§ 2.41 p.m.
§ Viscount AMORYMy 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 why a decision has been confirmed by the South-Western Regional Health Authority to terminate all tonsillectomy operations at the Tiverton and District Hospital, greatly to the inconvenience of local people, when that hospital has had an unblemished record of successful operations with no failures over a period of very many years.
§ Lord WELLS-PESTELLMy Lords, the decision was not one for the South-western Regional Health Authority. It was taken by the Exeter Health District management team, and subsequently confirmed by the Devon Area Health Authority. It was motivated by Departmental and regional guidance on ear, nose and throat services, with particular reference to the safety of patients.
§ Viscount AMORYMy Lords, does the noble Lord appreciate that there is a widespread feeling that these measures of centralisation in the National Health Service do not always achieve the economies or the improvement in service which are claimed for them, and sometimes result simply in the service being more remote and less accessible? I think he may find that this may well be one of those cases.
§ Lord WELLS-PESTELLMy Lords, there is no criticism whatsoever of what has happened at Tiverton—let me make that perfectly clear—but I think we must bear in mind that developments in medicine have led to a greater interdependence of the various branches and to an increasing realisation of the need to bring together a wide range of specialised facilities for diagnosis and treatment. This is becoming increasingly necessary; and, if I may say so with very great respect, it can be done only at district general hospital level. It is really for the benefit of the patients.
§ Viscount AMORYMy Lords, may I ask the noble Lord to believe that the first part of his Answer gave me more pleasure and satisfaction than the second part?
§ Lord ABERDAREMy Lords, if it is for the benefit of the patients, may we ask whether the local community health council was consulted, and what its view was? Presumably it would be representing the views of the patients.
§ Lord WELLS-PESTELLMy Lords, my understanding of the situation is that it was not opposed to it, but I think I ought to tell your Lordships that this matter was in fact decided as far back as 1972 by the then Regional Hospital Board, and what has happened since is merely a review of the situation and a confirmation of that decision.
§ Lord SEGALMy Lords, could my noble friend say where the residents of Tiverton now have to go for their tonsillectomies?
§ Lord WELLS-PESTELLMy Lords, I do not know the actual hospital. What I do know is that with any reorganisation of this kind certain people must of necessity be put to a certain amount of inconvenience. This is inevitable. With a tonsillectomy operation there are provisions, particularly where a child is involved, for the parent to stay overnight.
§ Viscount AMORYMy Lords, does the noble Lord appreciate that I know the answer to the supplementary question of Lord Segal if he would like me to give it?
§ Lord WELLS-PESTELLMy Lords, I was hoping that the noble Viscount was going to say so.
§ Viscount AMORYMy Lords, I can phrase it as a question. Does the noble Lord understand that patients must go to a new big hospital on the far side of Exeter, a distance of 16 or 17 miles; that the bus fare is over £1, and that for parents going to see their children in hospital that represents a substantial additional cost?
§ Several Noble Lords: Hear, hear!
§ Lord WELLS-PESTELLMy Lords, this is perfectly true. Noble Lords may say, "Hear, hear", but one must weigh 623 this against the need to provide in every kind of operation a back-up service should anything go wrong. This has not always been possible in the past.
§ Lord SLATERMy Lords, would my noble friend agree that the one who seems to be on trial here is the superintendent of the particular hospital? If anything goes wrong so far as the medical side of that hospital is concerned in regard to the care of the patients, surely it would come to the ears of the medical superintendent and it would be his responsibility then to take action with the Medical Council or the Regional Hospital Board, or whatever channels exist? We are moving in the direction here of laying the blame indirectly on the medical superintendant of that particular hospital.
§ Lord WELLS-PESTELLMy Lords, I am grateful for the intervention of my noble friend, but may I point out that the number of in-patients' beds required for any given population in regard to this matter is comparatively small. We require only about 12 beds per 100,000 population. It is necessary in these matters, as well as others, that full medical, nursing and technical staff are available, and that they are available throughout the year. It has been done simply and solely so that there will be two, and sometimes three, consultants available all the time to deal with anything that may go wrong, or that may need expert treatment.