House of Commons Hansard Debates for 9 Jun 1989

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We need to tailor the message to the community in which it is delivered. We have been acting through education co-ordinators. We have created in every education area education co- ordinators whom we have funded through central resources. That is extremely important. We have assisted also with in-school training and the preparation of training packages. Against a background of crack, we will have to ask ourselves whether we need to do more to deliver locally messages of demand reduction. That must go wider than the schools. It is one matter that I want to consider closely following my return from the United States.

I should like to answer a number of points that I have not so far covered. My hon. Friend the Member for Warrington, South requires the thanks of the House for having raised this matter. He has introduced a variety of important issues. I am glad that he supported us on the issue of condoms. I have been asked by the hon. Member for Kingston upon Hull, West to say why we are opposed to the issue of condoms in prisons. The main reason is that we believe that the issue of condoms would be likely to result in a greater prevalence of homosexual activity. Because of the failure rates associated with condoms, we fear that the result would be to increase and not to diminish the risk of HIV being present in prisons.

My hon. Friend the Member for Warrington, South was right about training. As he knows, we have created a video training package for prisoners and staff and we are anxious that those video packages and training materials should be available throughout our prisons. The question of the treatment of prisoners who are suffering from drugs was raised. It is not right to say that periods of cold turkey are a part of prison service department policy. It is right to say that it is a clinical matter for medical officers. To express a non-clinical opinion--my own--it seems right that where a person's treatment requires maintenance, if necessary by methadone, that, subject to the medical officer's clinical view, would be appropriate. If somebody is already on a treatment programme when he comes into the prison system, I would hope that medical staff would identify that fact and continue with the maintenance programme.

My hon. Friend the Member for Warrington, South also touched on the question of compulsory testing. As he knows, it is not our policy because there is no cure. It also would impose grave social and economic sanctions, and we do not have such testing outside the prison system. It would, in any case, require legislation. Our policy, therefore, on testing in the prison system is to make it voluntary. Broadly speaking, prisoners should be treated in the same way as persons outside prisons.

We were also asked about what we were doing to eliminate drugs in the prison system. As the House knows,

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we have abolished the right of remand prisoners to receive food from outside during the remand period. That was done simply to prevent remand prisoners having drugs brought in. We have also increased searches and the use of sniffer dogs.

Ninety per cent. of the finds of drugs in prisons are cannabis. I cannot remember the exact figure for the finds of syringes and needles, but I know that the figure is less than 100. Although one can become disturbed about it and although it is right to watch the situation, the suggestion that the injecting of drugs is commonplace in prisons is wrong. There is no evidence to support that. My hon. Friend the Member for Warrington, South also raised the matter of anonymous screening. The prison service department will hope to take part in the scheme and the policies that are being put in place by the Department of Health and which will rely on the project put forward by the Medical Research Council for a programme of anonymous testing.

The House will want to allow my hon. Friend the Member for Warrington, South to have a brief word at the conclusion of our debate, so I will summarise my remarks by saying that I have tried to give some idea of Government strategy in this matter. I have tried to respond to particular points and I apologise for not dealing with them all. We have committed substantial resources to this matter to the extent that if we see that there is a further requirement or an additional risk, we shall act as positively as we have done in the past.

2.28 pm

Mr. Butler : I am grateful to you, Mr. Deputy Speaker, for allowing me an opportunity to speak again. It is important for me to emphasise that we have had a constructive debate today about a subject that is important to the future of our nation. We have heard contributions from various parties, and the debate has shown the House in a good light as it has shown all of us contributing constructively and with a degree of unity that I find rare. That makes me a little prouder to be a Member of this institution at the moment.

My hon. Friends the Members for Lewes (Mr. Rathbone) and for Gainsborough and Horncastle (Mr. Leigh) referred to the international aspects of drug abuse. It is a global problem which needs to be tackled by global co- operation, but unfortunately we do not even achieve adequate co-ordination between our national agencies to tackle the problem. My hon. Friends the Members for Lewes, for Banbury (Mr. Baldry) and for Cheltenham (Mr. Irving) --

It being half-past Two o'clock, the debate stood adjourned.

