Hospital Building Programme — [Mr Virendra Sharma in the Chair]

– in Westminster Hall at 9:30 am on 3rd November 2021.

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Photo of Virendra Sharma Virendra Sharma Labour, Ealing, Southall 9:30 am, 3rd November 2021

Before we begin, I remind Members that they are expected to wear face coverings. This is in line with current Government guidance and that of the House of Commons Commission. I also remind Members that they are asked by the House to have a covid lateral flow test twice a week if coming on to the parliamentary estate. That can be done either at the testing centre in the House, or at home. Please also give each other and members of staff space when seated, and when entering and leaving the room.

Photo of Kieran Mullan Kieran Mullan Conservative, Crewe and Nantwich

I beg to move,

That this House
has considered the hospital building programme.

It is a pleasure to serve under your chairmanship, Mr Sharma. I welcome the chance to discuss the Government’s £3.7 billion hospital building programme, and particularly welcome the opportunity to make the case to the Minister for my local hospital, Leighton, to be included as one of the final eight sites chosen by the Government.

Leighton Hospital was built in the 1970s, and officially opened by the Queen in 1972. I have looked back at the pictures of her visit, and it made me think about just how long Her Majesty has been serving our nation in this way—visiting, before I was even born, the hospital that serves my constituents today. At that time, Leighton Hospital represented a huge change in how healthcare was provided in the area, going on to pick up the role of several smaller hospitals spread across the patch. Its importance and role have only grown since then, serving a population that has increased significantly and now stands at more than 300,000 people.

Whether it is the hip and knee replacements it carries out, the babies it helps deliver, the thousands of cancer screening tests and treatments it undertakes, the cataracts it repairs, or the urgent GP and accident and emergency care it provides, Leighton is at the heart of our local health services. In an ordinary year, Leighton provides around a quarter of a million out-patient appointments, carries out more than 30,000 operations and more than 200,000 diagnostic imaging tests, and has more than 90,000 visits to its emergency department. Of course, none of that would be possible without its fantastic staff: Leighton employs more than 4,500 staff, and that fantastic team of cleaners, porters, cooks, receptionists, healthcare assistants, physiotherapists, occupational therapists, nurses, doctors, volunteers and many others is what turns a building into a hospital.

Those staff can be proud of their achievements in the battle against covid. Not only have they cared for covid patients, but they have also vaccinated 47,000 people under the leadership of their director of pharmacy, Karen Thomas. I had the absolute pleasure of volunteering alongside the staff during the first lockdown. I was quite uncomfortable with the media attention on me for doing this for only a short period of time, when those staff do it day in, day out without any fuss or attention.

As I have seen again and again during my time working in the NHS, its staff have an enormous amount of dedication, often going above and beyond, and are perhaps too accustomed to working in departments and environments that make doing a really good job more difficult than it should be. That is why, although we are talking about buildings today, it is important to highlight that—as others have said—we will only be able to make the most of new facilities if we are able to carry on with the success we have had so far in recruiting more staff.

Photo of Edward Timpson Edward Timpson Conservative, Eddisbury

My hon. Friend is making a strong case for Leighton, and he will know that, as a former Member for his constituency, I was able to work with that hospital very closely. All four of my children were born at Leighton Hospital, which sits in my constituency, and I also spent a week working in that hospital and cannot praise its staff highly enough. I hope that this building programme will give those staff the environment they deserve in order to provide the healthcare we know they can deliver, which is world class.

Photo of Kieran Mullan Kieran Mullan Conservative, Crewe and Nantwich

My hon. Friend is absolutely right, and what he has said is typical of people who live in the area, who have also experienced their children being born at that hospital and receiving excellent care there.

Photo of Fiona Bruce Fiona Bruce Conservative, Congleton

Speaking as a neighbouring constituency MP whose family has also made great and beneficial use of Leighton over many years, I strongly support my hon. Friend’s campaign for additional resources and support for Leighton. I very much respect him for that effective campaign, which I know has strong support across our constituencies.

My hon. Friend has spoken about the number of people who seek services from Leighton at the present time. Does he agree that that number is not going to diminish: it is going to increase, due to the additional numbers of houses that are being built in our areas? I note, for example, Northwich, where there is a huge amount of house building on the former ICI site, Middlewich in my constituency and Sandbach. Altogether, in recent years, thousands of new houses have been built for people who will want to look for support from Leighton.

Photo of Kieran Mullan Kieran Mullan Conservative, Crewe and Nantwich

My hon. Friend is absolutely right. One of the great things about the plans for the new site is that they take into account those future projected increases in population. I do not know what we will do if the resources are not there to do that.

Going back to staffing, we have more nurses and doctors and more staff overall working in the NHS than ever before, but it remains a huge undertaking for the Government to continue to work on recruitment and retention to staff new facilities. I know a lot of the media and campaigning by Opposition parties has focused on pay. While it is important, my experience is that fixing staff shortages would be the priority for most staff. The obstacles for further recruitment will not simply be solved by higher pay; the challenges are more complicated than that.

Of course, buildings and facilities matter, but we have to remember that the material used to build Leighton was expected to last only 30 years. It might seem odd to us now to create a major public facility with that sort of life span, but that is the reality.

Photo of Mike Amesbury Mike Amesbury Shadow Minister (Housing, Communities and Local Government)

The hon. Gentleman is a neighbouring MP. A reference was made to Northwich in my constituency. This proposal certainly has cross-party support. I support the hon. Gentleman and all Cheshire MPs in arguing this case with the Minister in front of us for much-needed investment in a first-class hospital facility in our patch.

Photo of Kieran Mullan Kieran Mullan Conservative, Crewe and Nantwich

It is great to get cross-party support to demonstrate to the Minister how important it is to all our local communities. I thank the hon. Gentleman for his support.

As I was saying, the building was not designed to last this long or to serve the size of population that it serves. My view is clear that we can be more efficient and do more in the community, but an aging population will have an ever-increasing demand for healthcare. We can delay the need for the most specialist hospital care in a population, but we can almost never remove it and stop the demand increasing overall.

How has Leighton managed this challenge over recent years? Rightly, it has benefited from major investment, as mentioned by my hon. Friend Edward Timpson who is working closely with me on this campaign alongside my hon. Friend Fiona Bruce. I remember his excellent work in helping to secure funding for brand new theatres and a brand new ITU.

My first campaign after becoming the candidate for Crewe and Nantwich was to reverse the decision to turn down a request for an emergency department extension, which was ultimately funded in 2019. More recently, Leighton received £15 million to build a brand-new emergency department. As the Government understand the necessity, Leighton has had funding to tackle the parts of the original building that are simply not fit for use in the short term. However, there comes a point where the costs of one-off investments, accumulated maintenance and the need to replace the original building structures become a cost that cannot be borne by the ordinary capital spending, and when a whole new building becomes the best option financially and for patient care. That is where Leighton is at.

The life span of the original building is coming to an end. I suggest to the Department of Health and Social Care and the Treasury that they view the funding committed to the hospital building programme as a unique opportunity to look at estates that are winding down towards the end of their life span and address that now.

Under the leadership of the chief executive officer, James Sumner, Leighton has done an enormous amount of work for many months to develop its plans for a new hospital. The team sought expert advice on the life span of the current estate and, importantly, the cost of maintaining it and to keep the existing original buildings in use. I know the Minister will scrutinise the figures and see for himself the financial sense in the case that has been made. Independent analysis demonstrates that the ongoing refurbishment of the present failing infrastructure over the next 15 years will cost substantially more than projected new build costs.

Importantly, the plans are ambitious in ensuring better healthcare is delivered in a better environment for patients and staff. As well as providing the mentioned much-needed bed capacity to meet the projected demand later in the decade, the new facilities will deliver single rooms to improve privacy, dignity and infection control. The new layout will incorporate the latest design advice for supporting patients with conditions such as dementia.

The site as a whole will be reorganised some of the long journeys from key locations, such as the emergency department, to other parts of the hospital that have grown as a result of sporadic development to date. They will future proof the hospital with the most up-to-date digital infrastructure which is becoming increasingly important for delivering the best possible care and doing so efficiently. A new site will enable Leighton to play its part in the race to net zero with more energy efficient buildings and solar power and even, potentially, a geothermal heat source, which is a technology I am campaigning for the Government to support to get off the ground across the country.

