland or to further afield.
Thus, my Lords, we believe that it is of the utmost relevance to discuss the military hospital in Colchester tonight since soldiers who are liable to be separated from their families suddenly and for up to six months would feel happier, and will be able to perform their duties more efficiently and without strain, if they are confident that their families' problems, and particularly those of health, can be settled while the Serviceman is away, swiftly, efficiently and, above all, quietly and discreetly. The noble Lord, Lord Alport, mentioned this evening—and told me earlier—that approximately 4,500 Service children (if that is the appropriate term) are in and around the garrison of Colchester. Naturally, any health care, apart from major and chronic problems, could be, and I believe would be, dealt with at the hospital at Colchester. Service families demand a high standard of health care, and we believe they are entitled to do so as we ask the Servicemen to carry out obligations the like of which we civilians would hesitate to fulfil in the conditions in which the Servicemen carry them out. I am sure that both Lord Winterbottom and Lord Melchett would agree that in Northern Ireland these problems of morale and of spirit are particularly relevant.
Surely it is very relevant that the United Kingdom "mobile fire brigade" as the noble Lord, Lord Alport, called it, which 1279 is liable to move anywhere in the world, is quartered at Colchester. This means that instead of this particular garrison being a training establishment where the Servicemen, both carrying out the training and learning new tasks and drills, are able to look forward to some form of routine, the mobile forces are at instant readiness; and of course welfare problems must loom large in the minds of both the Servicemen and their families. All of us in the House look forward to hearing what the noble Lord, Lord Winterbottom, will say, since the noble Lord who raised this Question is asking for the hospital to be kept open for only a further two years beyond the present planned closing date.
My Lords, this may appear to he a constant whine, particularly from all of us who seek to reduce unnecessary Government expenditure at all levels; but we hope that it is not unreasonable in this field for the Government to defer what we would call a permanent decision, especially as we may wish—and, indeed, Lord Winterbottom's Department may wish—to redeploy the Army mobile forces in the near future, within the next two, three or four years. When the noble Lord, Lord Winterbottom, replies, will he give some indication of the financial saving expected or anticipated as a result of closing the Colchester Military Hospital, and particularly in view of all that we have heard of what I call the "substitution effect" whereby Colchester Military Hospital is able to assist in the medical needs of the civilian population which may not be directly connected with the Colchester Army garrison?
Of course we are aware that the Government wish to improve, as they call it, the "teeth to tail" ratio in the Armed Forces. Many of us are very grateful when funds are spent on combat weapons, particularly aimed at improving the efficiency of the forces. Yet all of us will agree—and the noble Lord, Lord Winterbottom, more than most—that the most important element of all is the spirit, enthusiasm and keenness of our volunteer forces. They are indeed second to none. They are, above all, professionals; and we have to see that when we ask much of them we do not treat them as mere machines, drones, conscripts or "bachelors in barracks", as the noble Lord, Lord Alport, put it so poetically earlier. We 1280 believe that welfare is coming increasingly to the front of Servicemen's needs, and all of us must do more to help them. For this reason—and for many others which we have not time to go into tonight —we support the noble Lord, Lord Alport, most warmly in asking this Question and look forward to what the noble Lord, Lord Winterbottom, will have to say.
§ 7.13 p.m.
§ Lord GREENWOOD of ROSSEN-DALE
My Lords, like the noble Lord who has just sat down, I am most grateful to the noble Lord, Lord Alport, for having raised this matter tonight because it is one of considerable importance and can have long-term effects upon the attitude and reaction of the Services to the way that the civilian world treats them. do not want to be over-dramatic about this question because the logical and rational case is so strong as not to need emotion. Nevertheless, I must confess that I was for a time a patient in the Military Hospital. I had suffered a mild heart attack in the Middle East, was convalescing in Essex and drove into Colchester one day to visit a friend in the intensive care ward. As I drove into the hospital grounds, I discovered that I was having a further mild attack. Within five minutes I had my ECG; in 20 minutes I was in bed, and for three weeks I was a patient in the intensive care ward. Without the prompt treatment which I received on that occasion, it is possible that I would not have been addressing this House tonight.
