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Column 533bring to the House our conclusions on the second Griffiths report on care in the community. They were extremely important, and were deliberately omitted from the White Paper "Working for Patients" because our thoughts and deliberations had not been concluded. However, they will shortly be complete and we shall bring them to the House.
A more tangible sign to the local community of the Government's commitment to improve services is the local building programme, in particular, the completion of the Burnley general hospital phase 3 development, the Wilson Hey unit. That has provided 49 paediatric and surgical specialty beds, with a playroom and outside play area for the children, 105 surgical beds, four high-dependancy beds, three operating theatres and one minor operating theatre, at a total cost of about £6.1 million. A further £5.9 million project to expand Pendle community hospital is also well under way to providing an additional 72 geriatric beds by May 1991. Those new buildings and the facilities which they contain will ensure that the improvements in patient care achieved in recent years will continue well into the future.
I take further issue with the hon. Gentleman. I do not think that he would dispute the figures that I have given because they are facts. It is not sensible to equate hospital closures with cuts. They are sometimes necessary because buildings are worn out and beds, wards and hospitals need new buildings.
The hon. Gentleman implied that any closure was wrong, although, to be fair, he qualified that. He referred to Hartley and Victoria hospitals. Closures are merely signs of the re-provision of health care services. As I have already said, the Health Service is spending £12 million on new capital projects in the health authority area. That is an example of our commitment constantly to improve the care and provide it in a more modern and acceptable way, which is in the patients' interests.
Mr. Freeman : That is not right. I am informed that the elderly use 80 per cent. of the 43 beds currently available at the hospital, which gives a figure of 34. I am informed that the replacement Deerplay ward at Marsden hospital will provide 26 beds and that a further 10 beds will be available at the district general hospital for family respite. They will not be beds for members of the family to use as patients, but so that they can enjoy some respite. That makes a total of 36 beds. Therefore, I do not agree with the hon. Gentleman that, in the short term, facilities will be reduced. I also take issue with the hon. Gentleman's argument that private nursing health care and residential homes are wrong in principle. He implied that they were immoral because a profit is made from them. I disagree. Private nursing homes and residential homes, when properly organised and providing a good quality of care, are perfectly acceptable. As the hon. Gentleman well knows, patients are supported, when appropriate, by the Department of Social Security through income support.
Mr. Freeman : I am aware of that. For nursing homes, the state provides about £200 per patient per week. I know that fees often run in the range of £230 to £240 a week, implying some contribution from the savings of the elderly persons or their families. That is a significant degree of support. Private health care can march in step with the NHS in terms of the quality of care delivered.
The hon. Member for Burnley asked me about staff protection. I am informed that the Burnley, Pendle and Rossendale health authority, after consulting the district joint negotiating consultative committee, has already adopted a policy for staff protection in the event of any change or use of premises, and that policy will be fully implemented.
Turning to the Bank Hall hospital, the opening of new and better NHS facilities must rightly be accompanied by a rigorous examination of the continuing use of older existing beds. The Burnley health authority has considered how the hospitals in the district are being used, the services they provide and the level of patient activity involved. It has also considered the capacity of the private sector to meet the needs of elderly patients for nursing care.
Major changes in the pattern of care of the elderly have occurred in recent years and are due to a large extent to the development of private sector nursing homes and, in part, to technological changes in medicine. We all welcome the fact that people are living longer. Although there are many more elderly patients and many more are being treated, it is a fact that the pattern of treatment has changed. The average stay in hospital for geriatric patients is much shorter, and because the number of beds has been maintained in the health authority concerned, and the average use of beds is decreasing, even after the demographic pressures, the occupancy of beds is falling. In Bank Hall, the decrease has been from 90 per cent. to 82 per cent. occupancy, as the average length of stay has fallen from 227 to 108 days. This is partly the result of the greater availability of residential places in the private sector. Elderly patients can readily find a place which provides nursing care, following a period in hospital for active medical treatment. In the past, many such patients would have been kept in hospital for want of suitable alternative accommodation. I am sure the hon. Gentleman joins me in welcoming this move, whether it takes place within the Health Service or without it. Patients who are medically cured should not be in wards in hospital. They prevent others from being treated there and it is not good for their morale or general wellbeing.
Taking account of these developments, the district health authority has concluded that there is a need to rationalise hospital services in the district. That is the reason for the proposal to close Bank Hall hospital. As a result, financial, medical and nursing resources can be used to greater effect within the NHS.
The option favoured by the district health authority and set out in its consultation document is for the closure and disposal of Bank Hall while expanding services for elderly people at Deerplay ward at Marsden hospital in Burnley. The proposals are set out for consultation under arrangements that apply to all proposals for a significant change in patient services. This is covered in departmental guidance issued in October 1975.
The hon. Gentleman mentioned the time scale for consultations. The normal provisions will apply in this case--a three-month period for consultation at district health authority level, taking us to the end of July. I hope
Column 535that all the parties involved will play their full part, as, I am sure, will the hon. Gentleman. I hope that the community health council and all involved will make constructive comments on the proposed closure and on alternative ways in which patients should be cared for.
Finally, I turn to the main theme of the hon. Gentleman's speech, the level of funding. He said, fairly, that he is specifically concerned not about this particular site or about its future but about the level of funding. The White Paper proposes that the basis of funding should be changed-- first, through the regions and, secondly, through the regions to the districts. We wish to fund district health authorities on the basis of weighted capitation--on the number of residents in a particular district health authority area, weighted by their relative age and morbidity, which in turn will reflect various social and industrial health factors--and the relative cost of providing health care. A more automatic system of allocating taxpayers' resources will, we believe, be fairer and more certain and will enable Health Service managers to plan with greater confidence for the future.
I do not know about the particular demographic and
Column 536population pressures in the hon. Gentleman's health authority area. However, when the new system is in place--the successor to the old resource allocation working party targets for regions, and, through them, for districts, and the targets that Ministers, of whatever Government, chose to aim for in terms of resource allocation, a system that served us well for many years--it will reflect fairly population movements, population growth and the other factors that I have mentioned. There will then be less criticism of whether one area has been more or less fairly treated than another.
When the new system of allocating funds is in place, I hope that the hon. Gentleman will agree that it will be for the health authority to decide local priorities. I hope that greater attention will be paid to using finite resources effectively in any year. The resources of any Government, of whatever political complexion, are finite. After a health authority has received finite resources in any particular year, it must use them effectively and efficiently. Both the hon. Gentleman and I agree that we want to improve both the quality and the quantity of health care.
Question put and agreed to.
Adjourned accordingly at two minutes past Three o'clock.
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