The team at Leighton have a track record of delivering improved and innovative care to back up their pledges. For example, the trust recently received an award for its same-day emergency care programme, led by surgeons David Corless and Ali Kazem. I am sure that, with improved facilities, they will continue to find new and better ways to care for their patients.

Photo of Edward Timpson Edward Timpson Conservative, Eddisbury

My hon. Friend has been extremely generous with his time. Will he also confirm that this project, if delivered, would save more than £400 million in backlog maintenance, as well as helping to free up a lot of the community care, which at the moment is under extreme pressure because of the lack of beds available at Leighton and in the surrounding area?

Photo of Kieran Mullan Kieran Mullan Conservative, Crewe and Nantwich

My hon. Friend makes an excellent point. This is actually about saving money in the long term given the unavoidable costs at the existing site.

Of course, building the hospital will provide jobs and opportunities for local people, with apprentices at South Cheshire College and others well placed to take advantage in the parts of Crewe where employment and salaries are still not where we would want them to be. I know that the plans have the full support of my hon. Friends for Congleton and for Eddisbury. Leighton’s bid is also supported by both Cheshire West and Cheshire East, as our local authorities, and the Cheshire clinical commissioning group. There is also cross-party support with Mike Amesbury.

The chair of our newly formed Crewe Town Board, Doug Kinsman, has been keen that the whole board support the proposal, and the rest of the board have seen how important Leighton is to Crewe, both economically and in improving the health and wellbeing of Crewe residents. Importantly, we have the support of those residents. So far, more than 1,000 people have signed our petition supporting the hospital in its efforts to make it into the final eight. The residents include Betty Church, whose daughter was born in the hospital the year it opened, 1972, and Steve Burnham, who explained that not only were three members of his family born there, but his mum worked there for 40 years.

I asked residents to tell me about their experiences and share why they were supporting the campaign. Janice Butler wrote:

“My husband, elderly mother-in-law and father-in-law have all received fantastic help and treatment here. The hospital serves a huge population now and help to improve and upgrade its facilities is desperately needed and has been for many years. Despite the huge pressures, we have experienced excellent help here.”

Susan Marsh wrote:

“I started work at Leighton in 1972 and worked there for 35 years. Since retiring I have been a patient there numerous times. It has changed in the care it delivers since my day, both numbers and treatments. With a new build it will be able to continue to grow along with the population in the area, which will be badly needed.”

I will finish with what a current staff member said about Leighton, both as somewhere to work and as somewhere their family received treatment. Sophie Morris has shared her perspective from what must have been a difficult time in her life, which makes her words even more powerful. She wrote:

“I have worked at Leighton A&E for 6 years now and over that time the demand on the hospital has increased massively. Our last few summers have been busier than most winters. Shortly after starting as a nurse in A&E, my husband became ill. We found out he had terminal throat cancer when I was 7 months pregnant. From beginning to end we had fantastic support and care from all over the hospital.

I think it says a lot about the place and the fabric that is the staff who work there, that I could carry on working in a place that holds so many raw memories. As a body of staff we work so hard to look after the people who come to us for help, now we need some help so that we can provide the care that is demanded of us. Now we need some help so that we can provide the care that is demanded of us.”

I could not have put it better myself.

I know that the Minister will hear the case for investment in many other sites. He will need to consider all the applications carefully. I will work with residents to campaign for this much-needed investment, whatever the outcome of this opportunity, but I hope that I have left him in no doubt today that the case for Leighton to be included is a strong one and there is a whole community of people who want to see it succeed.

Photo of Mike Penning Mike Penning Conservative, Hemel Hempstead 9:44 am, 3rd November 2021

It is a pleasure to serve under your chairmanship, Mr Sharma, as was alluded to by my hon. Friend Dr Mullan. This debate is enormously important. Hospitals are often the heart of our communities. The staff in our hospitals, whatever job they do, do a fantastic job, and it is right and proper that we pay tribute to them. But the environment that they work in is also vital to them.

To give a little history lesson from Hemel Hempstead and South West Hertfordshire, which is my part of the world, we had three hospitals—three acute hospitals—until just over 20 years ago when St Albans was closed as an acute hospital. The promise was made at the time that the emergency facility would be picked up by Hemel Hempstead and partly by Watford. That promise was made and then, sadly, Hemel Hempstead was closed—I am not going to get into party politics, but it was by the previous Administration—and we fought tooth and nail, as most constituency MPs would, to save it. Now we have partly elective surgery for non-emergency care at St Albans and I have a clinic—there is no other way I can describe it—at Hemel hospital. Three quarters, if not more, of my hospital is boarded up or vandalised on a site worth hundreds of thousands or millions of pounds.

I was thrilled—absolutely thrilled—when the Prime Minister announced at the general hospital in Watford, which is the only acute hospital we have left in our part of the world, that we were in the top six to get a brand-new hospital. That thrilled us not because we wanted suddenly to bring back our hospital—we understand the restrictions on doing so and what a modern hospital needs to provide for a community—but within hours of the Prime Minister announcing that we were in the top six and that there was the funding, unlike what it sounds as though the management did in my hon. Friend’s constituency, the management ruled out a new hospital on a greenfield site.

As for many of my colleagues, the population in my part of the world on the edge of London is booming. We have a thriving economy, and we have more jobs than we actually have people to fill them, even after the pandemic. The population is growing massively, and I have 20,000 homes coming to my own constituency in the next 15 years. The logic of not building a new hospital on an available greenfield site is confusing to everybody, especially to those who know that Watford hospital is a Victorian hospital next to the Watford Football Club ground in the middle of a Victorian town. All we have been offered is a refurbishment of Watford and a running down even more of the Hemel site.

What fascinates me is that the West Hertfordshire Hospitals NHS Trust seems to be completely unaccountable to the politicians who are giving them the money to look after care in our constituencies. I know that the Health and Care Bill going through Parliament at the moment is going to address that going forwards, but it does not address the historical problem going backwards. The trust spent millions of pounds proving that we cannot have a new hospital on a greenfield site, rather than actually spending some of its consultancy money proving that we could have it on a greenfield site.

My constituents had been campaigning to save the Hemel hospital long before I was around, and there is cross-party support in our part of the world for saying, “Watford is not the right place, and it is not a new hospital. It is a refurbished hospital in completely the wrong place. Please see sense.” I fully understand that Watford constituents are worried they might lose their hospital, but they will not lose it because nothing is going to close until the new one opens. However, we have already lost ours, and the largest town in Hertfordshire has a clinic, with proposals for no intermediate care beds whatsoever and with pathology being taken away as we speak.

The point I want to make to the Minister is that, when we look at the bids that come in, we have to be careful that trusts have done what they were supposed to do, which is to look at the best possible options for the community they are supposed to serve, in the same way that we are serving them, rather than be blindfolded by the situation. In my case, the trust seems fixated with one site in the middle of a town and next to a football stadium, which by anybody’s logic would seem to be ludicrous.

I wish Watford every success—they may well stay up again this season. I am not a Watford fan, although most of my constituents are. I am sad to say I am a Spurs supporter, and that comes with a lot of problems, as we know. However, when Watford play at home, there is a massive knock-on effect on the hospital next door. Believe it or not, but the trust gives up some of its parking spaces to the football club, which is an historical agreement.

I can give an instance of when an ambulance was turned away from the route it would normally take into the hospital because Watford were playing at home. I am not blaming Watford and I am not blaming the police for this; it is just a logistical problem. The ambulance was turned away and sent on a different route as the road was closed because of the home game. I said to the police officer in charge, “If one of your officers had been injured, what would you have done? Would you have allowed that ambulance through?” He said, “Of course, we would have done.” The guy in the back of the ambulance that was trying to get to hospital had had a heart attack; fortunately he survived.

That is the sort of illogical thinking that is going on in some of the trusts, though clearly not in that of my hon. Friend the Member for Crewe and Nantwich. In my trust, its unaccountability to do what is right for the people it serves seems to be blindfolded. I politely ask the Minister, as he knows I have been pushing on this for more years than I can remember, please do not trust the management of my trust to give the full information. We want a new hospital on a greenfield site. I have letters showing that there is £590 million available for that, but not for refurbishment.

