Hospitals: Single-Sex Accommodation (Hansard, 31 March 2003)

§ Baroness Andrews
My Lords, the majority of NHS trusts were successful in eliminating mixed-sex accommodation by the target date. More than 98 per cent of wards now meet our guidelines; the remainder will comply once private finance initiative and other building projects are completed. Those projects affect only 2 per cent of 10,000 wards. To name those would give a false impression that the whole trust was not compliant when that is clearly not the case.

§ Baroness Noakes
My Lords, I thank the Minister for that reply. I remind her that in February 1998, the noble Baroness, Lady Jay, then a health Minister, said: We promised we would end the unacceptable practice of mixed sex hospital accommodation, and we stand by that promise". Has not that promise been broken? Have not wards been excluded from the Government's figures on a massive scale by allowing screens and other dubious devices to mask the real picture? Is not that the real reason for not disclosing non-compliant hospitals?

§ Baroness Andrews
Absolutely not, my Lords; I could not disagree more. The overall target set stated that we should have eliminated 95 per cent of mixed-sex accommodation by December 2002. That meant complying with three standards: single-sex sleeping accommodation, bathroom and toilet facilities, and 1041 additional safety for patients who are mentally ill. Our figures now show that 98 per cent of trusts have met the first standard; 93 per cent have met the second; and 95 per cent have met the third. Huge effort has gone into meeting those targets and we are pleased with the result.
The most important figure I can give the House is that 164 wards out of 10,000 do not meet the guidelines. What constitutes segregation is not flimsy screens but strong segregated facilities which mean that patients are not overheard or overlooked.

§ Lord Clement-Jones
My Lords, it is now nearly six years since the Government made their pledge on single-sex accommodation. Why is it not now 100 per cent? Successive Ministers have made that pledge. The extra 2 per cent surely cannot be far away. There is confusion about whether the target relates to single-sex wards or single-sex accommodation. Can the Minister clarify that?

§ Baroness Andrews
My Lords, two big questions have been asked. The first is why we are not now at 100 per cent. Of the 24 trusts that remain outstanding, 22 are involved in major-scale conversion or building programmes. Those take time. We are expecting 97 per cent compliance by April 2004, but a few hospitals have even bigger projects scheduled after that.
On definitions, we use the term accommodation rather than wards because accommodation involves not just wards but single bedrooms, groups of single bedrooms and mental health units—the whole range. By single sex, we mean proper segregation within all those different forms of accommodation.

§ Lord Stoddart of Swindon
My Lords, is the noble Baroness aware that it is now well over seven years since I introduced a Bill to the House, which it was good enough to pass through all its stages, to outlaw mixed-sex wards throughout the National Health Service? That has still not been achieved, because, I believe, of resistance within some trusts and hospitals. Even if only 164 wards remain, we should surely be told in what hospitals so that pressure can be brought on the trusts to eliminate them forthwith.

§ Baroness Andrews
My Lords, it pains me to disagree with the noble Lord, but there is no question of resistance. As I explained, the 164 wards remain mixed sex because of the new build coming on stream. The noble Lord will admit that we have made extremely good progress considering the position on single-sex accommodation that we inherited seven years ago.

§ Baroness O'Cathain
My Lords, does the Minister not think there is good reason for naming and shaming the national health trusts? The Government name and shame everyone else—schools, et cetera—so why not trusts? I am sure that it would create the impetus whereby there would be only single-sex wards after very few months.

§ Baroness Andrews
My Lords, as I explained, we do not name and shame because there is no shame attached. Twenty-two trusts are involved in new build conversions and major development programmes, which is something to be proud of. The issue of the remaining wards is not being neglected. Privacy and decency are high priorities. We attempt to provide patients with what they want in different ways, not least by having modern matrons and ward housekeepers. The fact that 164 wards are outstanding is not neglect.

§ Baroness Gibson of Market Rasen
My Lords, my noble friend mentioned privacy and dignity. Having just come out of hospital, I have heartfelt views on that. Can the Minister say more about what has been happening in relation to privacy and dignity?

§ Baroness Andrews
My Lords, privacy and dignity do not depend entirely on single-sex accommodation, although it is an important factor. The training given to nurses and the success of the role of the almost 2,000 modern matrons now in place make a difference to the dignity accorded patients. A benchmarking document, The Essence of Care, helps nurses, patients and everyone else on a ward to understand the importance of respecting patients' feelings, their particular concerns and how they wish to be addressed. Standards in that respect are being driven up significantly.

§ Earl Howe
My Lords, when the noble Lord, Lord Hunt of Kings Heath, announced earlier this year that 98 per cent of NHS trusts met the single-sex accommodation standards, he added the rider that that achievement was in relation to planned admissions. What about unplanned, emergency admissions?

§ Baroness Andrews
My Lords, we must be realistic. There must be scope in hospitals to manage unplanned admissions and to treat patients quickly and appropriately. The guidelines suggest that when people are admitted on an emergency or unplanned basis they enter admission wards, which are sometimes mixed sex but within 48 hours they must be found single-sex accommodation. If the noble Earl asked any patient to choose between waiting until a bed in a single-sex ward became available and receiving the treatment that they need, I think I know which they would choose.

§ Baroness Sharples
My Lords, the noble Baroness mentions modern matrons. What is the difference between a modern matron and an old-fashioned matron?

§ Baroness Andrews
My Lords, I dread the perspicacious questions of the noble Baroness. I think that it is because matrons have been recreated.

§ The Earl of Listowel
My Lords, what is the current situation as regards adolescent residents in mental health units? To what extent are they divided between sexes?

§ Baroness Andrews
My Lords, 96 per cent of NHS trusts have met the additional criteria for mentally ill patients. It is very important, particularly for women and young people, that we develop the best possible quality mental health accommodation. A range of issues, including safety, surround the treatment of turbulent and disturbed adolescents. We are making good progress, but it would be good if we hit the 100 per cent target as soon as possible.

§ Lord Geddes
My Lords, further to the noble Baroness's reply to my noble friend Lady O'Cathain, and accepting, for the sake of the question, that the vast majority of the 2 per cent of mixed-sex wards exist because of massive new building projects—as a former NHS trust member, I understand that—rather than name and shame, would it not be a good thing just to name and give the reason? If that happened, the country would have a fair idea why the 2 per cent were not meeting the target.

§ Baroness Andrews
My Lords, as I said in my first Answer, it is difficult for people to grasp that such a small number of wards in the 22 trusts are involved. It is too easy to extrapolate that, if a ward is not compliant, the trust has not complied. It is a subtle process.