Premature Baby Care: Manchester (Hansard, 23 February 1988)

§ Lord Dean of Beswick
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 (Lord Skelmersdale)
My Lords, no such request has been received.

§ Lord Dean of Beswick
My Lords, is the Minister aware that that Answer is in conflict with information that I have had from the chairman of that authority? Is he also aware that that authority has had to reduce from 15 to 10 the number of beds provided for 1050 premature births? Is he also aware that because of the cut-back more than one baby has died while places were being sought in other authorities? Is he satisfied with the fact that the children of that area of Manchester have less than the national average chance of living? The figures for premature baby deaths, infantile mortality and deaths in the first 12 months of life in that area of Manchester now stand at twice the national average. Is the Minister happy about that situation? If he is not, when will he do something about it?

§ Lord Skelmersdale
My Lords, the problem which the noble Lord brings to the attention of the House today is one, as he says, of a reduction in the number of beds in that particular paediatric unit from 15 to 10. I should make the point that within that unit are exactly the same number of doctors and the same number of nurses. What has happened is that with advances in medical science, which mean that smaller babies can now be treated—for example babies under 2lb. in weight—it has become necessary to use intensive care nursing with more nurses per baby. I am aware that the district health authority is in discussion with the regional health authority to produce two more cots for the unit, but that will require extra staffing.

§ Lord Ennals
My Lords, how can a Minister justify a situation in which urgently needed special care baby cots are cut by a third? How long can this game of Russian roulette with children's lives go on? Does he accept that, whatever may or may not be the solutions to the problems of the NHS, the most urgent need at the moment is to stop the bleeding and to stop those beds being taken out of use, particularly when children are dying?

§ Lord Skelmersdale
My Lords, the point that I was trying to make clear is that there is no cut in resources in that case. I explained why; namely, because of the medical decisions made on the ward there had been a reduction from 15 to 10 cots. I also explained that discussions were going on between the district health authority and the regional health authority to have two more beds in the unit.

Lord Wallace of Coslany
My Lords, is the noble Lord aware that he is saying in fact that there is no extension of facilities, the status quo is being maintained and any increase in demand is not being met?

§ Lord Skelmersdale
My Lords, I am saying that the nature of the demand has changed and the circumstances have changed to take account of it.

Lord Winstanley
My Lords, bearing in mind the beds that have already been lost from the Duchess of York's Hospital for babies in Manchester, does the Minister accept that it would be highly undesirable for any further beds for premature babies to be lost from St. Mary's Hospital, Manchester? Can he give the House an assurance that there will always be beds for premature babies in the Manchester area when needed?

§ Lord Skelmersdale
My Lords, within the region, yes. Within any particular district I am afraid that I am unable to give that assurance. I repeat that discussions are going on to provide two extra cots for that unit.

§ Lord Kilmarnock
My Lords, can the noble Lord undertake that some allocation will be made from the special funds for the reduction of waiting lists to redress this problem?

§ Lord Skelmersdale
My Lords, yes, within the waiting list fund quite a lot of money has been found for central Manchester, as has £300,000 from the special bridging fund; and £518,000 has come from the extra allocation announced by my right honourable friend the Minister for Health in December. It is for the region and the district concerned to allocate precisely where those moneys are to go.

§ Lord Ennals
My Lords, is the Minister saying that the decision to reduce the number of cots available is not a matter of resources? If so, how much is saved by a reduction in the number of these cots?

§ Lord Skelmersdale
My Lords, to exemplify my original Answer to the first supplementary question of the noble Lord, Lord Dean, nothing is saved in this case.

§ Baroness Fisher of Rednal
My Lords, can the Minister tell the House how the trained nurses will fill the gap at St. Mary's Hospital? The same problem of the shortage of skilled nurses in intensive care has arisen at the Birmingham Children's Hospital. Is the Minister aware that the training facilities for these nurses are very limited? Will the Government make further provision outside the London area for the training in these specialised areas?

§ Lord Skelmersdale
My Lords, yes. As I told the House the other day, a new training course in Birmingham for such nurses will be provided very shortly. Over and above that, there is the problem of people leaving the nursing profession. The reason is widely regarded as being the amount of pay for particularly stressful occupations, of which I would regard paediatric nursing and intensive care paediatric nursing as two examples. We are waiting for the report of the nurses and midwives salary review body to tell us where it considers that extra moneys would be most appropriately spent.

§ Lord Dean of Beswick
My Lords, does the Minister recall that in my first supplementary question I made the point quite forcefully that, because of the reduction of beds in Manchester, efforts have to be made to find placements for children in Liverpool and Leeds? I understand that there has been more than one death while children were awaiting placements in some of these other hospitals.
Is he aware that I am totally dissatisfied with his answer? The Government have an overall responsibility. I wish that the Minister would stop foisting the responsibility onto regional and district 1052 health authorities. Is he aware that those of us who have a regard for our city of Manchester are not prepared continually to sit back while the children in this area do not have the same chances of survival as those in other areas of the United Kingdom? In the end it is the Government's responsibility and nobody else's. When will he do something about it?

§ Lord Skelmersdale
My Lords, the Government's responsibility is underlined by the National Health Service Act, which, as the House well knows, gives us the duty to provide health care facilities. We do this on the basis of delegation to regions and from regions to district health authorities. It has always been done in this way. The Government's primary responsibility in this area is to make enough finances available globally for such distribution.

Lord Winstanley
My Lords, will the Minister accept that babies who are born prematurely have already demonstrated a commendable lack of interest in waiting lists? We need an assurance that there will always be beds available somewhere in the Manchester area for premature babies who need hospital treatment. Can he give that assurance?

§ Lord Skelmersdale
My Lords, I have given the assurance that sufficient beds will be available in the region. However, for obvious reasons I am unable to do so for particular districts.

§ Baroness Blatch
My Lords, is it not true that a review is considering some of the problems already addressed this afternoon and the funding of the health service? Is it not also true that it is a poor use of your Lordships' time to discuss in isolation a very emotional case without the background knowledge of how the millions that are going to the Manchester area health authority are being spent?

§ Lord Skelmersdale
My Lords, I am able to answer the questions that are put to me only to the best of my ability. However, I confirm that the review body is being asked to recommend rates of pay for a new grading structure for clinical nurses which has recently been agreed by the nursing and midwifery staffs' negotiating council. The new structure will mean better rewards and recognition for those nurses who provide hands-on care to patients and will place more emphasis on post-basic skills in key specialisms such as paediatric nursing and intensive care.