Photo of James Wild James Wild Conservative, North West Norfolk 9:50 am, 3rd November 2021

It is a pleasure to serve under your chairmanship, Mr Sharma. I congratulate my hon. Friend Dr Mullan on securing this important debate on the new hospitals building programme. I warmly welcome the Government’s commitment to 48 new hospitals and the funding that was included in the spending review.

My local hospital, the Queen Elizabeth Hospital in King’s Lynn, serves 300,000 people across Norfolk, Cambridgeshire and Lincolnshire, and is in dire need of modernisation. QEH is one of the best-buy hospitals that have proved to be anything but. It is more than a decade beyond its planned life span and has real issues with planks of reinforced autoclaved aerated concrete—RAAC—that are structurally deficient.

The Standing Committee on Structural Safety issued an alert regarding RAAC planks two years ago, having first warned in 1999 of problems with them. That warning came after the collapse of a school roof. As much as 80% of QEH’s decaying and ageing estate is RAAC-planked; it is the most propped hospital in the country, which is nothing to boast about, with more than 200 props supporting the cracking roof in more than 50 areas across the hospital. The trust’s risk register has a red rating, with a direct risk to life and safety of patients, visitors and staff, due to the potential catastrophic failure of the roof structure. The critical care unit had to close for two weeks earlier this year as a result, while mitigation measures were put in place.

Although the trust is managing that risk, and the £20 million provided by the Department of Health and Social Care and the Minister for some of the most immediate issues is very welcome, the funding is but a sticking-plaster for the problem. The Minister knows he has an invitation to come and look at the modular endoscopy unit that is being constructed to allow the decant and fixing of fail-safes. As well as the very real structural issues, the layout of the hospital does not meet modern care pathways. There are too few consulting rooms, there is poor co-location of services and there are wards less than half the size of national guidance. That impacts on both patient experience and infection control.

In short, the hospital needs to be replaced. There is a once in a generation opportunity to fix this and a compelling case for QEH to be one of the new eight schemes for which the Government are currently holding a competition. The Queen Elizabeth Trust has submitted an expression of interest for a single-phase new build that will meet current and future demand, with many thousands of homes planned in the area. The need is strong; QEH covers areas of deprivation, with poor health outcomes, and is in the Government’s priority areas for levelling up.

The plans put forward by the trust will eliminate RAAC from the hospital, but it is not just about replacing defective buildings. It is also an opportunity to transform and modernise local health care, integrating primary, community, mental health, acute, social care and third sectors in a health and wellbeing village. It will also promote sustainability, using modern methods of construction and net-zero principles, incorporating the digital-first approach.

The project is well advanced and highly deliverable, with a strategic outline case well developed. It is backed by 4,000 staff at the hospital, and more than 15,000 people have signed a petition in support. The borough and county councils are on board, the regional NHS and at least seven right hon. and hon. Members whose constituents are served by the Queen Elizabeth. An acute hospital is essential in the area and the plans would deliver major improvements in care, patient outcomes and staff experience. An alternative multi-phased plan has also been submitted, although that would not deliver the same benefits or value for money.

Now is the opportunity to deliver a new hospital and support the trust’s strategy to be rated “good”, then “outstanding”, and to be the best rural district general hospital in the country. The Department of Health and Social Care has already committed to the removal of RAAC from the estate, and its risk will only continue to worsen. By including QEH in the new hospital programme, the inevitable need for replacement will become a funded programme, rather than an unplanned demand repeatedly requiring emergency capital funding. The people of North West Norfolk and beyond deserve nothing less.

Photo of Robbie Moore Robbie Moore Conservative, Keighley 9:55 am, 3rd November 2021

It is a pleasure to serve under your chairmanship, Mr Sharma. I congratulate my hon. Friend Dr Mullan on securing this important debate. I am glad to speak once again in this place about my campaign for a new Airedale hospital in my constituency. I have raised the subject in Westminster and met the Minister on several occasions.

To set the scene about why we need a new, rebuilt Airedale hospital, similarly to the case that has just been made, my hospital suffers immensely from aerated concrete. The hospital opened in the 1970s, construction having started in the 1960s. Although the hospital’s original life expectancy was 30 years, we are now in its 51st year. The 1960s design sadly leaves a huge legacy of structural failings. Some 83% of the hospital is constructed from aerated concrete, which is in the roof, floors and ceilings. In total there are 50,000 aerated concrete panels in the hospital—five times more than any other hospital affected by that issue.

Aerated concrete is not the only unfortunate hangover from 1960s hospital design. The Airedale is also the largest flat-roofed hospital of any NHS asset in the country and, given that my constituency has some of the wettest weather in the UK, that leads to severe leakage. Unfortunately, the Airedale has more recorded leaks than any other hospital in the UK. Since being elected I have made several visits to the hospital, including up to the roof, where I have seen these issues for myself. I have also been shown parts of the hospital that are closed to the public to mitigate the risks from the aerated concrete and the flat roof.

Aerated concrete panels, such as those found in Airedale hospital, are prone to fail when deflections are recorded between 50 mm and 90 mm. More and more panels are constantly getting to this risk deflection. To put it bluntly, if swift action is not taken then the possibility of a collapse within the structure of the Airedale will constantly rise. We only need look back to 2019, when a school roof unfortunately collapsed because it had been constructed from aerated concrete. Such a collapse would be unthinkable, which is why we need to take swift action.

The Airedale trust has informed me that if it were to experience a closure, even a temporary one, then 45,000 referrals to treatment, 60,000 diagnostic tests, including MRI scans and ultrasound therapy treatments, and 2,000 maternity deliveries would be affected. That cannot arise and I cannot stress how important it is that it is avoided. I firmly believe that that can only be done by delivering a new Airedale hospital.

The catchment area for Airedale hospital covers a huge rural area. I have the full support of my right hon. Friend Julian Smith and my hon. Friends the Members for Pendle (Andrew Stephenson) and for Shipley (Philip Davies), all of whose constituents use the Airedale hospital alongside mine. We also have to look at the wider area. The local authority has proposed plans for 3,000 new houses to be built in my area alone, which will add pressure on existing hospital services.

It is fantastic that the Government have announced that there will be a further eight new hospitals, on top of the 40 already announced. I was proud to see that in September the Airedale trust submitted its bid for one of those final places. It is an ambitious bid, detailed and affordable. The plans are convenient, in that they will not disrupt the current workings of the Airedale and are following a fully strategic outlined case.

A full appraisal recommended that the most cost-effective and future-proofed solution would be a new Airedale hospital on the grounds already owned by the trust. Indeed, the trust owns 43 acres of land and can build a new hospital while keeping existing operations until a transfer to the new build. The plans have a strong environmental case and outline the Airedale trust’s vision to be Europe’s first carbon-neutral and fully digitally enabled hospital, with the capability to generate renewable energy on site.

May I once again request a visit to Airedale hospital by my hon. Friend the Minister? I want to raise again the urgency of the case, as I did last week in the main Chamber to the Prime Minister. The Airedale needs and deserves a rebuild, and I will continue to do everything that I can to stand up for my constituents and press the case.

Photo of Jill Mortimer Jill Mortimer Conservative, Hartlepool 10:00 am, 3rd November 2021

It is a pleasure to serve under your chairmanship, Mr Sharma. I thank my hon. Friend Dr Mullan for securing the debate.

The coronavirus pandemic has thrown health inequalities in this country into stark relief. Those living in the poorest constituencies of England and Wales have been twice as likely to die from the virus as those in more prosperous constituencies. Figures from the Office for National Statistics covering March to May 2020 show that those living in the poorest 10% of England, which includes my constituency of Hartlepool, died at a rate of 128.3 per 100,000, whereas in the wealthiest 10% the rate was 58.8 per 100,000.

Any death in any part of the country is a tragedy, but such grotesque levels of health inequality cannot be allowed to continue in the world’s fifth-richest country. That is why I fully support the bid by the North Tees and Hartlepool NHS Foundation Trust for a new hospital by 2030 to replace the current North Tees hospital in Stockton—another hospital crumbling with concrete cancer that has outlived its life span, and facing huge remedial costs.

