§ Motion made, and Question proposed, That this House do now adjourn.—[Mr. Alan Howarth.]2.34 pm
§ Mr. Martin Redmond (Don Valley)
I am pleased to have this opportunity to draw to the attention of the House the disastrous consequences that the closure of Fullerton hospital will have for the local community. The importance of the matter is evidenced by the presence of so many hon. Friends. Fullerton hospital was built by the Denaby-Conisbrough community many years ago, to provide facilities for and to meet the demands of local people. Cadeby and Denaby pits were major contributors to the building of that hospital. However, when the National Health Service was created, the local community had no hesitation in seeing that Fullerton was a part of the service.
The building has not had much spent on it in the past. Nevertheless, it is still a substantial building which has stood the test of time. It is surrounded by gardens, providing a healthy environment for patients in their twilight years. There was a need for Fullerton when it was built, and there is still a need for it now.
The two wards at Montagu hospital will not stand the test of time and will require substantial amounts of money spent on them if they are to remain in use in, possibly, 10 years. Also, Montagu hospital does not have the same environment as Fullerton.
Doncaster hospital has one of the lowest administration costs in the country. It has been and still is nurse-oriented, but, because of the way in which the Government funded the pay rise last year, Doncaster now has financial difficulties. If that were not so and if the Government had played the game with the health authority, I would not be making this case for Fullerton hospital this afternoon.
By closing Fullerton hospital and thus reducing services, £100,000 will be saved to fulfil the previous commitment to Montagu hospital—robbing Peter to pay Paul, or hand-to-mouth short-term policies. I honestly believe that the long-term needs of the Doncaster area will be met only by long-term planning. If the authority did not have such financial problems, which are through no fault of its own, it would have opened a children's wing.
Last week, I received a letter from the Minister, drawing my attention to this new development. But there is no money to staff it. Is the Minister suggesting that another old folks hospital such as Fullerton should be closed to get the money to provide the staff? The Cancer Trust in Doncaster is providing a hospice. Doncaster health authority cannot meet the promise on the staffing of it.
There is a cash crisis in Doncaster, and the closure of Fullerton will result in several premature deaths. The closure of Fullerton has no relation to the future needs of Doncaster. We must ask whether we are to provide love and care for our elderly or allow them to end their lives alone and unwanted. Society owes it to them to allow them to end their lives in dignity, and we should show them some compassion in their twilight years. That is the hallmark of a civilised society. The problem is a growing number of elderly people and the absence of any long-term strategy to cope with them.
631 We still await the Government's reponse to the Griffiths report, which is wanted as quickly as possible and should be considered in conjunction with the Wagner report. There is a national discrepancy between the number of residential and National Health Service beds of about 25,000. For humane reasons alone, there is a case for keeping Fullerton open until the sums are correct. If Fullerton closes, that will have terrible consequences for a long-term policy has yet to be determined.
Trent regional health authority has no long-term plans. According to a recent parliamentary answer, Trent is still holding consultations and reviewing its strategy. Examination of Doncaster's population shows that those aged between 75 and 85 numbered 12,785 in 1986. By 1996, that figure will grow to 14,290—an increase of 11.8 per cent. By 2006, that aged population will grow to 15,720—an increase of 23 per cent. In 1986, those aged 85 or more in Doncaster totalled 2,750. By 1996, that figure will grow to 3,161—an increase of 14.9 per cent. By 2006, the figure will be 5,070—an 84.3 per cent. increase. Those figures are horrendous.
The local authority will not be able to assist because the average age of those in local authority care is 82. More than 80 per cent. of all residents in social service care are more than 75 years of age. Everyone knows that local authority part III accommodation is under stress. Because of the make-up of our population, social services are the second biggest spenders in the local authority. The local authority has suffered a one third reduction in rate support grant since the Government were elected in 1979, and one can see the effect that that has had.
The Dearne valley is a deprived area, and that is why the Government, with the co-operation of the local authority, are endeavouring to lift morale. However, with the proposed closure, the health authority will undermine the work both of the Government and of the local authority.
Because of high unemployment, many people leave the area to seek work. It is the young and active who leave, giving rise to an imbalance in the population and to a disproportionate number of the infirm and elderly to be looked after. The family unit is split up, because if the young go away to seek work, they cannot take with them their elderly or infirm parents. As a consequence, the local authority has to provide care services. Other family members who remain are faced with Government regulations that hit those wishing to meet their family responsibilities, because the care allowance is so small. Looking after their parents could financially affect their own families.
I turn to the Trent regional health authority report, a copy of which I presume the Minister has. The report of the health authority's sub-committee gives the background to the proposed relocation. The sub-committee took just five minutes to discuss that important subject, which is deplorable. Paragraph 1.2 of the report states:Fullerton Hospital … currently provides a maximum of 34 beds.However, it is stated later:There are currently 25 beds in use at Fullerton Hospital.That represents a deliberate policy of run-down by the local authority in advance of the Minister's decision.
Paragraph 1.3.3 talks about paramedics, but not with this type of patient. I should like the Minister to look at some photographs I have here because they depict the type of patient. Paragraph 13 talks about Fullerton having to 632 be served from Montagu hospital. Montagu hospital is already linked with Doncaster royal infirmary, so I do not see any difference between DRI-Montagu and Montagu-Fullerton.
