§ Motion made, and Question proposed, That this House do now adjourn.—[Mr. Peter Lloyd.]2.30 pm
§ Mr. Tom Clarke (Monklands, West)
I welcome the Parliamentary Under-Secretary of State for Scotland, especially on a Friday afternoon, and I also welcome my hon. Friend the Member for Livingston (Mr. Cook) the shadow Secretary of State for Social Services, who has a great interest in these matters.
I wish to draw attention to the problems of Stoneyetts and Woodilee psychiatric hospitals in my constituency. They are two separate hospitals, but they have a great deal in common—not least their geography. Woodilee is well over a hundred years old and Stoneyetts is post-Edwardian.
The most significant date in the history of Woodilee hospital was 13 March 1987. My constituents described that day as "Black Friday". As a result of structural faults, which we were told had been suddenly discovered, decanting of patients took place. There was a massive evacuation of hundreds of patients to hospitals all over Greater Glasgow. One reason why I am seeking this debate is that we have simply not recovered from that experience. The Minister will be aware that my hon. Friend the Member for Strathkelvin and Bearsden (Mr. Galbraith) and I met the chairman of the Greater Glasgow health board, Dr. Thompson, and some of his colleagues. There were also several ministerial meetings, including two meetings with the Minister's predecessor, Lord Glenarthur, and one meeting with the Minister.
I believe that the ministerial responsibility for such matters is important. In some ways I regret that Lord Glenarthur is not replying to the debate, because I believe that he has a major responsibility for some of the events that took place at that time. I put some questions to Lord Glenarthur at a famous—some might say infamous—meeting in Edinburgh. At that meeting he gave me the impression that he did not even think that I, as an elected Member, had the right to ask questions at all.
I found it astonishing, to say the least, that, when the avacuation was taking place, the Coathill hospital at Coatbridge had a ward, which had been modernised and refurbished at a cost of hundreds of thousands of pounds, lying empty 10 minutes away from where the drama was taking place. It is in the same parliamentary constituency as Woodilee, yet many patients were dispatched to parts of Greater Glasgow long distances away from Woodilee.
Lord Glenarthur gave me no reply on that occasion. He promised to contact me, but he has not done so. 1 hope that the Minister will remedy the matter.
The conditions of the hospitals to which many of these elderly, geriatric and psycho-geriatric patients have been sent leave a great deal to be desired. I know that this is a subject of controversy, but, if the Minister takes my advice, and listens to my remarks perhaps we can get unanimous agreement about the conditions. I speak with the full agreement of COHSE, NUPE and the Royal College of Nursing. Even the Prime Minister appears to pay some regard to the views of the latter. For example, in Leverndale we saw semi-derelict buildings being used. At Mearnskirk, pavilions erected during the second world war, and meant to be temporary, are still being used for these patients.
675 I saw the conditions. For example, at Mearnskirk, in units which had been closed for some time and suddenly reopened, I saw signs which stated, "Asbestos — keep out." Lord Glenarthur challenged me on my facts. He had to admit that he had not visited any of these places. Therefore, he should have been unable to give any opinion, other than that of the civil servants who feed him with his lines. I have not seen Gartloch, but I am told—I accept this because it is the view of the Royal College of Nursing and others—that there is a small ward with 15 patients. The conditions have been strongly criticised by the Mental Welfare Commission, because the patients are two floors up and have no other accommodation for leisure or medicinal purposes. I am told that that ward is the size of a double garage, and patients leave it only when they need food. As the Minister will know, the Royal College of Nursing has described the conditions at Ruchill as inadequate to house such heavily dependent patients.
The David Elder hospital was vacant for a long time and it is still being vandalised, because many youths believe that it is no longer used.
These conditions are appalling. It is a tragedy that the Minister and the Greater Glasgow health board are not addressing themselves to the potential for improvement at Woodilee and Stoneyetts. Stoneyetts received many of the evacuated patients from Woodilee. The board takes the view that there is not a great future for Stoneyetts. That is unfortunate because, as I saw on Sunday afternoon when I visited the hospital, a great deal of money has recently been spent there and in some parts the painting was very fresh. Many thousands of pounds have recently been spent in Stoneyetts, but the problems remain.