The replacement hospital must be built in an equitable location for all residents north of the Tees, and I have a site available in my constituency—one of the most deprived areas of the UK, where health inequalities have been most apparent. The number of people suffering from a range of health problems is consistently higher in Hartlepool than the England average. Those include cancer, depression, asthma, obesity, heart disease and high blood pressure. As a result, life expectancy in Hartlepool is significantly and regrettably below the national average. If the Government are serious about tackling health inequality in the UK, they must start in Hartlepool.

Despite the sheer scale of deprivation and health inequality in my constituency, healthcare services in Hartlepool have not been expanding over the past decade, but shrinking. My constituents are often required to travel to the currently crumbling North Tees hospital in Stockton for urgent or specialist treatment. For example, owing to the lack of a doctor-led maternity ward in Hartlepool, mothers-to-be in my constituency must travel 20 miles in labour to the nearest hospital if there are potential complications, which, sadly, commonly occur with the prevailing underlying health conditions in my community. During the birth of their baby, mothers have to undertake that terrible journey to a hospital that is crumbling. A child’s first experience of this world should not be health inequality.

I appreciate that the coronavirus pandemic has placed unprecedented pressures on healthcare services in this country and I welcome the record levels of investment that the Government are injecting into the NHS to tackle waiting lists and treatment backlogs, but I fear that will not be enough to reverse decades of neglect and indifference on the part of my predecessors. Only a new hospital can do that. Levelling up must mean more than simple investment in transport and general infrastructure. Levelling up life expectancy across the country should be a priority. Plans must be put in place now to abolish health inequality in the UK and to ensure that our ability to live a good and decent life is not determined by an arbitrary postcode lottery.

Photo of Maria Miller Maria Miller Conservative, Basingstoke 10:04 am, 3rd November 2021

It is a pleasure to see you in the Chair today, Mr Sharma. I congratulate my hon. Friend Dr Mullan on securing the debate. He is absolutely right to say that our hospitals are the centre of our communities. That is absolutely the case in my constituency of Basingstoke. Of course, care is provided by our doctors, our nurses and all the staff involved in running the hospital, but it is also one of my largest local employers. I congratulate the Minister, who I am pleased to see still in his place, on all the work he is doing to ensure that the Government’s commitments to build 40 new hospitals by 2030, the other eight previously committed to and upgrades to more than 70 hospitals, are being progressed as fast as they can be.

My hospital is a similar age to that of my hon. Friend the Member for Crewe and Nantwich. Like his, Basingstoke and North Hampshire Hospital was built to last 30 years, back in the 1970s. The backlog of maintenance reflects the fact that it should have been replaced many years ago. Hampshire Hospitals NHS Foundation Trust, an excellent trust that serves my community, was already well advanced with plans for a new hospital when the Government also identified that the current hospital needed replacing and included it in the renewal programme.

Basingstoke hospital has served our community extremely well since the 1970s, but the buildings are reaching the end of their useful life, for many of the reasons that Members have gone through. Those buildings were not built to last any longer. Furthermore, estimates show that the population that is served by the Hampshire Hospitals NHS Foundation Trust will increase by around 23% between 2018 and 2050. Unlike many areas of the country, Basingstoke has continued to build houses not just for the last two decades but for the last four decades. We have grown extraordinarily as a town over that time, served by the same hospital. Our population is therefore rapidly ageing, with all the implications that brings for our health services. Our over-75s population in Hampshire will have increased by a shocking 35% between 2017 and 2024. I should not be surprised about that, given the level of house building.

So many of the people who moved to Basingstoke when it rapidly expanded in the 1960s and 1970s are reaching an age where they are much more reliant on the health services available. The Government need to make sure that they follow through not only on more recent commitments to building houses, particularly in the south-east, but on the commitments that date back many decades, when people were encouraged from London out to places such as Basingstoke. That is an ageing population, and the Government need to ensure that the right facilities are in place for that much bigger population.

I am fortunate in Basingstoke that all the organisations involved in planning for the new hospital are working together in exemplary fashion, through an organisation that has been formed called Hampshire Together, which is all about modernising our hospitals and health services. That organisation firmly welcomed the Prime Minister’s announcements in October that all NHS trusts that receive seed funding to develop a business case for a new hospital project as part of phase 2 of the health infrastructure plan 2 programme, including Hampshire Hospitals NHS Foundation Trust, will be fully funded to deliver those by 2030.

The trust was especially pleased to note that Hampshire Together had been earmarked for inclusion in first group of HIP2 projects due for completion. The trust’s plans are well-developed with a preferred site, which the Minister already knows a little about, at junction 7 on the M3, which has been identified by the ambulance services as the best location to save more lives, providing acute care for hundreds of thousands of people living in the rapidly expanding communities in north and mid Hampshire. The planning authorities of Basingstoke and Deane Borough Council and Hampshire County Council are working actively and positively together, and Hampshire hospitals have been working to put together their business case and have forwarded their cases to the Department. They are very much looking forward to putting those cases out to public consultation as soon as possible.

Because our house building has been so rapid in Basingstoke throughout the 50 years that our hospital has been in existence, there is a need for a new hospital now. We would value a commitment from the Minister on the timelines and the next round of seed funding, so that we can continue to develop the business case and will be able to start building from 2025. I also renew my offer for the Minister to visit Basingstoke to see the site that we have already earmarked for the construction of the hospital. It is a greenfield site, so that residents’ enjoyment of the hospital facilities will not be disrupted during the building process.

Photo of Justin Madders Justin Madders Shadow Minister (Health and Social Care) 10:10 am, 3rd November 2021

It is a pleasure to see you in the Chair, Mr Sharma. I congratulate Dr Mullan on securing the debate. As a fellow Cheshire Member, our paths will no doubt cross as we get involved in the megalithic integrated care system that covers our area, and it is good to see healthy representation from Cheshire Members, which shows the interest and passion that we have for improved health services in our area. He mentioned that he volunteered to use his medical skills on the frontline during the pandemic, and we thank him for his efforts, just as we thank everyone who contributed to the fight against covid, be it in the NHS, in social care or in any of the other many sectors that played their part. We recognise and value the commitment that was made by so many people over such a long period of time.

As the hon. Member for Crewe and Nantwich set out, hospitals are more than the buildings themselves. It is the staff who make hospitals, and he brought that to the fore in his comments. He said that the site of Leighton Hospital has exceeded its original lifespan—I think it is as old as I am, which is a concern. Hopefully, I will not be up for a rebuild any time soon. It was a common theme of contributions to the debate that a lot of the buildings in Members’ constituencies have reached the end of their natural lifespans. It would be useful to hear from the Minister whether any assessment has been made of how many hospital buildings, and buildings across the wider NHS, have already exceeded their original lifespans. The hon. Gentleman made a compelling case for why a new hospital needs to be built in Crewe, and he mentioned that the local population has grown considerably.

Photo of Mike Amesbury Mike Amesbury Shadow Minister (Housing, Communities and Local Government)

I thank my hon. Friend and constituency neighbour for giving way. Of course, Leighton Hospital is part of the Mid Cheshire Hospitals NHS Foundation Trust, which also includes Victoria Infirmary in Northwich. This would be a real opportunity to capture investment across the campuses, which serve a number of our constituents, and I would certainly welcome my hon. Friend’s support on that. As a Cheshire MP, it would certainly be very welcome indeed.

Photo of Justin Madders Justin Madders Shadow Minister (Health and Social Care)

My hon. Friend probably needs to direct his pleas to the Minister more than me—at this stage, of course—but I would be delighted to visit the facility with him. I am sure that he will make a strong case for investment, as other Members have done. There is an issue with how the interplay works between some of the competing bids for what is obviously a very competitive process, which I will return to later. Like Edward Timpson, my hon. Friend Mike Amesbury has shown that there is cross-party support for the case for a new hospital that was made by the hon. Member for Crewe and Nantwich, who also set out why this is good for patients. He talked about some of the issues around privacy, dignity and infection control, and he said that a new build gives us an opportunity to invest in modern digital infrastructure. Of course, he also mentioned important stuff to do with COP26 and the energy efficiency of a new build. Those were all well-made points.

We also heard from Sir Mike Penning, who made a persuasive and passionate case as to why the current plans need to be reconsidered. He made a very interesting point about the accountability of trusts. He is probably not aware that the Minister and I have been debating this issue in Committee for a number of weeks, and it is fair to say that we have differing views as to how accountable the current system is and whether it will actually change at all when the Health and Care Bill receives Royal Assent. There is an issue with how large trusts have their own priorities, which are not necessarily in tune with the rest of the wider population and healthcare system.

