§ 2.48 p.m.
§ Lord MOYNEMy 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 how many of the 20,000 Service dependants estimated to be based on Salisbury Plain are expected to opt for National Health Service care if the Tidworth Military Hospital is closed; what spare capacity there may be in the Salisbury General Hospital; and how many additional patients the National Health Service surgery at Ludgershall can accept.
Lord WELLS-PESTELMy Lords, when Tidworth Military Hospital closes, the Ministry of Defence plan to provide a military general practice, together with a medical reception station for Servicemen and their dependants in the area. While it is not possible to give precise estimates, it is not expected that very many dependants will opt for National Health Service care.
§ Lord MOYNEMy Lords, while thanking the noble Lord for his reply, which he may be sure will be carefully studied by those who are so concerned about the closure, may I ask him three brief supplementary questions? First, 1286 is it not likely that more than a few Army dependants will opt for civilian treatment, especially in maternity cases, when Wroughton, the hospital which is to take the place of Tidworth, is 24.8 miles from Tidworth and is without public transport? Wroughton has to be compared with Salisbury General Hospital, at a distance of only 16.3 miles from Tidworth, with public transport available. Secondly, does the noble Lord realise that the doctors' practice in Ludgershall which works under contract with the Ministry of Health has no physical space for any additional doctor? Finally, will the noble Lord ask the Minister to consider the life-and-death importance of the 10 civilian beds for civilian casualties from the two major main roads of the neighbourhood?
§ Lord WELLS-PESTELLMy Lords, as I pointed out to your Lordships in my reply, there is no reason to suspect for one moment that a great number of dependants will opt for National Health Service care. Noble Lords must bear in mind that the Wessex Regional Health Authority are satisfied that the hospital facilities at Salisbury, Winchester and Basingstoke will be able to absorb the additional patients resulting from the closure of the Tidworth Military Hospital. I should point out to noble Lords that last year only 60 per cent. of the beds at the Wroughton Hospital, which will be maintained when Tidworth is closed, were, in fact, used. We are of the opinion that the Wroughton Hospital, together with the established medical services in the area, can more than meet the need.
Baroness VICKERSMy Lords, will the noble Lord be kind enough to ask the Ministers concerned to reconsider this matter, in view of the fact that the Tidworth Hospital has one of the best intensive care units in the country, that a new maternity wing has just been built at a cost of approximately £85,000, and that military drivers estimate that to drive patients to Wroughton will involve 2 million miles? Furthermore, pathology results at Tidworth can be received in two hours, whereas in the National Health Service they take anything from four days to a week.
§ Lord WELLS-PESTELLMy Lords, noble Lords must not think that adequate 1287 consideration has not been given to this matter. This is a decision which has been taken by the Ministry of Defence and not by the Department of Health and Social Security, although my Department was consulted. The Ministry of Defence set up in 1971 a committee known as the Jarrett Committee, and on that committee there were five very distinguished members of the medical profession unconnected with the Ministry of Defence and with my Department. They went very carefully into this matter and they came to the conclusion in their report that it would be perfectly proper to close the Tidworth Military Hospital and leave the resources, which were quite adequate, to the Wroughton Hospital.
§ Viscount ECCLESMy Lords, is the Minister aware that I live in the village of Chute which is served by the doctors in Ludgershall? The North edge of Salisbury Plain is quite an empty part of the country. These distances really matter, and not only the doctors but the people all round really fear that the closing of Tidworth, which is only five or six miles from us—and very much nearer than going all the way to Wroughton—will make matters extremely difficult. If we have an accident on the farm or on the road it will take a long time to convey somebody 20 miles when there is no transport. I think the Minister should look at this again.
§ Lord WELLS-PESTELLMy Lords, I can understand the feeling which is being expressed by people living in the area, but I would say they have been extremely fortunate in having two military hospitals on their doorstep. However, the military hospitals were put there originally to serve the needs of military personnel. If it is found that the new arrangements are not adequate—and I would remind the noble Lord that I pointed out that the Ministry of Defence can provide a military general practice together with a military reception station—the family practitioner committees have the duty to provide general medical services in their areas for all persons who wish to receive them. If a large number of Service dependants were to request National Health Service care, then the family practitioner committees could consider—and would do so—advising the 1288 medical practices committee to allow an additional doctor or doctors to set up practice in the area.
§ Lord ABERDAREMy Lords, may I ask the noble Lord whether the relevant community health council for the district concerned have been consulted and whether they have agreed with the proposal?
§ Lord WELLS-PESTELLMy Lords, we are dealing with military hospitals and not with hospitals under the National Health Service.
§ Lord ABERDAREMy Lords, may I ask the noble Lord whether he is aware that it is the National Health Service hospitals which will have to absorb the load and therefore it is a matter of direct relevance to the National Health Service?
§ Lord WELLS-PESTELLMy Lords, I accept that, but I hoped I had said sufficient to your Lordships to indicate that the Wessex Regional Health Authority, who have gone into this matter very carefully—and these decisions are not made lightly—are quite satisfied that the normal general medical services and general practitioner services can deal with the situation.
§ Baroness SEEARMy Lords, would the Minister agree that it is one of the functions of this House to question the decisions reached through the administrative machine, however eminent the people may be who have reached those decisions?
§ Lord WELLS-PESTELLMy Lords, that has never been in dispute; but if noble Lords are going to question the wisdom of certain things, I think they must also have regard to what the Government representative has to say in respect of the matter when that matter has been gone into very carefully by the authorities concerned.
§ Lord SEGALMy Lords, can my noble friend give an assurance that the medical facilities now available at Wroughton will not be reduced but that, on the contrary, they will be extended for civilian patients as well?
§ Lord WELLS-PESTELLMy Lords, there are something like 200 beds at Tidworth Hospital. The number of beds occupied by civilian patients seldom 1289 exceeded 10 in the course of a year, and we are quite satisfied that the Wroughton Hospital will be able to cover any emergency resulting from the closure of the Tidworth Hospital, because from a National Health Service point of view they can accommodate at least three times as many civilians.
§ Lord HARMAR-NICHOLLSMy Lords, the noble Lord's answers make it clear that whether or not the decision is a correct decision depends on very few wishing to opt for the National Health Service. He seems to have replied categorically that very few would want to do that. What research has been entered into to try to establish whether or not that would be the general reaction?
§ Lord WELLS-PESTELLMy Lords, in reply to the noble Lord I can only say that a good many inquiries have been made into the matter. But I did say that in the event of more people opting for National Health Service treatment, the family practitioner committees, which have a duty to provide medical services, would then advise the medical practices committee to provide more doctors in that particular area.