The problems are mainly those of patient care. For example, I saw in the same ward schizophrenics, new chronic sick, long-term geriatrics, and patients being prepared for rehabilitation. They ranged in age from 33 to 87. I saw the conditions in which the staff are expected to work. The Minister might be interested to know, for example, that this fragile paper towel is typical of those supplied to staff to deal with doubly incontinent patients. Clearly, this is absolutely disgraceful.
At Stoneyetts, nursing and ancillary vacancies are not being filled. The hospital is clearly understaffed. Such people as Willie Copeland, Jim McGeachey, Ricky McManus and Elizabeth McMullin, with whom I spoke, are dedicated to the hospital, have given years of service to it and know of its importance to the community. They are anxious about the approach of the health board, despite the publicity that these hospitals have received.
I return to the problem of Woodilee. We are entitled to ask what happened, and whose fault it was. It was a major happening in the lives of the patients and the personnel, from which they still have not recovered. I know that the Minister, to his credit, visited the hospital fairly recently, and I thank him for doing so. However, he left the impression that the problem was everybody else's fault rather than that of the Greater Glasgow health board and the Government. However, both the Government and the board were well and truly warned. Hansard will record that in March 1986, less than a year before "Black Friday", I spoke of the deteriorating conditions at the Woodilee hospital. I went on to say about the Secretary of State: 676nobody in my constituency will regard him as generous so long as those intolerable conditions remain".The Secretary of State insisted:the resources that will be made available will be based on the formula, which the health boards as a whole see as a reasonable approach to the matter."—[Official Report, 26 March 1986; Vol. 94, c. 940.]We know what has happened since then.
That is not all. Yesterday I sent the Minister a copy of the Woodilee file, prepared by the local COHSE branch before all this happened, and many of the points that it made are still relevant, given the conditions today. Perhaps most importantly of all, Mr. I. R. N. Crawford, the director of administrative services, expressed his concern on 25 November 1985 in a paper which he sent to the board, with a private copy to all interested parties, including the trade unions. In his covering note he said:The Unit Management Team has been very concerned for some time about the fabric of the building and a need to undertake urgent structural repairs, and as part of that process we have developed our ideas to the stage where the paper has been sent to the Board in the hope that it will open discussions in this area.Nobody can genuinely say that they had not been warned and that what happened on 13 March 1987 was a great surprise.
Many of the features of which we were aware then still exist today in both hospitals, such as reductions in nursing staff, people working within a limited budget, reductions in domestic staff, lack of adequate repair and maintenance, and, most importantly—the view shared by many people, and one that I take—that consultation between the board and the staff is at a minimum, and consultation between the board and the patients is virtually non-existent. Patients are entitled to know what is going on.
It is surprising that, shortly after it was announced that this Adjournment debate would take place, the unions received a copy of a document headed:Timetable For Relocation of Displaced Woodilee Patients.It was dated 18 November 1987, but was not sent to them until 22 January 1988, after it was made clear that I was to have an Adjournment debate. Some of the items within the schedule were due to take place last month but simply had not. It is no wonder that Donald Henderson, the secretary of the local branch of COHSE, recently wrote:Wards are consistently left short staffed and being faced with management stock answer of 'Living within the budget'.The support services side is just as bad, with non-replacement of domestic staff leading to a lowering of hygiene standards, catering managers cutting back on ward supplies, hairdressers cutting back on shampoo, hospital roads with pot holes and once beautiful grounds now unkempt.The Minister will also be aware that the food supply to Woodilee hospital is available exclusively from Stobhill hospital, which is many miles away. I shudder to think what would happen if we had a repetition of last year's dreadful January weather. Frankly, it would be impossible to ensure that Woodilee received its food.
I hope that the Minister will be convinced, and in due course will persuade the board, that there is still a need for both hospitals, a need to invest in those hospitals and a need to improve capital and revenue expenditure. Those hospitals are communities. However, they are part of a wider community. I know that the Minister may be influenced by Mr. Peterkin's paper entitled "Strategy Overview" or by the Scottish health authorities' priorities for the eighties proposals. However, those proposals have 677 been grossly underfunded, as the Minister must be aware. I do not share the board's view about the catchment areas. There are areas with large populations around Woodilee and Stoneyetts. The need for the services provided by those hospitals is self-evident in my constituency and in that of my hon. Friend the Member for Strathkelvin and Bearsden.