I cannot speak too highly of the treatment that is given in the Colchester Military Hospital. It is given so utterly unselfishly and so devotedly by both the officers and civilian helpers. It is given to the citizens of Colchester just as much as it is given to the members of Her Majesty's Forces. I am grateful to them, as are a large proportion of the 50,000 people who signed the petition asking for the hospital to remain open. I believe that to close it in favour of a "pie in the sky" major civilian hospital would be the height of folly and, indeed, a case of reckless extravagance.
Over the past two or three years some-thing in the neighbourhood of £400,000 has been or is being spent. There is a completely new operating theatre; the 1281 intensive care ward has been completely reequipped and many facilities that the hospital offers are as good as one would find anywhere in the country. I hope that the House will remember what the noble Lord, Lord Alport, said about the affection that Colchester has for the military presence. As my noble friend Lord Rhodes said to me a few minutes ago, Colchester ought to be cherishing the Servicemen who are there or who have left their families there while they serve abroad. Unless one knows Colchester as the noble Lord, Lord Alport, and I do, it is difficult to understand the place that the garrison occupies in the respect and affection of the people of the town. A noble Lord referred to the inconvenience and expense to which the relatives will be put if they have to go all the way to Woolwich to visit those who are sick or injured. It is no way of cherishing them, as my noble friend suggested, if one puts families to that expense and inconvenience.
Having studied the hospital thoroughly, it will be much better to abandon the idea of a mammoth civilian hospital and the infliction of great hardship on the military. I believe that the Military Hospital (which is, incidentally, extremely accessible to all the villages around Colchester) should be kept open at least for the period that the noble Lord, Lord Alport, suggested. Much of it, as I have said, is reasonably modernised to a high standard. The site should be developed. It is perfectly feasible to do it from an architectural and planning point of view, and it should he partly financed by the National Health Service contributing on a per capita basis for the cost of the civilian patients which the Military Hospital is only too happy to care for.
My Lords, I do not want to take up any more time. In my view it would be much cheaper, would cause less disturbance and bring great happiness to my fellow citizens of one of the oldest military towns in the country, if the Government could see their way to concede to the modest request that the noble Lord, Lord Alport, has made tonight.
§ 7.20 p.m.
§ Lord BOURNE
My Lords, forgive me for butting in at the end of this debate, for which we are grateful to the noble Lord, Lord Alport. The noble Lord 1282 put the case very well indeed. I should like to ask a few questions about what happens if the Ministry of Defence go through with this plan. First of all, how far is it from Colchester to Woolwich? A man might die on the way. Secondly, what happens to a soldier who is very seriously injured, say, in the Stanford battle area, some 50 or 60 miles to the North and of which I have charge? Thirdly, what happens to an RAF pilot who has a terrible flying accident at one of the many airfields in East Anglia? Does he go to an RAF hospital, to a civilian hospital, or to Woolwich?
The noble Lords, Lord Alport and Lord Greenwood of Rossendale, have both mentioned the friendly feeling that exists between Colchester garrison and the town. I have experienced this myself. I know the Colchester Military Hospital very well indeed. I would suggest that this is not just a question of saving money; it is a question of saving morale. I would ask: What are the chances of a soldier in barracks at Colchester, after this move has been carried out, going to a civilian hospital? If lie should go there, although he may get very good treatment he will say. "The Army ought to be looking after me"—and the Army is at Woolwich, 60 or 70 miles away. I do not think this issue ought to be measured in terms of money but in terms of morale.
§ 7.22 p.m.
§ Lord WINTERBOTTOM
My Lords, perhaps your Lordships and my Department will forgive me if I do not cling too tightly to my brief. May I start with the opening remarks of the noble Lord, Lord Alport, when he talked about the almost historic battle between the Millbank Military Hospital and the Tate Gallery. I had in fact the very pleasant experience of being laid up in the Millbank Military Hospital next to the Secretary of State at that time, Mr. Denis Healey. From that admirable institution, we seemed to be able to run the affairs of the Ministry of Defence with some efficiency, particularly in view of the fact that alcoholic beverages were not considered to be unhealthy. I remember that at that time, as I was turned over and some unpleasant things were done to me, I was never allowed to forget for one single minute about the sinfulness of the proposals then existing. I notice, incidentally, that the Millbank 1283 Hospital still stands and the Tate goes on with developments on land which it already possessed. But, my Lords, that is a small aside.
