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Hospital, Mid-Cheshire

Volume 610: debated on Thursday 30 July 1959

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12.47 p.m.

The people of mid-Cheshire will be grateful for having this opportunity, through me, to raise the matter of hospital facilities in mid-Cheshire. The area concerned is that included, roughly, in the urban districts of Middlewich, Wins-ford and Northwich and the rural district of Northwich. I wish to ask my hon. Friend whether he can give us any help in obtaining the erection of a hospital to serve the area of mid-Cheshire.

The need has been very well established. In the first place, the county council has supported the local authorities of Middlewich, Winsford and Northwich in their endeavours, over three or four years, to have such a hospital erected. I will quote from a letter from the medical officer of health for the county which, I think, shows the very great need for such a hospital in the area. The county medical officer wrote to the Northwich Urban District Council on 26th November, 1957, saying that he was interested to know that the councils in mid-Cheshire had banded together to try to persuade the regional hospital board to provide an additional general hospital in the area. He was, he said, very happy to support their endeavours and he reminded them that, if it had not been for the passing of the 1946 Act under which this activity was transferred to the regional hospital board, the county council would, in his opinion,
"undoubtedly have put forward proposals to the Minister to erect a new general hospital on the Lines of Clatterbridge, to serve the mid-Cheshire and surrounding areas."
He gives his opinion of the present accommodation, saying,
"At the present time"—
this was as long ago as November, 1957—
"the hospitals in mid-Cheshire are small, and when the accommodation is added together it is totally inadequate for the area."
He says that the best evidence is provided by the ambulance service which does the biggest mileage in the county, by far the greater part of which is due to the long distances over which patients have to be conveyed to hospital for both in-patient and out-patient treatement. He says that the hospitals are over 12 miles away from the ambulance station, and he adds that
"undoubtedly there is an urgent need for hospital provision for the chronic sick in mid-Cheshire."
The facts about the provision of an ambulance service are very serious. No fewer than 85 hospitals are visited by patients in the mid-Cheshire area. The total mileage of the ambulance service is 200,000. It will be appreciated that when patients have to travel these long distances they must be assembled in parties of four to six people. They have to wait a good many hours before the ambulance is filled and it may be that they are going to the hospital only for the very briefest treatment. Perhaps the treatment might last for only five or ten minutes, but the patients have had to waste the greater part of the day, and some people from remote rural areas in this district may have to spend the whole day going to a hospital in Manchester to have five minutes' treatment. In the case of those going for a longer visit to the hospital, those who may have to be hospitalised, it is difficult for relatives to visit them.

The regional hospital board itself recognises the need for a new hospital. In a letter dated 17th September, the secretary of the board wrote to the Northwich Urban District Council saying:
"The Committee requested me to inform you that the Board are aware of the need for development of the hospital services in the mid-Cheshire area and that they have already requested the local Planning Authority to reserve land in this area as a site for a new hospital at a future date. Whilst the Board have in mind, therefore, the need for a new general hospital … it is not quite correct to say that the hospital has been 'programmed'."
It is true that a site has been reserved at Davenham. It is intended to use 11½ acres as a site for the new hospital.

As I understand, the procedure is that in cases where the finance exceeds £250,000 the regional hospital board has to put forward a scheme of this sort to the Minister when he calls for schemes for what are called central financing. The disappointment of the council, about which my hon. Friend the Parliamentary Secretary knows, stems, I think, from the fact that the board was asked by the Ministry, following a meeting of the council with the Minister earlier this year, whether it would like to add the hospital for mid-Cheshire to its existing programme of works for central financing and, if so, whether it would like it to be ahead of other schemes or at the end of schemes which had already been put forward. Very disappointingly, from the council's point of view, the board said that it would wait until it was asked for the next lot of schemes to be centrally financed. In other words, it did not propose to add it to the existing schemes to be financed by the Ministry of Health but would wait until the Minister called for a new programme.

This was especially disappointing as there had been a letter from the board in 1957 to the Northwich Urban District Council saying that it had reserved the site and that the Minister was in the habit of asking for a programme for central financing every year, therefore giving the impression that the board was likely to put this scheme into the central financing programme the next time it was asked. It appears that after 1957 there was another central financing programme. On this occasion, too, the board did not include the proposal for this hospital in the programme.

The object of my raising this matter is to impress on my hon. Friend the need for a new hospital in this area in Cheshire. There are other factors of which perhaps my hon. Friend is not altogether aware. At the moment we have an excellent small hospital at Northwich, the Victoria Infirmary. Being small, it naturally does not have the facilities of a larger hospital. For instance, it is not equipped to have a resident doctor. Unfortunately, like all areas in this country, there are many road accidents in this area and I suppose that the Victoria Infirmary gets road accident casualties from within a radius of ten miles of the infirmary. There are some very important and dangerous roads in the area, like the Manchester—Chester road, which runs very near to Northwich.

