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Birmingham Children's Hospital

Volume 127: debated on Friday 12 February 1988

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11 am

(by private notice): To ask the Secretary of State for Social Services if he will make a statement on the decision of the Birmingham children's hospital to halt the admission of emergency cases requiring intensive care.

I understand that the doctors at Birmingham children's hospital — I emphasise that this decision was taken by the doctors at the hospital—have decided that, because there are a number of children awaiting cardiac surgery at Birmingham children's hospital, it would not be right to delay operations by admitting further patients who need to be in intensive care beds. Therefore, they have made arrangements for a limited period that any emergency admissions requiring such intensive care facilities will go to hospitals in nearby regions or to Great Ormond Street hospital.

How many more children have to die in Birmingham and the west midlands before the Government ensure that there is cash to give those children the life-saving operations that they need when they need them? Will the Minister confirm that more than 100 innocent children are now in that tragic queue at the hospital, the doors of which have been slammed, and some will certainly die before they are admitted? Will the Minister now undertake to contact the regional health authority to agree an immediate allocation of funds to ensure the reopening of this hospital for the benefit of the children in Birmingham and the rest of the west midlands?

It is not a matter of cash or resources. Nevertheless, discussions are taking place with the regional and the district health authorities about the level of facilities that are available for paediatric cardiac surgery in Birmingham children's hospital. Arrangements are being made in the interim to seek to place these children elsewhere.

The hon. Gentleman's rhetoric outruns the reality. In the past two months, December and January, 20 open-heart operations and a further 24 closed-heart operations have been performed in Birmingham children's hospital. Because of the build up of cases there, the doctors have decided that it would be wise, rather than have children either extending the queue at Birmingham children's hospital or having their operations delayed, to make sensible alternative arrangements with other health authorities or with Great Ormond Street hospital.

Has not this measure been taken because of the shortage of skilled nurses? Are not the Government addressing this problem in their proposals for higher pay for nurses who take more skills? Are there not alternative possibilities of treatment in other hospitals, so there is no question that patients will be left without the treatment that they require?

My hon. Friend has put his finger precisely on the point. It is a matter of the shortage of skilled nurses, not cash resources at Birmingham children's hospital. As my hon. Friend says, the Government are taking steps to rectify that shortage.

Why were there no Ministers from the Department of Health and Social Security here yesterday when my hon. Friend the Member for Stoke-on-Trent, North (Ms. Walley) applied for an emergency debate to urge that Claire Wise and 100 other children desperately in need of heart surgery at this hospital be given those operations? What action is the Department taking to ensure that those operations take place? In view of the applications for emergency debates which were made yesterday and in recent weeks concerning this hospital, will the hon. Gentleman arrange for a full statement to be made on Monday by the Department so that the public of the west midlands and elsewhere may know what action is being taken to deal with the obvious crisis that grips this hospital?

I am advised that my right Friend the Minister for Health was on the Front Bench yesterday when this matter was raised. The question of a statement being made on Monday is not, of course, a matter for me, but I am sure that my right hon. Friend the Leader of the House has heard the hon. Gentleman's comments. I repeat that this is a perfectly sensible decision which was taken not by the administrative staff but by the doctors at the hospital to ensure that the queue at Birmingham children's hospital is not prolonged and that delays are not imposed but that the children get the treatment that they need in the hospitals in a position to provide it.

Will my hon. Friend confirm that we are operating at the frontiers of medical technology? The problem is that demand has suddenly been built up by progress in medicine and that, with the best will in the world, it is difficult to respond instantly when a large number of cases emerge because of changes in technology. Is not my hon. Friend the Member for Bromsgrove (Mr. Miller) correct, in that at the heart of the problem is the need for new and additional skills for nursing staff? The review, which is now being conducted as a matter of urgency and which will soon report, will seek to address that problem. Does my hon. Friend agree that it is grossly irresponsible to distress the parents of the children involved by raising this matter repeatedly in a public arena and giving the impression that this problem can be solved by making emotive speeches in the House of Commons?

My hon. Friend has put his finger on the point. I said that the rhetoric had outrun the reality. It is clear that the Opposition are more determined to make political points than to provide care for these children. This care will be provided by the arrangements that are being made. I cannot emphasise that sufficiently.

Of course, I understand that emotion is involved in these matters and it is right that we should remain as objective as we can, but the hon. Gentleman sounds dangerously complacent. If he is saying that he relies on the regrading of the structure and payment for specialist nurses—he seems to have admitted that the shortage of specialist nurses is causing these problems for the doctors—surely he must accept that it will take months, if not years, not just for the pay review to consider the matter but for implementation of the recommendations, even if the Government decide to fund them. Meanwhile, these problems keep cropping up with monotonous regularity. This is not acceptable. What will the hon. Gentleman do about it, and how quickly?