James Wild made a very strong case for the Queen Elizabeth Hospital in King’s Lynn; he highlighted the critical nature of the maintenance issues there, which are clearly having an effect on patient care now. The Minister will not be surprised to know that I will be referring to the maintenance backlog during my comments today. The hon. Member also set out very well how new builds can not only improve infection control, but enhance the patient experience. We should always remember that the patient journey is central to these things. A new hospital always has to have the interests of patients, and their perspective, at the heart of its plans.

Robbie Moore made a strong case for why a new hospital is needed in Airedale. Again, it is a building that is past its original lifespan; it has critical infrastructure issues. Describing it as the “leakiest hospital is the UK” is not something the hon. Member will want to repeat for much longer. It shows again that many of these issues have been building up for some time.

I was very interested in what Jill Mortimer said about health inequalities; it was an important point, and perhaps a broader one than some of the others that have been made. She is absolutely right that the pandemic has shone a light on the existing health inequalities in this country. I agree that if we are serious about levelling up, reducing health inequalities has to be central to any policy.

Mrs Miller made a compelling case about how investment is needed for her new hospital, and how the change and growth in local population has created additional demand. It is an important point that, because of the way that her town has built up, there is more demand from an increasingly ageing population.

All the Members have made very good cases today; if it was based on the commitment and passion of individual Members, the Minister’s job would be quite straightforward. However, I know there will be many other demands on the departmental budget. There is a serious point here. We need to have transparency on the criteria that will be applied when the decisions are made. It would be fair to say, if we look at levelling-up bids, there has been some consternation that the decisions are not always made on the merits of the case. It is important that the Department is crystal clear on why particular projects are getting the go-ahead, and why others may have to wait a little longer.

I am sure that the Minister would be disappointed if I did not make a reference to whether the Prime Minister’s claim to be building 48 new hospitals is in fact an accurate one. We take with a large pinch of salt the definitions from the Department’s playbook that the following count as a new hospital: they say this includes

“a new wing of an existing hospital (provided it contains a whole clinical service, such as maternity or children’s services).”

They also say this includes

“A major refurbishment and alteration of all but the building frame or main structure, delivering a significant extension to useful life which includes major or visible changes to the external structure.”

That may well be investment in buildings—which is of course welcome—but it stretches credibility to say that those are new hospitals. I will not repeat the whole debate again on whether those descriptions can be classed as new hospitals, except to say that the Minister will no doubt rely on his VAT notices to reach that figure of 48: we will rely on the good sense of the British public to judge whether a new hospital is indeed a new hospital. When we get to 2030, we will see how many new hospitals we actually have—although it is possible that both the Minister and I will have moved on by that point.

Let us return to the present day, move away from the headlines and the spin, and ask some specific questions about the programme. I will start with the cost issue. It is my understanding that the projects identified in phase 1 have been promised a total of £2.7 billion, although some reports suggest that a £400 million price cap is being applied to each scheme, even though some of the published plans for those schemes have exceeded that limit already. Could the Minister comment on whether there is in fact an upper cash limit on particular projects, and whether it is indeed £400 million?

Almost exactly a month ago, the Prime Minister made an announcement on round 2 of the health infrastructure plan, in which, incidentally, only three out of the 25 hospitals are in the whole of the north of England. I think that says something about the Government’s commitment to levelling up and bolsters the case made by the hon. Member for Crewe and Nantwich to push forward for a new building in Crewe. Could the Minister advise what period and how much of the total programme the £3.7 billion mentioned in that announcement covers? Could the Minister also advise if the £4.2 billion, announced in the spending review last week in relation to new hospitals, is the same money as the Prime Minister announced on 2 October or is in addition to that? If it is additional, what period does that £4.2 billion cover? We want a little clarity on how much has actually been allocated and the period that it covers. I am sure the Minister realises that, even if we add up all those figures, it would not be the total cost of all those projects moving forward to 2030.

We have had three separate announcements over the last year. I make that point because the foreword to the health infrastructure plan talks about ending the “piecemeal and uncoordinated approach”. We have an investment plan spanning a decade, but the necessary investment has been announced for only the first half of that decade, at best, to come out in dribs and drabs. I suggest that the Minister might need to read the foreword to the plan again to see whether the ambitions set out there are being met.

NHS Providers has said that the actual cost of the planned building projects would be around £20 billion, most of which will need to be found in the next few years. Even building an average-sized new hospital costs around £500 million, which rather puts the spotlight on the supposed £400 million cost limit I referred to earlier. I wonder if the Minister could put a total cost—

Photo of Mike Penning Mike Penning Conservative, Hemel Hempstead

I think we have to be slightly careful when referring to costs such as that £500 million. Built into that is inflation, because of the way the Green Book works, because of the risk. I had to deal with this on the roads programme as roads Minister: what happens is that a figure is set out, but it is not the same as the actual cost of the build project. That is probably where some of that cost anomaly comes from. The Treasury Green Book insists on inflation of that price when the build price is much lower; in my case, £500 million was £420 million in the Birmingham build. We have to be careful of trusts that do not want to do that; for example, my trust—the West Hertfordshire Hospitals trust—inflates the cost into £600 million because it does not want to do it.

Photo of Justin Madders Justin Madders Shadow Minister (Health and Social Care)

I will reflect on the right hon. Gentleman’s comments. That leads on to another point I wanted to raise with the Minister: we are aware that the economy is currently in something of a flux in a whole range of sectors, in terms of finding the right people and the right skills, and construction is not immune to that. Do the plans include any wiggle room to take account of the fact that the cost of labour and materials is unfortunately going up quite rapidly at the moment?

NHS Providers said that

“there are still significant questions on whether the NHS will be able to meet the government's manifesto pledge to upgrade 70 hospitals and build 40 new ones given the lack of clear, long term, funding commitments beyond 2024/25.”

It also said that it awaits

“confirmation of the money that will be available to providers to tackle the £9.2bn maintenance backlog that has built up.”

The Minister will know that that has shot up in recent years, leading to cancelled operations and a 23% increase in treatments being delayed or cancelled in the last year because of infrastructure failures, and yet we are hearing very little on what is being done about that. I think the hon. Member for Eddisbury mentioned something in the region of £400 million being identified as the maintenance backlog costs at Leighton Hospital alone. We have also heard from other Members on infrastructure issues causing difficulties in their own trusts.

These problems are not new; they are the result of a decade of underfunding on both capital and revenue, with the Health Foundation reporting that

“the UK is investing significantly less in health care capital as a share of GDP compared with most other similar European countries.”

Of course, we have also seen frequent revenue raids on capital in the last few years. If these plans are to be successful, those raids must stop. I hope the Minister will be able to guarantee that there will be no revenue raids on capital for this programme in the next decade. I would also be grateful if he could set out the Department’s plan to tackle the maintenance backlog.

A few moments ago, I mentioned the interplay between large infrastructure projects and other capital requirements at a system level, particularly around how we get capital investment into primary and community care. Taking my own patch, Ellesmere Port, which I know best, we have several GP premises in the town centre that are past their best—past their useful life, perhaps—they are not really suitable in these covid-conscious times. We are not short of more modern, available premises in the town centre, where there might even be greater potential for integration with other services

However, these projects take time and money, and some decision must be taken at a system level to prioritise them. I think that would be an important step forward for improving access in my community and dealing with some of the health inequalities we have talked about. I recognise that sometimes it is a fact of life that the bigger players—the acute trusts—will always be higher profile than individual practices for attracting funds and investment. In many ways, this is an echo of the debate that the Minister and I have had in recent weeks on the Health and Care Bill Committee. I mention it again because, particularly with capital investment, there is a danger that primary and community services will struggle to have their voices heard against some of the bigger players in an extremely large integrated care system.

I will end with a few comments from stakeholders regarding the Chancellor’s statement last week. The King’s Fund said that

“the real game changer would have been clear funding for a workforce plan. Chronic workforce shortages across the health and care system heap further pressure on overstretched staff who are exhausted from the pandemic. Yet despite pledges, promises and manifesto commitments, the government has failed to use this Spending Review to answer the question of how it will chart a path out of the staffing crisis by setting out the funding for a multi-year workforce strategy.”

