§ 11.59 p.m.
§ Mr. Leslie Huckfield (Nuneaton)
Mr. Deputy Speaker, it was one of your colleagues in the Chair who this afternoon dared to forecast that I should rise to 1391 speak on the Adjournment at precisely midnight. I welcome the opportunity of my constituents to raise what they and I consider to be a most serious issue, namely, the threatened closure of the High View geriatric hospital in my constituency at Exhall in what is now called Nuneaton.
Ever since I have been the Member of Parliament for Nuneaton, at every surgery I have had in my constituency and, indeed, in every week of correspondence that has gone by, I have had yet another case, or a couple of cases, of old people whose relatives would dearly like to look after them but who are very much afraid that because of the difficulties they encounter the old people could be far more adequately and capably looked after and nursed in a geriatric hospital.
The trouble is that there is a severe shortage of geriatric beds in the Nuneaton and Bedworth areas. I am not saying that these are relatives who want to get rid of their obligations. They are relatives who feel that in many cases geriatric hospitals would be far more adequate and suitable places for them to be looked after.
I am proud to say that I have worked in the past with Dr. Thompson, Dr. Qasim, social services officers and area health administrators to try to do something about the problem. Nevertheless I feel that it was rather adequately summed up in the letter which I received from the Chairman of the West Midlands Regional Health Authority on 14th April when I wrote to him about this threatened closure. He said in that letter that the need for geriatric beds in my area had been calculated on the Department of Health and Social Security's norm of 10 beds per 1,000 population over age 65 and he gave me the figures which showed that Coventry would soon have 324 beds, which would give a bed deficiency of 14, that Rugby would soon have 66 geriatric beds, giving it a deficit of 29, and that Nuneaton would have 60 geriatric beds, giving it a deficiency of 105 beds.
Those figures assume that the closure of High View Hospital might have taken place and the opening of the new phase IV of Walsgrave Hospital had taken place. Perhaps I might go on to quote 1392 the Chairman of the West Midlands Regional Health Authority because he puts it in words which I should like to echo:On these figures Nuneaton will be worse off than either Coventry or Rugby, both numerically and relatively. In the present financial climate there is little prospect of dealing with any other than the worst problems. In the case of the threat to High View, Nuneaton's need is paramount.I can testify to that from my surgeries and from my experience in correspondence. He goes on to say:It is inevitable in these circumstances that the 196 beds provided by Phase IV of the Walsgrave development will be regarded as replacement of the 198 beds in High View so far as Coventry Area Health Authority's area is concerned.My case is quite simply that, because of the geriatric situation in my constituency, not only do we need phase IV at Walsgrave but we also need High View.
When I talk about High View Hospital, I talk about a hospital which was first constructed in the early 1900s. It is a neat little hospital with nice lawns and gardens and with a friendly atmosphere. It has local staff,about 75 per cent. of whom live within walking distance. Although a great deal has been left to be desired of the buildings we have recently had a fairly throughgoing upgrading programme, in some cases spending as much as £4,000 to upgrade a ward. This includes the installation of central heating and quite a few other modern conveniences. Anybody in my constituency who has visited High View Hospital can testify to the dedication and the loving care of the staff, and this makes a worthwhile contribution to the continuity of High View.
It is also interesting to note the comparison in the running costs of High View compared with other geriatric accommodation. In a reply which I received from the Under-Secretary of State—not my hon. Friend who is on the Front Bench tonight—on 28th April he told me that the patient cost at Walsgrave per week was £130.51 and at George Eliot in Nuneaton it was £91.07, whereas in High View it was only £4810. I concede, of course, that it is not possible to segregate the separate in-patient geriatric cost in the case of Walsgrave and George Eliot, but the in-patient cost at High View is considerably cheaper.
1393 This hospital accommodates possibly 400 patients a year, although it has only 198 beds. One of the things which the other Under-Secretary might have confused in the answer he gave me on 28th April when he said that only 11 patients were awaiting admission in Nuneaton and 59 in Coventry and that only three and five respectively were waiting for admission from old people's warden schemes was that, because local authorities take a different attitude to warden accommodation and to phase III or geriatric hospitals, not too much reliance could be placed on these figures.