Road casualties are continually coming into the Victoria Infirmary. When they arrive, the infirmary has to call up the doctor who is on call and who has other demands on his time. He may be out dealing with another case, and the hospital then has to call on the next doctor. Inevitably, with the best will in the world and in spite of all-round efficiency, the result sometimes is that the injured cannot be dealt with as quickly as their injuries perhaps demand. What I am afraid of is that one day somebody may lose his life through not being attended to in time.

If there were a proper general hospital in the area it would have all the resident doctors, specialists and apparatus that it would need. As it is, the skilled and devoted matron and nurses of the Victoria Infirmary, who have very great knowledge, deal with the casualties when they come in. I have been visiting the hospital when some casualties have come in, and the staff deals with them very well indeed, but I am afraid that one day special medical attention will be needed which will not be forthcoming.

A questionnaire was sent out to the doctors in the area. Of the twenty-eight doctors who answered, twenty-four said that the hospital facilities in the area were not sufficient. All twenty-eight said that a general hospital would meet the need of the area.

Let me illustrate the need in a little more detail. The Manchester Regional Hospital Board, which, as I have said, is the authority to put forward this proposal for a general hospital, held a meeting on 24th September, 1957. I have here the minutes of the meeting. The board was in possession of a schedule of the various areas most in need of further hospital facilities, from the point of view of having additional medical beds. North and mid-Cheshire are grouped together. The minutes show that the north and mid-Cheshire area has only 11 medical beds per 100,000 of population. Of the other areas also in need of extra hospital beds, Preston and Chorley has 30, nearly three times as many as north and mid-Cheshire. There are five other areas which are allocated up to 48 beds per 100,000 of population in need of additional hospital beds. The mere evidence of this figure, 11 per 100,000, shows how great is the need in this area for medical beds.

I should now like to deal with general surgery beds. Here again, north and mid-Cheshire are most deficient, although the difference between it and the runners up is only 7 per 100,000 instead of 19 per 100,000. North and mid-Cheshire have 34 general surgery beds per 100,000 of population. The other six areas in greatest need of extra surgical beds have as many as 62 beds per 100,000. In orthopaedic surgery, north and mid-Cheshire are third in the list of deficiency, while in gynaecology beds they are sixth or seventh in need and come towards the end of the table. The board is reported as having in mind a new hospital eventually near Northwich to serve the southern end of this group in central Cheshire.

I would like, in conclusion, to impress upon my hon. Friend the Parliamentary Secretary the need for this facility in mid-Cheshire and the fact that it has excited a great deal of local interest. I understand that arrangements are being made to get up a petition to the Minister and the matter has attracted a great deal of attention in the local Press. It is felt by all the doctors, the medical officers of health and the councillors of the local districts that the need is a real one. While they appreciate that they are not in a position to weigh the need of one district as being higher than another, because they do not have the facts in their possession, it is difficult for them to imagine that any other district under the Manchester Regional Hospital Board is in such need as the mid-Cheshire district. The need has existed for some years and the fact that a site has been reserved, and the medical officers and doctors in the area have given the answers to which I have referred, shows that the need is great.

I am asked by the councils to thank the Ministry for the courteous reception they had at a meeting earlier in the year and to urge not only upon my hon. Friend, but, through him, the regional hospital board, the urgent need for the establishment of this general hospital. As is shown in the correspondence, even if it were decided today to proceed with the scheme, it would probably be three years from the making of the decision until the hospital was erected. Therefore, for another three years at least, this great need must continue, with danger to patients and great inconvenience, which spreads to their relatives.

The figures show that about one person in eleven took an ambulance journey in the district in the past year. All these people are visited by their relatives and one can realise the general dislocation and frustration in the area. In many cases, the bus services to get to Stalybridge, Manchester, Crewe and Liverpool are not sufficiently adequate for these visits, having regard to the visiting hours.

I know the sympathetic nature of my hon. Friend the Parliamentary Secretary and that he recognises a need when he sees one. I urge him to do all he can to induce the regional hospital boards to put up a scheme to him for central financing. To satisfy the needs of the area, it is necessary that it should be treated as a matter of urgency.

1.3 p.m.

