§ Lord SandysMy Lords, I beg leave to ask the Question standing in my name on the Order Paper.
The Question was as follows:
To ask Her Majesty's Government what progress is being made with the hospital building programme.
§ Lord HeskethMy Lords, the largest ever sustained health building programme continues to gain momentum. Information held centrally shows that there are currently over 450 building schemes, each costing over £1 million, at various stages of planning design and construction. The total value of the programme is estimated at £3.26 billion and it will provide over 24,000 new hospital beds. This compares with a programme of 380 schemes, with an estimated total value of £2.84 billion, reported last October.
§ Lord SandysMy Lords, I thank my noble friend for that very encouraging answer. Can he comment on whether damages, defects and delays are causing slippage in the programme?
§ Lord HeskethMy Lords, I am glad to say that, although all the problems can never be eliminated in such complex construction projects, the situation is much improved. There has been a marked improvement in the completion of schemes both in terms of cost and time. A sample of 36 completed schemes has indicated an average cost overrun of about 1.7 per cent., or about £100,000, and a time overrun of about 4 per cent., or six weeks. That compared with averages respectively of 11.6 per cent. and 29.7 per cent. for a similar sample of pre-1980 schemes.
§ Baroness SeearMy Lords, can the noble Lord assure us that the building programme is not being carried out at the expense of smaller hospitals, some of which have been either shut or had beds removed, which are greatly valued by local communities and badly needed for the community care that we have increasingly to provide?
§ Lord HeskethMy Lords, the noble Baroness will not be surprised that I am unable to give a specific answer to her question. She is well aware that we are committed to an expanding and successful National Health Service.
§ Lord Taylor of BlackburnMy Lords, will the Minister ask his right honourable friend to take a leaf out of the book of the Secretary of State for Education and Science who is announcing today that he no longer intends to close small schools? Perhaps he will ask him not to close small hospitals in the same way.
§ Lord HeskethMy Lords, I feel that that is slightly wide of the Question on the Order Paper.
§ Lord EnnalsMy Lords, if the hospital building programme is doing as jolly well as the Minister says it is, why is the number of beds available to NHS patients now 10,000 fewer than it was eight years ago? Why is it that, except for two periods of industrial action, hospital waiting lists are longer than ever before—devastatingly and cruelly long?
§ Lord HeskethMy Lords, for the record, the number of hospital beds was reduced by 35,000 from 1974 to 1979—the period of the last Labour Government—and has been reduced by a further 36,000 since then. The reduction results from the replacement of inefficient and obsolete hospital stock, usually built in the 19th century, by modern hospitals which are more economical to run and provide a better health care environment for patients and more productive working conditions for staff. The facts speak for themselves. The numbers of in-patient treatments has increased by 18 per cent. since 1978, from 5.3 million to 6.3 million. The number of day case treatments has increased by 71 per cent., from 562,000 to 969,000. Out-patient treatments have 3 increased by 10 per cent., from 33 million to 37 million.
§ Lord MolloyMy Lords, we all welcome a programme to build hospitals. However, it is pointless to build hospitals if we do not have the staff to operate them. There should be a vast range of staff in every modern hospital. Does the Minister agree that in the past there has been a deleterious effect on the staffing of hospitals? Does he agree that it is essential to put that right so that hospitals that are to be built will be properly staffed?
§ Lord HeskethMy Lords, the Question on the Order Paper concerns the hospital building programme and not staffing.
§ Lord AucklandMy Lords, those are impressive figures. However, is my noble friend aware that there are some new hospital wards that have not been opened due to staff shortages and that in existing hospitals there are too many wards not in use due to such shortages?
§ Lord HeskethMy Lords, I am here to answer a specific Question rather than to comment on questions which are not on the Order Paper today.
§ Lord EnnalsMy Lords, perhaps the Minister can respond concerning what he himself said. Why does he insist on giving figures for new patients, either day patients or in-patients, when he does not know such figures but only the number of admissions? Does he accept that the figures which he keeps giving are simply not based on the facts in any way whatsoever?
§ Lord HeskethMy Lords, I should not come to the Dispatch Box if I believed that.
§ Lord MellishMy Lords, the Minister has just read out the Government's manifesto for the National Health Service. Will he now be good enough to give us the date of the general election?
§ Lord HeskethNot without notice, my Lords.
§ Lord UnderhillMy Lords, the Minister referred to some small hospitals as being inefficient. Perhaps he will reconsider that statement. There may be criticism on grounds of cost-effectiveness. However, some of us who have used small hospitals resent the use of the word "inefficient".
§ Lord HeskethMy Lords, I did not use the word "inefficient" with regard to small hospitals; I used it in relation to old and obsolete hospitals.
§ Lord SandysMy Lords, will my noble friend tell the House how the hospital building programme is being funded? Is it possible for proceeds from local sales within a regional health authority to be credited towards a particular scheme?
§ Lord HeskethMy Lords, capital spending on the National Health Service has increased in real terms every year since 1979. This year, when income from 4 sales of land and property no longer required for the health service is taken into account (health authorities being able to retain that money) capital investment in the National Health Service will amount to nearly £1,000 million.