Hospitals

Wednesday 23rd April 2025 Commons Chamber

[Mr Speaker]

I inform the House that I have selected the amendment in the name of the Prime Minister.

12:49

[Helen Morgan (North Shropshire) (LD)]

I beg to move,

That this House regrets the appalling state of repair of NHS hospitals across the country; notes that the NHS maintenance backlog rose to £13.8 billion in 2023-24; further notes the sustained pattern of cannibalising NHS capital budgets to keep day-to-day services running; condemns the previous Government’s record of starved repair budgets and exploding maintenance backlogs, which made sewage leaks, cracked walls, crumbling ceilings and sinking floors commonplace; further condemns the previous Government for launching the New Hospital Programme with no realistic plan to fund or deliver it; further regrets that almost half of the selected hospitals are now not set to begin construction until after 2030; calls on the Government to reverse the delay to the New Hospital Programme and create a crumbling hospitals taskforce to bring construction dates forward; and further calls on the Government to end the vicious cycle of false economies and rising repair backlogs by putting hospitals across the country on a path towards sustainable funding.

The appalling state of our hospital buildings is a national scandal. Everybody in this country should be in control of their own lives and health, which means everybody getting the care they need when and where they need it, but that can never be realised while so many patients are treating in grossly inadequate settings. From Shropshire to Cornwall, Cambridgeshire, Watford and Devon, patients are losing their dignity because of decisions taken by the Conservatives, and the Labour Government’s failure to rectify them.

The Conservatives’ record is one of starved repair budgets, serious leaks, crumbling ceilings and bucket-strewn wards. It is an outrage that millions of people are waiting for treatment, yet overcrowded hospitals have had to close operating theatres because they are no longer fit for use. Patients and hospital staff deserve the dignity of safe, modern and clean environments, but instead the previous Government shamefully chose to raid the repair budget to plug the gap in day-to-day costs, as our hospitals fell apart, and the new Government, who were elected on what increasingly looks like false hope, are pursuing a false economy in delaying the desperately needed new hospital programme.

As with so much of their agenda, the Government promised so much but are delivering so little and betraying those who put their faith in the Labour party. Farmers who were fed up with the Tories taking them for granted have been hit with a tax grab on their families’ futures. Employers, who were promised growth and no new taxes, have been whacked with a national insurance increase. Patients, who were promised new hospitals, have had them taken away.

[Andy Slaughter (Hammersmith and Chiswick) (Lab)]

I was with the hon. Lady almost up until that point. I congratulate her on opening the debate. It is absolutely true that the new hospital programme did not deliver new hospitals and was unfunded under the Tories. However, it is being funded now under Labour. Money is being invested in my local hospitals, in the Imperial College Healthcare NHS trust, and it is preparing for major rebuilds. Will she perhaps give the new Government a little credit for what they have done, and correctly identify the shambles that we were left with?

[Helen Morgan]

The hon. Member will be aware that there were not 40 new hospitals—they were not all hospitals and there were not 40 of them. The issue here is that the start dates for work on many hospitals that need urgent rebuilding have been pushed back into the 2030s, long beyond the life of this Parliament. The people who are served by those hospitals were promised new facilities and have not had them. That is devastating for those communities.

If the Conservative approach was contemptible, Labour’s approach has been to procrastinate. The cost to the NHS of papering over the cracks and keeping hospitals running past their natural lifespan is enormous. That is why the Government must reverse the delay to the new hospital programme at once and urgently deliver the new hospitals that patients have long been promised.

[Mark Ferguson (Gateshead Central and Whickham) (Lab)]

I wonder if the hon. Member can explain to me how spending £22 billion extra on the national health service this year can in any way be described as procrastination.

[Helen Morgan]

It is important to recognise that the additional investment in the NHS amounts to about £10 billion a year—according to Office for Budget Responsibility numbers, which I am sure the hon. Gentleman has looked at—because of the cost of national insurance hikes and of compensating other public sector employers for those hikes. The £22 billion figure is somewhat misleading. The point that we are making is that it is a false economy to keep those buildings going, to keep repairing a crumbling estate, to keep patching up and putting a sticking plaster on those problems. Those buildings need to be demolished and rebuilt, so that approach is a false economy. It would be much better to build new buildings up front and save on future repair costs. We need to ensure that no one is treated in broken, uncomfortable and unsafe facilities. Repairing and replacing crumbling, substandard hospitals is not only vital for delivering better care and treating-more patients, but crucial for rebuilding the economy after years of Conservative economic vandalism.

