Skepticism has met the Government’s launch of the ‘largest hospital building programme in a generation’, with fears many of the projects will never go ahead and calls for a more-long-term solution to improving the NHS estate.
Health and Social Care Secretary, Matt Hancock, recently announced a new Health Infrastructure Plan.
At the centre is a new hospital building programme, with £2.8 billion funding for six new large hospitals, with plans to deliver them by 2025.
The trusts involved are: Barts Health NHS Trust; Epsom and St Helier University Hospitals NHS Trust; West Hertfordshire Hospitals NHS Trust; Princess Alexandra Hospital NHS Trust; University Hospitals of Leicester NHS Trust; and Leeds Teaching Hospitals NHS Trust.
A further 21 schemes have also been given the green light, with £100million of the seed funding that they need to develop their business cases and with the aim of delivering between 2025-2030, subject to business case approvals.
Lack of clarity
The Government claims that in total this programme covers more than 40 hospital building projects as some schemes involve the development of more than one hospital site.
However, Richard Murray, chief executive of the health think tank, The King’s Fund, said,
“On the face of it, the Government has pledged a substantial investment. But these piecemeal announcements are not the same as having a proper, multi-year capital funding plan.
“It is unclear how the new schemes have been selected, and how the pledges fit within the Department for Health and Social Care’s overall financial settlement. So it is difficult to tell how generous the Government is being.”
A wider focus required
Maintenance & modernisation
Murray said: “The announcement focuses on new schemes at acute hospitals, but a longer-term investment programme is also needed to tackle the £6billion NHS maintenance backlog, upgrade GP surgeries that are no longer fit for purpose, and modernise the NHS so it can take advantage of new technology. (Particularly given the ambitions of the NHS Long-Term Plan to develop facilities in the community).”
Murray also points out that as well as shoring up buildings, "urgent action is needed to shore up the NHS workforce. Severe staff shortages are the biggest challenge facing the health service, with nearly 100,000 vacancies in NHS trusts.
“If the Government really wants get the best value out of this new capital spending, there needs to be a comprehensive plan to tackle staffing shortages in both the NHS and social care.
Public health & social care
Also vital are plans for future investment in public health spending and social care, to help keep people well for as long as possible and out of hospital when they don’t need to be there.”
Accusations of misleading figures
Dr Tony O’Sullivan, co-chair and retired paediatrician of the Keep Our NHS Public campaign, and secretary and health policy academic, Dr John Lister, state, “34 of the ’40 new hospitals’ announced by Boris Johnson in time for the Conservative Party Conference are, in fact, existing hospitals which are being given only £100m between them for repairs. In fact there is a £6billion deficit in new building, repairs, and equipment.
“Johnson claimed to be 'announcing' 40 hospitals, but only six of the projects are to start now. “The remainder may never happen at all. 21 more schemes, one of which is for up to 12 small community hospitals, will not be funded, or begin, until at least 2025.”
Questions about funding for new schemes
Lister and O’Sullivan warn the capital injection must be set against the current £6billion deficit and the fact that the money has been pledged over five to ten years.
“The 21 schemes that are being deferred are to share a mere £100m ‘seed money’ to begin thinking about the new hospitals in six years’ time. But how are how are these additional projects to be funded?” they add.
“Seed funding is normally followed by seeking the remaining cash from banks and other sources. But, at the end of last year, Philip Hammond announced the Government would sign off no more projects funded through the Private Finance Initiative.
“The new chancellor has declared no new policy. So we are likely to have no money, and no new hospitals.”
These concerns come as The Health Foundation argues that the NHS needs £3billion each year for the next five years to upgrade crumbling buildings and replace outdated equipment.