Hospital Beds: Statistics (Hansard, 26 February 1987)

§ Lord Ennals
My Lords, I beg leave to ask the Question standing in my name on the Order Paper.

§ The Parliamentary Under-Secretary of State, Department of Health and Social Security (Baroness Trumpington)
My Lords, between 1979 and 1985 bed numbers were reduced by 36,182, or 10 per cent., to 325,488 beds. In-patient cases rose by 953,692, or 17 per cent, to 6,353,812 in the same period. Bed numbers fell by more than 10 per cent. in six regions.

§ Lord Ennals
My Lords, I am grateful to the noble Baroness. She has revealed the fact that 36,000 fewer beds are now in service than in 1979—this at a time when, except for periods of industrial action, waiting lists are at an all-time high. Does she not consider this a very disturbing situation, particularly for the elderly since we now have 20 per cent. more people over the age of 75 than we had in 1979? Is this really fulfilling responsibilities to the community?

§ Baroness Trumpington
My Lords, between 1978 and 1985, thanks to the greater efficiency that this Government have demanded from the NHS and the extra resources provided, the number of elderly in-patient cases rose by 60.5 per cent. and elderly out-patient cases by 40.7 per cent. Services in the-community have been developed to help old people to live in their own homes, as most of them wish to do. Between 1978 and 1985, the number of elderly people treated by district nurses rose by 28 per cent.

§ Lord Renton
My Lords, in view of the increase in resources for the National Health Service mentioned by my noble friend, can she explain how it is that the number of beds in hospitals has had to be reduced?

§ Baroness Trumpington
My Lords, reasons for change include the shift from unsuitable long-stay institutions to more suitable care in the community involving the loss since 1979 of 1,500 beds, 13,000 mental handicap and 9,500 mental illness beds. There have also been changes in technique involving less open surgery and more day treatment. Other factors are efficient use of resources, including high turnover rates, as well as care in the community policies for long-stay patients.

§ Lord Kilmarnock
My Lords, is not the effect of this reduction that patients are often kept waiting with their bags packed for weeks on end before they are admitted and that when admitted they are often sent home again because the bed is still occupied? Even if they are admitted and treated, are they not then frequently discharged when still too frail and at a time when friends and relatives are not ready to receive them?

§ Baroness Trumpington
My Lords, the noble Lord will know that the Government have recently instituted a waiting list fund. The project has been funded and the action that health authorities already have in hand should ensure that many more patients receive the treatment they need more quickly. The most worrying excessive waiting times will be reduced.

§ Lord Ennals
My Lords, bearing in mind that the Thames regions alone have lost 15,000 beds, which means on average a 14 per cent. cut, would the noble Baroness comment on the question put to her that a large number of people are not only waiting to get in but are also being pushed out? Would she comment on the suggestion that too many patients are being moved out too quickly and therefore having to be readmitted? Surely this is not efficiency?

§ Baroness Trumpington
My Lords, with regard to the waiting list and the national position, the latest 324 figures show that the size of the list remained stable between March 1985 and 1986, despite a small rise in the size of the list in the six months to March. Waiting times continue to fall. First indications are that there was a small further rise in the six months to September 1986, although waiting times remain fairly constant. This position underlines the necessity for the fund which my right honourable friend has announced and which we hope will have a very marked effect on waiting times and lists.

§ Baroness Lane-Fox
My Lords, can my noble friend the Minister tell the House whether the areas affected by bed reduction are mostly those areas affected by RAWP? If that be the case, should we not be pleased that RAWP is now under review?

§ Baroness Trumpington
My Lords, the regions were Yorkshire, minus 10.5 per cent; North-West Thames, minus 14.6 per cent; South-East Thames, minus 14.5 per cent; South-West Thames, minus 15.4 per cent.; South-Western, minus 10.3 per cent.; and Mersey, minus 16 per cent. My noble friend will be aware that regions not covered by the present national RAWP formula will be helped by a special fund which has been announced.

Lord Winstanley
My Lords, while accepting that it may well be wise to discharge many patients from some older institutions into the community for community care, will the noble Baroness accept that the back-up support services for that community care are far from being provided?

§ Baroness Trumpington
My Lords, the noble Lord may be aware that a review of community care is being undertaken at the moment by Sir Roy Griffiths. It would be unfortunate if I pre-empted the results of his review.

§ Lord Elton
My Lords, will my noble friend accept that in an organisation as large and complex as the National Health Service, it will always be possible to select statistics that make it look inefficient as well as statistics showing that it works well? Will she further accept that for the Opposition to select such statistics is legitimate and in some ways healthy because it keeps her on her toes? Finally, will she accept that what most of us look at is the number of people treated rather than the number of beds in wards? In that regard, she is doing very well and should keep on at it.

§ Baroness Trumpington
My Lords, speaking as someone who is practically toeless by now and in need of urgent treatment, I am most grateful to my noble friend. I agree entirely that it is people who matter, not furniture.

§ Baroness Seear
My Lords, will the Minister agree that if community care is to be the preferred way of dealing with some patients, it would be sensible to start up community care services before hospitals begin to be emptied? What has happened to the numbers of home helps who are absolutely crucial to any effective community care?

§ Baroness Trumpington
My Lords, that is a bit wide of the Question, if I may say so. However, above all, our policy is not to put people out of beds in institutions until better alternative care is ready for them. At the moment, due to our policy of care in the community, there are approximately 10,000 empty beds available in mental hospitals.

§ Lord Leatherland
My Lords, will the Minister inquire into the possibility of expanding district nurse services? Those people perform a very valuable service which results in many people not having to enter hospital.

§ Baroness Trumpington
My Lords, the number of doctors and dentists has increased. There are 16 per cent. more GPs, for example, and the number of nurses has increased. There are 11 per cent. more district nurses and 18.6 per cent. more health visitors than there were in 1979.