How much would all this cost? In my county of Shropshire, the cost of the maintenance backlog across all sites has reached about £75 million. I am sure that everyone here would agree that £75 million is a lot of money—indeed, it is so much that it is the total amount of Government capital investment for hospices this year—but in terms of hospital maintenance it is a drop in the ocean. Torbay hospital needs more than £50 million to clear the backlog, Watford hospital has a backlog of £63 million, and Hull royal infirmary requires an eye-watering £70 million. Across England, the figure is a colossal £13.8 billion—and that is just to bring our existing hospital estate to the minimum standard.

[Josh Fenton-Glynn (Calder Valley) (Lab)]

The hon. Member is right that a huge amount of money needs to be spent. A lot of that goes back to the fact that, as Lord Darzi tells us, £37 billion less was spent on hospital buildings in the 2010s than was necessary. Will she remind me who was in government for the for half of the 2010s?

[Helen Morgan]

The hon. Gentleman will be aware that, when one comes into government and has to clean up the mess left behind by the previous Government, one has to make difficult choices. It is the job of the Opposition to point out where they would make those choices or take different options. We would invest to save money in the long run, rather than fritter money away on a repair bill for buildings that need to be demolished. It is not sensible to pour good money after bad when the right thing to do is invest in a new fit-for-purpose and modern estate that does not have endless and extortionate maintenance requirements.

[Several hon. Members rose—]

[Helen Morgan]

I will make some progress.

At North Devon district hospital, the ducting of the ventilation system that serves the operating theatres has not been changed since it was installed in 1979, and cannot be replaced because of ceiling height and asbestos. As a result, all operating theatres have been non-compliant with NHS England buildings guidance since 2007. The good people of Devon clearly need a new hospital, and they were promised that they would have one by 2030, only for the Labour Government to take it away and decide that the change those people need will not be delivered for another decade.

Even hospitals with comparatively few maintenance problems, such as the Royal Shrewsbury hospital, which serves my constituents and has a £35 million backlog, are clearly a long way short of being up to standard. I will not go into detail again about the catalogue of issues in Shropshire—the ambulance delays and station closures, the waiting times for check-ups, scans and surgeries, or the substandard state of cancer care—but they all combine to put huge pressure on hospitals, where staff and buildings are straining under the load.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady and the Liberal Democrats for securing this debate. One issue that they have not mentioned in their motion is car parking at hospitals, which is an ongoing problem for disabled people and patients who miss or delay their appointments as a result of a lack of spaces. Does she agree that car parking is central to addressing the issues that she is setting out?

[Helen Morgan]

Car parking is a real problem, particularly where public transport is poor—it plagues my constituents—and when it is unrealistically expensive for people who need to use hospital facilities. I thank the hon. Member for that point.

The NHS crisis impacts on patient outcomes. My constituent Emma was left in the “fit to sit” area for 48 hours despite having been diagnosed with suspected sepsis, 96-year-old Mary waited outside in an ambulance for 11 hours, and 82-year-old Paula spent 24 hours on a trolley in a corridor. That is the reality in hospitals up and down the country. I think we all agree that that is a disgrace and it must be rectified.

[Ben Coleman (Chelsea and Fulham) (Lab)]

Will the hon. Lady give way?

[Helen Morgan]

I will make some progress.

One of the main reasons those problems have not been rectified is successive delays from successive Governments. Shropshire is, again, a prime example. This is not related to the new hospital programme, but none the less, £312 million was granted for the hospital transformation programme in Shropshire back in 2018. Seven years later, while the country has been through five Prime Ministers and eight different Health Secretaries, Shropshire is still waiting for that transformation to take place. Opposition from both the Labour and Conservative councils that serve the area, along with the ridiculously lengthy process that capital expenditure has to go through to be signed off, means that desperately needed improvements have been horribly delayed as construction costs rise. As a result, the original plans have been scaled back and their value diminished.

[Daisy Cooper (St Albans) (LD)]

My hon. Friend mentions the inordinate delays that occur with regard to applications for capital funds. I have watched with horror as my local hospital trust in West Hertfordshire has had to submit business case after business case while watching the costs rack up. Does she agree that one way to spend the allocated money more efficiently would be by devolving those budgets to local hospital trusts, rather than having a centralised programme that drives up the costs?

