Hospitals: Building Finance (Hansard, 20 January 1992)

§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Hooper)
My Lords, the main criteria used to allocate capital for new developments are that there is a demonstrated service need and support for the development by purchasers, that purchasers can afford the development, that there is a sound business case to support the development, and that the development should accord with national priorities.

§ Lord Dean of Beswick
My Lords, I thank the Minister for that reply. However, perhaps she will understand that some of us find the position difficult to comprehend. For instance, the figure quoted in a recent press report of the allocation for Guy's Hospital in London, using the present criteria, is £36 million. I make no criticism of Guy's Hospital being allocated that money or the use of it. Is the Minister aware of a report in the Manchester Evening News on Friday last which uses the term "shocking conditions" with regard to Withington Hospital in Manchester? Elderly people and the chronically sick are suffering because of the conditions at the hospital. The figure quoted to those who have to manage and operate that hospital to deal with the backlog of repairs and maintenance to put the hospital into an acceptable condition is £26 million. Why is there that difference between Guy's Hospital and Withington Hospital when human beings are involved in both cases?

§ Baroness Hooper
My Lords, I am glad that the noble Lord acknowledges that the capital allocation to Guy's and Lewisham National Health Service Trust is not the result of any special treatment but merely the continuation of capital investment which commenced prior to the unit becoming a trust. Much the same applies to the Manchester situation. Virtually the whole of the capital allocation has been for ongoing schemes in the North West. Allocations for both Manchester Central Hospital and Christie Hospital result from those ongoing schemes. The funds for Withington Hospital, to which the noble Lord specifically referred, again are in proportion to the ongoing nature of the arrangements.

§ Lord Mellish
My Lords, is the Minister aware that some of us believe that every penny spent in Guy's Hospital is worth while?

§ Baroness Hooper
My Lords, yes.

§ Lord Carter
My Lords, on capital allocation, does the Minister agree with the view that the trust hospitals fare better if they are underbedded, thus ensuring that all the beds are full? It has been observed by one of the trust general managers that that may be unfortunate for the patients but it is "commercially sound".

§ Baroness Hooper
My Lords, as I have already established, there has been no special treatment for trusts. Any disproportion between the number of new developments funded in the first wave trusts compared with directly managed units may reflect the ability of the trusts to produce sound business cases for new developments, which is an important new criterion.

§ Lord Carter
My Lords, that is not the question that I asked. I asked about the effect of the technique of underbedding to ensure a larger capital allocation for trust hospitals.

§ Baroness Hooper
My Lords, I had assumed that the noble Lord referred to sound business cases. The management and use of beds is part of the sound business case.

§ Lord Boyd-Carpenter
My Lords, is my noble friend aware that the considerations set out in her original Answer will strike most fair-minded people as thoroughly sensible?

§ Baroness Hooper
My Lords, I can only agree with my noble friend.

§ Lord McColl of Dulwich
My Lords, will my noble friend agree that Guy's Hospital is in the middle of a building programme? Does the Labour Party seriously suggest that we should not put the roof on?

§ Baroness Hooper
My Lords, I believe I underlined the fact that in that case the capital allocation was part of an ongoing and very large new capital investment. We are pursuing what I believe is known as Guy's Phase III as of this moment.

§ Lord Dean of Beswick
My Lords, the Minister will be aware, as I am, that Guy's Hospital has two powerful advocates in your Lordships' House. The noble Lord, Lord Mellish, did not seem to be concerned about Withington Hospital, although I expressed anxiety about Guy's Hospital. I do not know whether the noble Lord who has just spoken is still employed by Guy's Hospital. However, he has had the advantage of being employed at Guy's Hospital. Therefore Guy's Hospital is in a very privileged position: an advocate who works at Guy's Hospital is a Member of your Lordships' House and makes a special pleading.
However, the point that I put—

Noble Lords
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§ Lord Dean of Beswick
My Lords, the Minister has not answered my question. Is she satisfied that elderly 561 people and the chronically and mentally sick in Withington Hospital are obtaining a fair deal from the criteria cited? That hospital requires £26 million to put it into a reasonable state of repair, irrespective of the allocations to Guy's or anywhere else?

§ Baroness Hooper
My Lords, the short answer is yes.

§ Lord McColl of Dulwich
My Lords, does my noble friend agree that the noble Lord, Lord Dean, makes an important point; namely, that hospital buildings in the National Health Service are in a sorry state because in the past management in the NHS has been very bad and money was saved by not repairing buildings?

§ Baroness Hooper
My Lords, I know that there is strong feeling about the state of Withington Hospital. It is a matter that is under discussion and review. I certainly hope that patients in that area receive the best possible treatment in the future, as the health authority aims to ensure.

§ Lord Molloy
My Lords, does the noble Baroness agree that the point made by the noble Lord, Lord McColl, is a real one and that hospitals have been starved of money and not been able to undertake repairs, particularly over the past eight or nine years? Is he not correct in that?

§ Baroness Hooper
My Lords, we all recognise that there were problems in the National Health Service. That is the reason for our reforms.