I welcome this opportunity to draw Parliament's attention to a matter that is causing great local concern in the Bromley area. I refer to the proposal made by the Bromley health authority to close the Lennard hospital at Bromley common in my constituency and to accommodate the geriatric patients there in hutted wards at Farnborough hospital, the day hospital being relocated at Beckenham. I am pleased to see my hon. Friend and neighbour the Member for Chislehurst (Mr. Sims) present for the debate today. If he is able to catch your eye, Mr. Deputy Speaker, I know that he will want to make a brief contribution.
The history of this matter is that in May this year the Bromley health authority published its district bed strategy for the 10 years from 1983 to 1992. It is worth noting that it was stressed at that time that the document was essentially a discussion paper. It certainly aroused a great deal of discussion.
In my view, the Bromley health authority deserves full credit for presenting its strategy in this helpful and comprehensive way, although I am bound to say that I believe its subsequent actions and decisions may be open to question and criticism. I shall be developing that point during the course of my remarks.
The document set out five possible options for future geriatric care, but in the end the health authority debate on 20 September concentrated on option 2, the consequences of which I have already described to the House, and option 6, which was an additional option, put forward at the meeting, proposing the total transfer of geriatric care from the Lennard to the Beckenham hospital. There was a tied vote between those two options, but, because the chairman understandably wanted to avoid using his casting vote, the debate was allowed to proceed. After further discussion, one member of the authority changed her mind and option 2 was then carried by the narrowest majority. I recount that merely to emphasise that the health authority's decision in this matter was far from unanimous. Indeed, the authority, as I have shown, was almost equally split, and its final decision was taken against the advice of the medical advisory committee.
The measures now being taken by the Bromley health authority under option 2 are described as temporary, to meet an immediate financial crisis. But the fear of many, including the community health council and the Lennard hospital action group, which has wide support in the area, is that once the Lennard hospital is run down — I understand that it is due to close by 23 March of next year —we and, indeed, the Minister will be faced with a fait accompli. I hope that we may be able to have some reassurance about that matter in the course of my hon. Friend's reply today.
The purpose of this debate, therefore, is to alert my hon. Friend to what is happening and to secure more time for fuller consideration of all the implications of the policy on which the Bromley health authority has embarked. I understand that the authority will be initiating the formal consultation process early in the new year, but unless there is some immediate ministerial guidance, I fear that the proposal for the temporary closure of the Lennard hospital will, for all practical purposes, become irrevocable.
I must also report that at its meeting on Monday, the Bromley community health council put forward an alternative solution. As this affects Beckenham hospital, which is not in my constituency, it would be improper for me to discuss the merits or otherwise of its counterproposal in this debate today. However, I think that the community health council's views, together with the various options put forward in the health authority's original document, indicate that there are a number of viable alternatives to the plan that has been adopted. Therefore, I hope that my hon. Friend will look carefully at all of these possibilities before coming to a final conclusion.
The Lennard hospital is situated in my constituency in a pleasant rural setting on the fringe of the green belt, and anyone visiting it gets an impression of space and tranquility. It began life as a fever hospital, but since 1962 it has been used solely as a hospital for the elderly, with its dedicated nursing staff attracting international praise and respect. In 1972, the Lennard hospital introduced a new concept in nursing—the five-day ward—which was funded by the Queen's Institution for Home Nursing and the King Edward Hospital Fund for London. Under this arrangement, patients stay for five days in hospital and then go home at weekends. The average stay is just four weeks. This provision is meeting a real need. My worry is that, under the option 2 proposal, there is, as I understand it, no provision for a replacement for this five-day ward.
Perhaps the most distressing and regrettable feature of the option 2 proposal is the separation of geriatric patients frm the day hospital and the consequent loss of the invaluable interaction between the two.
I recognise that the bed strategy at Bromley must be seen in the context of the redistribution of National Health Service resources—the famous, or perhaps infamous, RAWP formula that decrees a reducing revenue allocation for authorities, such as Bromley, that are deemed to be over-endowed. That policy started a long time ago—it is by no means the responsibility of this Administration —and it is accepted, albeit reluctantly, by most of my constituents. Such a redistribution, however, imposes on us an obligation to make the most sensible and far-sighted use of the resources that we have, and I wonder whether the authority's present proposals for the replacement of the Lennard hospital do that.
Another important factor to be taken into account in hospital planning in Bromley is the present imbalance of hospital provision in the borough. Some 60 per cent. of the population live in the northern part of the borough, but most of the hospital facilities are in the southern part. Indeed, at the Lennard hospital, which is in the south, 72 per cent. of the patients come from the northern part of Bromley. That is clearly inconvenient for the patients and their visiting relatives. I believe that future plans and proposals for hospital provision, geriatric and general, should more closely reflect the population patterns in the borough. In that respect, there is a strong case for an expansion of the acute bed provision at Bromley hospital, but that is another subject and perhaps I shall be seeking another Adjournment debate in due course to explore more fully that aspect of hospital care in the Bromley area.
The Government rightly give high priority to geriatric provision in the NHS. In my view, the establishment of this priority dictates that the proposals of Bromley health authority relating to geriatric provision should be considered with critical care.
In a recent visit to the hospitals in my constituency, I was repeatedly told of geriatric patients occupying acute beds which could otherwise be made available to other patients. That emphasises the continuing need for more geriatric provision and the importance of an expanded provision of part 3 sheltered accommodation, provided by the local authorities or housing associations. Greater emphasis on the provision of this type of housing for the elderly would do more than anything else to release acute beds in our general hospitals and relieve pressure on geriatric beds. At the same time, it would enable the frail elderly to live settled and contented lives in the community. I hope, therefore, that the Minister will consult his colleagues at the Department of the Environment to see what new initiatives can usefully be taken in that important area.
To return to the special problem of the Lennard hospital, I hope that as soon as the formal consultation procedure is initiated, the necessary local comments are obtained and the alternative proposals are submitted by the community health council, my hon. Friend w ill act speedily to resolve our local anxieties. In doing that, I hope that he will give full weight to the points that I have outlined today. I also hope that in reply to the debate he will give an assurance that there is no fait accompli and that the closure of the Lennard hospital will be sanctioned only when a viable and acceptable alternative has emerged. At present, I do not believe that the proposals of the Bromley health authority meet that crucial test.