Oonagh McDonald – 1986 Speech on Orsett Hospital

Below is the text of the speech made by Oonagh McDonald, the then Labour MP for Thurrock, in the House of Commons on 5 March 1986.

I make no apology for talking about the plight of Orsett hospital, which serves the majority of my constituents.

The hospital’s future has been under discussion in the Basildon and Thurrock district health authority area for the past few months. Because so many doubts have been raised about some of the services offered there, my constituents made their views felt by a petition, which 55,000 of them signed. That constitutes almost the whole electorate.

A poll of 500 residents showed unanimous opposition to the removal of any services from Orsett hospital. On 27 February, the district health authority again considered the future of services in the area and proposed this time that all maternity, gynaecological and children’s surgery should go to Basildon hospital, subject to a three-month consultation period.

Before I continue, I want to say that I am deeply concerned about the possibility of any cuts in hospital provision in the Basildon and Thurrock district health authority area. Nevertheless, at the moment it is the future of Orsett hospital which is causing me and my constituents great concern.

Although Orsett hospital is situated in the east end of the borough and is in fact in the Billericay constituency, it largely serves my constituency from the west end of the borough. Although Orsett and Basildon hospitals might appear to be not too far apart geographically, the journey from Basildon, from the west end of my constituenly, is very difficult. Constituents—mothers-to-be—travelling from Grays, Purfleet, Tilbury, West Thurrock, Aveley and South Ockendon, find the journey to Basildon hospital even more difficult than the journey to Orsett hospital. If an ambulance had to bring an emergency patient to the hospital, the additional few miles could cause tremendous problems.

Traffic in the area is very bad and it would be possible for an ambulance to be held up, perhaps a little too long, to the detriment, even death, of a patient.
The hospital has been described as an excellent hospital in which the maternity unit and antenatal care form a good service for my constituents.

About 40 percent. of births in the area take place at Orsett hospital, and it has about 1,700 births per year. I asked the Department of Health and Social Security for figures and found that the number of births at Orsett hospital per year is about average when compared with other maternity units in England and Wales.

The maternity unit at Orsett hospital does not have a special care baby unit, which would be desirable. However, there are about 60 other hospitals with maternity units which do not have special care baby units. If my constituents are to be provided with a full and proper service, not only should the maternity unit remain, but the hospital should be provided with a special care baby unit so that the needs of my constituents can be fully met.

The district health authority has problems of staffing, but it is difficult to be sure what form those problems take. For example, the district health authority suggests that it wishes to phase out a particular grade of specialist in the maternity and gynaecological unit, but when I questioned the Department on that matter, I found that it was not ​ Department policy for that particular grade to be phased out. Staffing problems are indicative of financial problems. Since 1982, the district health authority has had its budget reduced by £2·5 million—5 per cent. Some of that is due to the resource allocation working party formula and some is due to a reduction in efficiency.

Over the period 1984 to 1993 there is a planned reduction for the regional health authority in the long-term resource allocation. All of those cuts will mean not only the disappearance of the maternity unit at Orsett hospital, but the ear, nose and throat, children’s services, pre-convalescent geriatric services, cuts in the family planning service and other general cuts. Those cuts are being made in an area which is growing. At present the need for maternity units at Basildon and Orsett hospitals is based on population figures that are somewhat out of date. In fact, the area is developing pretty rapidly. In Thurrock, my constituency, the number of houses has already increased substantially, and most of them are occupied by young families, many of whom will have children in future years. That feature of the area has been picked up by the local press. For example, the Basildon Evening Echo reported on 28 February:

“Essex, already one of the largest shire counties in the country, will be the centre of another massive population explosion between now and the year 2001.”

The paper goes on to comment that the prospective baby boom is one of the main Problems·worrying county hall officials, and that possibility should be worrying the district health authority more than it appears to be at the moment.

