Hospital Building Programme (Hansard, 13 July 1987)

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

§ Lord Skelmersdale
My Lords, new hospitals are usually built in stages involving a series of building schemes. Information held centrally shows that 262 health building schemes, each costing over £1 million, were completed in the period April 1976 to March 1986. A further 28 have been completed since April 1986, and over 200 more are planned for completion by 1990.

§ Lord Auckland
My Lords, I thank the Minister for his Answer to my Question. Is he aware that this is an impressive record? Is he further aware that there is far too much publicity given to the old hospitals but not enough to the new constructions?
Perhaps I may ask two supplementary questions. First, will he ensure that the regional health authorities, with the new buildings, do not build too many very large hospitals of 2,000 beds or more, because communication between staff and patients is a problem? Secondly, is the Minister aware that with the very impressive record of new hospitals being built there are too many empty wards? Will he ensure that this matter is dealt with, in particular with regard to the second part of my question?

§ Lord Skelmersdale
My Lords, I am grateful to my noble friend for recognising that this is indeed an impressive record. In fact, there is more hospital building going on now than ever before. It is also true that health authorities are having difficulty in recruiting sufficient qualified staff in particular locations and specialties. Nevertheless, the total number of nursing and midwifery staff has increased by 40,000 since September 1979. Even allowing for staff required to maintain the level of services following the reduction in working hours in this period, this still leaves an increase of 20,000 for service expansion.
One of the ways in which we are seeking to reduce the problems of staffing in these circumstances is by persuading those trained personnel who have left the nursing service to return. We have also increased the pay of nurses (which under Labour fell by 21 per cent.) by 30 per cent. over and above inflation during the lifetime of this Government.

§ Baroness Seear
My Lords, can the Minister tell us how many of these new hospitals include secure units of the kind to which courts could send people whom they now send to prison, not because they think that is the right place but because there is inadequate secure unit accommodation in hospitals?

§ Lord Skelmersdale
My Lords, I regret that I cannot answer that question without notice. However, I shall write to the noble Baroness.

§ Baroness Lockwood
My Lords, is the Minister satisfied that these new hospitals—no doubt containing admirable high technology and catering largely for acute cases—satisfactorily replace some of the smaller hospitals which catered largely for long-stay elderly and handicapped patients? In the absence of adequate care in the community, will he consider this aspect of hospital service?

§ Lord Skelmersdale
Yes, my Lords. We are talking on the whole in this rebuilding programme of those patients whom I might describe as the physically disadvantaged. We recognise that small hospitals can make a valuable contribution to the delivery of health care. The building programme includes schemes for the upgrading and refurbishment of small hospitals as well as large hospitals. But it is for the regional health authorities to decide on the proper mix of facilities in their areas.

§ Lord Ennals
My Lords, apart from the hospitals which were completed between 1976 and 1979, can the Minister say how many of the hospitals built between 1979 and 1986 were both approved and given the go-ahead before 1979?

§ Lord Skelmersdale
My Lords, I am not sure that I can help the noble Lord very well, but he can probably answer his own question as he was Secretary of State at the time. I can tell the House that information held centrally shows that 213 health building schemes costing over £1 million have been completed since 1979, compared with 120 from 1974 to 1979.

§ Lord Molloy
My Lords, is the Minister aware, in regard to the increase in nurses' pay, that nurses are now very much in favour of having annual general elections? That seems to be the only way they can have their full pay awards made a reality. Can he say whether or not in the construction of new hospitals the Government will take into consideration the need for proper nurses' living accommodation to avoid what happened earlier this year when makeshift accommodation was provided for some nurses? When it became evident that there might be a possible rundown of the nursing profession, the nurses were evicted from these homes. This was a distressing and morale-dampening situation for British nurses. Could proper accommodation for nurses be considered in the construction of new hospitals?

§ Lord Denham
My Lords, that is a speech.

§ Lord Skelmersdale
My Lords, I am not sure that I approve of annual general elections if that would result in leaping backwards and forwards to the IMF. On the more serious point that the noble Lord made, it is for the health authorities and the hospital authorities to satisfy themselves that the living accommodation for nurses is suitably placed.

§ Lord Lloyd of Kilgerran
My Lords, can the Minister say, either now or later, how many of the 28 new hospitals are for private patients' use only?

§ Lord Skelmersdale
My Lords, we are talking about the public sector.

§ Baroness Ewart-Biggs
My Lords, can the Minister say whether the new hospital building will include sufficient maternity wards? Is the Minister aware that press reports are saying that women already in labour are waiting in passages because there are no beds available for them? That must be a very unsatisfactory situation for them.

§ Lord Skelmersdale
Yes, my Lords; I am aware of the press reports. I know that the provision of midwifery services, which includes the beds and so on, is a prime consideration in the planning of new hospitals.

§ Lord Mackie of Benshie
My Lords, can the Minister tell us how many of these new hospitals were built in Scotland?

§ Lord Skelmersdale
My Lords, I understood that I was answering a Question about England, but I am sure I can get the information for the noble Lord on that point.

§ Lord Mackie of Benshie
My Lords, if the Minister reads the Question he will find that it is not confined to England.

§ Lord Mellish
My Lords, while I commend the Government's new hospital building programme, perhaps I may ask the Minister whether he will consider the number of hospitals that were closed down. Is he aware that not a lot of money would need to be spent to bring them back to life? I admit this is my own hobby-horse, but I give as an example St. Olave's Hospital in Rotherhithe, where there are 200 beds, first-class operating facilities, first-class catering and first-class nursing accommodation available, but it is derelict in the heart of inner London. Why do not the Government spend some money there to bring it back to life instead of building a new hospital?

§ Lord Skelmersdale
My Lords, I do not think it would be wise for me to comment on a particular case; but nonetheless there are usually—in fact, always, so far as I can tell—very good reasons for providing new hospitals at the expense of closing old ones. However, I am aware of one case in the West Country where a hospital due for closure has been kept open longer to help to reduce the size of the waiting list. So various factors come into play here.

§ Lord Tordoff
My Lords, is the noble Lord aware that he has been somewhat inaccurate in two responses that he has made to my noble friends? The first is that this Question does not relate only to public sector hospitals, and, secondly, it does not refer to hospitals only in England and Wales.

§ Lord Skelmersdale
My Lords, I am sorry if I have been inaccurate in my responses in your Lordships' House. What I should perhaps have said was that I took the Question to mean that it related to England and to the public sector.

§ Lord Campbell of Alloway
My Lords, accepting that new hospitals cannot operate without adequate nursing staff, will my noble friend the Minister agree, in view of the speeches made by my noble friend Lady Cox, that it is most unlikely that the Government would ignore that aspect of hospitalisation?

§ Lord Skelmersdale
My Lords, I am grateful to my noble friend. Most certainly we shall not ignore that aspect. I mentioned in answer to an earlier supplementary question two of the measures we were taking to help solve it.