I am grateful to you, Mr. Speaker, for allowing me to raise this matter tonight and to my hon. Friend the Joint Parliamentary Secretary to the Ministry of Health for being here to reply. I also welcome the fact that my hon. Friend the Member for Yarmouth (Mr. Fell) is here to join me in the debate.
Great Yarmouth and Lowestoft have a long and deep-rooted rivalry and it is not always that my hon. Friend and I have exactly the same views on leading issues of the day, but as we have personally good friendship and good relationships, so I think have our two towns. Certainly anything that we can do to foster the good relationships between the two towns we shall try to do.
My purpose in raising the question of the future of the Lowestoft Hospital and of hospital services on the East Coast, which affect Great Yarmouth as well, is to call attention to various problems which have cropped up in the last year or two. During the past two or three years I have been waging something of a campaign to bring about an improvement in the orthopaedic and maternity services at the hospital. Whilst I must admit that I have had my disappointments with the maternity service, on the question of providing further maternity services I have met the Chairman and the Chief Medical Officer of the Eastern Regional Hospital Board. They have explained the position fully to me and I have to say frankly that I have been quite convinced that their decision not to build further maternity accommodation in Lowestoft but to concentrate on building it at Great Yarmouth was a correct decision. I should like to hear from my hon. Friend when he expects the new maternity unit at the new Northgate Hospital at Great Yarmouth to come into operation, and I hope also that he will give some idea of its cost.
Once the new maternity unit is completed, the six beds at Lowestoft will become available for general practitioner maternity cases, and, of course, on completion of the new general hospital at Northgate, the number of maternity beds at Lowestoft will go up to 24. This, I think, will be ample for the needs of the Lowestoft area. At the moment, there are about 800 births registered in Lowestoft during one year. Although we have only six beds, 254 live births and nine still-births were registered as taking place at the hospital last year. No one can deny, therefore, that there is a great need for more beds; but, equally, no one can deny that the staff did a wonderful job in dealing with the number they had.
I pay my tribute to the hospital staff and to the work which they do. There is no better or more loyal staff anywhere, but, unfortunately, their morale has been lowered recently by what I must describe as irresponsible rumours surrounding the future of Lowestoft Hospital. I hope that my hon. Friend will be able to state quite categorically tonight that there is no intention to close Lowestoft Hospital, that it will continue to play the rôle earmarked for it in the Hospital Plan, and that the 74 acute beds which are mentioned in the Plan will be used for ordinary surgical cases as well as for other purposes.
I hope that my hon. Friend will say that the new Northgate Hospital, with all the equipment now needed for neurosurgical, orthopaedic and serious operations, will concentrate on that type of work. At present, most of my constituents who have serious illnesses of those types have to go to London, Cambridge or Norwich, and it will be a great improvement for them and their relations who have to visit them if we have a new hospital as close as Great Yarmouth. We have to realise, of course, that, whatever our local ambitions may be, the important point is that patients must have first consideration and we must do what is right for them.
The waiting list at the hospital has grown in the last two years. My hon. Friend will be able to confirm that much of this is due to an increase in the number of orthopaedic cases. This follows partly from the fact that we pressed very strongly, two or three years ago, for greater orthopaedic facilities, as a result of which a specialist was appointed to Great Yarmouth and Lowestoft, and he has now taken on a good many of the cases which previously were put on the Norwich list. This has increased our waiting list locally, perhaps giving a rather unfair impression of the local situation.
I want this debate tonight to kill the rumours which have been floating round the town about the future of the hospital, to show quite plainly that the hospital has shortcomings but that they can be overcome. I want my hon. Friend to give encouragement to the medical and hospital staff generally, to restore their confidence and to enable them to see a reasonable future ahead.
My hon. Friend could do something else. He could, as an earnest of his good intentions for the future of the hospital, say a word about the need for a new pathology laboratory. The one we have badly needs replacement. Perhaps my hon. Friend will also accept my thanks for the new casualty and out-patient department that has recently come into operation and also for the provision of a new theatre.
If he can give me the assurances I have asked for, I think he will realise that I am trying to take a balanced view—and my constituents, I am sure, will do the same—of the need of the East Coast generally. We need improvements in the East Coast hospital services generally. We are keen that these should be carried out quickly and efficiently. With that in view, we are prepared if necessary to forget our local problems in order to achieve better all-round services.
I am grateful to my hon. Friend the Member for Lowestoft (Mr. Prior) for his kindness in allowing me time to say a few words in the debate which, as he said, affects both his constituency and mine. I also welcome anything that brings the two constituencies closer together. He has a reputation in this House for being most zealous for the people of the area and it is typical of him that he should have started this short debate in this generous way.
I thoroughly support everything he said and underline the question he put about the new Northgate Hospital, the maternity part of which I understand is a special provision to be built first. I understand that it will be ready in a year or two—I am not sure which. I hope that it is the former, because the position is rather serious. When my hon. Friend the Joint Parliamentary Secretary answered a Question I put to him about the number of babies born at home in the County Borough of Great Yarmouth, he said that the percentage was 55 per cent. of live births in 1962. The figure I had was 62 per cent. I am not proud that that figure was greater, although I was assured that it was correct. It was, indeed, alarming because it was the highest percentage in the country.