More seriously, I should like to say that I regret the fact that the noble Lord, Lord Alport, referred to the "medical white elephant "at Woolwich. That is a major hospital which is just about to become an operating organism. It is due to open on 1st April next year. At one point of my life, I was involved in hospital design and the manufacture of equipment; and the hospital at Woolwich may very well be a pioneer as regards hospital design and it may form a model for other hospitals to copy in the future. It is not a white elephant; it is going to be a major medical centre. The problem we have to face is that as medicine becomes more complex, the various services required have to he provided by larger and larger units. That is the situation—the noble Lord, Lord Alport, shakes his head but, unfortunately, as medicine becomes more sophisticaed units have to become larger. That is one of the facts of life.
As I see it, we are dealing here with three sets of things. Perhaps the most important, assuming that we are not engaged in a major war, is the one which was mentioned by the noble Lord, Lord Bourne, concerning the soldier who is seriously injured during a training exercise, a soldier seriously injured in Northern Ireland, or an Air Force pilot who has crashed, and so on. In my view, to take care of these cases is the primary objective of a military hospital, and not looking after over-weight Ministers such as myself. I should have thought, as things now are, that a serving soldier who is injured in training or on active service would be moved by helicopter to Woolwich. It would thus take no more time to take him from a battle training area or from an airfield crash than would be the case at the moment. I have not really looked at the total layout of the Woolwich Hospital complex, but I am perfectly certain there would be a helicopter pad there. Any hospital dealing with neurosurgery must have one so that people with broken backs, and so on, can be moved without undue movement into a place where they can be treated.
The closing of various peripheral hospitals has been mentioned. I had a very 1284 interesting debate in your Lordships' House concerning the closing of one hospital on Salisbury Plain, and the noble Baroness mentioned one in another area. We have to be prepared to face the fact that if we want to be able to perform major neurosurgery and provide sophisticated medicine, we must have a large central hospital to which an individual suffering from severe damage can be moved by helicopter and treated by the most sophisticated means available to us.
Then we come to the enormous tail which the Army possesses these day—the wives and families, and so on. Obviously, it is highly desirable that medical services should be available to them almost on their doorstep. In a sense, that will continue hut, if rather more than the simple taking of temperatures and the dispensing of pills is necessary, then what is proposed in the relationship between Colchester and Woolwich is a twice-daily round bus service, which will take two hours each way. so that the individual patient, whether a soldier or a family dependant, can go to this major central hospital, have his case examined and treatment prescribed, and then be taken—
§ Lord ALPORT
My Lords, if I may intervene just for a moment, I understand there are not going to be maternity services at Woolwich; nor is there to be a paediatric department. Therefore, although I would accept fully the importance of good medical and surgical attention for soldiers, the point I was really emphasising, and which has been emphasised throughout this debate, is the problem of wives and children.
§ Lord WINTERBOTTOM
My Lords, this is absolutely right. Your Lordships are entirely right to raise this issue. But, in defence, I should like to call to my support the important point made by the noble Baroness, Lady Robson, who said, quite rightly, that until recently the military hospital in Colchester was treating civilians and military personnel in the ratio of 4½ to 1. Is that not correct?
§ Lord WINTERBOTTOM
I am sorry, my Lords. That is a difficulty of communication. Nevertheless, it is not the 1285 duty of the Armed Forces to look after the civilian population. The Armed Forces are under constant pressure to make economies, unlike other Departments of our society, and the pressures brought to bear on the Ministry of Defence are far greater than those brought to hear on the Department of Health and Social Security. I know that this is a matter which the noble Lord, Lord Bourne, has brought to the attention of the Treasury and, so far as I understand, he has not yet received a reply.
