§ Motion made, and Question proposed, That this House do now adjourn.— [Mr. Berry.]2.31 pm
§ Mr. Thomas Torney (Bradford, South)
I was called by BBC local radio this morning to say something about this Adjournment debate that I have secured. The BBC asked me why I did not wish to see the closure of Thornton View hospital, in my constituency. I said that the first reason was that I disagreed with the closure. The second important reason was that many of my loyal constituents have protested to me that the hospital should not close. They listed various reasons for the prevention of the closure, about which I hope to inform the Minister during my short speech.
The decision to close Thornton View hospital was undoubtedly taken solely because of the need to cut expenditure. That decision is dictated by the calculated decision of the Government not to provide sufficient money to the regional health authority, which in turn does not provide sufficient money to the district health authority properly to fulfil its duties to those members of the community least able to fend for themselves. I do not think that anyone in the House would deny that such people cannot fend for themselves, and that they are right to expect the Government, the Opposition and everyone in control to succour them so that they may enjoy the evening of their lives as much as it is possible for them to do so.
At present there are 70 patients in Thornton View hospital, whose bed complement is 82. Patients are in their 70s and 80s with some in their 90s. Seventy-three per cent.—almost three quarters—of all elderly people in institutional care in the city of Bradford have no living relations. They are entirely dependent on the type of service that the community, or the Government, can provide for them.
Last Sunday I visited the hospital and saw the patients and the staff. The patients are frail, elderly and confused. Some are suffering from organic brain disorders. Many patients have no living relations. The hospital is therefore home to them, and the staff of the hospital are their family.
I was impressed by the tremendous dedication of the staff. The hospital itself, though an old, solid building, is bright and cheerful inside with amenities to try to make it home for those unfortunate folk. The staff, by the happy and cheerful way they went about their work, treated the people more like their own elderly relatives than just institutionalised patients. I was tremendously impressed by the atmosphere in every ward and room, by the care, the homeliness and the constant skilled attention that was given to the patients. I am convinced that they cannot possibly be continued by moving those unfortunate people to three or four other hospitals.
We cannot deny that money is being saved, but the cost can be reckoned only in terms of human suffering and possibly death. On behalf of a section of Bradford people who are least able to defend themselves, many of whom are without relatives to fight for them, I am thankful that many of my constituents are not like the Government—without compassion. Many of my constituents have rallied round and demanded that Thornton View should remain to administer its special kind of loving care to the people who need it.
638 Hospitals in my constituency are responsible for two-thirds of Bradford's geriatric beds. Therefore, I feel that I have a special responsibility to geriatric patients throughout Bradford. The Northern View hospital, to which some of Thornton View's patients will be moved if the closure proceeds, is recognised by all concerned—the local authority, the area health authority and so on—as a slum and a fire trap. We need more, not less, money, because the real alternative to the closure of Thornton View is to demolish Northern View and build a new geriatric hospital on the site. If that were proposed to be done, we would have no complaint.
About 700 people in Bradford are elderly before their time due to dietary deficiencies when they were young and the climatic conditions. In much the same way as people of 85 and over, they suffer from pre-senile dementia. In most inner cities they have greater frailty than elderly people living in the posh outer suburbs. Bradford probably has more Asian immigrants than any other city in the United Kingdom. They bring with them health problems which, in particular, affect the aged and people who suffer from pre-senile dementia.
For the reasons that I have described, Thornton View should not be closed. More, not less, money should be poured into the health services in Bradford. From an economic view, it is not sound policy to close the hospital. The saving, at great human cost, is minimal. The usual practice, when considering closing a hospital, is to take into account the main saving to the authority concerned. A capital saving is usually involved. Saving in wages and salaries is secondary. At Thornton View the saving is secondary and minimal because the authority does not own the building. The building belongs to the Bradford metropolitan district council. The only saving will be in staff wages and a few incidentals. For that, helpless, sick and elderly folk will undergo an upheaval.
I am not convinced that they will be as happy, settled or well cared for as they are now if they are moved. They are not to be moved to one place. These 70 elderly, confused and sick people are to be split between three or four places. At least one of the places in my constituency is not a fit place to take them.
A radio interviewer put it to me that it would be better to close the hospital and use the money saved to improve facilities for the people involved. But some are to be moved to a slum, which is unsafe because of the fire risk.
The Bradford metropolitan district council has a good record for its help for the elderly. It has had an excellent relationship with the district health authority in the past, but since reorganisation last April that relationship has deteriorated, with adverse consequences for the elderly.