The Health Foundation said that

“new money for technology and buildings, although vital, is of limited value without additional staff. A workforce plan backed by investment in training are critical and we await details of both so that the NHS’s recovery can be secured.”

The Nuffield Trust said:

“It is striking that there is a lack of strategic workforce investment alongside this boost in funding for facilities. Staffing is recognised as the number one issue for the sustainability of the health service. Recovery from the pandemic not only rests on investment but on hard-working staff as well.”

Finally, the NHS Confederation said that

“to ensure the extra money delivers for the public, a strong and supported NHS workforce is needed. This is why training and increasing the supply of doctors, nurses and other health and care professionals is so important at a time when public polling recognizes that staffing is the biggest problem facing the NHS.”

While we welcome the investment in new buildings, we hope that none end up being a white elephant, because the elephant in the room is that we could find ourselves in the remarkable position by 2030 that brand new hospitals, extensions, or refurbishments are delivered, but are not fully operational because of a failure over the preceding decade to tackle the workforce crisis. That is here and now, and it needs to be tackled in the short, medium and long term. That is the final plea I make to the Minister: these investments are welcome, but we must ensure that we have a plan so that these buildings are fully staffed when they are up and running.

Photo of Virendra Sharma Virendra Sharma Labour, Ealing, Southall

Before I ask the Minister to contribute, I will just say that I will be joining that long queue very soon to lobby for Ealing Hospital’s future, but not this morning.

Photo of Edward Argar Edward Argar Minister of State (Department of Health and Social Care) 10:29 am, 3rd November 2021

I am very grateful to you, Mr Sharma; that was a deft and adept use of the Chair. It is a genuine pleasure to serve under your chairmanship.

I pay particular attention and pay tribute to my hon. Friend Dr Mullan for securing this debate. The case that he makes for Leighton Hospital has cross-party support, as we have seen, including from Mike Amesbury and, indeed, from the shadow Minister, Justin Madders. This has been a cross-party and very well-tempered debate, and as ever I am grateful to the shadow Minister for the tenor and tone of his comments. We have spent the past couple of months sitting opposite each other in a Bill Committee, which reported yesterday. Clearly, so shocked were we at the prospect of not continuing to sit opposite each other, here we are in Westminster Hall this morning.

I am also grateful to my right hon. Friend Mrs Miller for her kind words in highlighting the fact that I am still in this role. In the same vein, I should say that the hon. Member for Ellesmere Port and Neston is still in his role, having served as shadow Minister even longer than I have served in my role. There is some value in that, because too often in this place we see a very rapid churn of Ministers and shadow Ministers. Issues such as those we are grappling with today need, by their very nature, a long-term view and a long-term understanding.

I join the shadow Minister in paying tribute to my hon. Friend the Member for Crewe and Nantwich, not only for introducing this debate but for his work on the frontline. He was typically humble about that work, but his contribution was significant and he should be proud of it. He quite rightly paid tribute to all of those in our health and care system, as we all should—and should continue to do—for the work that they have done; not only the work they have done throughout the pandemic, which has been incredibly challenging, but the work they do every day, year in and year out, on the frontline to help to keep our constituents safe.

My hon. Friend is absolutely right about the importance of the topic that we are debating today. Buildings are hugely important. They give our clinicians, our frontline staff and our ancillary staff the context or the environment in which they can do their best. Therapeutics, research, new diagnostic kit, technology: all these things are hugely important because, as the shadow Minister alluded to, they allow the beating heart of our NHS—the workforce; the people—to do their job, and who, for want of a better way of putting it, make the magic happen in those environments. It is incumbent on us to give them that environment and these tools, so that they can do their best.

Various right hon. and hon. Members have highlighted the context in which we approach this debate. Many areas are undergoing significant development, growth in housing and increases in demand. There are demographic changes, with ageing populations in some areas needing increased hospital facilities.

Coupled with that, the context was set out again by many right hon. and hon. Members, particularly my hon. Friend Robbie Moore, who spoke about the state of the estate, for want of a better way of putting it. There are hospitals that have, in a sense, served for far longer than they were designed to serve. They have been kept going, but that poses challenges, not just with reinforced autoclaved aerated concrete, or RAAC, planks, which I will turn to in a moment, but operationally with the task of running them, given the day-to-day choices that clinicians and managers have to make to put fixes in place, so that they can continue to provide services.

The shadow Minister asked several questions. I will address one or two of them now, then come on to the others later. He talked about the workforce, whom I have just mentioned. I say to him that the number of doctors is up, the number of nurses is up, and the number of radiographers and radiologists is up since 2010. We have continued to grow our NHS workforce. Do we need to continue to do more to do that? Of course we do. That is why the Government are committed to, for example, the 50,000 more nurses that was a manifesto commitment, and we are on course to deliver that by the end of this Parliament.

We need to be conscious, and I know that the shadow Minister is, that as we talk, for example, about elective recovery and getting waiting lists and waiting times down, we need to be honest with our electors and the British public that that is a huge job that will take time. That is because the workforce who will deliver those things are the same workforce who have been through the pandemic, and they need time to recover, emotionally and physically, from what they have had to do over the past year and a half. Often, we hear some commentators saying, “Ah, yes, but some were in the ICU wards, or in A&E, and a lot of others wouldn’t have been on the frontline.” Well, the reality is that, for example, surgeons who may not have been operating on their usual lists will have gone back to the wards to assist their colleagues, and we know that a team is needed to perform surgery. The anaesthetists will certainly have been working flat out during the pandemic, as will the theatre nurses, so we need to ensure, as we deliver our recovery plan for the NHS, that we give the workforce the support they need to recover.

Let me turn to the specifics of the programme. My hon. Friends the Members for Crewe and Nantwich, for Congleton (Fiona Bruce) and for Eddisbury (Edward Timpson), and the hon. Member for Weaver Vale all made, as one would expect, a passionate, well-informed and cogent case for investment in a new hospital at Leighton. My hon. Friend the Member for Crewe and Nantwich will not be surprised when I say that the expressions of interest period has closed. The expressions of interest are all being considered carefully and a decision will be made next spring on the long list to whittle them down, with further work to determine the final eight. I therefore hope that he will allow me not to be drawn on the specifics of the merits or otherwise of his case while that process is under way, but as ever he makes a strong and powerful case on behalf of his constituents.

In the context of the next eight, the shadow Minister asked about criteria and how the process would take place. That is set out and published on the programme website, but the key considerations are these. Does a scheme or proposal have the potential significantly to transform and improve the quality and quantity of care available to a community? Is there a safety or other pressing need that has to be addressed in the system? Equally, we will be looking to achieve a degree of geographical spread to ensure equity and fairness—levelling up. With any of these schemes, as hon. Members would expect, we will look at whether the proposals are clear and can be delivered on budget, and whether there is the capacity and capability to deliver on them.

Photo of Mike Amesbury Mike Amesbury Shadow Minister (Housing, Communities and Local Government)

One such scheme, for which I and my hon. Friends the Members for Warrington North (Charlotte Nichols) and for Halton (Derek Twigg) and Andy Carter have been campaigning, is two campuses for Warrington and Halton trust. They seem to meet those criteria, so I look forward to an assessment and conclusion in the not too distant future.

Photo of Edward Argar Edward Argar Minister of State (Department of Health and Social Care)

I am grateful to the hon. Gentleman, who quite rightly never misses an opportunity to champion his constituents’ interests.

Hon. Members will be aware that the interest around the country is significant. A significant number of expressions of interest have been submitted, so whittling them down will be a competitive and challenging process, but we undertake to be as clear and transparent about that as we can be. I suspect that, when the final list is announced, if I do not come to the House with a statement, the shadow Minister may well UQ me, to give colleagues an opportunity to say they are very pleased or to ask why their hospital is not on the list.

Let me turn to points made by other hon. and right hon. Members. My right hon. Friend Sir Mike Penning will not be surprised that I will not be drawn on the specifics of the internal politics and the plans for his trust at this point. However, he quite rightly made the extremely important point that when trusts develop their plans and bring them forward, they need to carry the communities they serve with them and genuinely reflect on stakeholder input from elected Members and others, rather than—I am not saying that this is or is not the case with this trust—automatically having a preconceived idea of what the right answer is.