In the Coventry and Nuneaton areas many more people are awaiting admission to geriatric beds either because they are currently in phase III warden schemes or because they are being looked after by relatives. To give a proper answer to this question, we should consider the different policies of the different local authorities and the loving care and kindness which in so many cases is preventing more people from being on the waiting list.
There is still a great deal of confusion in my constituency about the precise position. In a letter dated 11th April, Miss Hickey, the area nursing officer, and Mr. Condon, the area administrator, wrote to the staff of High View:First of all, we would stress that no final decisions have been reached regarding High View Hospital—either with regard to its partial or total closure.They then appealed to the staff to continue working. The letter also stressed:The Hospital Management Committee, and its successor the Area Health Authority, have been given assurances over a period of years that Walsgrave Phase IV was not the replacement of High View Hospital.Many of us in Nuneaton are certainly hoping that, if this closure ever comes about—I hope that it will not—Walsgrave phase IV will not be regarded as a replacement.
Then we heard of the circular which was presented to some of the staff at High View, containing extracts from the report of the area management team to be submitted to the meeting of the authority to be held on Tuesday 29th April—for example:Further mining at High View Hospital will make the building an unacceptably high risk, and it therefore appears to the Regional Team of Officers that further mining will almost certainly mean the closure of High View Hospital.1394 So we have official notification that no final decision has been taken and further official notification that the decision to close has already been taken.
I was, therefore, a little relieved to hear from the other Under-Secretary on 28th April thatThere is no proposal at present for the closure of High View Hospital. The health authorities are considering the implications of the National Coal Board's plans for mining in the area."—[Official Report,28th April 1975; Vol. 891, c. 6.]Last week, however, we read in the Coventry Evening Telegraph that discussions had taken place at the Coventry Area Health Authority at which the impression was given not only that the closure of High View was to take place but that phase IV of the Walsgrave development would be its replacement. I hope that my hon. Friend can set the record right tonight. My constituents, certainly the staff of High View Hospital, are undecided, puzzled and anxious about what will happen. Apart from representing the staff of the hospital, because it is in my constituency, and some of the patients, I am proud also to represent nearly 5,000 Warwickshire coal miners. Many of the staff of the hospital are coal miners' wives. As their Member of Parliament, I deplore some of the attempts to set husband against wife and vice versa, a tactic which has been employed in my constituency in the past. It was once used on the M6 service area at Corley, when the management told miners' wives that because of mining underneath it the service area would close. I am sorry that the area health authority is telling miners' wives who work at the hospital that their jobs and the hospital may be in jeopardy because of the possibility of mining subsidence underneath the hospital.
Because I was concerned about the precise position, I checked up with the National Union of Mineworkers and the National Coal Board this morning. They told me that the subsidence is minimal at present, well within the area health authority's capabilities to absorb. I understand that in 1978, according to the projection made by the board, there is a plan for what we call the 5a area of Newdigate Colliery possibly to go under the hospital. But I am also told that this projection has now been revised 1395 and that mining may not take place under the hospital at all.
My constituents and I cannot reconcile the fact that the area health authority is almost counting on it as definite that there will be mining under the hospital with the fact that the South Midlands area of the National Coal Board says that mining may never take place there. It seems to me and to many of my constituents that the authority may be looking for an excuse to close down the hospital. We are not content—certainly the staff of the hospital are not content—that the National Coal Board should be used as an excuse. In short, we do not accept that mining subsidence is necessarily a reason for the proposed closure of the hospital.
There is a great deal of concern in my constituency and in Coventry about the proposed closure. I have been in touch with a number of Coventry councillors, including Councillor Bob Looseley and Councillor Eric Williams. The staff of the hospital have formed an action committee with an able secretary, Mrs. Palmer, from Keresley. The Confederation of Health Service Employees is also concerned and has written to local Members of Parliament and many other people.