If a mother wants to have her baby at home then, provided that she is fit, she should be allowed to do so. Nevertheless, I always feel that women are not all the same in these matters. I remember, as a boy in New Zealand, a Maori woman with 11 children. One morning she cooked breakfast for the family, cleaned up the house, had a baby at about 11.30 and then cooked lunch. Not all women are the same, however, and certainly not all could achieve such a miraculous thing.
Perhaps admission to hospital is not necessary for the first birth but I think that it is necessary for births thereafter, if only from the point of view that the mother can then get a little respite from looking after the rest of the family.
It is important to get these facilities not only for Lowestoft but for Great Yarmouth as well and to get them very quickly. According to the statistics, the people of Great Yarmouth are the worst provided for in the country in this respect. I am sure that my hon. Friend the Joint Parliamentary Secretary is doing and will do the best he can.
Another aspect is that of staffing. The nurses do a wonderful jot—and I have had quite close experience of it. What worries me is how we are to get the nurses for these great hospitals which we are building and rebuilding and which we are to build. I wonder whether the Ministry of Health could have a further examination of this subject. My hon. Friend will probably agree with me that it is not basically a question of wages necessarily, although that enters into it when it comes to competition with other wages in the locality, but it is also a question of hours of work—which are very difficult—and facilities.
The facilities for the nurses in some hospitals in the counties are abysmal. The nurses do the best they can with them, but it does not help to attract nurses to the profession if facilities are bad. If facilities were better and if there were more staff so that young nurses did not have to do jobs which they were not competent to do, so that their jobs were not so alarming for them, more nurses might be attracted into the profession.
I end by saying how grateful I am to my hon. Friend the Member for Lowestoft for giving me this opportunity to speak, and I hope and trust that the maternity block in Northgate Hospital will be built very soon.
I should like to compliment my hon. Friend the Member for Lowestoft (Mr. Prior) and my hon. Friend the Member for Yarmouth (Mr. Fell) on the way in which they have put their case. It is not the first time that they have pressed me or my right hon. Friend on the subject of hospital facilities in their area.
The area with which they are concerned is in the easternmost part of the East Anglian hospital region. In this part of the region, much of which is sparsely populated, the main hospital centres are Norwich and Great Yarmouth. This has been so for many years and the main reason is, of course, that Norwich and Great Yarmouth and Lowestoft contain about half the 500,000 or so population of the whole sector. Some increases in population are expected to occur in the years ahead, but although there may be local variations in these increases, the pattern is likely to remain approximately what it now is. The Norwich hospitals serve the general hospital needs of two-thirds of the whole and the Great Yarmouth and Lowestoft hospitals the remaining third.
In this sector of the region, two district general hospitals are needed to serve this population of about 500,000, the several Norwich hospitals acting as one. There is not now, nor is there likely to be in the future, a need for a third such major district centre. What I might describe as the coastal population, centred mainly in Great Yarmouth and Lowestoft, is therefore expected to share one hospital, and our broad planning for the hospital service is on that basis.
The Hospital Plan, published in 1962, foresaw that as major development schemes were completed, they would enable better provision to be made for the work now done at Lowestoft General Hospital, but this was essentially a long-term forecast. Tonight, my hon. Friend the Member for Lowestoft has asked me about the future of the hospital in his town. He will be glad to know that the Regional Hospital Board is not contemplating its closure. In fact, the Board has always considered that there will be a continuing need for substantial hospital facilities in Lowestoft. My hon. Friend will be aware that the Hospital Plan shows his hospital as still having 98 beds in use by about 1975.
Of course, the rôle of the hospital may change: as developments take place elsewhere, and as the new district general hospital develops in Great Yarmouth and begins to provide a full range of services for the people of the area. I can assure my hon. Friend that there is no intention to reduce the actual number of beds in Lowestoft, though there may well be some changes in their use. My hon. Friend has asked me particularly whether the acute beds which will still be available at Lowestoft by 1975 will be used for ordinary surgery. He will appreciate, I know, that not even doctors, let alone laymen, can be sure how particular conditions will be treated 10 years from now, and what will then be the ideal pattern of medical services, since the pace of progress in medical science is very rapid indeed. But I can tell him that when the project team which will be set up to plan the new Northgate Hospital in Great Yarmouth gets down to work, it is bound to take into account the excellent surgical team already operating at Lowestoft. This, I think, is a matter which is best discussed at professional level.
As my hon. Friend has rightly surmised, once the new Northgate Hospital is fully in commission and is equipped to deal with serious illness and major operations, Lowestoft and Yarmouth patients, who at the moment have to go to hospitals in London, Norwich and Cambridge, will be treated much nearer home. It is quite clear that my hon. Friend's constituents will benefit considerably from the developments in Great Yarmouth, and I was glad to hear him say so tonight.