Paragraph 1.3.4 talks about savings of £100,000. I question whether that is a true figure. Certainly when one takes into consideration humanitarian aspects, money pales into insignificance. Paragraph 1.3.5 talks about appropriate medical care, but it is rubbish. Fullerton is better. Paragraph 1.4 talks about the relocation of services. Could we not have a ballot of staff, patients and the community on that?
I pay tribute to the staff and friends of Fullerton hospital. They have played a tremendous role in the past and have been instrumental in adding many years to patients' lives. Paragraph 3.2.2 talks about giving the name "Fullerton" to a ward at Montagu hospital. That is a load of rubbish. Paragraph 3.2.3 talks about upgrading, but, because of the financial problems of Doncaster, that will not take place. I do not think that the proposals in paragraph 3.2.4 will take place either.
Paragraph 3.2.5 talks about Conisbrough hospital being at risk. Unless we get cash to maintain services, we are on a downward spiral. Paragraph 3.2.6 will be affected by restrictions on finances. All I can say on paragraph 3.2.7 is that Doncaster council has its own financial problems. One must question whether paragraph 3.2.9 is correct. Money problems will affect paragraph 3.3. For those reasons we need to look again.
The principles that adequate health care should be provided to all regardless of ability to pay must be the foundation of any arrangements for financing the Health Service.Those are not my words, but those of the Prime Minister at the Conservative party conference in 1982 and repeated in the 1983 Conservative party manifesto.
I pay tribute to all those connected with Fullerton. They have done a tremendous job in the past and would do so in future. Will the Minister instruct the health authority to consult the patients and the staff at Fullerton, and the people of Doncaster? If he does, there will be an overwhelming majority, indeed a unanimous vote, to keep Fullerton open. I plead with the Minister on behalf of the elderly who have been served so well in the past and on behalf of my constituents to intervene and keep Fullerton open.
§ The Parliamentary Under-Secretary of State for Health (Mr. Roger Freeman)
I congratulate the hon. Member for Don Valley (Mr. Redmond) on his success in the ballot. I know that the hon. Gentleman takes a keen interest in the welfare of his constituents and in the affairs of his local district health authority, Doncaster, and its region. Trent. The hon. Gentleman pursues that interest with great energy and vigour. I am well aware that the hon. Gentleman served as vice-chairman of Doncaster health authority in 1982. I am sure that the House appreciates the clear and direct way in which he has presented the arguments on behalf of his constituents. As he knows, I stood for election in his constituency in 1979, and I have great respect for him, for his constituents and for the county of South Yorkshire.
Fullerton hospital has been serving the people of Doncaster for more than three quarters of a century—initially providing acute services to the local area and for 633 many years catering for orthopaedic patients transferred from the Doncaster royal infirmary. In recent years the hospital has been used to provide continuing care for elderly patients. Given that history, I well understand the intense feelings of loyalty that it arouses among the local community. The health advisory service, when it looked at services for the elderly in Doncaster at the end of 1987, praised the good quality of care being given at Fullerton. I should like to echo what the health advisory service said and put on record the Government's appreciation of the tremendous efforts and dedication of the hospital's staff over many years.
I know, too, that there has been considerable uncertainty about the future of Fullerton hospital for some time now and that proposals to close the hospital were put forward two years ago, but later withdrawn. I am sure that it is in everyone's interest for that uncertainty to be ended quickly. The health advisory service advised Doncaster health authority to include Fullerton in its reconsideration of the disposition of beds for the elderly.
It would be quite wrong for me to comment further on the current proposal, because, as the hon. Gentleman knows, it is about to be referred to Ministers. I understand that it will reach the Ministry next week. It might, however, be helpful if I were to outline where matters stand at present on the health authority's proposal.
I am sure that the hon. Gentleman is aware that there is an established procedure that must be followed before the closure or change of use of National Health Service facilities. Doncaster health authority issued a consultation document in October last year in which it proposed to transfer 35 beds for the elderly from Fullerton hospital to the Montagu hospital two miles away in Mexborough, with a view to the Fullerton closing later this year.
The local community health council objected to the proposal to transfer services to Mexborough Montagu hospital and to close Fullerton and so the matter was subsequently referred to the regional health authority, where it was considered by a members' panel. I know that that panel visited Fullerton hospital and the wards at Montagu hospital to which it is proposed that services should transfer and met representatives of staff and the local community.
At its meeting on 10 April, the regional health authority endorsed the recommendation of the members' panel and approved Doncaster health authority's proposal to close Fullerton, subject to a number of conditions being met. Doncaster district health authority has indicated that it will be able to comply with those conditions. Doncaster community health council still wishes to object in the light of the conditions the regional health authority has placed on implementation of the closure. The hon. Gentleman outlined some of those objections. The proposal will therefore come to my right hon. Friend the Secretary of state for Health for a final decision.
