§ THE EARL OF MANSFIELD rose to ask His Majesty's Government if they are aware of the inadequacy of the hospital maternity services in Dumfriesshire and Galloway, due largely to the persistent refusal of the local authorities to co-operate with the directors of Dumfries and Galloway Royal Infirmary in providing the accommodation and facilities required; and to move for Papers.
§ The noble Earl said: My Lords, the subject which I am bringing before your Lordships this afternoon is of local, rather than national importance, but at the same time it is so important to a large area of the South-West of Scotland, containing a considerable population, that I do not think an apology is needed for bringing it forward, particularly as our programme to-day is considerably lighter than has been the case for some time past. In short, the position is that over the area of country comprising the County of Dumfries, the Stewardry of Kirkcudbright, and the County of Wigtown, which last two constitute the old province of Galloway, there are most inadequate hospital maternity services. The population of this area is approximately 140,000 persons, but as the western portion of the County of Wigtown is more easily served from the adjacent County of Ayr, one may say that the number of people directly affected is probably in the neighbourhood of 120,000.
§ This area is served for hospital purposes by the old established Dumfries and Galloway Royal Infirmary, which, like most 376 infirmaries, has been found for some time to be entirely inadequate in size for the calls made upon it, so much so that recently the waiting list of patients has been on an average no less than 140. It was the desire of the directors—and for this purpose they collected a considerable sum of money—to make a large extension and that this extension should include a proper hospital maternity ward. That has been entirely lacking up to the present time. The infirmary has been treating maternity cases but that has been done under protest. The matter was brought to a head some little time ago by the very distinguished consulting gynaecologist of the Infirmary, Professor Cameron, who gave it in writing as his considered opinion that the Infirmary should refuse to take in any further maternity cases until it had better provision for looking after them, in view of the great risks involved owing to there being no proper facilities for that purpose. This the directors have been unwilling to do, largely because up to the present time no fatalities have been incurred in the course of treating such cases. That has been due, however, not only to the skill of those who have been looking after those cases, but also to some extent to good fortune, because the case has been that if any one of a number of complications sets in, the Infirmary has not had the technical apparatus and premises wherewith to treat it.
§ When this extension was first proposed something over two years ago, the directors of the Infirmary requested each of four local authorities concerned—that is, the three county councils and the Town Council of the Burgh of Dumfries, which, having over 20,000 of population, is for Scottish local government purposes regarded as a large burgh—to bring forward some scheme which should embody their requirements, so that the directors should be able to make their proposed hospital wing of such a character that it would be able to serve all the maternity cases from their own area which were in need of hospital attention. Nevertheless, the four authorities concerned have been completely oblivious of their duty to those who put them into office, and no one of them has brought forward any proposal worthy of the name. Two of them suggested that some two beds should be provided for each of those two authorities, 377 but brought forward no proper scheme which the directors could consider in any way adequate.
§ As I have explained to your Lordships, it is impossible for the Infirmary to do its duty properly unless it has this extension built, and that at a very early date, in view of there being no other place where such treatment could be given. But the directors now find themselves on the horns of a dilemma. Owing to the refusal of the four local authorities to co-operate, a refusal which has not been in so many words but rather in their lack of action, they find themselves in the position that either they must continue to put up with their very long waiting-list, which they are most loth to do, or else they must proceed to draw up a scheme for the enlargement of the premises without knowing what maternity services they would really be called upon to render. That was why I sent the whole of the information in my possession about it to my right honourable friend the Secretary of State for Scotland. I hope that the noble Marquess, who I presume will reply, will be able to make some statement of what the Scottish Office think the position is and what they consider should be done. I do not wish to bring forward any particular suggestion myself. All I do wish is that sufficient publicity shall be focused upon this point and sufficient pressure put on these local authorities by the Scottish Office to ensure that something may be done in the near future which will provide, for this very considerable local population, hospital maternity facilities which are at the present time completely lacking and which in the estimate of everyone in those areas are very badly needed indeed. I beg to move for Papers.