Hon. Members : Object.

Second Reading deferred till Friday 7 July.

RIDERS OF EQUINE ANIMALS BILL

Order for Second Reading read.

Hon. Members : Object.

Second Reading deferred till Friday 16 June.

CONTROL OF LITTER (FINES) BILL

Order for Second Reading read.

Hon. Members : Object.

Second Reading deferred till Friday 7 July.

AGRICULTURE (CONTROL OF NITRATES) BILL

Order for Second Reading read.

Mr. Deputy Speaker : Second Reading, what day? No day named.

BUSINESS OF THE HOUSE

Ordered,

That, at the sitting on Monday 12th June, if proceedings on the Motion in the name of Mr. John Wakeham relating to Televising of Proceedings of the House have not been previously disposed of, Mr. Speaker shall at Ten o'clock put any Questions necessary to dispose of them and of any Amendments to that Motion which may have been selected by him and which may then be moved ; and proceedings in pursuance of this Order, though opposed, may be decided after the expiration of the time for opposed business.

Ordered,

That, at the sitting on Thursday 15th June, the Motion in the name of the Prime Minister for the Adjournment of the House shall lapse at Seven o'clock, if not previously disposed of.-- [Mr. Sackville.]

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Bank Hall Hospital, Burnley

Motion made, and Question proposed, That this House do now adjourn.-- [Mr. Sackville.]

2.33 pm

Mr. Peter L. Pike (Burnley) : I wish to raise the proposed closure of Bank Hall hospital in Burnley. Let me make it clear at the outset that I shall argue about the reduction in the level of service provided to the people of Burnley rather than about the building itself, which dates back to the 18th century and needs a considerable amount spent on it. It was the former home of General Scarlett, who fought his first parliamentary election in Burnley as a Conservative candidate, fortunately unsuccessfully. He was the victor in the charge of the heavy brigade which took place on the same day as the charge of the light brigade.

The closure highlights yet again the financial restraints that the Government are imposing on the Health Service and the reduction in the provision of services. It will cut still further the facilities available to the people of Burnley, Pendle and Rossendale. This will be the third hospital closure in two years. The Hartley hospital in Pendle and the Victoria hospital in Burnley have both been closed and we have now to consider the closure of Bank Hall hospital. It is somewhat surprising that at exactly the same time as the announcement of the consultation was made in the local press, a Dr. Gupta of Blackburn and a consortium of eight other people announced the purchase of the former Victoria hospital for £550,000--£350,000 to go to the region and £200,000 to the district health authority--to open a private residential and nursing home for the elderly. Once again, that highlights the way that the Government are shifting their responsibility and the public responsibility to provide care for the elderly. It is time that they put forward clear proposals about the care that should be provided.

I am not opposed to those who have sufficient resources choosing to go into private residential or nursing accommodation, but increasingly to force people to do so is quite wrong. The key element in supporting the private sector, as the Government do, is that a profit element comes into the provision of care. I am not suggesting that some of the nursing and residential homes do not provide a high standard of care, but it is obscene to make profit out of old age. Society and the Government have a responsibility for the care of the elderly.

The consultation exercise has a closing date of 5 July for submissions. That is a reduction of the period laid down from three months to two months, the main objective being to save money--exactly the reason why we are considering the proposed closure. Once again the National Health Service is being tailored to meet financial restraints rather than what should be the priority objective of meeting the needs of those whom it serves. The Lancashire Evening Telegraph of 8 June carried the editorial headline :

" Shoestring' an unwelcome NHS buzz-word."