The Thorton View building is shared between Bradford metropolitan council and the health authority. The costs of running it are also shared. Closure will mean a loss to Bradford metropolitan social services of about £80,000 to £100,000. That is at a time when the Government are severely restricting local authority spending. The repercussions of the closure of Thornton View are almost certain to be further restrictions of local government social services for elderly persons. I refer to part III of the Act concerning accommodation for elderly persons. The health authority does not own the hospital. It uses it. It belongs to the Bradford metropolitan council.
The Bradford metropolitan council is a hung council. The Liberals and the Social Democratic party hold the balance. The rest of the membership of the council is 639 almost equal, Labour and Conservative. The council unanimously supported a resolution against closure of the hospital. All through the region revenue to district health authorities is limited. Bradford is pressing for help from the region. The region is considering that, but we must bear in mind that £4.9 million of the money that is allocated to the region is used in connection with the new hospital in Leeds, which is sucking away most of the regional funds. If ever there was a need for ministerial intervention with more money, it is in the case that I am pleading today.
I remind the Minister that the Prime Minister said at the Tory Party conference last year that theHealth Service is safe with us".I wonder whether she meant that the private health service was safe with the Government, because the Health Service in Bradford does not seem to be safe. I plead and beg for an intervention to stop the closure of the Thornton View hospital.
§ The Under-Secretary of State for Health and Social Security (Mr. Geoffrey Finsberg)
I am sorry that the hon. Member for Bradford, South (Mr. Torney) has turned what was an important constituency Adjournment debate into an untrue political attack on the Government. He talked about compassion. He should remember that it is easy to mouth compassion, as he has done, but the fact is that, far from cutting expenditure on the Health Service, the Government have, as he knows full well, increased it in real terms by over 5 per cent. It was the Government whom he supported who cut expenditure on the National Health Service.
Having demolished the political part of the hon. Gentleman's speech, I shall refer now to the important part and the factual things that he mentioned. As he said, Thornton View hospital is at Clayton, in his constituency. I know that he is taking a deep interest in it and that he visited it last Sunday. I want to try to clarify some of the issues that he has raised because I know that there has been a great deal of local concern at the proposals by Bradford health authority to close not only Thornton View but Shipley hospital. The closure of any hospital arouses strong feelings and it is important, therefore, when such a course of action is proposed, that all aspects should be fully and widely discussed, considered and assessed.
As I mentioned, the future of Shipley hospital is also currently being discussed. I must make it quite clear, as I did to my hon. Friend the Member for Shipley (Mr. Fox) when we debated the future of Shipley hospital on 15 December, that neither I nor my right hon. Friend the Secretary of State has been asked at this stage to take any final decision about the future of either Thornton View hospital or Shipley hospital. Bradford health authority is consulting widely on proposals it has put forward to enable it to live within its means in future. The future of these two hospitals forms a part of a package of proposals that the health authority has prepared for this purpose.
As the hon. Gentleman knows, a clear procedure is laid down in this sort of case and I can do no better than refer him to what I said in columns 457ߝ462 of Hansard, on 15 December 1982, in reply to a speech by my hon. Friend the Member for Shipley.
Let me say something about the financial position that the Bradford health authority faces. Its revenue allocation in the current financial year is £49 million. While the DHA 640 is assessed by the RHA still to be some 7 per cent. below its RAWP target, the current year's allocation represents a growth in real terms of about 1.5 per cent. over 1981ߝ82. It is wrong, therefore, to speak of cuts in the level of resources and of the National Health Service "being starved of funds". Of course health authorities are required to contain their expenditure within the notified cash limits. If they fail to do this in any year they naturally erode their financial position for future years. The need, therefore, to maintain strict controls on expenditure is paramount, but it is well accepted throughout the NHS.
Last autumn the Bradford DHA concluded that if it were to fund all the proposals in its operational plan in full and meet its other commitments, there would be an anticipated shortfall of income against recurring expenditure in 1983ߝ84 of about £1 million. In the light of this potential deficit, the authority has been reviewing the proposals in its operational plan as well as the current levels of provision being supported in the district.
If the closure of Thornton View hospital went ahead it is estimated that a net saving of about £500,000 would result. The remaining gap between income and expenditure would be bridged by a whole range of economies throughout the district in such areas as staffing levels, energy conservation and so on. This is the essential background against which the Bradford health authority's proposals must be judged.
