I congratulate my hon. Friend the Member for Belper (Mrs. Faith) on raising this important issue. I thank her for allowing me to support her. We are aware—I know that the Minister is—that the Trent area has been the Cinderella in the national allocation of funds. The matter has been raised several times in the House in recent years. We now have an understanding that the Government are allocating increasing amounts to put that situation right over forthcoming years.
It is not a deprivation of cash that has created this crisis. Increases in VAT have added to pressures on the budget. Pay increases resulting from the strikes of last winter and the subsequent inflation have added to the considerable pressures. But that is not an adequate excuse for what is happening to health provision for patients in Derbyshire.
It is not only Etwall that is affected. In my constituency, Draycott hospital is being temporarily closed. I understand that it is to be a 15-months'closure. I wonder what is the definition of "temporary" when we are talking in terms of 15 months. The real cause of the trouble is that the area health authority has not provided early enough for the inevitability of tighter budgeting.
It has continued overspending. It has not done enough to improve its efficiency, cut out waste and top-heavy administration. I should like to put some questions to which I hope the Minister can address herself or make subsequent inquiries.
What administrative savings have been made by the area health authority over the past year since it became aware that pressures were building up on the budget? What could be saved by better hospital management—I am referring not simply to management but to administration in the hospitals—if a real economy drive were undertaken? I found the answer, as anyone could find it, by speaking to nurses and staff in hospitals. All can point to areas of waste in the daily administration of hospitals.
Thirdly, why is it that the Draycott hospital is fully staffed, yet half the beds are empty? This is another post-operational hospital, just like Etwall, which could have been reducing the pressure on Derbyshire hospitals, where there are long waiting lists. Yet Draycott hospital has been starved of patients who must be waiting.
Fourthly, I think that we are entitled to know why, at the Draycott hospital—I cannot speak for others—in recent months there has been a considerable amount of capital expenditure of a maintenance and repair nature that was not essential but has been carried out. The area health authority must have been aware that the budget was tight and that other hospitals were about to be temporarily closed. Why, during that time, was expenditure of an unnecessary and inessential kind continued? I maintain, and the area health authority has admitted, that the financial crisis, as it describes it now, was anticipated. If so, why were precautionary measures not taken earlier to cut some of the spending?
Fifthly, why were the community health councils not consulted properly and their constructive advice taken on how economies could have been made to avoid these closures?
Sixthly, why has no effort been made to use more voluntary support? The league of friends of the Draycott hospital—an excellent organisation—would have been prepared, and still is prepared, to provide more support rather than see the hospital close.
Finally, if the pay awards of last winter resulted in budget excesses—which they have done—why have there not been more reductions in the service staff rather than a closing of the hospital beds?
Until these questions are satisfactorily answered, the suspicion must remain that the area health authority has mismanaged its finances and is now, in an unnecessary and unacceptable way, depriving Derbyshire of services and taking it out on patients. This is not good enough. I hope that the Minister will call in the area health authority to account for its present position.