The final paragraph of the editorial stated :

"Like the British Medical Association's current telling campaign about the present drive for an even more businesslike approach to the running of the health service, we believe it won't do much for patients if the shoestring outlook to funding still stays in place." The problems that we face with the proposed closure of Bank Hall and the general problems of the NHS are caused by the Government's shoestring approach and the

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necessity for health authorities to cut, cut and cut again to meet budget objectives laid down by the Government. The simple truth is that whenever a health authority makes a cut or a closure to meet the criteria laid down by the financial restraints imposed by the Government, in another 12 months it will have to make yet another cut or closure. If the Bank Hall closure goes ahead, some of the elderly will be moved to Marsden hospital but within two or three years that hospital, too, will be considered for closure. Consultation about closing it a few years ago was deferred, but we know that closure will be proposed again in the foreseeable future.

The interim short-term programme of the health authority for 1989-90 and 1990-91 has been on the basis of achieving savings of £934,000 minimum to £2.5 million. That again highlights the fact that the health authority constantly has to spend its time concentrating on meeting the Government's financial restraints. Those savings mean cuts in what is already an insufficient level of service provision to the people of Burnley. The short-term programme assumed the Bank Hall closure and anticipated that the consultation exercise would receive a favourable response.

I have referred to the Lancashire Evening Telegraph editorial of 8 June, and on the same day there was a news item covering the same issue. In that article, councillor McGeorge said :

"I cannot see any advantage to patients in this closure and they are what count."

Councillor McGeorge is the Labour leader of Burnley council. However, in case the Minister thinks that it is just one party that is protesting, I shall quote the words of a Conservative member of the council who spoke at the same meeting. He said :

"On this side of the council we don't want to see Bank Hall close either.

We don't think anyone can say that private nursing homes can replace the service offered at Bank Hall. I only hope that people who have decided to shut Bank Hall are prepared to accept responsibility of what might happen."

At the end of the day, it is the health authority that is making the decision, but it is making it because of the constraints put on it by the Government.

Councillor Kevin Kirkham of the SLD also spoke. He said that he agreed wholeheartedly with what councillor McGeorge, the leader of the Labour group, had said. An article in The Burnley Citizen, which also came out on 8 June stated :

"Councillor Butterworth, who is chairman of the League of Voluntary Workers for Burnley's remaining hospitals added : Bank Hall should be kept open and all hospital closures should be opposed'." The Burnley Express and News, which came out today, described the proposed closure as

"Criminal and horrifying for the elderly and long-stay patients accommodated there."

Councillor McGeorge is quoted as saying that

"the gloves have now come off. We are going to fight this all the way."

He went on to call on the community health council to join the fight and not, as in the past, cop out and agree with the proposals being made by the health authority. I shall be fully involved in that fight, and I shall fight every inch of the way to ensure that we do not see a further reduction in service level provision for the people of my area.

Mr. Wolstenholme, of the Burnley, Pendle and Rossendale health authority, sent a document to the unions saying that, in addition to the problems for the

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patients involved, there would be reductions in staff. In a letter sent to the National Union of Public Employees, he said : "Whilst some staff will be needed to transfer to Marsden Hospital with the patients such an arrangement will not be extended to cover all the staff presently at Bank Hall Hospital."

That, too, shows further job reductions.

The health authority's policy and resources committee, in its integrated planning statement for 1989--it has not yet been approved by the full district health authority--indicated other problems as well as that of finance. I have already briefly referred to the growth of private residential and nursing homes. That document says :

"The rapidly expanding number of private residential and nursing homes has also had an effect upon the service demands for this client group. Over the past five years, the number of private nursing home places has increased by approximately 23 per cent. and the number of residential home places by 25 per cent."

It goes on :

"Work had been due to proceed on the new Geriatric Unit at Rossendale General Hospital in 1989-90, but this scheme has now been omitted from the Regional Capital Programme. The District is now seriously concerned over the standard of care that can be provided to the elderly at Rossendale when the service is severely limited by grossly inadequate accommodation which was condemned over 10 years ago."

That shows not only the Bank Hall closure threatening the service level provision, but provision that would have been made at Rossendale general hospital being dropped from the programme. Of course, many of the people who cannot go into Rossendale would have been accommodated in Bank Hall hospital in Burnley.