[Helen Morgan]

I could not agree more. That is exactly the situation we saw in Shropshire. Once again, the people who will suffer are the patients.

Last year, less than £900 million of the £13.8 billion required to eradicate the repair backlog for hospitals was invested—just 6.5%. It does not take an accountant to work out that at that rate, it will take 15 years to clear the current backlog, let alone the further deterioration of the crumbling buildings. Investment in eradicating the repair backlog fell sharply from £1.4 billion in 2021 to £895 million in 2023-24—a fall of 37%. I am afraid that, just like their approach to fixing social care, the Government’s continued lack of imagination and ambition is leaving our NHS less productive and less stable, which risks leaving millions languishing on NHS waiting lists.

[Several hon. Members rose—]

[Helen Morgan]

I will give way to the hon. Member for Chelsea and Fulham (Ben Coleman) because he has tried to intervene before.

[Ben Coleman]

I am most grateful to the hon. Lady for her delayed response. I am struck by her lack of response to two of my colleagues. She did not acknowledge to my hon. Friend the Member for Hammersmith and Chiswick (Andy Slaughter) that in my constituency of Chelsea and Fulham, the Imperial College Healthcare NHS Trust is getting money from the Government as a precursor to rebuilding the hospitals promised to it. More importantly, she did not address the point made by my hon. Friend the Member for Calder Valley (Josh Fenton-Glynn) that we are all reaping the whirlwind of the decisions taken by the Conservative-Liberal Democrat coalition Government. The Liberal Democrats made a choice to go into that Government, to take on roles including as Chief Secretary to the Treasury and as Health Ministers, and to make those cuts and destroy the NHS. We are now reaping the whirlwind of the decisions that she and her colleagues made. Is it not a little bit cheeky of her to make some of the points and claims she is making today?

[Helen Morgan]

I am pleased that the hon. Gentleman’s hospital is being dealt with, but I am sure that the residents of Torbay will not feel the benefit of that. I am slightly surprised that he thinks that the decade since the Liberal Democrats were in power has had no impact whatsoever. I did address the point that when a party comes into government and has to clear up the appalling mess left by the previous Government, there are difficult choices to be made. His party knows that. Labour Members, for example, have voted to retain the two-child benefit cap and keep a quarter of a million children in poverty—something that no one in my party has ever voted for.

The last time I opened a Liberal Democrat Opposition day debate was in October, and the topic was primary care. I explained how the Government’s failure to invest in primary care was a false economy that increased pressures and costs in the critical parts of the system. The management of our hospital buildings displays that same false economy. Just as spending money on critical care instead of prevention and public health is a poor approach to managing a health service, waiting for the roof to collapse is an irresponsible way to manage NHS buildings. As problems are ignored and investment is poorly targeted, it is the patients and the hard-working staff striving to help them who are forced to suffer.

This is not just about the new hospital programme. Across the country, there are thousands of GP surgeries that need urgent improvement if they are to provide the care that patients deserve. More than 2,000 hospital buildings across England were built before the foundation of the NHS in 1948, while the state of GP surgeries varies wildly. Many surgeries are simply no longer fit for purpose, having been built in the 1950s. Prescott surgery in my constituency, for example, has long been recognised as somewhere that needs to drastically increase in size because the population of the village has increased drastically itself. Despite the land and the community infrastructure levy funding being available, there is no sign of a new surgery being built. As the delay continues, the costs are rising and the challenge grows for both the council and the integrated care board, which are already under immense pressure to cut their costs.

Instead of pursuing fantasies like the Conservatives or false economies like the Labour party, the Liberal Democrats would invest to save by starting construction now, and ending the epidemic of cancelled operations, closed-off wards and huge sums wasted on emergency repairs. That would save the taxpayer money in the long run and benefit patients much sooner.

[Andy Slaughter]

The hon. Lady is being a little bit unrealistic. I have three world-class hospitals in my constituency: Charing Cross, Hammersmith and St Mary’s Paddington. The repair bill is £874 million, but the rebuild or new build cost would be £4 billion. Yes, we are refurbishing parts of Charing Cross and putting a lot of investment into preparing for that work, but the idea that suddenly the hon. Lady is going to come up with tens, if not hundreds, of billions of pounds is unrealistic, is it not?