Your Lordships and the country must accept the fact that if defence expenditure is cut the first things that will go, and must go, are the trimmings—the benefits which the Armed Forces can give to the civilian population. Those have to go. The civilian population may not like it, but they must accept it. They have willed it, and they must accept it. So what I see happening is that we shall have at Wool-wich and elsewhere very efficient, highly specialised military hospitals to which the wives and children of the Servicemen will go, and the civilian population will have to be looked after by the Department of Health and Social Security.
What I cannot understand is that it has been said, partly by the noble Baroness, and hinted at by my noble friend Lord Greenwood, that the National Health Service does not seem to want to take over the Colchester facilities to provide for work that has so far been done by the Army.
§ Baroness ROBSON of KIDDINGTON
My Lords, I do not think there is any argument any longer about the National Health Service being quite happy, and quite prepared, to pay the cost of the use of beds in the Military Hospital, on the basis of what it costs us to run a bed in a National Health Service hospital. The argument about Colchester is that the capital requirement to uprate it is such that the Health Service cannot afford it at the moment.
§ Lord WINTERBOTTOM
My Lords, I cannot accept what strikes me as a bureaucratic argument. There is a solid block of medical facilities which the National Health Service could offer, if it so willed. If the only argument against it, which was put forward by the noble Baroness and was, I believe, countered 1286 by my noble friend Lord Greenwood, is that it happens to be in the centre of a military complex, that is just too bad. The civilians may have to rub shoulders with the beastly military, if they want treatment. But do not let them come whimpering here, if they are unwilling to take it over.
§ Lord ALPORT
My Lords, the noble Lord is being most unfair on this. There has never been any question, on the points I put to him, as to whether it was in the interests of the civilians. I would draw the noble Lord's attention once again to the fact that the whole of my argument was based upon the interests of the soldiers and their wives and children. If he is simply lumping the wives of the Servicemen with the rest of the civilian population, then I understand it. But that is certainly not how we look at it in Colchester.
My Lords, I am anxious to be absolutely clear about precisely what the noble Lord is saying in regard to this matter. If he is telling your Lordships that, in the present situation of economic difficulties and so on, with which we understand the Minister of Defence has to contend, then in no circumstances must civilian personnel be treated in military hospitals—the corollary of which is that no military personnel must be treated in civilian hospitals—I would say that he is embarking on a very wasteful and extravagant course.
§ Lord WINTERBOTTOM
My Lords, I did not say that. Perhaps I have been foolish to stray too far from the safety of my brief. The hard fact of life is that I am absolutely certain that the arrangements being made with the new Woolwich hospital will provide for the medical needs of the Armed Forces. I say this quite firmly to the noble Lord, Lord Alport. I am certain that the sense of duty and dedication that: exists within the Armed Forces will make sure that the very good modern facilities being arranged at Wool-wich will supply the needs of the Armed Forces.
The argument has been that this hospital is being closed, and nothing is to take its place. Throughout the discussion, I heard the lament that everybody is waiting for a white elephant, a major civilian hospital, to be built in the area. We all know that hospitals take about 10 years to build, so 1287 why should the National Health Service not take over the hospital in question? I have not heard any argument except that it is in the middle of a military area. That is my view. I believe that the facilities provided for the Armed Forces and their families will continue to be adequate, and may even be improved. The Armed Forces, quite rightly, particularly when they are separated from their families, are concerned that their wives and children are well looked after, and I believe that they will continue to be well looked after.
We have time for thought as to what we do with the excellent facilities described by my noble friend Lord Greenwood. The new Queen Elizabeth Military Hospital opens on 1st April, and Colchester is planned to close on 1st January 1978—about a year from now. If the National Health Service and the area feel that it is desirable to keep the existing facilities open, then there is time for them to make up their minds on the subject. But I am quite confident, knowing the attitudes existing within the Armed Forces, that they and their dependants will continue to be looked after extremely well when Colchester is closed.
