§ The Minister of Health (Mr. Kenneth Robinson)
Mr. Speaker, I will, with permission, make a statement about the hospital building programme in England and Wales.
When the original Hospital Plan was published in 1962 it received a measure of support from both sides of the House, but it soon became apparent that the individual hospital schemes which comprised the plan had been imprecisely defined and costed. The resources originally thought necessary for the development of the plan were found to be far from sufficient for all these schemes to be undertaken.
In the two succeeding annul revisions of the plan, despite a substantial increase on each occasion in the aggregate sum assumed for the decade in question, deferment on a considerable scale of schemes in the original programme has, I know, led to frustration and disappointment among hospital authorities and to some extent among the public at large.
The position in the coming financial year is no less difficult. To enable a start to be made on developments which are ready and scheduled to start in 1965–66 will involve a total capital expenditure of about £5 million over and above the allocation earlier envisaged for that year by the previous Government. In order to avoid the postponement of much needed new hospitals we have accordingly decided to provide for a special extra capital allocation to hospital boards for 1965–66 of 41 a further £5 million in aggregate, making a total of £68 million. I am now reviewing the future hospital building programme with three objectives in view.
First, I have to look still more closely at the content and estimated cost of each project in order that the total programme can be more realistically matched with the resources that are likely to be available.
Secondly, I shall be asking hospital boards to examine, and where necessary, to adjust the priorities within their programmes; in particular, we must be satisfied that the needs of geriatric and psychiatric patients are properly weighed against other needs.
Thirdly, I propose to give special attention to the co-ordinated planning of hospital, local health and welfare and general medical services and I shall be considering with the various health authorities how this can best be furthered. I am hoping that in the first instance we can work out together comprehensive plans in a limited number of suitable areas.
It is important that the various authorities responsible for the services should have enough time to consider and work out their plans. I do not, therefore, intend to publish my revision of the Hospital Plan this spring as was done in 1963 and 1964.
It is, however, essential that the momentum of the hospital building programme is not lost by reason of the radical review I am undertaking, and I have no intention of allowing the review to interrupt the progress of new schemes whose preparation is well advanced and which are planned to start within the near future. Subject to the necessary resources being available, I shall expect those to proceed according to the programmes provisionally agreed between my Department and hospital boards.
§ Lord Balniel
May I, first, welcome that part of the right hon. Gentleman's statement which refers to improved coordination between the local authority and hospital reviews and also the increased attention which we all feel should be given to the proportionate weighting of geriatric and psychiatric units in the hospital building programme?
42 However, is the right hon. Gentleman aware that we are absolutely astonished that he is not to publish the hospital review programme? Is he further aware that this will give widespread currency to the generally held belief that he is slowing up or phasing down the hospital building programme?
How can the Minister square his refusal to give the House the figures with the absolutely categorical pledges given by the Prime Minister and the Secretary of State for Economic Affairs and hon. Members opposite, in their election manifesto, to accelerate the hospital building programme? Can he say, "Yes" or "No", whether he is intending in the coming year to accelerate the hospital building programme over and above the present rise in building costs?
§ Mr. Robinson
Before the noble Lord leaps to conclusions, I would ask him to await the conclusions of the review of the plan, which inevitably will be a lengthy business. I shall be working very closely with the hospital boards in this review. If we hurry, and get it wrong, there will be still more disappointments to follow. I propose to take time to get it right. The resources for hospital building are and will be under consideration in relation to the resources of the nation as a whole.
§ Mr. David Kerr
Will my right hon. Friend bear in mind that we prefer a discreet silence to the misleading nonsense that we had from hon. Members opposite over the building plan? Can he say whether the delays in achieving their outrageous targets are based on the inability to recognise the need for a proper brief to hospital architects and the long delays in specifications? Further, can my right hon. Friend say, at this stage, what means he will employ or envisages to improve co-operation between general practitioners and the hospital services?
§ Mr. Robinson
I think that some of the main difficulties which arose out of the original plan were the result of its being a rush job, as I have said on many occasions. Right hon. and hon. Members opposite just did not take the time necessary to produce a well-thought-out and properly costed and sophisticated plan, and I do not propose to make that error again.
43 As far as the comprehensive plan is concerned, I am looking for areas where we can do pilot studies, bringing in not only the local authorities but the general practitioner services. I do not want to specify what these areas are at the moment.
§ Mr. Wood
May I congratulate the right hon. Gentleman on being one of the first of his colleagues to make a statement in the House which contains any element of surprise? Is he aware that the general condemnation of the targets which were set by my right hon. Friends when they were Ministers of Health did not prevent the present supporters of the Government from trying to outbid them on every possible occasion?