[Helen Morgan]

The plan that we have put forward involves £10 billion over 10 years, and I will come to that in a moment. The real issue is that we cannot pick one hospital and say that it is indicative of an NHS that is being dealt with appropriately. Hospitals across the country are falling apart. For example, Stepping Hill, in the constituency of my hon. Friend the Member for Cheadle (Mr Morrison), is not in the new hospital programme, yet it is falling apart at the seams. We need to address the whole estate fairly urgently.

Our 10-year guaranteed capital investment programme would provide long-term security and fix our crumbling hospitals and creaking GP surgeries. It would provide an extra £10 billion for our crumbling buildings over the next decade, improving outcomes for patients, boosting productivity and cutting day-to-day costs for the NHS. Providing certainty is crucial. As it stands, managers have to raid precious budgets not just to plug leaking pipes, but to plug staffing gaps when winter pressure arrives. That is why we would also end the reactive approach to the annual winter crisis through our winter taskforce. Instead of the average £376 million of emergency funding announced late into the winter each year for the last seven years, our winter taskforce would manage a ringfenced fund of £1.5 billion over the next four years. That would help hospitals to plan their budgets and build resilience in wards, A&E departments, ambulance services and patient discharging.

[Mr Andrew Snowden (Fylde) (Con)]

The hon. Lady is talking about the day-to-day budgets of the NHS, in particular the costs of paying off previous debts. She talked about the work that needed to be done during the coalition years and in the decade and a half since then, in response to interventions from Labour Members. Does she agree that one of the biggest messes that needed to be cleared up then, which is still being felt in NHS budgets, is the disastrous private finance initiatives of the Blair and Brown years?

[Helen Morgan]

There have been successive failures in NHS management that all parties need to hold their hands up for—that is a fair point. We should, though, focus on the task in hand rather than continually going back decades, either to the coalition Government or to the Blair Government before that. That is not helpful to our constituents, who want a solution now.

[Ben Coleman]

On that point, will the hon. Lady give way?

[Helen Morgan]

No. I have been very generous with my time and I am going to make some progress.

We are also campaigning for a review of outdated Government finance rules that prevent NHS trusts from investing the funds that they have raised into their own buildings. Even NHS managers struggle to access common-sense investment in their facilities due to overly complex rules and glacial processes. Trusts are prevented from using unspent funds on improving their buildings. We need root-and-branch reform, combined with our 10-year programme of investment, to bring our local health facilities up to scratch.

In conclusion, the recent history of the NHS is one of short-term decision making and of the failure of successive Governments to grasp the nettle of long-term sustained investment in the things that matter: hospital buildings, GP services, dentistry, pharmacy and, crucially, the unspoken crisis of social care. The outcome is an organisation that is spending millions of pounds to go backwards. It truly is a false economy.

This Government have spoken warmly of the need to reform the NHS and improve productivity, and we support them in that, but we cannot expect to retain staff and provide high-quality care when so many doctors and nurses are negotiating leaking roofs and sewage backing up on the wards. Dealing with the new hospital programme is a matter of urgency, and I urge the Secretary of State to, at long last, grasp the nettle.

[Mr Speaker]

I call Stephen Kinnock—is it?—to move the amendment; I have a different name in front of me.

13:09

[The Minister for Care (Stephen Kinnock)]

I am glad you recognised me from the Chair, Mr Speaker. I have lost some hair since we last spoke.

I beg to move an amendment, to leave out from “it” to end and insert:

“also notes that the Chancellor has announced new fiscal rules to ensure capital budgets can no longer be cannibalised, with transfers from capital to resource budgets not permitted; recognises that the previous Government left a New Hospital Programme which was unfunded, unrealistic and undeliverable; welcomes that the Government has taken action to review that Programme and has published the New Hospital Programme Plan for Implementation, to put the Programme on a sustainable footing; supports the Government’s investment in the Plan, which will increase to up to £15 billion over each consecutive five-year wave, averaging around £3 billion a year from 2030; and further supports the work being done to bring forward construction of the reinforced autoclaved aerated concrete replacement schemes wherever possible, to ensure that patient and staff safety is prioritised.”

The amendment on the Order Paper is in the name of my right hon. and learned Friend the Prime Minister. I thank the Liberal Democrats for using their Opposition day to address a matter of vital importance for so many Members, including many colleagues right across the Chamber and their constituents. I sincerely hope that the Liberal Democrats will work with us on solutions, not on soundbites, because we need to be realistic about the problems we face and serious about how we tackle them.