§ Lord RHODES
My Lords, before the Minister sits down, may I ask him a question? I understand that there are 60 beds available at this military hospital in Colchester. Have they allocated 60 beds in the Woolwich hospital for the benefit of the soldiers and their families? The Minister keeps saying: "Oh, yes; they will be taken care of". But we have heard all that before. Have they made special arrangements for those people?
§ Lord WINTERBOTTOM
My Lords, the Woolwich hospital will absorb a large number of beds from the Royal Herbert, among others. It is a very big, modern hospital complex. Obviously, there will be room for the individual soldier and his family in the new, modern hospital at Woolwich.
§ Lord RHODES
My Lords, it may be that there is room, but will the Minister answer my question? Have they made arrangements for 60 beds, instead of the 60 beds at Colchester?
§ Lord WINTERBOTTOM
My Lords, we are playing the numbers game. My figure is 91, and the figure mentioned by the noble Lord, Lord Rhodes, is the operational number. We are not quite up to strength in nursing staff. But I am certain that the planning is such that the requirements of the hospitals that are to be closed will be fully met by the new and modern hospital that is to be opened.
§ Lord STONE
My Lords, are there any specific arrangements made to cover what will happen when the Colchester Military Hospital is closed down?
§ Lord WINTERBOTTOM
My Lords, as I tried to explain, nobody seems to know; but I understand that the National Health Service could have it. At the moment, however, they do not seem to want it.
§ Lord LYELL
My Lords, can the noble Lord answer one question which follows on from his explanation? Does he know whether the Ministry of Defence has consulted the Department of Health and Social Security? We are wondering whether there might be some possibility of aid being I given to Colchester, thereby lessening the drain on what the noble Lord has said about defence expenditure. Secondly, I think that the noble Lord will agree with me that there has been much ammunition flying around. Certainly I have adopted a low profile so far as the civilian aspect of the Colchester Military Hospital is concerned, but so far the military aspect of the noble Lord's reply has been some-what inconclusive. I will not play the numbers game, but does the noble Lord believe that even to provide an equivalent or greater number of beds or facilities in Woolwich will help Colchester families? If the noble Lord believes that this is the case, will he use the same theory and the same argument so far as Tidworth is concerned?
§ Lord LYELL
My Lords, the noble Lord says that it is a fair distance from Tidworth, but I wonder whether it is a 1289 fair distance by road. As the noble Lord will be aware, to travel from Colchester to Woolwich involves coming right down and using the Dartford Tunnel. I do not know what mileage or complications are involved in getting there, but if I were the wife or husband of a person serving at Colchester I should wonder whether the answers given so far by the noble Lord were fair and reasonable so far as the substitution of Woolwich for Col-chester is concerned.
§ Lord WINTERBOTTOM
My Lords, I am now going to cling tight to my brief and read it in ringing terms. We are satisfied that, after the closure, the medical facilities available to Servicemen and their dependants in the area will be adequate and comparable to those available to Servicemen and their families in many other parts of the country. The new hospital at Woolwich will be no further away than the nearest Service hospital in many other areas, and we shall also open a 10-bed medical reception station in Col-chester when the hospital closes. That is similar to the arrangements at Tidworth. These will provide cover for Servicemen and their dependants, although of course dependants are fully entitled to use National Health Service facilities and so they will be able to opt for the local National Health Service treatment if they so wish. The provision of medical facilities for the civilian population is of course a matter for the National Health Service authorities, and the Department of Health and Social Security were fully consulted about the closure. This is the answer to the noble Lord's question. The hospital was offered to the National Health Service authorities for civilian use, but I under-stand that they decided that the existing buildings could not be adapted for National Health Service use at reasonable cost. Well, what is "reasonable cost"?
My Lords, may I ask the noble Lord a final question on that point? Since the noble Lord has told us that he is satisfied that if and when this hospital closes the accommodation in other establishments will be adequate for civilian needs, is he therefore saying that there is surplus capacity now in the civilian hospitals in this area? That is the obvious inference from what the noble Lord has said.
§ Lord WINTERBOTTOM
My Lords, I did not say that. I said that there was a very good 91-bed hospital waiting to be taken over by the National Health Service if they wished to have it.