Lastly, on his statement, may I ask the right hon. Gentleman whether the refusal to publish the revision of the Hospital Plan this spring means exactly what it says and will he confirm that he has firmly in mind to publish the revision later in the year?
§ Mr. Robinson
When I have concluded my review of this programme, I intend to publish it and also to inform the House. What I am not prepared to do is to produce a hurried revision of my predecessors' plan, which is what happened in 1963 and 1964.
On the right hon. Gentleman's first remark, I seem to remember that far from outbidding what the previous Government promised on hospitals, my right hon. Friend the Chancellor of the Exchequer was taken to task by the right hon. Member for Barnet (Mr. Maudling) for not outbidding them and for saying that the amount proposed was as much as any responsible Government could contemplate.
§ Mr. James Johnson
Is my right hon. Friend aware that we on this side welcome his careful and thoughtful statement, particularly in view of the fact, as he has said, that right hon. and hon. Members opposite had a most unrealistic building programme which, in our view, was motivated by the needs of the forthcoming election?
§ Mr. Snow
Is my right hon. Friend aware that we have heard with absolute astonishment the observations from hon. 44 Members opposite? Throughout the country there is pre-election stagnation in the hospital building programme. Is my right hon. Friend further aware that we welcome very much what he said about the geriatric possibilities and his view that there is room for greater co-ordination between the hospital service and the Part III authorities in the sense of using existing buildings for helping old people in the various stages of their old age?
§ Mr. Robinson
I am grateful to my hon. Friend for what he has said. I am only surprised that he maintains a capacity for astonishment at what is said by right hon. and hon. Members opposite.
§ Mr. Heffer
Is my right hon. Friend aware that in Liverpool there has been a great deal of thinking on the question of co-ordinating the welfare services and that we welcome very much his statement? Would he agree that Liverpool might well be one of the centres where the ideas for co-ordination could be worked out in greater detail?
§ Mr. Robinson
I will certainly bear Liverpool in mind in that connection. I am aware that a very extensive study into the hospital bed need is being undertaken in Liverpool at the moment.
§ Mr. Prior
Will the Minister say whether his statement represents a cut in the hospital building programme for the coming year, in view of the increase in building costs? How does he reconcile his earlier statement to my right hon. Friend the Member for Bridlington (Mr. Wood) with the statement contained in the Labour Party's election manifesto which referred to the "inadequate" hospital planbeing bogged down for lack of funds"?
§ Mr. Robinson
Before he starts talking about cuts, perhaps the hon. Gentleman would reflect on the fact that I have this afternoon announced an additional £5 million for the coming year in order to allow schemes to proceed which are ready to start. When I announce the conclusion of my review, this will be geared into financial targets for each year. I certainly do not intend to make any statement in the House about those financial targets before I am in a position to do so
§ Mr. Jennings
In view of today's statement, and the fact that another £5 million 45 is being added to the original estimate, may I ask what is the position of a general hospital scheme costing £¾million which was given priority and a building date fixed for 14th June this year? There was a sudden reversal of the decision in October last year and the whole scheme was sabotaged. There has been no request for any capital allocation for this general hospital in the past two years in view of the assumed priority given to it.
Will the Minister override the lack of priority given by the regional hospital board and assume ultimate responsibility, or will this matter be dealt with in a future year and not in the next year? This is the position concerning the Burton-on-Trent General Hospital.
§ Mr. Robinson
I cannot answer questions about individual hospitals on this statement, particularly as the hon. Gentleman has a Question about this hospital on the Order Paper to which he will get a Written Answer unless he likes to defer it. I must ask him to reflect that a decision which was announced in October can hardly be laid at the door of the present Government.
§ Mr. Jennings
On a point of order. I asked a general question and mentioned Burton-on-Trent in the very last sentence. My question has not been answered.
§ Mr. Speaker
It may not have been answered. Whether or not it was asked, I do not know. But in neither case does it raise a point of order.
§ Sir K. Joseph
The Minister is in an awkward position, in view of the categoric assurances given by his colleagues and his party that the necessary finances will be found. Will he explain to the House whether the necessary finances will be found? What he has said this afternoon contrasts very strangely with the 46 tone of all the speeches during the election, in which the Labour Party promised the country to go far faster than the pace of programme of the Tory Government, which they treated derisively and contemptuously, including the hospital programme?
§ Mr. Robinson
Unlike the right hon. Gentleman, I did not hear all the speeches that were made during the election. I can only assure him that the resources will be made available for the hospital programme as it emerges in my review when it is published.