§ Mr. Anthony Grantasked the Secretary of State for Social Services (1) how many hospitals built in the nineteenth century have not been upgraded because of lack of finance;
(2) at what age, in the opinion of his Department, hospitals with 100 beds or over become uneconomic to maintain.
§ Dr. VaughanThe age of a hospital is not necessarily a reliable guide to its condition. The building fabric of a solidly built Victorian hospital, for example, may well have deteriorated less than more recently built structures, particularly if it has been adequately maintained. In any case, hospitals of 100 beds or over usually comprise several blocks or wings, which will often have been built at widely different periods. The decision to cease to use an existing building, upgrade or replace it can only properly be taken in the light of detailed knowledge of its condition and future life.
Few hospitals built in the nineteenth century have not been substantially altered or improved. They may not have been upgraded for one or more for several reasons, viz:
- (a) they may be reasonably satisfactory in their present form;
- (b) the buildings may have a limited future life and may not warrant the cost of upgrading;
- (c) the buildings may not be suitable for upgrading to suit planned changes in the type and standards of the patient services required and within constraints on NHS expenditure;
- (d) the priority is not sufficiently high to warrant the expenditure.
It is not possible to identify from the Department's records what proportion of the National Health Service hospital stock falls within the category (d) above. Such information is not held centrally.
§ Mr. Anthony Grantasked the Secretary of State for Social Services if, for each of the areas of the National Health Service, he will set out the average current cost per patient bed.
§ Dr. VaughanThe following information has been derived from the costing returns submitted by health authorities450W in England for the financial year 1978–79, the latest for which returns are available:
Hospital Type Average cost per In-Patient Day £ Acute 1–50 beds 32.53 Acute 51–100 beds 36.43 Acute 101–300 beds 43.55 Acute over 300 44.04 Mainly Acute 37.30 Partly Acute 29.95 Mainly Long Stay 23.78 Long Stay 18.82 Geriatric 17.77 Pre-Convalescent 19.99 Convalescent 14.60 Rehabilitation 19.41 Isolation 52.24 Maternity 42.46 Psychiatric—Mental Illness 15.66 Psychiatric—Mental Handicap 13.48 Orthopaedic 39.42 Tuberculosis and Chest 43.39 TB Chest and Isolation 30.83 Children's Acute 59.42 Eye 48.20 Others 38.39