I should like now to deal with the proposals in relation to Thornton View. The hospital was built between 1853 and 1872 as a Poor Law institution and is about three miles from Bradford city centre. Access to the hospital is difficult. The hospital is roughly half a mile from the nearest public transport and is on a very steep hill at the end of an unadopted road, which is in a poor state of repair. A special visitors' bus service is provided three times weekly.
The hospital, which is owned by Bradford metropolitan council, combines local authority social services part III accommodation with 82 long-stay geriatric beds in four wards. Considerable effort, as the hon. Gentleman said, has been made to provide an acceptable environment for the patients but there are still shortcomings. Day space on the wards and sanitary facilities are below standard. These problems can be rectified only through substantial capital expenditure. In the view of the district management team, Thornton View hospital has the poorest geriatric patient accommodation in Bradford.
The overall number of geriatric beds currently available in the district is 556. On a population basis this is roughly equal to the estimated bed requirement determined by the regional health authority. However, the occupancy rates of these beds suggest that the present number of beds exceeds the actual need. At Thornton View, there are currently 70 patients, over half of whom have been there for 12 months or less. An analysis of their home addresses shows that only 14 of these come from the immediate vicinity.
What alternative provision is envisaged for the patients transferred from Thornton View? This would be at one of three sites. The first is Bierley Hall, which was opened in 1968 as a purpose-built geriatric unit. It provides the main rehabilitation facilities for the Bradford geriatric population as well as a 62-place geriatric day hospital. In recent years, because of changes in clinical management and an increase in assessment facilities at St. Luke's hospital, the occupancy rate of the unit has fallen. In 1981 641 the average daily number of beds occupied was 149 out of a total of 192. It is considered that a 90 per cent. occupancy is achievable without a significant increase in revenue costs or a reduction in the quality of care. This would effectively create an additional 24 beds.
The second location is at Leeds road hospital. Here a 23-bed geriatric ward was withdrawn from service by Bradford area health authority in 1980 when alternative accommodation at St. Luke's became available. This ward would require limited expenditure to bring it back into use. The third site is at St. Luke's hospital itself.
The transfer of the psychogeriatric assessment beds to Lynfield Mount, which should create a further 13 geriatric beds, is itself the subject of the change-of-use consultation procedure.
As the hon. Member has said, the movement of geriatric patients can have a profound effect both on patients' morale and on their health. There have been some examples in the past of geriatric patients having died soon after being transferred between hospitals, but there have also been far, far more instances where moves have had no serious effect.
§ Mr. Torney
Has the Minister taken into account the fact that Northern View, where some of these patients will be transferred, is recognised as a slum? It is much worse than Thornton View hospital and is also a fire risk. Remember that some of these unfortunate geriatric people will be taken there.
§ Mr. Finsberg
What I said to the hon. Gentleman was that that was the opinion of the district management team—doctors, nurses and administrators; the people who hae daily contact with all these problems. That is their view.
642 The hon. Gentleman asked me whether the patients are going to a slum hospital. He will have heard me name the three hospitals and I do not think that he would say that any of them is a slum hospital.
§ Mr. Finsberg
The three places where the patients would be going are the places that I have mentioned. The hon. Gentleman has had an invitation from the DHA to discuss the matter in detail. Had he had a chance to take up the invitation he would have known that the allegation that he made that the patients were to go to a slum hospital would not have chimed with the facts. I hope that I have at least reassured him on that point without expressing any opinion at all on the property that he mentioned. I am not prepared to express opinions without having seen the place and formed as sensible an opinion as I can, having done that.
I referred to the movement of patients and the possibility of death resulting from their being moved. If one takes the Toxteth disturbances in 1981, over 100 geriatric patients were moved at 1 o'clock in the morning under somewhat unpleasant circumstances without any apparent long-term problems. The movement of patients, particularly geriatric patients, is unsettling, but in the case of the patients at Thornton View, the better quality of the alternative facilities is an importat consideration.
I am grateful to the hon. Gentleman for raising the issue and for about 85 per cent. of the remarks that he made. I want to assure him very firmly that, should this matter be referred to my right hon. Friend the Secretary of State at some time in the future for a final decision—the hon. Gentleman will know that there is a long process before that—this debate will be of considerable assistance in helping us to reach our decision. We shall reach our decision on the basis of the facts and nothing else.
§ Question put and agreed to.
§ Adjourned accordingly at one minute to Three o'clock.