The debate and this whole sad saga is about people. It is about patients, their relatives and families. It is also about nurses who are being removed from nursing duties and given domestic duties and thereby reducing the time that they can give to patient care. It is also about the way in which we treat student nurses—and none of us can be proud about that. The debate is about people like Tom Smith, of the National Union of Public Employees, who is known to the Minister. It is also about Jim McGill of COHSE and David Rushent of the Royal College of Nursing who told me on Monday that some patients have been shunted about although they have been at the hospital since 1956.
Those union representatives and the people who have served the Health Service so admirably co-operated fully in the evacuation process. I must tell the Minister, with great regret, that they feel considerably let down and now have their doubts. They believe that the pledges that were given to them on behalf of the board have not been kept. So many months after the evacuation, they want to know just how temporary is temporary.
This debate is about people like Mary Dowell, who has been nursing for 35 years. She told me earlier this week that the morale in her profession is the lowest that she can recall. She said the same was true of the morale of the patients whom she seeks to serve. The debate is also about people like Mary Dowell's daughter, Anne McPhee, who was nursing at Woodilee for 13 years. She was sent suddenly to Leverndale many miles from Woodilee. She lives at Milton of Campsie. She found that her day on many occasions started at 8 am and finished after 10 pm. She did not speak to me about herself and her own conditions and worries, although it would have been understandable if she had done so. She spoke to me about the patients. She said that the patients are asking when they will return to Woodilee. They want to know when they will be going back home— and home for them is Woodilee.
Those people are now considering industrial action, in many cases for the first time. I did not ask their views about privatisation which I know is so close to the Minister's heart. However, I must tell him that time after time I received the unsolicited view that on top of the many problems that personnel are experiencing, the idea of the imposition of privatisation is unthinkable.
This debate refers to the future of Stoneyetts and Woodilee hospitals. I plead with the Minister to address himself to a future for both hospitals. The Minister should remember the need for investment on purpose-built psychiatric units, a better staff-patient ratio and a better environment based on patient care that is not anonymous and that will have response provided by smaller units when people know each other better.
I hope that the Minister will remove the impression that he left with some during his visit, that the money that must inevitably be found to remedy the problems might be taken from other aspects of patient care elsewhere in Greater Glasgow. The staff would welcome retraining and a redistribution of psychiatric in-patient facilities.
678 However, that is looking to the future. I do not believe that we can do justice to the problems unless we learn lessons from the past. It was a serious experience for the people involved. Therefore, I believe that whatever decisions the Minister takes —and I hope he will take them urgently, and likewise the Greater Glasgow health board—it is appropriate that there should be a proper public inquiry and that Lord Glenarthur, who is still a Minister and had responsibility for many of the decisions taken during that time, should be invited to give evidence at such an inquiry.
Those hospitals in my constituency serve an area whose industry has been utterly devastated. They live in the shadow of Gartcosh, Cardowan, and Buchanan's whisky plant. If the health board goes ahead with its proposals, more jobs will be lost and services will be even further from the communities that they seek to serve. That runs counter to the Minister's objectives — which he has stated on many occasions—regarding health care, community care and patient care. For those reasons I hope that he will take my arguments on board.
§ The Parliamentary Under-Secretary of State for Scotland (Mr. Michael Forsyth)
I congratulate the hon. Member for Monklands, West (Mr. Clarke) on raising the subject and I shall try to cover most of the points that he raised. I am aware of his long interest in the services provided for disadvantaged people and in the two hospitals he has spoken about this afternoon. The two hospitals invite the consideration of rather different questions and before addressing those particular questions perhaps I can begin by looking at the wider background to the issues raised by the hon. Gentleman.