With the greatest possible respect to the hon. Gentleman, he says that it is not acceptable, but I do not believe that it is unacceptable that the doctors in a hospital, faced with a sudden surge of demand while carrying out the number of open and closed-heart operations which I gave in my answer, should make the necessary arrangements with other hospitals and health authorities to cope with that sort of surgery. That is the short-term problem, which I believe is being handled eminently sensibly. There is a longer-term problem in the hospital—the shortage of skilled nurses. That shortage is not confined to Birmingham children's hospital. We are addressing that problem in the longer term as well.

My hon. Friend may know, or may wish to know, that there is a hole-in-the-heart child in my constituency who is currently on the list at Birmingham children's hospital. Does he agree that it would be a good idea for the private sector to give some help to alleviate that problem as it affects those working in that hospital? Could some arrangements along those lines be worked out? Will my hon. Friend be good enough to let me have an answer, if not today then certainly during the next few days?

I shall consult my right hon. Friend the Minister for Health, but I understand that discussions are in train with the private sector to ascertain whether its facilities could be used to shorten the waiting lists at Birmingham children's hospital.

Twice in his replies the Minister has drawn attention, correctly, to the fact that this is a decision by the hospital medical committee—all the senior doctors—and not an emotive or political decision of any kind. It is the more serious for that reason. This decision and the one which I mentioned to the Prime Minister earlier this week concerning Oldham have arisen because of the shortage of money. There are no trained nurses to staff the special beds. The new hospital in Oldham is unable to open all its wards because of the shortage of money. The Minister has taken refuge in the review of nurses' salaries and conditions but, if that review is not fully funded by the Government, the knock-on effect will be even more emergency decisions of this kind. I hope that the Minister realises that when such decisions are made by the hospital medical committee, that makes them all the more serious.

I thank the hon. Member for the reasoned way in which he put his point. I have already spoken about the longer-term problem. The Government and the Department are discussing with the region and the district, the interim problem of the level of facilities provided at the Birmingham children's hospital and whether there is any way in which it can be improved. Intensive care facilities are fully used at Birmingham children's hospital.

No, they are not being closed. All that the hospital is saying is that it will not accept referrals for cases of paediatric cardiac surgery. If there are other referrals, arrangements will be made with other hospitals in nearby regions or with the Great Ormond Street hospital to provide for those admissions to take place.

Is my hon. Friend aware that some of us who represent excellent hospitals in the regional health authority of the west midlands are getting fed up with the strident and emotional reactions from hospitals in Birmingham? Is it not a fact that if the costs per patient in Birmingham were as low as the costs per patient in excellent hospitals like the Burton hospitals, there would be more facilities and better patient care at Birmingham? Is my hon. Friend looking into the cause of the extremely high costs in the Birmingham hospital?

My right hon. Friend the Minister for Health is concerned about a number of matters in the west midlands region and is having discussions with the region as well as the district about those matters.

Behind the sensible decision that has been taken, is there not a saga of what appears to be neglect over a number of years by the Government, who did not recognise that the advances in medicine would be creating such situations? Will the Government announce, clearly and unequivocally, that, rather than cut taxes in the Budget, they will use the money to put matters right?

The Budget is not a matter for me. My understanding is that substantial extra resources have been made available. The point made by my hon. Friend the Member for Mid-Worcestershire (Mr. Forth) is true. Substantial advances at the frontiers of medicine, have meant that children who, some years ago, would have died can now be treated. As a result, we have a shortage of specially skilled nurses. That shortage has been recognised, and the Government are doing something about it.

Is my hon. Friend aware that, as long ago as 1982, when I held an office in the Department, we were making arrangements, for example, for hip operations? If there was a long waiting list in one hospital, arrangements would be made to have the operations performed elsewhere. Is it not surprising that Opposition Members are putting forward these somewhat strange ideas, because they welcomed such transfers then? I wonder whether they now think that there are votes in opposing them?

The Opposition will have to answer for themselves. It seems sensible that medical staff should make arrangements for children who need this help to have it provided for them wherever it is available.

This is an appalling announcement, yet the Opposition are accused of making political rhetoric. Have the Government no compassion? The National Health Service is not safe in Tory hands. This situation proves that more money is desperately needed in the Health Service and the Minister should pass on to the Treasury the message that it should abandon tax cuts and put money into the NHS so that children do not die—deaths for which the Government will be responsible.

As the House knows, substantial resources have been put into the NHS. I am not sure which aspect of the statement the hon. Gentleman finds appalling. Is it that arrangements have been made in neighbouring health authorities or at Great Ormond Street for these children to be admitted? I do not not believe that that is appalling.

Will my hon. Friend confirm that the problem is not the amount of money but how that money is used? Will he also confirm that the review being undertaken will examine how the Health Service is managed and the competence of the Birmingham health authority?

It is clear from the debates that have taken place and the questions that have been asked that the management of the resources in the NHS is at the heart of the discussions on the future of the service. That is being considered in the review that my right hon. Friend has announced.