NHS Hospital Beds: Numbers (Hansard, 20 January 1992)

§ Baroness Hooper
My Lords, the Government welcome this report but have no plans to respond directly to it. Local National Health Service managers will review their services in the light of the report and the further detailed work that the Audit Commission will carry out in all health authorities and National Health Service trusts over the next 12 months. The effect of any consequent decisions on staff will be a matter for local decision.

§ Lord Molloy
My Lords, may I assume from the Minister's Answer that staff associations, which are gravely concerned about this situation, will undoubtedly be consulted first at local level and then if necessary at national level? Is she aware of the grave concern that will be caused by an item in today's BBC programme "Panorama" according to which hundreds of beds are being closed down for very elderly and badly stricken patients who are to be moved—in the anomalous term—"elsewhere"? Can she enlarge on that information and say what it means?

§ Baroness Hooper
My Lords, first let me say that the Government welcome the thrust of the report to which the noble Lord referred. As I said, implementation of the report will be done at local level and will undoubtedly involve consultation with staff. The "Panorama" programme has not yet been transmitted; so we are talking somewhat hypothetically. During the period to which the programme, which has been trailed in the press, refers, there has been considerable improvement in hospital rehabilitation, acute care and community health services. That has resulted in a shortened length of stay, down from 79.3 days to 38.6 days. That reflects fully our policy of trying to keep to a minimum the number and length of any episodes of hospital care.

§ Lord Ennals
My Lords, does the Minister accept that many beds that might be closed under the proposals of the Audit Commission are beds for the mentally ill and for the elderly and mentally frail? Bearing in mind the commitments in the Patient's Charter, will she give an absolute assurance that beds will not be closed so long as there is a need for them and that patients will not be discharged until there is proper alternative accommodation and treatment for them?

§ Baroness Hooper
My Lords, decisions on the length of stay of individual patients are clinical decisions for the consultant concerned. With regard to discharge, the recommendations of the report reinforce our advice on arrangements for discharge already issued to health authorities. We expect health authorities to ensure, through their contracting arrangements, that discharge procedures are properly followed.

§ Lord McColl of Dulwich
My Lords, does my noble friend agree that the report of the Audit Commission is a great embarrassment to all those who have been making such a hoo-ha about all the beds that have been closed in the past 10 years? Is she aware that every year since 1964 on average 7,000 beds have been closed, irrespective of the government in power? Does she further agree that beds are dangerous places and that one should keep out of beds as much as one possibly can?

§ Baroness Hooper
My Lords, by way of agreement with my noble friend, I confirm that the National Health Service is there to look after patients and not beds.

§ Lord Carter
My Lords, is the Minister aware that the Audit Commission report found that in 90 per cent. of hospitals last year patients requiring emergency admission had to be put into beds earmarked for routine surgery? Is she further aware that that situation caused cancellation of operations and lengthened the waiting list? What proposals do the Government have to prevent such occurrences? Did the Minister not say in her first Answer that the Government did not propose to respond to the report?

§ Baroness Hooper
My Lords, I said that it was not for central Government to respond to the report. In fact we welcomed the report. Implementation of the report is for decision and action at local level.

§ Lord Cledwyn of Penrhos
My Lords, can the Minister confirm that the figure of 7,000 beds closed every year since 1964, given by the noble Lord, Lord McColl, means that a total of about 175,000 beds have been closed? Is that really true? Will she be kind enough to comment on that figure?
Furthermore, having heard what was said by the noble Lord, Lord McColl, to whom I listened with great respect, is it not a fact that there is acute anxiety as regards the number of mental patients and geriatric patients who are discharged unjustifiably? In view of that, is it not the duty of the noble Baroness's department to look into the matter very carefully? Will she ask her right honourable friend either to make a Statement or produce a short White Paper explaining the situation to the satisfaction of the people of this country?

§ Baroness Hooper
My Lords, it is true to say that substantial numbers of beds have closed over a long period of years. We welcome that because at the same time more patients are being treated than ever before. That is as a result of increased and improved techniques and technology which enable patients to stay in hospital for a minimum amount of time thus avoiding disruption to their lives. That must be the best way forward. We hope that the trend will continue.
As regards the latter part of the noble Lord's question, if any examples of patients who have been discharged at the wrong time are brought to our attention or to the attention of the health authority, those examples are investigated. That is what the Patient's Charter is all about. However, we take the advice and clinical judgment of the consultant in those situations.

§ Lord Cledwyn of Penrhos
My Lords, will the noble Baroness be rather more specific or at least give an undertaking that she will look again into the charge that 175,000 beds have been closed since 1964?

§ Baroness Hooper
My Lords, my noble friend is usually so good on his figures that I am prepared to accept them. However, I shall investigate the matter and let the noble Lord know if there is any substantial difference.

§ Lord Carter
My Lords, will the noble Baroness confirm that the report shows that in 1974 there were 158,000 beds and in 1988–89, 123,000 beds, a reduction of 36,000 beds in that period.

§ Baroness Hooper
My Lords, I have undertaken to look into the matter.

§ Lord McColl of Dulwich
My Lords, does my noble friend not agree that during the past 30 years in surgery we have managed to carry out operations without having patients in hospital beds for 30 days? 564 They are now only in for 30 hours. Is that not a good trend? Does my noble friend not agree that in view of that progress, we do not need as many beds?

§ Baroness Hooper
My Lords, certainly it is not the total number of available beds which matters but the use which is made of them. Medical and surgical advances, the development of day surgery, faster throughput and more efficient use of resources mean that the National Health Service is treating 25 per cent. more patients than it did in 1979 with some 30,000 fewer beds in that period.