The new hospital programme was announced by the last Government to much fanfare in October 2020, with a promise to deliver 40 new hospitals by 2030. We were told that there was a plan and a timetable, and we were glibly assured that it was fully funded, but from the outset it was clear that there were not 40 new schemes—some were just refurbishments or extensions. To put it simply, there were not 40 projects, they were not all new and many of them were not even hospitals.

The spin around the programme was widely questioned and challenged before the general election, but nevertheless we were truly shocked by what we found on entering the Department of Health and Social Care. The programme was hugely delayed, by several years more than had already been revealed by the National Audit Office. There was no credible plan to deliver the building projects, let alone to deliver them all in the next five years, and there was not even enough construction capacity in the UK to build all the hospitals in the new hospital programme by 2030. That is why when the hospitals with reinforced autoclaved aerated concrete were brought into the NHP in 2023, even the last Government had the sense to admit that nine schemes would have to be delivered past 2030 in order to prioritise the RAAC hospitals.

Perhaps most shocking of all, the funding for the programme was due to run out a month ago, with no provision whatsoever for future years: the money simply was not there. The programme was built on nothing more than false hope, dodgy claims and disingenuous press releases.

[Anna Dixon (Shipley) (Lab)]

Does the Minister share my constituents’ anger at the failure of the Tories to back up any of their promises about new hospitals? Will he reassure me that my constituents who are served by Airedale general hospital will finally get a new hospital to deal with the RAAC in an affordable, deliverable timetable, unlike the false promises of the Conservatives?

[Stephen Kinnock]

My hon. Friend is a doughty champion for her constituents, and she is absolutely right. The point she makes raises the even bigger issue of trust in politics and the trust that her constituents have in this place. That trust was fundamentally undermined by the disingenuous nature of what went on with the previous hospital programme. The British people are grown up enough for us to be able to level with them, be straight with them and say, “This plan is credible and affordable. It’s based on facts, not fantasy.”

[Daisy Cooper]

On the point of trust, the Conservatives completely blew trust with the constituents of West Hertfordshire. They promised a new hospital—they even said in 2023 that it would be fully funded, and it clearly was not. At the most recent general election, the Labour party promised that Watford general hospital would be a priority. Will the Minister make a new promise to keep that trust by coming to visit that hospital this year?

[Stephen Kinnock]

I am sure the hon. Lady will appreciate the fact that we have now come forward with a programme built not on sand or smoke and mirrors, but on reality, and the hospital she mentioned will be a part of that. She is very welcome to write to me with any further representations.

The situation I have described is the dog’s breakfast that we inherited from the Conservatives. This is genuinely not a partisan point, because when the previous Government did the right thing—for example, on the Tobacco and Vapes Bill—we were more than happy to support them, but where they failed, fibbed, and fobbed off Members of this House, we will not pretend that they were acting in good faith. It now falls to us to level with the British people about why their hospitals will not be fixed on time.

Our constituents are understandably furious, because our national health service is quite literally crumbling. As Lord Darzi found in his investigation, over the past 14 years our NHS has been starved of capital, with a staggering £37 billion under-investment over the course of the 2010s. I know that we will hear today from hon. Members about many examples of hospital roofs failing or falling, leaky pipes that freeze over in the winter and buckets for catching rainwater in corridors, and I know that capital spending is needed now more than ever.

Although we are deeply shocked by the neglect and incompetence of the Conservatives, it has not prevented us from rolling up our sleeves and clearing up the mess that they left behind. That is why we immediately commissioned a review, which had two core objectives. The first was to put the programme on a firm footing with sustainable funding, so that all the projects can be delivered to a realistic and affordable timetable. The second was to give patients a realistic, deliverable timetable based on facts rather than fantasy.

[Chris Vince (Harlow) (Lab/Co-op)]

My hon. Friend talks about realistic timelines, which are really important. My constituents in Harlow were promised a new hospital when there was clearly no money, no business plan and not even a site made available for it. Does he agree that this work is so important for the trust that we want to have from our constituents? Certainly in Harlow, we have a realistic timeframe and plan that we can actually meet.

[Stephen Kinnock]

My hon. Friend is also a doughty champion for his constituents. With each brick we build in the new hospital programme, I hope that we will start to rebuild some trust between his constituents and this place. He is absolutely right to point out that it is much better to have a realistic programme, rather than one built on smoke and mirrors.

