Hospitals: Capital Investment (Hansard, 20 December 1989)

§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Hooper)
My Lords, since 1st January 1980 more than 500 building schemes each costing over £1 million have been completed in the United Kingdom. A further 183 schemes are currently under consideration. The Government continue to maintain the largest ever programme of capital investment in the National Health Service.

§ Lord Gainford
My Lords, I thank my noble friend the Minister for that information. However, can she possibly give the House what information she has about the proposed capital expenditure on hospitals for next year?

§ Baroness Hooper
My Lords, as I said, the Government are committed to modernising and improving national health buildings. We have sustained a high level of capital investment in the National Health Service. Capital investment for next year will be about £1.4 billion of which about £1 billion is to be spent on buildings. Further, as my noble friend is aware, in the current year —that is, 1989–90—we estimate that over 60 new health building schemes each costing over £1 million will be brought into use.

§ Lord Molloy
My Lords, can the Minister say whether there is a programme for modernising the older hospital buildings? If there is, can she say whether there will be a system of priorities in the programme?

§ Baroness Hooper
My Lords, the noble Lord has raised an important point about getting the right balance between modernising and replacing existing stock. Of course, it is ultimately for the regional health authorities to decide such matters. However, the department monitors the National Health Service estate to ensure that the right balance is maintained. Generally speaking however we would say that new hospitals are capable of operating more efficiently. They provide a better health care environment for patients and more attractive and productive working conditions for staff.

§ Lord Renton
My Lords, can my noble friend elaborate on her very satisfactory answers by giving your Lordships some idea of the total number of hospital beds that will be provided by these hospitals which have been completed?

§ Baroness Hooper
My Lords, I do not have specific figures concerning the number of hospital beds.
257 However, substantial maintenance and improvement is involved in relation to the existing number of hospital beds.

§ Lord Ennals
My Lords, perhaps I may assist the Minister on that point. Bearing in mind the fact that according to the department's own figures the number of available hospital beds has actually been reduced —I repeat "reduced" —during the past 10 years by 21 per cent., can the Minister explain how all the new hospital projects to which she referred have created a situation in which last year there was a significant fall in the number of in-patients treated; a significant fall in the number of day patients treated; and a significant fall in the staff caring for such patients? Therefore, I ask: what sort of success story is that?

§ Baroness Hooper
My Lords, I hope that the short answer is that we are being more efficient and successful in our treatment. I have come across some Figures which might be helpful to your Lordships. Although the number of beds was reduced from 362,000 in 1979 to 297,000 in 1988, activity has increased by 25 per cent.; 22 patients are now being treated per available bed, compared with 15 in 1979. I think that that is the answer.

§ Lord Jenkin of Roding
My Lords, will my noble friend not take too seriously the comments of the noble Lord, Lord Ennals? Unless he is going to imitate Mr. Gorbachev and confess the sins of the past, he is not in a position to criticise, having cut the capital expenditure of the National Health Service under his regime by over one-third in the period during which he was responsible for health.

§ Baroness Hooper
My Lords, I am grateful to my noble friend. Perhaps I may supplement what he said by pointing out that although some 350 hospital units have closed during the past 10 years, as I said in my Answer, more than 500 building schemes have been introduced over the past 10 years.

§ Lord Ennals
My Lords, the Minister referred to greater efficiency. Is it really greater efficiency if we decrease the number of patients but if we increase the waiting period for those patients and we even decrease the number of patients on day treatment as well as those undergoing in-patient treatment? How can one possibly call that increasing efficiency?

§ Baroness Hooper
My Lords, when we talk about the reduction in the number of beds, we are not talking about a reduction in the number of patients. I stated that there was a quicker turnover of patients and they were therefore being dealt with more efficiently.

§ Lord Orr-Ewing
My Lords, can my noble friend say whether it is not a fact that one thing that certainly has not gone down is the members of COHSE and NUPE now employed in non-medical functions? Are the numbers not continuing to rise despite other restrictions?

§ Baroness Hooper
My Lords, that is a separate Question. I am pleased to hear mention of the subject from my noble friend.

§ Lord Jenkins of Putney
My Lords, is the Minister aware that not all changes are necessarily improvements? Some of the changes which the Government have made in relation to new hospitals have been looked at askance by the people affected. For example, there is a proposal to close Westminster Hospital and erect a new building in Chelsea which will take its place. Some noble Lords might regard that as a curious improvement. Will the Minister comment on it?

§ Baroness Hooper
My Lords, there is always a NIMBY syndrome. I believe that if the noble Lord spoke to people in areas such as Barrow-in-Furness, St. Albans, Eastbourne, Medway, Bournemouth, Bristol, Stoke-on-Trent and Stirling where major new hospital developments have taken place, they would hear a more satisfied response.

§ Lord Tordoff
My Lords, perhaps people in this House would prefer to have the hospital in our back yard rather than several miles away.

§ Baroness Hooper
Yes, my Lords.

§ Lord Auckland
My Lords, I congratulate the Government on the figures for new hospital building. Can the Minister give an indication, particularly for district hospitals in the country areas, of expenditure on extensions to present hospitals? These are important in areas of new towns anti where the population is growing.

§ Baroness Hooper
My Lords, as I said earlier, the important point is to achieve the right balance. The monitoring carried out by the department is intended to do that. If I find that I have some specific figures which I can give to my noble friend, I shall let him have them.

§ Lord Alport
My Lords, is my noble friend aware that we are having to close wards because there are insufficient resources to keep them open? This is causing great concern throughout the whole of north east Essex. Is it possible to equate the resources necessary to use the new facilities fully when those facilities are available?

§ Baroness Hooper
My Lords, the intention is that the best possible use should be made of existing facilities. I believe that the figures that I have already quoted on the use of hospital beds proves this. We are doing our utmost to help the relevant regional health authorities and the district health authorities in order to ensure that no closures take place.

§ Lord Cocks of Hartcliffe
My Lords, is the Minister able to say what proportion of beds in the hospital which will replace Westminster Hospital will be devoted to the treatment of AIDS?

§ Baroness Hooper
My Lords, no. I shall write to the noble Lord on that point.