I support my hon. and learned Friend the Member for Northwich (Mr. J. Foster), who has put the case so clearly and fairly and with his customary eloquence. This agitation for the provision of better hospital services in mid-Cheshire has been going on for several years. The position, as the doctors have reported and as we all know, is that the patients who have to be treated from mid-Cheshire are forced to attend hospitals in Manchester, Liverpool, Chester, Warrington, Macclesfield and Altrincham. Tremendous distances, therefore, have to be covered. We all wonder whether there are any other districts in the country whose people are scattered over 85 hospitals for treatment. At the moment, there is no sign of any proposed hospital being built. What is even worse and causes such anxiety in mid-Cheshire is that there is hardly any sign that anybody is even thinking of building one.

The Minister has said that it is a matter for the Manchester Regional Hospital Board to decide and the board states that it is a matter for settlement when the Minister calls for further proposals for central financing. This is a clear case of passing the buck backwards and forwards, which is supposed to be a rather favourite pastime for public servants. The Cheshire public are getting fed up and feeling is very strong.

We Cheshire Members have been in close touch with the local authorities in the district, who have made strenuous efforts to obtain better hospitals. As a final gesture, they have asked us to persuade the Minister to hold an inquiry, because such an inquiry would clearly show what bad hospital service mid-Cheshire has. All of us, however, have received the same reply from my right hon. and learned Friend the Minister refusing to hold an inquiry. Therefore, the people of mid-Cheshire feel that they will have to go on suffering.

This is no new problem. Attention was drawn to it years ago and the situation is getting worse. All we ask is that an inquiry should be held at top level. There is also a feeling of deep frustration in the area. The people look at the hospital building programmes all over the country, which show that expenditure is increasing rapidly each year and next year will be double what it was three years ago.

Why cannot the people in Mid-Cheshire have their share? Is it not about time that they should be next on the list for better hospital services? What a wonderful record this Government have. The Socialists did not build any hospitals at all between 1945 and 1951, but since the Conservatives have got in, the first parts of four new hospitals are in use in England and Wales and work is in progress on ten more new hospitals. In addition, 40 large schemes involving new units or major extensions are in progress and more are being planned. Many other smaller schemes are under way or completed. These include new laboratories, operating theatres, X-ray equipment and improved out-patient and casualty departments. Already, the benefits are showing in at least 100 hospitals at a cost of £7 million. Cannot mid-Cheshire have a fair slice out of this huge national cake?

I end this plea on a personal note. My right hon. and learned Friend the Minister of Health has a record which is, possibly, second to none amongst his colleagues and my hon. Friend the Parliamentary Secretary is his ardent lieutenant. After the election, when the Conservatives are returned with an increased majority, he is bound to be promoted. Before he leaves his Department, however, what mid-Cheshire would like to see would be my right hon. and learned Friend crowning his brilliant record by saying, first, that he will hold an inquiry and, secondly, stating publicly that he realises the great hardship in mid-Cheshire and that he will give an early priority to improving the hospital service in that area.

The last thing that the people of mid-Cheshire want to see is this country living beyond its means. Overspending of the taxpayers' money is a favourite pastime of the Socialist Party. All we ask is that a fair slice of the National Health Service cake should be given to the central area of our lovely county of Cheshire.

1.10 p.m.

First, I must thank my hon. and learned Friend the Member for Northwich (Mr. J. Foster) and my hon. and gallant Friend the Member for Knutsford (Lieut-Colonel Bromley-Davenport) for raising this matter and so ably arguing the undoubted and acknowledged needs of their area. In doing this they have simply followed up the numerous and pertinacious representations which they have made in correspondence with me and my right hon. and learned Friend, and also the representations made by the local authorities in the area to my right hon. and learned Friend and to the Manchester Regional Hospital Board.

I should like to give a short account of the recent history of this matter. The local authorities concerned, the Northwich, Winsford and Middlewich Urban District Councils and the Northwich Rural District Council, set up a joint committee with the object of taking all necessary steps to ensure the provision of adequate general hospital facilities in the area. It is from that point that I want to trace the course of events.

On 13th May, 1958, a deputation from this body was received by the regional hospital board. I am told that the board informed the deputation that it fully appreciated the need for additional hospital developments which the deputation was seeking in mid-Cheshire. But at the time the Board could not finance a new hospital out of its own capital allocation. Therefore, the project would probably have to be considered for inclusion in the programme of major schemes selected on a national basis by my right hon. and learned Friend. On the next occasion when the Board had the opportunity to put forward a list of schemes for this purpose it would give very serious consideration to the mid-Cheshire case.

