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Health: Mixed-sex Wards

Volume 698: debated on Monday 28 January 2008

asked Her Majesty’s Government:

Whether they continue to support the policy in England to remove all mixed wards in hospitals except for emergency admissions.

My Lords, our guidance requires the provision of single-sex accommodation, not wards. This may mean single rooms or single-sex bays within a mixed ward as well as single-sex wards. Single-sex accommodation should be the norm for elective care and remains the ideal for all admissions. We have made our continuous commitment to this clear in this year’s operating framework, which charges primary care trusts with setting and publishing stretching local plans for improvements in this area.

My Lords, I thank the Minister for that Answer. However, he is saying that, after 10 years of this Government, the removal of mixed wards is no longer part of their policy. The issue is totally fudged by his Answer. I have just come back from Sri Lanka where I visited its public wards, which—the Minister may not be aware—are 100 per cent single-sex. If a developing country can do it, and many do, why is it impossible in this country? Does the Minister not understand that it is degrading, insensitive and barbaric that we should have any mixed wards anywhere in the National Health Service?

My Lords, first, I remind the House of the definitions that we are using. The Government are committed to single-sex accommodation, not single-sex wards. Those are two different things. I also reassure the noble Lord that we used to have single-sex wards. That was 15 years ago—I remember practising in them as a trainee. However, medicine has moved on and, as it has, the design of wards in the health service is based on the disciplines, expertise and competencies of the staff working in those wards. As a result, the commitments that the Government made in 1997 were met in 2002 and 2004, with 95 per cent of patients in single-sex accommodation.

My Lords, if the Minister would like to consult the many patient forums up and down the country, he will find that real mixed-sex wards still exist and male and female patients still have to share with each other. As the noble Lord said, that is quite degrading. Would the Minister not agree that government targets have done this damage and are forcing managers to look at the quantity, not quality, of patient care?

My Lords, the noble Baroness refers to the dignity and respect of patients, and I could not agree with her more. I reiterate that we are talking about single-sex accommodation, and if anyone is infringing that guidance I will be more than happy to look into it. She referred to the initial target in 1997. It was based on eliminating mixed-sex accommodation, which we have done. The current guidance looks at three different principles: the annual healthcare check, which looks at a number of different standards; the patient environment action teams, which is the PEAT score; and, more recently, the Healthcare Commission, which looks at the in-patient surveys.

My Lords, having been in a mixed ward, I wonder whether the Minister considers that curtains between beds are sufficient.

My Lords, curtains to separate the sexes in the same bay are not sufficient. However, we are talking about separate bays within wards. This is an interesting question that has been debated in this House for many years. The only way that we can have single-sex wards in the NHS is to build the whole of it in single rooms. Transforming a ward into a single-sex ward is not achievable. That aspiration cannot be met. We are talking about single-sex accommodation within wards—in other words, different bays for different sexes.

My Lords, I entirely agree with what the noble Lord said: it would be desirable to treat people in single rooms with their own facilities. Since that can be done in other countries, why can we not meet that aspiration in this country? Is the Minister aware that in 1995 this House passed a Bill outlawing the practice of treating people in mixed-sex wards? Since then, many promises to phase them out have been made, but they are still there and we are still getting many complaints. On 22 January, the Minister answered a Written Question from me:

“We do not collect information on the number of trusts which have mixed-sex wards per se”.—[Official Report, 22/1/07; col. WA 33.]

How can the Government possibly say whether they have been phased out if they do not have that information?

My Lords, I come back to definitions: we are referring to mixed-sex accommodation, not mixed-sex wards. We have guidance that we need to increase the number of single rooms by at least 50 per cent of any new build. We have made slow but steady progress since 1997. The number of single rooms has increased from 22 per cent to 27 per cent across the National Health Service. We measure single-sex accommodation through the trio that I referred to earlier: the annual healthcare check, the patient environment, and the Healthcare Commission’s in-patient survey.

My Lords, I feel a bit confused, but confused at a very high level. At midnight tonight, how many men and women will have to sleep in the same room in a hospital?

My Lords, with the exception of those in critical care units or intensive care units and other seriously ill patients, the answer should be none.