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NHS: Mixed-sex Wards

Volume 693: debated on Monday 25 June 2007

asked Her Majesty’s Government:

What progress they are making in phasing out mixed-sex wards in National Health Service hospitals.

My Lords, single-sex accommodation should be the norm for elective care and remains the ideal for all admissions. We have made that clear in this year’s NHS operating framework. In emergencies, the need to admit has priority. Some 99 per cent of trusts provide single-sex sleeping accommodation in wards other than A&E admission units and critical care.

My Lords, I thank the noble Lord for that Answer. However, as he will be aware from the report by the NHS Chief Nursing Officer, although it is claimed that 99 per cent of people are in single-sex wards, the survey, when questioned, shows quite different figures. Many more people complain than is suggested by the figures. Is the Minister aware that the Chief Nursing Officer has also said that people give priority to clean hospitals rather than to single-sex wards? What a disgrace that it should be either/or.

My Lords, in fairness to the Chief Nursing Officer, the work she undertook was partly to get the views of patients, who made it clear that cleaning is a top priority. That does not mean that there is any complacency about the issue of mixed-sex accommodation. The noble Baroness refers in her Question to “mixed-sex wards”, but the target that was set in 1997 was on mixed-sex accommodation. That definition of mixed-sex accommodation was the same one used by the noble Baroness's own Government.

My Lords, the Minister will recall that I have been pursuing this matter since 1994. We still do not have a resolution of it. All the reports show that patients, particularly women, rate this problem as very important indeed. As we are presently spending £91 billion a year—equivalent to £1,500 per person each year—is it not appalling that we cannot solve this problem? Can he assure me that hospital staff have the idea that patients are top and should be treated properly as customers and not supplicants?

My Lords, I hope very much that the whole ethos and value of the NHS is to treat patients as people who deserve dignity and quality of care, and of course they should not be treated as supplicants. The noble Lord has been asking questions about single-sex accommodation for a number of years; and I have been answering questions about the same subject for what seems any number of years. The health service has made considerable progress. It did reach the target of 95 per cent of trusts eliminating mixed-sex accommodation except in areas such as emergency admissions where it is not always practical to do so. The problem arises because eliminating “mixed-sex accommodation” is taken to mean removing mixed-sex wards. In modern health service terms that is not possible because of the need for specialisation. That is why the emphasis is on segregation within wards. I agree that that has been the cause of some confusion for patients.

My Lords, does the Minister agree that failure to eliminate mixed-sex wards is due in large part to hospital managers trying to achieve unrealistically high bed occupancy rates? Does he also agree that, like the failure to control MRSA, this problem is due in great part to the obsession with targets, which militate against good patient care?

No, my Lords; I do not accept any of those comments. We have targets in order to reduce long waiting times for treatment. Time and again patients have made it clear that that is what they want. On the question of whether this is done by managerial diktat, the answer is no. Fifty years ago there were single-sex wards, but specialisation in today’s modern health service means that patients need to receive specialist care in the same area. That leads to the safest possible care. We have to ensure that in that context there is segregation in those ward areas, and this is being done.

My Lords, I note what the Minister said but there is still a certain lack of clarity. In 2004, NHS managers told the Secretary of State that mixed-sex accommodation had been eliminated in 99 per cent of trusts and yet she subsequently discovered through work done by journalists and many case studies—examples provided by patients themselves—that this clearly was not the case. Does the Minister put this anomaly down to inaccurate data collection or has the problem got worse over the past three years as trusts have found themselves under increasing financial pressure?

My Lords, that is not the position at all. It is clear that the original target can be met with men and women being nursed together in some circumstances—principally in emergency areas, including admission and assessment units. As regards some of the survey work that has been undertaken, the discrepancy between the number of trusts which are complying with the original target and the perception of patients in that regard concerns the distinction between mixed-sex wards and mixed-sex accommodation. Clearly, much more needs to be done. More also needs to be done to inform patients. However, I assure the noble Earl that we continue to see this as a priority. The Chief Nursing Officer will issue further guidance later this year. We are not at all complacent about this matter.

My Lords, I declare an interest having spent two nights last summer in a bay of an orthopaedic ward with two women and four men. I place on record my gratitude to the nurse who provided me with a pair of pyjama trousers in addition to my surgical gown. Does the noble Lord recognise that targets need to be changed to provide for a greater surplus of beds in hospitals in order to avoid the acute shortage of beds that left me in that position?

My Lords, I am sure that the noble Lord looked most elegant in that outfit. Of course, it is important that individual hospitals have flexibility to ensure that targets can be delivered while ensuring that safety is a paramount concern. They have flexibility in the way in which wards are managed. However, central targets have ensured that waiting times for patients have been drastically reduced. The targets that we set in train from the centre dealt with mixed-sexed accommodation. Through those targets the health service understands the priority to be given to this important area. Of course, we want to reduce the number of targets, but there will always be a need for some central direction and guidance.