Hospital Closures (Hansard, 4 July 1991)

§ The. Parliamentary Under-Secretary of State, Department of Health (Baroness Hooper)
My Lords, the relevant information is the number of patients treated. That is the information that we collect. It shows that more patients are being treated nationally than ever before. Hospital closures and related staff reductions, if any, are not a good indicator of levels of service in the National Health Service; nor do they take account of the many new facilities being built.

§ Lord Molloy
My Lords, I thank the Minister for that reply. Is she aware that the National Health Service associations know full well what the real answer is? Far too many people are being sent home far too early. That puts a massive strain on health visitors and on home helps who have been trained in some form of medicine to help people who ought to have remained in hospital for another three or four weeks. Perhaps I may quote from the Central Consultative Specialist Committee of the BMA. Two months ago it stated that 3,247 beds were cleared away, 20,000 operations were cancelled and 300,000 were delayed. I read the figures because they are important. I do not overstate any figure.

Noble Lords
Question!

§ Lord Molloy
Those are the figures from the Central Consultative Specialist Committee of the BMA. Is not what is happening to our once famous National Health Service an awful shame?

§ Baroness Hooper
My Lords, I wish that I could share the confidence of the noble Lord in the source of his statistics. The fact remains that increased activity in patient care results from a number of factors. They include shorter hospital stays, to which the noble Lord has referred, less invasive procedures, increased day care, increased out-patient care and the fact that many GPs are developing health teams and in many cases performing minor surgery. With reference to bed use, in 1989–90, 28 cases were treated per available bed, whereas only 17 cases were treated in 1975. I am sure that the noble Lord welcomes the increased bed use.

§ Lord Ennals
My Lords, does the Minister agree that there is some link between the number of beds that have been closed and the fact that the waiting lists are at their all-time highest since the National Health Service began? Does she deny the report of two or three days ago that the Government are considering stopping publication of waiting lists and not making that information available?

§ Baroness Hooper
My Lords, the reason why there are more people on the waiting lists is that more people are being treated. The important aspect to tackle, which is what the Government are tackling, is to reduce the length of waiting time, and we have had considerable success.

§ Lord Nugent of Guildford
My Lords, is my noble friend aware that one of the most valuable developments in recent years has been the increased speed in treatment, which has resulted in a large number of cases being treated now as day cases so that the patients can return home the same day? Nothing pleases them more. Treatments generally now require a shorter stay in hospital and an earlier return home, the patient having recovered and not requiring further treatment.

§ Baroness Hooper
My Lords, my noble friend is absolutely right. He at least is moving with the times. There is no simple relationship between the number of beds, the number of patients treated and the number awaiting treatment. Between March 1989 and March 1990, the latest data available, the number of available beds fell by 4.6 per cent; that I can agree. However, the number of patients treated rose by 4.4 per cent. I hope that all noble Lords will welcome that fact.

§ Lord Ennals
My Lords, is it not obvious that because we are all growing older and living longer there are more patients in hospital? Why is the noble Baroness unconcerned about the numbers of those who wait, often one or two years, to have their treatment?

§ Baroness Hooper
My Lords, I should be interested to have a little more information as to why the noble Lord believes that I am unconcerned about the length of waiting times.

§ Lord Ennals
My Lords, the noble Baroness stated so.

§ Baroness Hooper
My Lords, I did not. I replied clearly that the Government have tackled the issue and are having considerable success in slashing waiting list times.

§ Lord McColl of Dulwich
My Lords, does my noble friend not agree that we could cheer up the doom and gloom merchants on the Benches opposite with the good news that the Sydenham Children's Hospital has recently been successfully moved to Lewisham Hospital into purpose-built accommodation which is much better than the accommodation provided in the original hospital? That has been done without any compulsory redundancies.

§ Baroness Hooper
My Lords, as always, I welcome the good news put forward by my noble friend. Also I should like to mention the case of the North Middlesex Trust, which plans to make 15 administrative staff redundant. The savings from that will go into direct patient care. The aim of this Government is to have more people in post providing direct patient care. That is what we have achieved.

§ Lord Murray of Epping Forest
My Lords, from the replies so far of the noble Baroness are we to take it that that she does not know how many hospitals have been closed in the past three years? If she knows, will she tell the House how many hospitals have been closed in the past three years?

§ Baroness Hooper
My Lords, as I said, the question of how many hospitals have been closed is not relevant to what should be our main interest. Our main interest must be in the number of people being treated, which has increased by 25 per cent. since 1979.

§ Lord Hailsham of Saint Marylebone
My Lords, will the Minister take comfort from the fact that on this side of the House, and I believe in all quarters of the House, we greatly respect my noble friend and resent the suggestion that she is unconcerned by human suffering?

§ Baroness Hooper
My Lords, I am most grateful to my noble and learned friend.

§ Lord Jenkins of Putney
My Lords, if the noble Baroness answered the Question there would be no difficulty. Why does she not answer it?

§ The Countess of Mar
My Lords, can the noble Baroness cheer us further by telling us that there have been no redundancies among nurses and doctors who have been trained by the National Health Service? Can she tell the House that none of them has been forced out of the National Health Service into private practice because there are no jobs available for them in the health service?

§ Baroness Hooper
My Lords, as well as the increase in the number of doctors, there have been increases in the number of nurses and midwives in the National Health Service. The figure rose to 398,460 in 1989 and has increased further since then. What is particularly interesting is the number of general practice nurses in 1108 England and Wales who are involved in primary health care. Their numbers increased by 350 per cent. between 1979 and 1989.

Lord Wallace of Coslany
My Lords, is the noble Baroness aware that apart from hospital closures there is the question of closures within existing hospitals which is causing enormous delay and inconvenience to many people? My opinion, if the noble Baroness wants it, is that at present the health service is in one hell of a mess.

§ Baroness Hooper
My Lords, I am sorry that the noble Lord is not better informed on the subject. I have been trying my best. I should be surprised if he persists in believing that hardware, beds and hospitals are the important statistics and not the number of people being treated.

§ Lord Molloy
My Lords, despite the Question on the Order Paper the noble Baroness obviously cannot give me the information today, but will she tell us how many closures are anticipated? She challenged my figures. I challenge her to ask the BMA, which is now wisely considering talking with the department, to verify the figures which I have given. Is she prepared also to talk to the Royal College of Nursing and the Confederation of Health Service Employees, some of whose members say they are at their wits end to know what is happening in the NHS? Following the lead which has been given by the BMA, is it not about time that the Royal Colleges and the Confederation of Health Service Employees met with senior Ministers in the department to learn precisely what the policy of this Government is?

§ Baroness Hooper
My Lords, we have an ongoing dialogue with all the bodies referred to by the noble Lord. We are delighted at the new constructive approach by the British Medical Association and we certainly hope to move forward further to improve our National Health Service for the benefit of patients.