Photo of Mike Penning Mike Penning Conservative, Hemel Hempstead

The Minister might not be willing to say that my trust has preconceived the decisions it was going to make; I will, because it made its mind up long before the latest announcement. However, we are in a slightly different position from other colleagues here. We are in HIP 1—part 1 of the health infrastructure plan—and we do not want that money to be wasted. We do not want a sticking plaster; we do not want a refurbishment in the middle of Watford. The community in my part of the world is absolutely solid on that, and if that meant that we slipped out of HIP 1 into HIP 2—I will put my neck on the block—I would be happy with that, as long as we get the right facility on a greenfield site, rather than the wrong facility as a refurbishment in the middle of Watford next to a football ground.

Photo of Edward Argar Edward Argar Minister of State (Department of Health and Social Care)

I did not regret giving way to my right hon. Friend quite as much as I feared I might, although he may yet come back to me. As ever, he makes his point powerfully and clearly, and I suspect that, as well as my having heard it, his trust will also have heard it.

As the shadow Minister said, my hon. Friend Jill Mortimer made broader points, in addition to points about her local hospital and trust, about health inequalities and the role that the right infrastructure and staff—the right people in the right place—can play in tackling that. I have to pay tribute to her. Within a day of her arriving in this place following her fantastic by-election victory, she had pinned me down so she could come and see me and talk about Hartlepool and health services there. Her constituents are extremely lucky to have her. She hit the ground running and has not stopped working since on behalf of her constituents.

My right hon. Friend the Member for Basingstoke and I, as she alluded to, have spoken a number of times about her trust. How can I not accept her kind offer of going to the site and seeing her in her constituency? I have known her for a long time, so it is a pleasure to say yes. I would like to go there and do that, then perhaps we can discuss the plans further. She and I have met on several occasions. She is a great champion for the new hospital in her area, so I am grateful for the invitation.

My hon. Friend the Member for Keighley—I almost said “my hon. Friend the Member for Airedale”, given the frequency with which, he raises and champions in the House at every opportunity the need for a new hospital at Airedale—is right to highlight the challenges that his trust faces, as he has done on many occasions, particularly in the context not only of the needs of his population, the challenges of an old building that has long exceeded its intended lifetime, but also the RAAC plank issue. I know that his trust is keen to be one of the eight. I will only say to him, I am afraid, what I said to my hon. Friend the Member for Crewe and Nantwich, which is that the bids will be considered very carefully. I know that he will continue making the case, as he has done in the past.

Photo of Edward Argar Edward Argar Minister of State (Department of Health and Social Care)

I will give way briefly to my hon. Friend, then I will turn to the contribution of my hon. Friend James Wild.

Photo of Robbie Moore Robbie Moore Conservative, Keighley

Can the Minister clarify how the final eight will be decided and will structural risk profile be a key consideration?

Photo of Edward Argar Edward Argar Minister of State (Department of Health and Social Care)

My hon. Friend, quite wisely, presses his advantage. I can give him some reassurance on that, as I did to the shadow Minister when talking about the criteria, that safety and risk will not be the only criterion, but that will be a key factor in the consideration.

I turn now to the contribution of my hon. Friend the Member for North West Norfolk. The other day in the Chamber, I inadvertently paid tribute to my hon. Friend Duncan Baker for the work being done by my hon. Friend the Member for North West Norfolk in one of my responses. I pay tribute to my hon. Friend for North West Norfolk, who has quite rightly raised with me on several occasions the Queen Elizabeth Hospital King’s Lynn and the challenges posed by RAAC planks there. I know he is campaigning both in Parliament and locally on that issue. Courtesy of him, I have met his trust in the past and we have provided more than £20 million in this financial year for critical risk remediation. I know that, quite understandably, my hon. Friend is saying very clearly that that is welcome and will help, but it will not solve the problem. He will continue to press the case for a new hospital. He, too, has kindly invited me to his constituency, so I think I am due to go on tour around the country at some point, visiting various hospitals and colleagues.

Turning to some of the broader underlying themes that have emerged in the debate, I will seek to answer some of the questions posed by the shadow Minister. He gently tempted me on definitions. I am clear that the definitions we have—the three key elements he alluded to—not only pass the common-sense test and the understanding of what the reasonable person in the street would consider a new hospital. Equally, he teased me gently about VAT notice 708. I mentioned that at the Dispatch Box because—he says that we should be transparent and have a logical reason for how we define, do and choose things—our starting point was that there can be a VAT exemption for new builds, but not necessarily for refurbishment. I took that as a starting point for developing the common-sense definition. A lot of what he sees in the definitions is reflected in the same one used there, so there is consistency.

The shadow Minister talked about skills and inflation and whether we will have the people to build the hospitals. He is right to do that, because, as we have seen following the bounce back after the pandemic, builders and construction firms are very much in demand. There is pressure on materials as well, not just inflationary pressure, but on quantities. That is one of the reasons why, even before the impact of the pandemic, this is a phased programme. These hospitals will be built over a period of years up to 2030, allowing for market capacity.

Equally, one of the reasons why we have set out this long-term plan is so that we can make the market aware of what our plans are. If there is certainty in the market that the hospitals will be coming through, we will see firms investing, because they know there is potential for long-term business and work for them. That is one of the ways in which we have helped to handle that.

The shadow Minister asked about funding, and what would be available for what period. He will be aware of the initial £3.7 billion that has been allocated to this project, which takes us to 2024. Future funding will be subject to future spending reviews for that period. Between the 2024 period and 2030 there will be a general election at some point, and I suspect that may play a part in the spending review as well. We have the funding up front to get going with this programme, and off the top of my head, I think we already have eight hospitals in construction. The Cumberland Cancer Hospital has already been opened by my right hon. Friend the Health Secretary. Over this period, we will continue to start further construction of new hospitals.

The shadow Minister also alluded to geography and the distribution of the hospitals. Off the top of my head, 30 of the 40 are outside London and the south east, so we have sought to achieve geographical spread for the new hospitals and, equally, will seek to do that with the new eight. He also asked about the quantum needed for a new hospital, and he had a particular figure in mind. If he looks at the list of 40, many of them are very different hospitals, from the major acute district general hospital to a community hospital with in-patient beds; it is clearly a new hospital. The costs vary in the nature of what is built, its scale and size.

The shadow Minister also asked whether there would be a cap and whether trusts have complete freedom. No—as he would expect, there is a balance is to be struck between delivering what a trust wants for its plans and the need for financial prudence and recognition of the need to safeguard taxpayers’ money; it is not a limitless amount. Conversations are going on between the national team and local projects to ensure that their schemes are affordable and not hugely over budget. That is a pragmatic, ongoing process.

The shadow Minister also touched on some of the criteria for the scheme and how we are making the national scheme work. We include in this modular build modern methods of construction. We have a national set of standards for what we would expect from a new hospital, but a degree of local flexibility for the delivery of that. We recognise that each trust is slightly different, but we want to standardise where we can, because that keeps costs down and provides certainty in the market and speeds up construction. We have also built into our plans, since they were originally announced, even more ambitious green targets and energy efficiency targets for those trusts.

Photo of Justin Madders Justin Madders Shadow Minister (Health and Social Care)

I am grateful to the Minister for giving way. He has made a valiant attempt to answer all my questions.

Photo of Edward Argar Edward Argar Minister of State (Department of Health and Social Care)

I thought the hon. Gentleman would lob another one at me.

Photo of Justin Madders Justin Madders Shadow Minister (Health and Social Care)

No, but there is one that the Minister has overlooked, on the sum announced in the spending review last week. Was that additional money on top of what had been previously announced?

Photo of Edward Argar Edward Argar Minister of State (Department of Health and Social Care)

I omitted to mention two things to the shadow Minister: the spending review and backlog maintenance—he always avails himself of the opportunity to gently raise that issue. We have seen a confirmation of the money already in place for the new hospital programme, but we have also seen further moneys announced for capital in the spending review—new money—for example, just over £5 billion for community diagnostic centres, surgical hubs and the IT infrastructure around that. We have therefore seen a reconfirmation of money, plus new money in the capital space.

