HL Deb 24 November 1987 vol 490 cc537-9

3.5 p.m.

The Countess of Mar

My 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 where parents of children in the West Midland Regional Health Authority catchment area are to obtain treatment for their children following the regional health authority's announcement that no further planned surgery requiring intensive care could be carried out because of a lack of suitably qualified nursing staff.

The Parliamentary Under-Secretary of State, Department of Health and Social Security (Lord Skelmersdale)

My Lords, children are still receiving the surgery that they require, although delays may occur at the children's hospital in central Birmingham due to staffing difficulties. If a health authority is unable to offer treatment for whatever reason, it is open to clinicians to refer patients elsewhere if they judge it to be clinically necessary.

The Countess of Mar

My Lords, I thank the Minister for that reply, but I must say that I am somewhat saddened by it. Can he hold out any hope for the baby about which so much has been written in the press or for the parents of over 30 other tiny babies and children who are waiting for surgery in the Birmingham area? Can he say whether he is aware of the case of a baby who was transferred to Liverpool from Birmingham some eight months ago and who died on the journey? Parents are very anxious that such a thing should not happen to their children.

Lord Skelmersdale

No, my Lords, I was not aware of the baby that the noble Countess has brought to the attention of the House. It is a very tragic circumstance. The Government sympathise with the predicament in which such children and their parents find themselves through no fault of their own. However, in the case of that particular hospital the matter of resources is not in question. It is a matter of a shortage of trained nursing staff. Regrettably, it is impossible to conjure trained staff out of thin air.

Lord Kilmarnock

My Lords, does the Minister agree that medical advances inevitably give rise to greater demand and expectations which cannot possibly be met simply out of so-called efficiency savings? Can he say what plans the Government have to take into account medical advances in their future funding of the health service?

Lord Skelmersdale

Yes, my Lords, I am on record as saying that demand for medical services is indeed boundless. So far as the West Midland Regional Health Authority is concerned, the region received 24–7 per cent. more money in real terms last year than it did in 1978–79. That enabled it to carry out 24 per cent. more in-patient treatments in 1986 than in 1978.

Lord Molloy

My Lords, is the Minister aware that this problem is not restricted to the West Midlands? There is no point in telling the House that if one cannot get treatment in the West Midlands one should try to get it in some other area because those areas are suffering in exactly the same way. This has probably been brought about by the lack of trained nurses and that situation has arisen because area and regional health managers, who can inflict the cuts in expenditure which cause it, can obtain extra remuneration by so doing. Does he not feel that that is disgraceful?

Lord Skelmersdale

My Lords, clearly the consultants in charge of the case mentioned by the noble Countess in her first supplementary question felt that the operation that was necessary could have been carried out at Liverpool, so the situation is by no means equally as serious everywhere in the country.

Lord Auckland

My Lords, can my noble friend say what on average is the ratio of nurses needed per patient in such very serious and technical cases?

Lord Skelmersdale

My Lords, as I understand it, the ratio of nurses to patients in intensive care units varies. The other day when I was at the Hammersmith Hospital I saw six nurses round the bed of a child in intensive care.

Lord Jacques

My Lords, is there not a strong current of public opinion which feels that more should be spent on the health service, even if less money has to be spent on something else?

Lord Skelmersdale

Yes, my Lords, but I am trying to keep within the bounds of order and the subject of this particular Question. Even with all the resources in the world, regrettably one cannot conjure nurses out of thin air.

Lord Prys-Davies

My Lords, can the Minister explain to the House why the Government refuse to acknowledge that their failure to provide satisfactory health services for all people, wherever they may live, is more costly to the state in terms of increased social security benefits, an increased NHS drug bill and time lost from work than is a few pence taken off income tax?

Lord Skelmersdale

My Lords, that goes very wide of the Question on the Order Paper. I have said that demand for services is boundless and, as has also just been pointed out, people are now receiving life-saving treatments that simply were not available even a few years ago.

Lord Wallace of Coslany

My Lords, will the Minister tell the House why there is a shortage of trained nurses?

Lord Skelmersdale

My Lords, for a number of reasons nurses are not coming forward in sufficient numbers to fill the extra places that are required owing to the expansion of the health service.

Baroness Fisher of Rednal

My Lords, is the noble Lord aware that nursing very small children is a stressful job, even more stressful perhaps than the intensive care of adults? Can he tell us how many places are available in the country to train children's nurses in intensive therapy, where those places are located and whether there are any vacancies?

Lord Skelmersdale

My Lords, I cannot do so in such detail without notice, although I agree with the noble Baroness's introduction to her question. What I can tell her is that there was an increase of 15.2 per cent. up to 31st March 1987 compared with the previous year.

Baroness Fisher of Rednal

My Lords—

Noble Lords


Lord Cledwyn of Penrhos

My Lords, can the noble Lord tell the House what is the percentage of nurses who have transferred to the private sector over the last three years and how many are now moving to the United States and Canada to find work?

Lord Skelmersdale

Again, my Lords, not without notice. If the noble Lord would like to put down a Question about that very interesting point I should be delighted to answer it.

The Countess of Mar

My Lords, may I ask the noble Lord whether he is aware that the West Midland Regional Health Authority allocated the money for a nurse tutor to train nurses in intensive care but did not allow enough money for state registered children's nurses to be withdrawn from the wards and substituted while they went on such a course? May I also ask him whether it is true that there is only one other hospital in this country which trains children's nurses in intensive care?

Lord Skelmersdale

My Lords, so far as substitution is concerned, this would have been totally impractical and I suggest wrong, because quite rightly in the case of children's nurses, especially in intensive care, students are not allowed.

The Countess of Mar

My Lords, there is no—

Lord Denham

My Lords, I wonder whether the noble Countess will allow me to say this. This is a subject on which people's feelings naturally run very strongly indeed, but it is developing far too widely into almost a debate on the National Health Service as a whole. I think it would be better, as we have spent a long time on this Question, to go on to the next business.

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