My hon. Friend quite properly raised the question of provision for maternity. As I think he knows, the Regional Hospital Board has carefully considered interim schemes to increase the number of maternity beds at Lowestoft. Unfortunately, it has found no acceptable solution. In view of this, and also because of the need to release the accommodation now occupied by the maternity department at the Great Yarmouth Hospital for use as a gynaecology unit, the Board has decided that the provision of additional maternity beds at Great Yarmouth must be given priority. I can tell my hon. Friends that the Board is considering a scheme at the moment. It has drawn up provisional schedules of accommodation as a basis of discussion and is treating the matter as one of great urgency. I am not able to answer precisely the questions about cost or about the date of completion, but I will watch the situation closely and I will let my hon. Friends have full information on that subject as soon as it is available. Once this scheme is completed, it will greatly ease the pressure in regard to maternity beds in the area.
My hon. Friend has asked whether, when this new maternity provision is made at Great Yarmouth, the six maternity beds at Lowestoft might again become available for general practitioners. I know that this is a matter of some importance to general practitioners in Lowestoft, but it is not one on which I can or should pronounce tonight. It is, I suggest, best discussed at professional level. There are a number of ways in which this might be done, and I would certainly expect it to be done at the appropriate time.
I fully subscribe to what my hon. Friend said about the devoted staff at Lowestoft General Hospital and the services provided there. But, as he knows, it is impossible to expand this hospital. The site is far too cramped. However, it seems certain that the hospital will continue to serve local needs after the new District General Hospital is built at Great Yarmouth, and in this rôle it is expected to have out-patients, casualty, pathology and X-ray departments. It will have more maternity beds and there will be provision for long-stay elderly patients. As I have already indicated, there may well be some surgery.
No one would claim that the present service at Lowestoft is entirely adequate for present-day needs. We are engaged all over the country in endeavouring to improve our hospital services, and a massive programme is under way. This is the reason why we have a hospital plan. Nevertheless, the Board has in the past spent not inconsiderable sums on improving the hospital at Lowestoft. Up to a year ago it had spent more than £35,000, the main items being a new boiler house and plant, air-conditioning for the main operating theatre, and improvements to the X-ray department. In the past 12 months a further £20,000 has been spent, including improvements to the casualty surgery which was brought into use a few weeks ago, and to the new theatre which began operating on Monday of this week.
My hon. Friend has mentioned the inadequacy of the pathology laboratory at Lowestoft. I agree with him about this. It certainly needs attention. I am glad to say that the Regional Hospital Board shares this view and has agreed in principle to carry out improvements which are to be discussed in detail shortly. My hon. Friend will know that there is not a great deal of scope here, because space is limited, but I hope that something can be done to improve the conditions under which valuable work is done.
I know that my hon. Friend has been concerned about the waiting list position at Lowestoft. I agree with him that the figures show rather more patients to be waiting for general surgery, ear, nose and throat and orthopaedic surgery at the end of 1963 than at the end of 1962, but the explanation is simple. Because of the appointment of new consultant staff, local patients who would formerly have had to go to Norwich are now being seen locally. More work is being done at Lowestoft, and it is being done under better conditions. It is true that in some specialties a few more patients are waiting. In gynaecology, where a new consultant has been appointed, more patients have been seen and treated. The picture is not one of stagnation or neglect, but rather one of improving facilities and better use being made of them.
I can well understand the view of my hon. Friend's constituents, many of whom feel that it will be a loss if their main hospital services are developed outside their town. I am sure that on reflection they will realise that there can be only one major district hospital for the two towns. I hope that they will see that it is necessary to take a firm decision as to where the new general hospital for the area must be located. The decision to build it at Great Yarmouth flows from the concept of a district general hospital as outlined in the Hospital Plan. This concept envisages such a hospital as normally containing 600 to 800 beds serving a population of 100,000 to 150,000. Other hospitals might be smaller, though they would rarely be of less than 300 beds. Each of these would be located in or near the middle of one of the centres of population of the area it serves. In practice, priority is bound to be given to the centre which is already serving a greater population, and in this instance, as both my hon. Friends recognise, this centre is Great Yarmouth.
There is a further consideration which is sometimes in danger of being overlooked. It is not always appreciated by laymen that recent years have seen considerable advances in medical science involving considerable changes in methods of diagnosis and treatment, and these advances will continue. Most patients needing in-patient care nowadays require the attention not only of the physician or of the surgeon, but also of other specialists such as radiologists, pathologists and anaesthetists in support who work as a team and require to have at their disposal complicated and costly equipment.
The district general hospital offers the most practical method of placing this full range of hospital facilities at the disposal of patients. My hon. Friend has rightly said to me that the first consideration in these matters must always be what is best for the patient, and viewed in this way I feel sure that it will be seen that what is being planned for this important area of East Anglia is really in the best interests of all who may need hospital care there
My hon. Friend the Member for Yarmouth raised the question of staffing. I entirely agree with what he said. But with the development of better hospital facilities conditions will improve for the staffs. The conditions in the new district general hospitals which are now being completed are superb, and second to none. We hope that they will attract the right kind of staff, in the right numbers. There are local shortages, but generally speaking staffing is running at record figures.
I am glad that my hon. Friends have raised this subject tonight, because it has given me the opportunity of putting this knotty local question into some sort of perspective. I hope, therefore, that what I have said will be of some use not only to my hon. Friends but to their constituents.