The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege): My Lords, we issued guidance to the NHS in March this year about implementing the revised Patient's Charter. We have carried out a survey into local policies, standards and design of wards. The results will be published shortly.
Lord Stoddart of Swindon: My Lords, I thank the Minister for that Answer. However, is she aware that there is still a great deal of concern about mixed-sex wards, not only among individual patients but also on the part of the Patients Association? Will the Minister tell the House what methods are being used to monitor the elimination of mixed-sex wards? Can she say whether Nightingale wards have now been eliminated? If not, how long will it be before they are? Are separate toilet and washing facilities available? What about new hospitals: does their planning and construction take into account the need for single-sex facilities for everyone who wishes them?
Baroness Cumberlege: My Lords, I am very much aware that people are extremely concerned about mixed-sex wards. Nightingale wards were last built in 1948 and no new ones have been built since then. The present situation is monitored through health authorities and their contracts. We are also monitoring centrally through the survey that I mentioned. Regarding toilet and washing facilities, there is a requirement on trusts to ensure that these are separate.
Baroness Gardner of Parkes: My Lords, is it not a fact, however, that, under new hospital designs going back at least 20 years, there are adequate facilities? Is it not the older hospitals that lack such facilities? Will my noble friend confirm that, although everyone is concerned about mixed-sex wards and most people do not like them, there is a difference between a long-stay ward and a short transit stay in, for instance, a recovery room or in intensive care, where other matters are paramount?
Baroness Cumberlege: Yes, my Lords, my noble friend is correct. There are now "bays" in place which are, in effect, self-contained compartments. They are still described as single wards because there are a number of such bays within one ward. They provide the privacy and dignity that people want, although they are part of a single ward. There are areas, such as intensive care and day surgery, where it is perhaps inappropriate to ensure that the sexes are separated, since the length of stay is likely to be hours rather than days.
Baroness Masham of Ilton: My Lords, will the Minister agree with me that it is unsuitable for a young woman in her 20s to be the only female in a ward with five men? The person to whom I refer was asked if she would go into such a ward and was so frightened that her operation would be put back that she agreed. She said that she hated every single moment. That was at Odstock Hospital, near Salisbury.
Baroness Cumberlege: My Lords, there are occasions when it is not possible to ensure that people have their wish to be in a single-sex ward. The situation is put to them and they can then choose to wait for the next available bed in a single-sex ward. They do not go to the bottom of the list; they are still treated very quickly.
Baroness Jay of Paddington: My Lords, will the Minister agree that, although a minority of patients may feel as she describes, the vast majority are unhappy about this situation? Is she aware that at the recent AGM of the Patients Association that I attended I was surprised to find speakers from different parts of the country referring to new facilities that did not allow for single-sex provision, although I believe it was one of the understandings of the new Patient's Charter? Is it possible for the Department of Health to ensure, through the contracting process, that new facilities offer this choice? If it is not possible, is it not unfortunately another sign of the fragmentation of the NHS about which we on these Benches are so concerned?
Baroness Cumberlege: My Lords, our guidance is quite clear: certainly new facilities should enable dignity and privacy. In that we include bays for single sexes. The guidance is issued. It is up to health authorities, when they let their contracts, to ensure what the position is. However, there are old hospital buildings where it is very difficult to accommodate people's wishes.
Lord Stoddart of Swindon: My Lords, is the Minister aware that, as the questioning continued, I have become more concerned about this issue? It seems that the National Health Service accepts mixed-sex wards as a norm. That, in fact, is completely outside the
Baroness Cumberlege: My Lords, I very much respect the noble Lord's views and accept entirely the contents of the letters that he received. But there is a balance to be maintained. We want people to retain their dignity and have their privacy respected. That is what it says in the Patient's Charter. They are told what the situation is and are allowed to refuse such an admission, in which case they will receive the next admission in an appropriate ward. However, in some hospitals which do not have such accommodation that would mean that the patient would have to move to another hospital. Toilet facilities are different and we are very determined that they should be separated. The other part of the equation is clinical care. In 1992 the Audit Commission's report said that it was more important to have a single specialty ward than a single-sex ward in terms of the delivery of care and the quality of care provided.
Lord Hooson: My Lords, I thank the noble Earl for that reply and note its brevity. I appreciate very much that these days in certain circles the term "integrated" is regarded as a dirty word. Nevertheless, do the Government agree that we need to have special transport strategies to enable us to take the greatest possible economic advantage of the single market? In particular, can the noble Earl say what steps the Government are taking to ensure that not only the south east of England but the whole of the United Kingdom can take advantage of, for example, the Channel Tunnel and the improved facilities in the Channel ports which are the gateway to Europe not only for south-east England but the whole of the United Kingdom?
The Earl of Courtown: My Lords, the Government have a clear transport strategy. One of their main aims is to strike the right balance between healthy economic development, protecting the environment and sustaining future quality of life. However, the Government's role is not to tell transport operators what services to provide or to tell people where and how to travel.
The Earl of Courtown: My Lords, the Fishguard rail link is not represented at present on the draft combined transport network as it is not used for the transport of unitised freight. British Rail believes that there is no immediate prospect of combined transport services being developed on that route.
Lord Cledwyn of Penrhos: My Lords, can the noble Earl say whether this matter has been discussed with the Secretary of State for Wales and the Welsh Office? If it has not been discussed, does he agree that that is an extremely serious situation? There will be a great deal of dissatisfaction in Wales when they hear what the noble Earl has said.
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