John McWilliam – 1986 Speech on Normans Riding Hospital in Gateshead

Below is the text of the speech made by John McWilliam, the then Labour MP for Blaydon, in the House of Commons on 7 February 1986.

First, may I thank the Minister for Health for the fair and interesting hearing that the hon. Member for Wycombe (Mr. Whitney) gave to the deputation from Gateshead that came to discuss the closure of the Normans Riding hospital. The Under-Secretary of State took on board several points. Unfortunately, he did not take on board all the points of concern. The Minister for Health wrote to me on 22 January informing me that the hospital was to close. He said that he had concluded

“that the interests of patients were best served by allowing the proposed closure to proceed. I am satisfied that by closing the hospital, significant financial savings will be achieved with no reduction in the services provided.”

That is the point on which I take issue.

In September 1985 the National Health Service health advisory service and the DHSS social services inspectorate reported on services for the elderly provided by the Gateshead health authority and the social services department of the borough of Gateshead. The report raises several problems and difficulties that do not confirm the Minister’s view that he kindly set out in his letter to me. Although not directly related to the closure, but related to the cause of the closure, paragraph 5 states:

“Despite the fact that Gateshead is a deprived District the Regional Health Authority’s budgetary distribution does not, in the short term, improve the situation in that the 1985–86 allocation leaves the District even further from target.”

Gateshead spends only 92 per cent. of what, even by the Government’s standards, should be spent on health. Gateshead was specifically mentioned in the Black report. We have severe problems of social deprivation and unemployment and the general difficulties of an area without major teaching hospitals. However, my constituency has a further problem, because it has a large number of former coal miners who worked in one of the dustiest coalfields in Britain. Consequently, the number of those with bronchial and other complaints associated with working with coal is markedly higher than it is in other areas. The fact that we have only 92 per cent. of the resources that we should have can only exacerbate the problems, because people are not getting the health care that they require.

Normans Riding hospital is largely a geriatric hospital. There are 10 general practitioner beds that deliberately have never been used as such. In the report, the general practitioners’ view on the provision of geriatric services is as follows:

“All but one of the general practitioners met expressed concern about difficulties in achieving admission to hospital of elderly people with sub-acute illness compounded by sociological and psychological overtones that precluded continued care at home. In such cases, a domiciliary consultation was virtually a precondition of direct admission to a geriatric bed and then usually via a waiting list.”

It is still via a waiting list.

The community health councils view of the proposed closure of Normans Riding hospital is,

“that there was considerable under-provision for the elderly in Gateshead with a fear that the needs upon which the Health Authority plans were based did not match the needs in the community: there was deep concern about the closure of Normans Riding hospital.”

That is true. Those needs do not match the needs in the community.

The decision of the district health authority is based on an assumption about the local authority provision, especially part III provision, that can be made. I have consulted the leader of Gateshead authority, the chairman of social work and the deputy chairman of social work. Their problem is that if the local authority increased expenditure to provide the part III provision that is needed to alleviate the problem, although it would not solve it completely, the local authority would inevitably incur penalty under the rate support grant scheme. The DHSS has not taken sufficiently into account the restraints which the Department of the Environment has placed on that local authority.

If we are to do something effective about care for the elderly in Gateshead, the two Departments must come together, and one of them—presumably the Department of the Environment—must admit that the allocation of rate support grant to Gateshead and the grant-related expenditure assessment for social work in Gateshead will have to be increased to meet what the district health authority expects the local authority to provide, because it clearly cannot be provided now.

The Minister’s officials also stated:

“The hospital service relies heavily on the practice of ‘swapping’ to gain admission to Part III beds. The present allocation system, with no health service input, reinforces this practice which medical have used to gain what they see as a fair proportion of beds for their patients. Between 4 January and 17 May 1985, 35 beds were allocated to the hospitals … of which 20 were ‘swapped’ with existing hospital patients.”

It is clear from cases that I have taken up in my constituency that, even in semi-acute cases, people cannot obtain geriatric beds unless something else is seriously wrong with them or unless arrangements can be made with the local authority.

The report continues:

“The Health Authority have proposals for the closure of the Normans Riding Hospital. In this situation it is inappropriate to dwell on the structural problems observed. However, the toilets and sluices on most wards are most unsatisfactory for elderly patients.”

They are, but it would be fairly inexpensive to bring those toilets and sluices up to standard. What is more, it would be a fairly inexpensive. job to sort out the structural problems in Normans Riding hospital, because they are not fundamental problems, but problems of construction begun at a time when people were working in a hurry because a war was about to break out. There would not appear to be too great a difficulty. The advice given by the Minister’s officials is:

“If patients are to be accommodated at the Normans Riding Hospital for any length of time, it is imperative that”

the sluices be brought up to date.

The suggestion is that those patients should be transferred to Dunston Hill hospital, which is also in my constituency and which I visited on Monday. I have every regard for the dedication and skill of the people who work an that hospital and for what they are trying to do in difficult conditions, but the advice of the Minister’s officials is this:

“The Health Authority should not transfer patients from Whinney House, Normans Riding and St. Mary’s Hospitals to Dunston Hill Hospital until accommodation of a satisfactory standard is available for each group of patients. Application to the Regional Health Authority for special funding to ensure this work is carried out should be considered.”

Within the last month, the northern group of Labour Members met the chairman of the regional health authority. Although helpful, he could not give the kind of commitment that we want. It will cost £400,000 to bring the wards at Dunston Hill to the standards suggested. If Normans Riding is left in place that expenditure will not be needed.

Two aspects of this annoy me particularly. First, the decision to close Normans Riding was taken on the casting vote of the chairman of the district health authority who is appointed and paid by the Minister. Secondly, I believe that we need both Normans Riding and the upgraded Dunston Hill to meet the needs of our elderly. The assumptions being made about the ability of the local authority to cope appropriately with the problems faced by elderly people in my constituency and in the rest of Gateshead will not be fulfilled unless that provision is made.

The decision to close Normans Riding was a mistake. It is an excellent hospital with special expertise nationally in the care of the terminally ill. I am very upset indeed that the Minister has decided to close that hospital on the casting vote of his paid chairman and against the wishes of the community and the GPs when all the evidence shows that insufficient provision has been made and when it is perfectly clear that £400,000 will have to be spent to provide an alternative.

Finally, Normans Riding is the only purpose-built isolation hospital on Tyneside. It is not connected to the main sewerage system, it has its own kitchens, and so on. I should not like to think of a situation arising in which we would need those isolation facilities, but if we get rid of Normans Riding we shall never again have a facility which — God help us — may at some time be needed. The alternative — the Queen Elizabeth hospital — is in the most densely populated part of the borough and is clearly not appropriate for the provision of isolation facilities in an emergency.