The local authorities, however, thought that the matter was one for the Minister and they sought an interview with him. A deputation was received by officers of the Department in November, 1958. It was pointed out to it that the regional board had not included this project in the list of schemes which it had submitted to my right hon. and learned Friend in June, 1958. I want to make the point, so that there will be no misunderstanding about it, that this does not imply any bad faith on the part of the regional board. These boards have had delegated to them the responsibility for planning hospital services in their regions. It follows that it is their duty from time to time to review the relevant urgency and importance of capital developments proposed throughout the regions under their control. This, of course, is a most unenviable and thankless task, particularly when one thinks of the conflicting demands for urgent developments in a region which has a population of 4,379,000 which extends from Windermere in the north to Crewe in the south, and which has 200 hospitals and clinics most of which could make out a claim for a certain amount of improvement.

I am sure that the Manchester Regional Board, in that kind of situation, is doing an honest job of trying to get the priorities right and, of course, it cannot please everybody on the way. When the board was invited in 1958 by my right hon. and learned Friend to submit a list of major schemes for inclusion in the programme, it was its conclusion, after weighing up all the circumstances, that certain other schemes, particularly the second phases of schemes already started, had a greater degree of urgency. This was a hard and difficult decision to take, but the board felt it to be the right one at the time and that explains how it was that the mid-Cheshire scheme did not come forward in 1958.

Does not all this add up to the fact that there is not sufficient allocation of money for the Manchester Regional Board to do what is reasonable?

No, I would not agree at all. We are never likely to agree that any sum of public money is sufficient for the schemes that we have in mind, but, as my hon. and gallant Friend the Member for Knutsford has said, the actual capital available next year will be double what it was three years ago.

The situation was explained to a deputation which visited the Ministry last November. The deputation then said that it would seek a further interview with the board. The views expressed by the deputation were transmitted to the board which was asked whether it wished to add a new hospital for mid-Cheshire to the list of major schemes which it had already submitted and, in particular, whether it wished this project to be ranked in priority after the schemes already submitted or to take precedence over any one of them. The board, however, felt that it should hold its hand until it had received the expected further approach from the local authorities.

This meeting with the local authorities took place on 10th March of this year. I understand that the local authorities were particularly anxious to receive some indication as to when a new hospital might be selected by the board for submission to my right hon. and learned Friend. As I have told my hon. Friends in correspondence, the board felt that it was not right for it to give any undertaking, since at that time—and I stress "that time"—it could not say how soon it might be asked to submit further proposals, and it felt that it should keep itself free to assess the priorities in its region afresh when the time came. I think that decision was right.

So far, I have been dealing with events up to the time when I wrote to my hon. Friends on 26th May. My hon. Friends will be glad to know, however, that a new hospital for mid-Cheshire was included among a list of schemes which the regional board submitted to my right hon. and learned Friend on 23rd June, and we shall thus be able to give consideration to this proposal when my right hon. and learned Friend is next considering the addition of schemes to the special major schemes programme.

I am sure that it will be understood that at this stage I cannot give any precise undertaking that this project will be selected on the next occasion, but it will certainly be considered, and I am sure that my right hon. and learned Friend will bear in mind the very cogent arguments forcefully put forward today. I am certain also that this submission is an important stage in the progress of the scheme and a definite advance on the situation which existed up to a few weeks ago.

I have devoted my attention mainly to the question of a new hospital, which was the principal issue raised by my hon. Friends. The need for it stems from the fact that mid-Cheshire itself does not contain sufficient hospital beds—

As my hon. Friends have said, numbers of patients living in the area have, willy-nilly, had to go to hospitals some distance away, but I would not have thought that the small hospitals in the area are not doing their bit. They have put up a very good show indeed.

It has not been possible to make major additions to these hospitals, but the regional board has done all it can to improve them. For example, at Davenham Hospital the isolation block has been converted to form a maternity unit, and a new physiotherapy and X-ray department has been provded at the Victoria Infirmary.

Generally speaking, the mid-Cheshire hospitals have had a fair share of the capital moneys available for developments in the group as a whole. My hon. and learned Friend the Member for Northwich mentioned specially the need for full-time medical staff at the Victoria Infirmary. I am glad to tell him that the regional hospital board, after consultation with the hospital management committee, has decided to appoint a junior hospital medical officer to this hospital.

The precise range of duties of the post are being discussed now with the general practitioners who form the present staff, and the board has also recently authorised the appointment of a junior hospital medical officer at Grange Hospital, where it is intended to admit a larger proportion of medical cases to permit more surgical cases to be treated at the Victoria Infirmary.

That, then, is the picture. I hope that the information I have given to my hon. Friend, that a new hospital for mid-Cheshire is among the schemes submitted to my right hon. and learned Friend for consideration, will prove acceptable at this stage. I am grateful for the constructive interest they have shown in this project, which, I recognise, is of undoubted and growing importance to the people they have the honour to represent in this House.