HL Deb 08 February 1988 vol 493 cc5-8

2.47 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 how many hospital wards have been closed during 1987 in order to effect financial savings, and whether they intend to take steps to bring them back into use as soon as possible.

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

My Lords, temporary closures may be made for a number of reasons; for example, staff shortages, damage to buildings and to prevent the spread of infection. It is for health authorities to decide when such measures are necessary, and information is not collected centrally on such closures or the reasons for them. Where such closures have been made to avoid overspending, the extra £75 million funding announced by my right honourable friend the Minister for Health in another place on 16th December has already enabled some re-openings.

The Countess of Mar

My Lords, I thank the noble Lord for that not very satisfactory reply. In view of the number of closures that have been reported over the past 12 months, can he tell the House what has happened to the DHSS guidelines of 1975, which stated that no patient requiring urgent hospital treatment should have to wait more than one month, and no patient requiring any hospital treatment should have to wait more than 12 months?

Lord Skelmersdale

My Lords, every endeavour is made by health authorities to meet those guidelines. Indeed, we are constantly looking at them to see whether such matters can be improved. However, it should be pointed out that demand for health care is totally uncontrolled. It is true that a number of districts are having difficulty remaining within their budgets this year. It should be remembered that managers are responsible for health authorities keeping within the law and, although they plan their district finances very carefully, they do not control the clinical decisions which determine the level of expenditure.

Lord Molloy

My Lords, is the noble Lord prepared to examine the situation which has occurred in one or two London hospitals where the staff have endeavoured to the best of their ability to reduce waiting lists but, on accomplishing that, have been punished by having wards closed? Does the Minister not consider that such instances at St. Bartholomew's and one or two other London hospitals ought to be examined so as to keep up the morale of the staff—if achieving nothing else— whose endeavours during the past few months have been wonderful?

Lord Skelmersdale

My Lords, I certainly agree with the second half of the noble Lord's supplementary question. The endeavours of the staff have been very praiseworthy indeed. I do not believe that anyone is being punished in the way that the noble Lord suggests. What has happened is that staff, particularly in London, have not been available for extra beds made available at the beginning of the financial year. That is why we have reached the present position.

Lord Molloy

My Lords, the word "punishment" was that used when I spoke to senior surgeons, senior physicians and specialists, and senior midwives and nursing sisters. They said to me, "For our endeavours we are being punished"—

Lord Denham

Question!

Lord Molloy

Will the noble Lord not examine the situation?

Lord Skelmersdale

My Lords, that may or may not be true; but I still do not believe that it is an appropriate word.

Lord Ennals

My Lords, whether or not the word "punishment" is right, is it not true that temporary closures are still taking place? In view of what the Minister said about health districts overspending, is not the message to the Government from doctors, nurses, patients and, overwhelmingly from taxpayers, quite clear—that the Chancellor really must use some of his surpluses to make a significant and major infusion of funds into the National Health Service to stop the bleeding that is now going on?

Lord Skelmersdale

My Lords, if the noble Lord is referring to the Budget, he knows as well as I do that this is not an appropriate moment to comment on what may or may not be contained in my right honourable friend's Budget Statement. Having said that, the decisions on what to pay for have already been made. The Budget tells us how to pay for them.

Lord Campbell of Alloway

My Lords, does the Minister agree that it is not so much a question of consideration by the Chancellor but that of a fundamental review of the service which I understand my right honourable friend the Prime Minister proposes to undertake? Is it not the case that all these questions on specific issues are very valuable and constructive but that they merge into a greater question for fundamental review?

Noble Lords

Question.

Lord Boyd-Carpenter

My noble friend did ask a question.

Lord Skelmersdale

My Lords, I certainly accept that there are many differing aspects to what is widely described as the health service problem, which principally exists within the acute services. It is because there are so many different aspects to it that an inquisition is being undertaken.

Lord Ennals

My Lords, is it not true that this very last-minute "inquisition" by the Prime Minister is one conducted by Ministers and civil servants and includes no independent people from the medical or nursing professions? It is a political exercise, does the Minister not agree?

Lord Skelmersdale

Most certainly not, my Lords. As I said in the House, I believe in answer to a supplementary question asked by the noble Lord, Lord Ennals, the other day, any thoughts that can be given by your Lordships, the professional bodies or anyone else will be well received by my right honourable friend the Secretary of State for Social Services.

Lord Hayter

My Lords, does the Minister really imply from his reply to the Question that the department does not know the number of wards that have been affected by financial savings?

Lord Skelmersdale

My Lords, what I said was that there are no centrally collected facts and figures for such closures or the reasons for them. I pointed out that financial reasons are not the only criteria for temporary closures.

Lord Ennals

Should the information not be available, my Lords?

Lord Skelmersdale

My Lords, it never has been, and the arrangements within the NHS currently—and during the time of the noble Lord, Lord Ennals—do not enable such figures to be collected.

The Countess of Mar

My Lords, will the noble Lord and his right honourable and honourable friends get right away from the misconception that the demands on National Health Service facilities are infinite? Everyone knows the average time people are going to live and the incidence of disease in the population. Therefore, there is some means of calculating what the requirements of the National Health Service will be.

Lord Skelmersdale

My Lords, if that were so, I wish the noble Countess would tell me.