I also wish to refer to the accident and emergency unit. I have, of course, discussed the matter with the district health authority, including the district manager, Mr. Taylor. He has given me assurances that the district health authority has committed itself to two-centre planning for accident and emergency units—one at Basildon and one at Orsett. In my view, those two units are essential not only because of the population, but because of the serious risks from the industry in the area. Thurrock, in particular, is noted for oil refineries, power stations, petrochemicals and the docks, and the M25 and the dualled A13 are extremely busy roads. As I fear we know all too well, traffic on such roads can mean serious injuries in accidents.

Although I have been given assurances, I am extremely concerned about the future of the two units in view of the cuts in the resources of the district health authority. Some of the savings that the district health authority expects to make will come from competitive tendering for cleaning services and so on.

Other savings are supposed to come from increased efficiency. I am sure the Minister knows that, as few services in the Basildon and Thurrock district health authority area have been put out to competitive tendering, the prospective savings from that can be only guessed at, and cannot be regarded as certainties. I do not expect the Minister to admit that, but, on the other hand, the efficiency savings are to be found more on paper than in actuality.

Therefore, I am concerned about the future of those services, in spite of the fact that I believe that the district health authority does not want to see the two accident and emergency units disappear. That point was also covered in the Basildon Evening Echo in some detail on 3 March, just this week.

I referred to the maternity unit, and that of course is my prime concern. It is an efficient and attractive unit. ​ Patients readily turn to it. They value the services provided by Orsett hospital very much, and many of the older residents in Thurrock regard Orsett as their hospital. Let me give the Minister a little history. The original hospital for Thurrock was in Tilbury, in the docks area. It was brought into being by public subscription. Eventually that hospital became out of date and was transferred to a new building at Orsett. The hospital is very much the result of past community effort. Any cuts in services, particularly in maternity services, would be bitterly resented by the whole community.

The Minister and other hon. Members have had experience of dealing with petitions. They will know that the obtaining of 55,000 signatures on a petition in a very short time, without any real effort by the organisers, shows the depth of feeling in the constituency about any threat to the maternity services and the accident and emergency units at Orsett.

The number of live births, 1,771 in 1984, means that the maternity unit is about the same size as other maternity units throughout the country. In regard to the views of the medical profession, Professor Sorors, professor of paediatrics at University College hospital, commenting on a suitable and viable size for a maternity unit, said:

“Not less than 2,000 deliveries a year would be ideal … but it is not practicable, I do not suppose, for every woman in this country to be delivered in a unit of that size.”

The West Midlands regional health authority has said that a minimal work load of 1,500 deliveries per year is acceptable for a maternity unit. The professor suggested that a large unit was ideal, but he recognised that other considerations were important besides the mere number of deliveries per year. The maternity unit must be acceptable and accessible. Patients must be able to reach it easily, should they find that the birth is more imminent than expected, or is risky. If a patient has to be rushed to hospital, the accessibility of the maternity unit is important.

Because of the antenatal care provided at Orsett, a mother has her baby in familiar and friendly surroundings. I have visited the maternity unit more than once for constituency, not personal, reasons. I have also visited the prenatal unit. I was most impressed by the care and concern shown by the staff, by the brightness and friendliness of the surroundings and by the way in which people are treated in the maternity unit.

The maternity unit is a valued part of the community to which the residents feel they have contributed in the past. They are determined that it should remain. If the petition is anything to go by, my constituents will not accept the closure of the maternity unit. They find the journey to Basildon long, difficult and expensive by public transport. They want their familiar and friendly hospital. The medical and financial reasons are not adequate justification for refusing to let the residents of Thurrock have the service that they need and desire.

The present population want the services. Mothers who are moving into my constituency in large numbers want a convenient maternity unit. If the number of births is to be a consideration, the growth of the population will remove that as a justification for closing the maternity unit. To close the maternity unit only to find that the growth in population necessitated its reopening would be a grave error that would cause unnecessary anxiety and suffering. It would simply be a financial mistake.

I hope that the Minister will take account of what I have said and begin the consultation period, which will be completed in May. I know that my constituents are relying on me to present their views tonight, and they will no doubt present their views very forcibly indeed during the consultation period.

We expect the Government to ensure that a good maternity service will remain at Orsett hospital to serve my constituency. We hope that the Basildon and Thurrock district health authority area will not experience cuts and loss of services.