The consultation document says :

"Major changes in the pattern of care of elderly people have occurred in recent years which to a large extent is due to the development of the private sector nursing home and rest home provision, and in part of technological changes in medicine. In 1983-84 the District Strategic Plan recorded that there were 385 places available in private homes for the elderly and 87 places in private nursing homes. By the beginning of 1989 this figure had risen to 1,500 places and 400 places respectively and is set to rise even further by 1990-91."

There is a public responsibility to care for the elderly, whether through the health authority or the social services. The House still awaits the Government's response and a debate on the Griffiths report, community care and the many other issues linked with problems such as the closure of Bank Hall hospital.

There will be a reduction in beds for the elderly from 43 to 26, and, because of the way the beds will be relocated, the provision of beds for children will be reduced from 65 to 54--yet another cut in services. A considerable amount of money is being spent to move the children's ward from Marsden hospital and to move the elderly from Bank Hall hospital to Marsden hospital. About £90,000 will be spent on adapting accommodation at Marsden hospital and £200,000 will be spent on transferring the children's ward from Marsden to Burnley General hospital.

Our main argument is that there will be a reduction in service provision. Areas such as Burnley, Rossendale and Darwen, and Pendle have particular problems because many people have worked in industries which cause chest problems and so on in old age. Also, many young people are leaving the towns because the Government's policies

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have reduced the amount of work available. We therefore need a higher than normal level of Health Service provision, particularly for the elderly.

I know that the Minister will refer to the developments at the Wilsonhey unit and Pendle community hospital. I welcome the developments and I do not say that we cannot change the use of a building, but I and the people whom I represent believe that there is insufficient provision now. Cuts will not be accepted by the people of Burnley, Rossendale and Darwen or Pendle. If the Government do not recognise that and make the necessary resources available, they will lose two seats at the next general election.

Care of the elderly is a public responsibility. The Government should wake up to that responsibility and make resources available to health authorities and county council social services so as to meet the needs of the community that those bodies serve.

2.47 pm

The Parliamentary Under-Secretary of State for Health (Mr. Roger Freeman) : I congratulate the hon. Member for Burnley (Mr. Pike) on his success in the ballot. I should like to give the House the background to the proposed closure of geriatric facilities at the Bank Hall hospital. As the hon. Member for Burnley pointed out fairly, the proposal is only at the consultation stage and has not yet been considered by the North Western regional health authority. If there is an objection by the community health council, it will be considered carefully by the health authority. If there is a sustained objection, it will come to Ministers for further consideration. The hon. Gentleman knows that and pointed it out.

I hope that the House will permit me to comment briefly on the provision of patient services generally in the Burnley, Pendle and Rossendale districts. The Burnley, Pendle and Rossendale district health authority provides a full range of health care services for a local population of about 227,000.

The hon. Member for Burnley referred to cutbacks. For the period from 1982 to 1987-88, the latest full year for which we have figures, in-patient treatments were up by 15 per cent. to 32,000 patients per annum and out- patient treatments were up by 7 per cent. to 165,000 patients per annum. I fail to see how the hon. Gentleman can sustain his argument that there have been health cutbacks. The level of resource funding, to which I shall turn in a minute, is a different issue. The record shows that the hon. Gentleman cannot sustain his argument, because patient care measured in terms of in and out-patient treatment, has risen. The number of people treated by community nurses in the district has also risen by 29 per cent. to 35,000 per annum.

Those figures do not show the increase in the quality of care that has also taken place and which reflects the staff's dedication and commitment. I know that the hon. Gentleman will join me in thanking and congratulating the health authority staff. As politicians, we do not thank Health Service staff enough. We take them for granted, and, as a Health Minister, I join the hon. Gentleman in congratulating the staff who work in his constituency.

The right hon. Gentleman asked me about the Griffiths report and I can only repeat the commitment given to me by my right hon. and learned Friend the Secretary of State for Health and the Prime Minister that we shall shortly

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