Orders of the Day — Scotland (Housing Support Grant)

Part of the debate – in the House of Commons at 12:15 am on 14th January 1980.

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Photo of George Young George Young Parliamentary Under-Secretary (Department of Health and Social Security) 12:15 am, 14th January 1980

I congratulate my hon. Friend the Member for Kidderminster (Mr. Bulmer) on securing this debate. Perhaps some might say that the first Adjournment debate of the new decade is only a minor milestone in the history of the House. What is certain is that for the people of Kidderminster this is a major debate, directed as it is to the future devolpment of their hospital.

I thank my hon. Friend for letting me know in advance some of the topics that he intended to raise. I thank him for making his case so cogently and persuasively. I appreciated in particular his kind words about the staff and I know that they will also appreciate them. There is little dispute about the facts of the case, which my hon. Friend has researched diligently.

It might be helpful if I said a few words about past developments at the Kidderminster hospital and then gave some details of the scheme that will be started shortly, and finally looked a little further into the future.

As my hon. Friend will know, acute hospital provision in the district, which serves a population of about 100,000, of which 90,000 are in Kidderminster, Bewdley and Stourport, is based on the general hospital. This hospital is split on two sites—the larger Bewdley Road branch, of about 270 acute beds, and the Mill Street branch, with out-patient, day hospital and long-stay geriatric facilities. There are additionally two small general practitioner maternity hospitals and a cottage hospital at Tenbury, just over the border with Salop. Future development at Kidderminster is planned for the Bewdley Road branch.

Up to now there have been four recent separate developments at the Bewdley Road branch of the Kidderminster general hospital. Phase 1, which was completed in 1968, consisted of twin operating theatres and X-ray suites, with administrative accommodation, a sterile supply unit and medical stall accommodation. Phase 2 comprised 116 acute beds, with a kitchen and dining room complex, stores, boiler house and workshops. Also included in this phase were nurses' residential accommodation and a training school, which was completed in 1972. Phase 3 comprised a psychiatric department of 60 beds and 80 day places. It was completed in August 1977 and forms part of the Worcester development project which my right hon. Friend is due to open formally later this month. Phase 4 provided a further 64 acute beds in May 1978. The proposals for phase 5 include a three-storey ward block of the design type known as "Nucleus", consisting of 34 children's beds, with assessment and outpatient facilities, 48 geriatric assessment beds and 28 general practitioner maternity beds, with an ante-natal clinic.

There will also be a new telephone exchange and facilities for uniform exchange and staff changing rooms. The ward block is essentially a replacement for an old block, which is structurally unsound and has a limited life, rather than an expansion of existing provision. Its content was the subject of protracted discussions at and between the area and regional health authorities, which were, I understand, resolved to the satisfaction of all parties.

It is hoped that work on this latest scheme, which will cost about £2 million, will start soon and be completed in 1982 or 1983. I think that it can be fairly said that the developments that I have described represent a quite steady rate of progress towards the modernisation of Kidderminster's acute hospital service.

Indeed, when I was told of these developments my reaction was that Kidderminster seemed to have done well as compared with some other parts of the country, although, as my hon. Friend the Member for Kidderminster said, other hospitals in his area may have done even better. But what of further phases at the general hospital? Here, the nub of the problem is whether Kidderminster should have its own consultant obstetric unit.

Perhaps I might at this point digress slightly to describe the difference between a consultant obstetric unit and a general practitioner maternity unit. In the former the expectant mother comes under the care of a consultant obstetrician who works from a particular hospital or hospitals. She may well attend ante- and post-natal clinics run by the obstetrician and his staff, and the delivery of her baby will be supervised by his team, which includes resident medical staff.

Such care is desirable when it is anticipated that the special skills of a consultant obstetrician and full hospital facilities, such as an aesthetic, paediatric and pathology services, are, or might be, needed. Where this is not the case, mothers-to-be may remain in the care of their general practitioner throughout their pregnancy, and the delivery and appropriate hospital facilities are often provided for this. Usually in a general practioner unit there is no resident member of medical staff.

Currently, patients from Kidderminster look to Bromsgrove, Birmingham or Worcester for consultant obstetric services, with the majority going to Bromsgrove. Consultant out-patient clinics are, and will continue to be, provided at Kidderminster, however, and this cuts down quite a bit of the travelling. Many mothers, of course, make use of the general practitioner maternity units at the Croft maternity home in Kidderminster and the Lucy Baldwin maternity hospital in Stourport-on-Severn.

The consultant unit at Bromsgrove is to be transferred to the first phase of the new Bromsgrove and Redditch district general hospital, which is to be built at Woodrow, on the outskirts of Redditch, about six miles further away from Kidderminster. I might say in passing that approval to proceed with the new Bromsgrove and Redditch hospital has recently been given by my Department, although, in view of the consequential changes that I have mentioned, I could well understand if that news was treated with rather less acclaim in Kidderminster than I expect it has been in Redditch. Because where will Kidderminster patients go when the Bromsgrove unit moves?

The Hereford and Worcester area health authority has, I understand, looked at all the possible alternatives and has concluded that consultant obstetric facilities should be provided at Kidderminster, as my hon. Friend said in his speech. It has therefore resolved that a consultant unit should be included in phase 6 of the Kidderminster general hospital development. The AHA also urges that the opening of such a unit should coincide with the transfer of the existing unit at Bromsgrove to Redditch.

The West Midlands regional health authority, which is responsible for major NHS capital developments throughout the region, considered this issue during the preparation of its recently published regional strategic plan, which covers the period up to 1988.

Unfortunately, this is one of a small number of issues that it has been unable to resolve. Apparently, on projected annual births, Kidderminster does not satisfy the RHA's criteria for a separate unit. The RHA is also concerned that the birth rate figures do not justify the appointment of the consultants which it feels is the minimum requirement to provide cover for such a unit, and problems are envisaged over the capacity to train sufficient midwives for units at both Redditch and Kidderminster.