Ever since I have been a Member the kind of cases that I have had presented to me most frequently have been either housing cases or cases which stem in some way from a shortage of geriatric bed accommodation. I am sure that my hon. Friend the Under-Secretary has had a similar experience. With such a chronic shortage of beds in the Nuneaton area, the closure of 198 beds would throw a tremendous burden on the community that I represent and on all the relatives and friends who have to look after old people in my constituency.
There is a very good case not only for the development of phase IV of the Walsgrave Hospital but for the retention of High View Hospital. Such is the shortage of geriatric beds in my constituency that there is a case for High View and Walsgrave phase IV. My hon. Friend knows that I have argued many times in the past against the withdrawal of various forms of hospital facilities from my constituency and their trans- 1396 fer into Coventry. This is yet another threatened transfer of facilities from my constituency into Coventry, with all the difficulties for visiting patients that this will cause. Walsgrave is on the far side of Coventry from my constituency and it would not make things easier for visiting by relatives.
I hope, therefore, that my hon. Friend will give some kind of reassurance that High View Hospital will not close. I hope he will give some assurance that mining subsidence in my area—and mining has taken place for many years in my area of Nuneaton and Bedworth—is not that serious, and I hope that he will say that both Walsgrave and High View will be kept open.
§ 12.16 a.m.
§ The Under-Secretary of State for Health and Social Security (Mr. Alec Jones)
I am sorry that the debate has been somewhat delayed by the sheer nonsense spoken by the Opposition, who have now departed, on the previous debate. When my hon. Friend the Member for Nuneaton (Mr. Huckfield) says that he is proud to represent miners and their families, he will understand that I am likewise proud to represent them, and I would not wish to do anything that would set miners against their wives. The consequences would be disastrous for both of us. I certainly understand the overall desirability of ensuring that we have adequate geriatric facilities in the areas close to the home of these elderly patients.
My hon. Friend referred to the Coventry Evening Telegraph, a newspaper which is not widely read in my constituency, as he will understand. I would hope that if that newspaper has created certain impressions I shall be able to set the record right this evening.
I am particularly pleased that my hon. Friend has raised the future of High View Hospital because there has been uncertainty and possibly some misunderstanding locally about the situation there. I hope to go some way tonight towards clarifying the misunderstanding, but I regret that there will still be a considerable degree of uncertainty. As my hon. Friend is well aware, the question of mining and subsidence involves an element of uncertainty.
High View is a geriatric hospital with about 200 beds. It is situated in the 1397 North Warwickshire Health District, which includes my hon. Friend's constituency of Nuneaton, but it mainly serves the population of Coventry and is managed by the Coventry Area Health Authority. There is no doubt about the contribution which High View has made over the years. The buildings are old and, in spite of various improvements which have taken place, I am advised that they are by no means satisfactory.
Nevertheless I would certainly wish to join my hon. Friend in paying tribute to the skill and devotion of the staff and to the very high degree of care which the patients there receive. I am glad to have this opportunity publicly to record my appreciation of the work of the staff at that hospital. I am frequently astonished by the quality of medical and nursing care given in unsatisfactory conditions.
For some months now there has been the possibility that High View might have to be closed, for safety reasons, at a fairly early date. This is because the hospital is situated in a mining area, prone to subsidence, and plans for mining seemed likely to endanger the hospital. For many years the health authorities and the National Coal Board have been remedying damage caused by minor earth movements at High View, but the National Coal Board's plans for future mining seemed to pose a threat to the safety of the hospital. For this reason, the West Midlands Regional Health Authority last year commissioned two expert assessments of the likely effects of future mining. Put briefly, the experts reported that if the National Coal Board carried through its plans to mine a particular panel known as panel 5a there would be an unacceptably high risk to the hospital.
I quote from the report by the experts. It said:If, however, the NCB do not agree to curtail the mining programme and proceed with all seams, then it is our firm opinion based on the other report and supplementary remarks, that most of the properties will be seriously affected…There exists therefore a distinct possibility of risks to the occupants as a result of damage which would arise.I am sure my hon. Friend will agree that neither the Department nor any health authority could completely ignore that sort of report. The implication was quite clear. If the NCB went ahead with its plans to mine the area known as panel 5a—and I am advised that the intention 1398 was to begin mining in 1978—the hospital would almost certainly have had to close.