§ THE SECRETARY OF STATE FOR INDIA (THE MARQUESS OF ZETLAND)
My Lords, I can quite appreciate the disappointment which has been experienced by the noble Earl at the protraction of the negotiations which have, as a matter of fact, been taking place between the local authorities in the area concerned and the governing body of the Royal Dumfries Infirmary. On the other hand, there is perhaps something to be said for the local authorities. As I understand it the position is this. When some four years ago it became known to the Department of Health in Scotland that the governing 378 body of the Infirmary were contemplating making considerable extensions, they suggested to the local authorities that they should get into touch with the governing body with a view to providing the maternity services which it is an obligation of the local authorities to provide in collaboration with them: that, in other words, instead of establishing a separate maternity unit of their own, they should join with the governing body of the Royal Infirmary and provide a certain number of beds at their expense at the Infirmary. I understand that as a result of investigations the local authorities came to the conclusion that the additional number of beds which they themselves would require would be something like seventy, of which forty would be maternity beds.
The question arose how this extension was to be financed. It was quite obvious that the local authorities would be called upon to invest considerable sums of the ratepayers money to meet their part of the bargain. In fact, I understand that the cost to the local authority would be something like £60,000. Then, over and above the capital outlay, there would of course be the repairing cost and maintenance. It was perhaps not unnatural, particularly since these are Scottish bodies, that they wanted to know, before they decided to invest this money in this particular institution, what the financial condition of the institution was. I gather that as a matter of fact the financial circumstances of the Infirmary are not too good. There is an annually recurring deficit, and I understand that of the total amount of capital which the Infirmary itself proposes to raise for its part of the extension, a total of £77,000, only some £37,000 has so far been raised, leaving still a further sum of approximately £40,000 to be found.
Nevertheless my right honourable friend the Secretary of State for Scotland is of the opinion that it would be to the advantage of all parties if a satisfactory agreement could be reached between the local authorities and the governing body. Although, as the noble Earl himself will no doubt realise, the responsibility is a direct responsibility of the local authorities and not of my right honourable friend, he is prepared to place his services at the disposal of both parties if they think that his good offices will be of use 379 to them. The noble Earl suggested that my right honourable friend should bring pressure to bear upon the local authorities. I do not know whether the noble Earl will regard my offer on my right honourable friend's behalf to place his services at the disposal of the different parties as sufficient to meet the case, but I rather hope that that may be so. At any rate, I shall be very glad to convey to my right honourable friend the very strong feeling which the noble Earl very naturally has upon these questions.
THE EARL OF MANSFIELD
My Lords, I must thank the noble Marquess very much for his reply, which on the whole I regard as quite satisfactory, because I think it is obvious that if the Secretary of State for Scotland is willing to use his good offices, it will be very difficult indeed for any local authority or body connected with the management of the Infirmary to refuse to co-operate with him. In regard to the question of the Infirmary's finances the noble Marquess quite correctly stated that there was an annual deficit, but I would much like to be informed how many infirmaries throughout Great Britain do not have a deficit, and certainly others with which I am acquainted have a much larger one. Also this Infirmary has started a new contributory scheme which is bringing in several thousand pounds a year and so far as my experience goes the finances of this hospital are decidedly better than most of those in this country. The whole position has been that the local authorities have proved themselves unwilling to bring forward any scheme of any kind and that is why it has been necessary for me to bring forward this Motion to-day.
I may say that an immediate result of this Motion appearing on the Order Paper has been that three of the county and town clerks concerned have met and discussed this matter from about 5.30 p.m. until the early hours of the morning, a sign of activity which had not been obvious at any period during negotiations 380 in the past. I think therefore that my bringing forward this Motion has had the desired effect. I thank the noble Marquess very much for his reply—I wish to associate the Secretary of State for Scotland also in my thanks—and I beg leave to withdraw my Motion.
Motion for Papers, by leave, with-withdrawn.