HL Deb 31 October 1990 vol 522 cc1847-50

2.58 p.m.

Lord Ennals asked Her Majesty's Government:

Whether the following numbers of beds have recently been closed in London hospitals for purely financial reasons: Guy's 109, King's College 120, St. Thomas' 175, Charing Cross 137, Westminster 89, St. Bartholomew's 140, North Middlesex 100, Whittington's 65, Lewisham 46, St. George's 75, Ealing 57; and whether they can give any assurances about the future of these beds.

Baroness Hooper

My Lords, given our decentralised system, it is for the individual health authorities concerned to determine the level of health service provision required in their areas, taking account of local circumstances and resources available to them. Bed numbers are not of course an accurate indicator of levels of service in the NHS. What matters is the number of patients treated and I am happy to say that in London that has increased.

Lord Ennals

My Lords, is the Minister aware that that is not good enough? Is she aware that under Section 1 of the National Health Service Act 1977, which applies to the Secretary of State, he is under a responsibility to provide health services and in fact to improve them? Does she not agree that in some of the leading hospitals in London an enormous number of beds are temporarily closed because of edicts from the department about reducing expenditure? Is it not grossly unsatisfactory that the noble Baroness says that she does not have this information and will not provide it to the House? Is she aware that I tabled a Written Question in order to obtain that information? She refused to give me the information then, as she refuses to give it to me now.

Baroness Hooper

My Lords, I have had the opportunity to say before—and I hope that your Lordships will forgive me for repeating it—that spending has never been higher in the National Health Service. As populations move, health services must change to reflect that. Since 1976 it has been the policy of successive governments to shift resources from London to where people are now living. This Government's recently introduced reforms will make it easier for health service funding and services to adapt to that sort of change. In future funding will reflect population and so distribution of funds will reflect population needs and not just the historical siting of buildings.

Lord McColl of Dulwich

My Lords, does my noble friend not agree that over the past 40 years the district authorities of Guy's and Lewisham have closed over 1,000 beds because they were not needed? Further, does she not agree that out of the total complement of beds, 69 beds have been closed for purely financial reasons? I am sure that my noble friend will agree that those financial reasons were because our late and unlamented district health authority told us three months into the financial year that we were to receive £1 million less this year than last, even though its budget had been increased.

Baroness Hooper

My Lords, as always, I am extremely grateful to my noble friend. He has given us the benefit of his particular expertise in this area. He points to the effects of the sort of crisis management which he has seen in the National Health Service and which has spurred us in introducing our reforms.

Lord Ennals

My Lords, will the Minister take it from me that, although she does not give the figures, the figures in my Question have been verified? I now ask her a question to which I am sure she has the answer. How many nurses across the whole span of the service have been sacked to produce the cost savings? I know of 50 sacked from St. Thomas's Hospital.

Baroness Hooper

My Lords, in answer to the first part of the noble Lord's supplementary question, I emphasise that all the closures to which the noble Lord's Question referred are temporary. On the whole, the figures are correct although for Lewisham the noble Lord's figure is 46 and I understand that it should be three, and the quoted figure of 120 for King's College should be 30. The noble Lord may be confusing that with Dulwich in some way. I know that the closure at St. Bartholomew's is not for financial reasons but in order to enable the hospital to carry out a major refurbishment programme, which I am sure the noble Lord will agree is very important.

My understanding as regards the question of staff is that as far as possible all staff involved in those temporary closures are either redeployed within units where they serve or within other units in the health authority area.

Baroness Ewart-Biggs

My Lords, does the Minister not agree that there is a very real anxiety that there should be such a shortage of hospital beds at the beginning of the winter? Does she not agree that when winter complaints such as bronchitis and 'flu start, there may be a real crisis'? Will she give an undertaking that special provision will be made if there is a serious 'flu epidemic?

Baroness Hooper

My Lords, as I reminded your Lordships on Monday, the issue of occupancy of beds is not the vital question. The vital question is the number of people being treated. Because beds are being used more efficiently than ever before, with swifter turnovers and more day surgery, the number of patients has continued to rise. Therefore, I do not believe the noble Baroness to be justified in suggesting that there will be a crisis of that sort.

Baroness Masham of Ilton

My Lords, is the Minister aware that on Monday I spoke with an orthopaedic surgeon who told me that at Westminster Hospital and other London hospitals it is possible to operate only on emergencies? If that is so, will the condition of other patients not deteriorate? Also, is that not a waste of expensive surgeons' operating time when they are twiddling their thumbs?

Baroness Hooper

My Lords, the noble Baroness bears out a very important point; namely, that all emergency situations are being dealt with immediately and any other requirements are being dealt with in due course.

Lord Underhill

My Lords, does the noble Baroness recall that due to my absence last Tuesday my noble friend Lady Hollis referred to a letter which I received from the health authority changing the date of my own appointment at an outpatients' clinic? My noble friend referred not only to bed closures but also to the fact that, due to financial reasons, the authority had no option but to cut staff and also to restrict the opening of outpatient clinics. I readily understand that the noble Baroness had not seen that letter and therefore could not reply to that question. However, has she now had a chance to look into the matter and are we likely to have a restoration of the outpatient clinics, which are as important as any other part of hospital treatment?

Baroness Hooper

My Lords, I thank the noble Lord, Lord Underhill, for reminding me again about his particular situation. The Riverside Health Authority is ensuring that steps taken to control expenditure will leave sufficient beds available, certainly for the needs of emergency admissions, as we have already established, and other cases such as cancer cases, HIV and AIDS cases, terminations of pregnancy and selected day cases.

The Lord Privy Seal (Lord Belstead)

My Lords, we have now been discussing Questions for half an hour. Perhaps I may suggest that we take a question from the noble Lord, Lord Mellish, and one more from the Opposition Benches. We should then call it a day.

Lord Mellish

My Lords, is the Minister aware that in between Lewisham Hospital and Guy's Hospital is a hospital called St. Olave's which was closed, with its 280 beds, lock, stock and barrel before this wretched Government even came into office?

Baroness Hooper

My Lords, I should draw the observation of the noble Lord, Lord Mellish, to the attention of noble Lords opposite.

Lord Ennals

My Lords, will the Minister now answer the last part of my Question on the Order Paper? Can she give some assurance about the future of those beds?

Baroness Hooper

My Lords, I believe that I have done that in saying that those closures are all temporary.