Officers of the regional health authority wrote to the NCB to ask it to reconsider its plans in the light of the experts' report and the need to retain the hospital. Officers of the Coventry Area Health Authority began to consider contingency plans and met the staff at High View Hospital to let them know the position. My hon. Friend has referred to the feelings of the staff. It was right that at that stage we should begin to make contingency plans and that the staff should be told of the possibilities facing them.
The NCB replied to the regional health authority. The board has reviewed its plans and will not now be working panel 5a in 1978. It has, however, left open the possibility of working this panel at some future, unspecified date, promising to give adequate notice if it decides to proceed. The last paragraph of the official letter to the West Midlands Regional Health Authority states:I can now inform you that the latest review has indicated we shall not be working panel 5a in February 1978. We might consider the working of this coal at some future, unspecified date and when any decisions are taken you can rest assured that adequate notice of our intentions will be given to you.There still remains doubt as to the NCB's wish to work this panel, which would pose this physical threat to the hospital and patients there at that time.
Officials of the regional health authority are still considering the implications of the NCB's letter and I know that they will seek clarification of the longer-term position. It seems that for the moment the immediate threat—the possibility of closure by the end of 1977—has been removed. The health authorities and the NCB will continue to keep a close check on minor earth movements, undertaking remedial work where necessary.
The longer-term future of High View is necessarily uncertain at present. It depends partly on the National Coal Board's plans for panel 5a, as the letter indicated. It also depends on the health authorities' plans for the provision of geriatric, psychiatric and psychogeriatric facilities in the Nuneaton district of Warwickshire and in Coventry. These arc partly dependent on the Board's plans.
My hon. Friend referred to the difficulties in ascertaining the needs of these 1399 areas in terms of numbers. This is one of the factors which the health authorities have taken into account as well as the National Coal Board's proposals for the area. When the health authorities are better able to judge whether they can rely on being able to keep High View open for as long as they wish, they will be able to prepare plans for geriatric, psychogeriatric and psychiatric provision in the Nuneaton and Coventry areas and will be able to decide the räle of High View in these plans.
As I said earlier, High View is an old hospital, built in 1908, and the buildings are in themselves not satisfactory. It may well be that in the longer term the hospital will need to be rebuilt, even if there is no further threat through coal mining. It will, however, not be possible to give any indication of the long-term future of High View until the health authorities have been able to map out a strategy. The strategy will depend on the geriatric needs of the whole area and will have to be conditioned by the National Coal Board's intentions for the area.
I am glad to have been able to tell the House that the immediate threat to High View seems not to have materiallised, but I regret that it is not possible to give a clear statement of the future rôle of High View. My hon. Friend will appreciate that as long as the National Coal Board's proposal remains there is 1400 bound to be a question mark about the extreme long-term future of the project. I am satisfied that the health authorities in the area will do all they can to end the uncertainty as soon as possible.
§ Mr. Leslie Huckfield
Will my hon. Friend bear in mind that the need is not only to consider High View and Walsgrave? There is also a need to consider the geriatric facilities as between, for instance, High View and George Eliot. Will he give an undertaking that nothing will be done to High View until the whole strategy for geriatric patients in the Nuneaton area has been worked out?
§ Mr. Jones
The health authorities in the area wish to plan in accordance with that principle. It is not reasonable to expect a categorical assurance about High View as long as the threat from subsidence arising from National Coal Board proposals remains. The need to provide extended and improved geriatric facilities for the people of the whole area is borne in mind. The threat to close the hospital, which has served the area so well, has been temporarily removed until we know the National Coal Board's long-term proposals for the area. Once we know what those proposals are, we can plan on a reasonable basis for the needs of the whole area.
§ Question put and agreed to.
§ Adjourned accordingly at twenty-eight minutes past Twelve o'clock.