I turn now to maintenance, which the shadow Minister rightly always highlights. He will know—he occasionally quotes it at me at the Dispatch Box—that backlog maintenance across the entire estate is around £9 billion-worth. That is pretty constant from the previous financial year; it has not particularly increased. It may have gone up by a tiny fraction, but it has remained broadly constant.

Photo of Edward Argar Edward Argar Minister of State (Department of Health and Social Care)

Let me just finish this point before I take interventions from my right hon. Friend the Member for Basingstoke and then the hon. Member for Weaver Vale.

Our investment in new hospitals will also significantly reduce the backlog maintenance, because it will take out of the total a number of hospitals, some of which have been mentioned, that are being propped up day after day, with money being spent just to patch up and mend.

Photo of Maria Miller Maria Miller Conservative, Basingstoke

I thank the Minister for agreeing to come to our new preferred site in Basingstoke—we will be grateful for that—and for his comment about backlog maintenance. I think Basingstoke is in the top three in the country for backlog maintenance.

May I press the Minister on the timelines of the next round of seed funding to develop business cases and to be able to start building our new hospital in 2025? Clarity on some of these timelines is essential not only for our communities but for the people developing the plans, because they need to know what will happen next and have clarity on that.

Photo of Edward Argar Edward Argar Minister of State (Department of Health and Social Care)

I am grateful to my right hon. Friend, and I entirely understand her call for clarity. Each case is being looked at on an individual basis, in the allocation of the £3.7 billion. The senior responsible officer of the new hospitals programme, Natalie Forrest, is in regular discussion with each trust, but business cases, more funding to develop business cases, and movement from outline business cases to final business cases are done on a case-by-case basis by trusts. It is not the case that every one must submit them by a fixed time.

Photo of Edward Argar Edward Argar Minister of State (Department of Health and Social Care)

Let me take the hon. Member for Weaver Vale first, because I promised him that I would give way. I also want to leave a few minutes at the end for my hon. Friend the Member for Crewe and Nantwich to wind up.

Photo of Mike Amesbury Mike Amesbury Shadow Minister (Housing, Communities and Local Government)

On the point about maintenance, several hospital buildings built in the 1970s have used Grenfell-style aluminium composite material cladding and high pressure laminate, so I assume that is part of the assessment criteria. Some have roof systems that are in a critical state.

Photo of Edward Argar Edward Argar Minister of State (Department of Health and Social Care)

I am grateful to the hon. Gentleman, who raises a couple of points. Yes, roofs are a factor. In some cases—my hon. Friend the Member for Keighley talked about Airedale—there is a flat roof, which is vulnerable to heat and water, and aerated concrete planks, which is extremely challenging.

The hon. Gentleman mentioned cladding. I might be slightly out, but from memory I think that there are no hospitals with cladding in need of remediation. We put a programme in place following the Grenfell findings. Off the top of my head, I think every hospital trust has either had it removed or been assessed by the fire brigade as not having a risk. If I am wrong about that, I will of course write to him to correct the record.

Photo of Mike Penning Mike Penning Conservative, Hemel Hempstead

On the point the Minister has just made, Natalie Forrest has taken on her new role. I notice that the Minister said she has been in communication with the trusts, but she has not been in communication with the MPs who have emailed her and asked her to respond to them, including me. My hospital action group and I met her predecessor and had very fruitful discussions, and Natalie Forrest would be very welcome to have a discussion with me.

Photo of Edward Argar Edward Argar Minister of State (Department of Health and Social Care)

I am grateful to my right hon. Friend. Understandably, the approach we take with right hon. and hon. Members is that correspondence is replied to by Ministers. Occasionally it is a little belated, but that is the conduit for responses.

On meetings with senior officials, I am always happy to facilitate that. Normally, the approach is that I would attend as the Minister in order to reflect the respect that I have for right hon. and hon. Members—and I suspect that he may be about to ask me whether I will therefore do that.

Photo of Mike Penning Mike Penning Conservative, Hemel Hempstead

The Minister is being very generous in giving way again. Yes, that would be great. However, I did meet Natalie Forrest’s predecessor without a Minister present, and I just want an email back to say, “I acknowledge you.” That might be quite nice.

Photo of Edward Argar Edward Argar Minister of State (Department of Health and Social Care)

I suspect that the Department will have heard my right hon. Friend’s point.

Photo of Edward Argar Edward Argar Minister of State (Department of Health and Social Care)

Very briefly, because I want to leave some time for my hon. Friend the Member for Crewe and Nantwich.

Photo of Maria Miller Maria Miller Conservative, Basingstoke

This is really important. What the Minister has just said is that no part of the process should be held up because certain projects might be ahead of others. Therefore, the public consultation that stands ready to go live in Basingstoke should not be delayed for any reason other than hopefully getting ministerial approval.

Photo of Edward Argar Edward Argar Minister of State (Department of Health and Social Care)

I take the point, and I think I understand where my right hon. Friend is coming from on this. I said that business cases will be considered on their own merits, but of course there has to be phasing of different trusts at different times and different phases of this programme, because of the profiling of that funding. Only £3.7 billion has been committed so far, with more to come in further spending reviews, so if every trust came forward and said, “We are ready”—as my right hon. Friend knows, many will do so, although I suspect she would say that her trust is genuinely ready compared with some others—we could not commit to every one of those, because we have to look at the financial profiling that the Treasury has given us about when that money becomes available. That is the point. I hope she will forgive me if I did not understand what she was getting at in the first instance, but I hope that is of some help.

I will conclude, in order to leave my hon. Friend the Member for Crewe and Nantwich a little time to wind up. As a Government, we are proud that we have committed to arguably the largest and most ambitious new hospital building programme in decades, with initial moneys of £3.7 billion put in place to get that programme going. Eight of those new hospitals are in construction and one is completed, and we look forward to delivering on that commitment in full by 2030.

Photo of Kieran Mullan Kieran Mullan Conservative, Crewe and Nantwich 10:56 am, 3rd November 2021

I thank the Minister and the Opposition spokesperson, Justin Madders, for the time they have taken to listen to us all in Westminster Hall today. I particularly thank the Minister for his openness and frankness in discussing this issue. I am sure that, as Members, we all understand why he cannot commit today to the various programmes we have put forward.

I particularly thank my hon. Friends the Members for Eddisbury (Edward Timpson) and for Congleton (Fiona Bruce), who have worked very closely with me on pushing forward this campaign for Leighton Hospital. I also thank Mike Amesbury for showing cross-party support for Leighton. The contribution from my right hon. Friend Sir Mike Penning reminded us all of what a unique role an MP plays in their constituency, having that individual voice on behalf of their constituents. My hon. Friends the Members for North West Norfolk (James Wild), for Hartlepool (Jill Mortimer) and for Keighley (Robbie Moore) and my right hon. Friend Mrs Miller all spoke powerfully and passionately about their commitment to their local hospital and the investment they are seeking.

There were a couple of common themes that I want to pick out, the first of which was about house building and population growth, which touches on work I have been doing in my constituency to address the postcode lottery when it comes to the voice of the NHS in the planning system. Very often, schools’ education provision is supported by housing development, but it is not very often that our local hospitals are supported financially by developers. Those developers have a role to play, and I encourage the Minister to look at what more he could do centrally to spread best practice. I have been doing that locally, but we need that central drive to make sure that hospital developments, mental health and primary care get the money they deserve where there is new housing.

We are all facing a similar challenge when it comes to the shelf life, so to speak, of our hospital buildings. There is no shame in that—when things are built, they have a timeline—but it is very important that the Minister makes sure that for those of us who may end up disappointed, particularly in relation to the RAAC plank issue, the Government have a clear and strong story about how they are going to tackle that issue and what investment will be put in place, regardless of which hospitals make it into the final round of the hospital building programme. I will finish by inviting the Minister to Leighton Hospital, if he does not mind,

Photo of Edward Argar Edward Argar Minister of State (Department of Health and Social Care)

What is one more visit on a tour? I am delighted to accept; it would be a pleasure.

Photo of Kieran Mullan Kieran Mullan Conservative, Crewe and Nantwich

I look forward to seeing him there with my hon. Friends the Members for Eddisbury and for Congleton. I thank the Minister for his time, and thank you, Mr Sharma, for chairing proceedings today.

Question put and agreed to.

Resolved,

That this House
has considered the hospital building programme.