As I have said, I cannot comment further on the proposal at this stage, because I do not wish to prejudice that decision. I do, however, understand the concern that has been expressed today on the subject. I can promise the hon. Member for Don Valley that when the proposal does come to the Department we shall give the matter the very 634 careful consideration that it clearly deserves. In doing so, I can assure him that full account will be taken of the points which he has made so clearly this afternoon.
In addition, given the projections for the ageing population over the years up to 2000 in the Doncaster health authority area, and indeed South Yorkshire as a whole, in the hon. Gentleman's judgment as, indeed, in mine, there must be adequate provision in future for the care of the elderly. His point was that a decision now could prejudice the ability of the health authority to continue to meet that demand. I carefully noted his point and I can assure the hon. Gentleman that, when we come to consider the representations in the case, we will bear that in mind.
I shall refer briefly to some of the services that Doncaster health authority provides and seek to answer the points made by the hon. Gentleman. I am glad to say that Doncaster health authority has benefited considerably from an expansion of resources. To take this year as an example, the health authority has an initial cash allocation of £61,589,000, which represents a real terms increase of 2.8 per cent. over last year—the third highest in the Trent region. That will bring Doncaster to a funding level of 96 per cent. of its RAWP target. I acknowledge the hon. Gentleman's point that, historically, Doncaster has been relatively under-funded. In recent years progress has been made, but the RAWP target has not yet been achieved.
§ Mr. Redmond
I believe that the RAWP has gone by the wayside. Doncaster has a cash problem and it is tearing at the services provided for its people. It is no good having new facilities if we do not have sufficient staff to maintain present levels of service. When considering the long-term needs of Doncaster it is important to consider the horrific figures I have given. I can substantiate those figures and if the Minister wants a meeting some time before he makes his decision I will provide the evidence.
§ Mr. Freeman
I would be glad to meet the hon. Gentleman at his convenience to go over the figures. He is right that, in two years' time, RAWP will disappear and that we shall move to a system of weighted capitation funding of the regions and in turn, the districts. That funding will reflect not only the total number of patients within a district health authority, but relative mobility and the relative cost of providing services. I will be glad to pursue this particular matter with the hon. Gentleman in due course.
The Doncaster health authority is using the injection of funds to develop and improve many of its services and facilities. The most notable recent example is the newly opened children's unit at the Doncaster royal infirmary. The unit is providing four new wards plus new out-patient and child assessment facilities at a total cost of about £31½ million. It means children's facilities at Doncaster have now been brought together on a single site.
The hon. Gentleman has said that three wards are open now, but one is not and that an appeal has been launched to raise sufficient funds to open it. The health authority had planned to open the fourth ward in 1991. Clearly if one is building facilities it is much easier to build four rather than three, even if the intention is to bring the fourth ward on stream in a number of years' time.
I understand that the health authority's formal plan was to bring the fourth ward on stream in two years' time. There is full revenue funding in the budget for that. The health authority then decided to launch an appeal to 635 accelerate the opening of the fourth ward. That appeal has been remarkably successful and that is a tribute to the great generosity of the people of Doncaster. I hope that the health authority will be able to open the fourth ward earlier than expected. That decision will enable the health authority to do other things that would not otherwise be possible as the commissioning costs for the fourth ward, which are funded at present from 1991, will no longer be needed. I have already said that the revenue implications of opening the fourth ward from 1991 have already been taken into account in the budget.
§ Mr. Redmond
Doncaster health authority launched a cash appeal to provide staff for the children's ward. That is the first time in its history that the health authority has gone out to ask for money to staff a hospital or a ward. Previous cash appeals have gone for the cream on the cake—to provide televisions or to ensure that other patient needs are met. Never before has an appeal been launched to meet staffing needs.
§ Mr. Freeman
The hon. Gentleman is absolutely right. The purpose of the appeal is to bring forward the opening of the fourth ward by two years, and to provide the capital and commissioning costs and revenue costs for the staff for those two years, but not beyond 1991. I do not believe that there is any dispute between us about the facts.
Doncaster health authority decided on such action because it had seen the tremendous success of the Great 636 Ormond Street "Wishing Well" appeal. I am sorry that some people think that the appeal is for the entire unit, or that it is a reflection on the health authority's determination to provide good children's care. It was launched for the best of motives. Observing the nation's generosity in the "Wishing Well" appeal, the authority saw a chance to accelerate the opening of the fourth ward.
I am sure that the hon. Gentleman will join me in complimenting the authority on the "Putting People First" initiative, launched in, I believe, 1984 as part of a regional campaign. I think that all parties in the House, whatever their disagreements about certain elements in our proposed NHS reforms, would agree with the excellent pamphlet provided by Doncaster health authority. I shall study the photographs with great interest. Patients in all hospitals, including Fullerton, should be treated as individuals. All members of staff, whether doctors, nurses or support staff, should treat people sympathetically and sensitively as individuals.
This has been a useful debate. I repeat the assurance that I gave the hon. Gentleman earlier: we shall give careful consideration to the proposal when it arrives next week following the objections of the Doncaster health council. I also assure him that I shall be happy to meet him to discuss the wider issue of resource funding for the Doncaster health authority.
Question put and agreed to.
Adjourned accordingly at one minute past Three o'clock.