Both Woodilee and Stoneyetts hospitals provide services for mentally ill people. In recent years much attention has been focused on the needs of that group, along with the elderly and the mentally and physically handicapped. The SHAPE report sets out the priorities for the years ahead. Between 1981–82 and 1985–86 the category A priority group indentified by the report has increased its share of hospital and community health expenditure from 37.2 per cent. to 38.6 per cent. That was against the background of a real increase of expenditure in the Health Service, and therefore represents a substantial real increase in the resources available. The same report pointed to the need to reduce the dependence on hospital provision for those groups. The Government have placed considerable emphasis in recent years on the need to achieve a gradual shift of care from an institutional setting to appropriate care in the community.
We have encouraged health boards and local authorities to give a high priority within the resources we have made available to them to the provision of community care facilities. We have made provision for local authority current expenditure on social work services in 1988–89 of some £39.9 million–36 per cent. greater in real terms than that for 1979–80, and 5–5 per cent. above the authorities' present budget. We recognise the vital importance of ensuring that adequate provision is made in the community before patients are transferred. Of course we accept that for some patients, hospitals continue to provide the most appropriate form of care.
Sir Roy Griffiths is currently undertaking a review of the organisation and funding of community care. Although it does not apply to Scotland, we have kept in 679 close contact with him about it. We shall study his report, which will be subject to collective consideration by Ministers.
I am sure that the hon. Gentleman and I could debate community care all afternoon, but he might be interested to hear more about the Greater Glasgow health board. It published a consultative document on its mental illness strategy in November last year, and it is still collecting comments on it. No doubt what the hon. Gentleman has said today will be noted.
The paper says that the board's expenditure on services for the mentally ill has not reflected its category A SHAPE priority, contrary to the national trend. The board proposed to redress that by budgeting for real revenue growth of approximately 12 per cent. in the development of services for the mentally ill. The hon. Gentleman made some tepid remarks about the benefits of competitive tendering. I must draw his attention to the fact that the board expects to fund that growth in services through internal efficiency savings.
It is in everybody's interests, including those of staff at the hospitals which the hon. Gentleman has mentioned, that we should get value for money in the Health Service and that the Greater Glasgow health board should be supported in its efforts to achieve that.
I took the opportunity this afternoon to read the minutes of the meeting which the hon. Gentleman had with my noble Friend Lord Glenarthur. My noble Friend gave an undertaking that he would draw the Greater Glasgow health board's attention to the position at Coathill hospital. He did just that. Woodilee and Stoneyetts hospitals lie in the northern division of Greater Glasgow. Woodilee has 892 beds and Stoneyetts has 240. There are 77 psychiatric beds at Stobhill, which is a general and acute hospital in the same division.
The population of the northern division is projected to fall to 175,000 by 1992. On that basis, the board estimates that 497 beds will be required and that, ultimately, only 680 394 will be required–324 of them can be provided at Woodilee hospital, the remaining 70 being at Stobhill. Given the need to provide a more geographically balanced service, the board considers it appropriate to provide the remaining 103 beds at Ruchill and Stobhill hospitals. It does not consider that there is a long-term future for Stoneyetts hospital.
In the consultative paper, the board explains that, apart from demographic factors, the hospital suffers from an isolated setting and poor conditions. It is not conveniently situated for the bulk of the population it serves. Its closure will not occur until the board is satisfied that the programme of rehabilitation and community care is successful and that the proposed revisions in bed numbers have been shown to be justified. The board will have to go through the usual consultative process for hospital closures and refer any proposals to my right hon. and learned Friend.
The hon. Gentleman talked about the evacuation of Woodilee. It has been a major complication of the implementation of the board's strategy in the short term. The evacuation of the 413 patients in March was due to the dangerous state of the main block. I do not think that it is necessary to spell out the problems which affected the block—they did not occur overnight. The fabric of this Victorian building has been deteriorating for a long time.
I accept, as the hon. Gentleman said, that it seems that the board did not do enough to identify and tackle the deterioration, but that is no longer the case. I applaud the prompt and effective action that the board took to deal with the immediate problems. I also acknowledge the cooperation of the unions and the inconvenience caused to hospital staff who have had to travel to various sites throughout the city—
The motion having been made at half-past Two o'clock and the debate having continued for half an hour, MR. DEPUTY SPEAKER adjourned the House without Question put, pursuant to the Standing Order.
Adjourned at Three o'clock.