Officials reported on the review in the autumn and set out a range of options for a more realistic timetable for delivery. In January, my right hon. Friend the Secretary of State for Health and Social Care announced five-year waves of investment, backed by up to £15 billion of investment over consecutive five-year waves, averaging £3 billion a year from 2030. Our programme is a balanced portfolio of hospital schemes at different development stages, being delivered now and into the future. It is the most efficient and cost-effective way of giving our NHS the buildings it needs, while also giving the construction sector the certainty that it needs to deliver.

[Calum Miller (Bicester and Woodstock) (LD)]

The Minister referred to the capital needs of the NHS as a whole. As my hon. Friend the Member for North Shropshire (Helen Morgan) mentioned, that applies to many GP surgeries too. In my constituency, we have rapid growth in population. The populations of Woodstock, Heyford Park and Bicester are struggling, because GPs want to expand, but they cannot access the money to do so. Will the Minister look urgently at releasing more funds through integrated care boards so that future revenue can be provided to allow for the capital investment that would give my constituents an expansion in GP surgeries and take some pressure off our much-pressurised hospitals?

[Stephen Kinnock]

I was very pleased to see the £102 million capital investment in GP primary care. I encourage the hon. Gentleman’s ICB to look very carefully at that fund and to explore the potential that it offers. We are in conversation with colleagues in the Ministry of Housing, Communities and Local Government about ensuring that section 106 processes are working properly, so that when there are new developments, there is proper wraparound in the social infrastructure required to make them sustainable. In the space of just nine short months, we have gone from a charade based on smoke and mirrors to a programme based on serious, systematic delivery.

[Jim Dickson (Dartford) (Lab)]

The Minister is setting out very articulately what this Government are doing to clear up the mess around the hospital provision that this country needs. Does he agree that the announcement by Dartford and Gravesham NHS Trust last week that it will build a new and expanded intensive care unit at Darent Valley hospital is a big step forward for Dartford residents? It badly needs new facilities to cope with waiting lists and get them down and to cope with the rising population of the area.

[Stephen Kinnock]

My hon. Friend is a strong campaigner for his constituents. He is right that that development will be a game changer. It will be important that we keep people’s feet to the fire to deliver on what has been promised. I guarantee that he will have my full support and that of the entire ministerial team.

With your permission, Madam Deputy Speaker, I will now address the Liberal Democrat motion, beginning with its point about the cannibalising of NHS capital budgets to keep day-to-day services running. I am delighted to confirm from this Dispatch Box that this Government have drawn a line under that appalling practice, to which the Conservative party was utterly addicted. The Treasury now has new fiscal rules to prevent that from happening again; capital spending is safe in our hands.

Secondly, on reversing the so-called programme that we inherited on 4 July, I hope I have made it clear that that whole sorry mess was a work of fiction. It is not a question of reversing anything, as the Liberal Democrats say in their motion, because there was nothing to reverse. Instead, we have gone back to the drawing board, and systematically designed and built a completely new programme and a completely new approach.

[Ms Stella Creasy (Walthamstow) (Lab/Co-op)]

As somebody who had to put up with what I think was seven photo opportunities by previous Conservative Ministers—including one who is sat on the Opposition Front Benches now—proclaiming that they were rebuilding Whipps Cross hospital with money that did not exist, it is clear that what needs reversing is the Conservatives’ chutzpah in saying that somehow they are the ones championing change on reforming PFI. Some of us spent years trying to persuade Ministers that we could reform the disgraceful spending on PFI—particularly private finance 2—schemes brought in by the previous Conservative Administration. Under those schemes, some trusts were spending £2 billion a year on repayments—more than they were spending on drugs. That is one way in which we could get some money for the new hospitals, so does my hon. Friend agree that it is this Government, rather than the Opposition, who understand good public finances?

[Stephen Kinnock]

My hon. Friend, who is a relentless campaigner for her constituents, is right: it was simply government by press release, with so many aspects of policy based on making announcements and unfunded spending commitments. When we came into government, we discovered a £22 billion black hole in the public finances, largely based on promises that had no funding whatsoever attached to them. That is the sort of behaviour that undermines trust in politics.

On the Liberal Democrat proposal to create a taskforce, we have excellent teams working on the programme, and they are getting on with the job. We do not have a second to waste. Setting up a new taskforce would simply mean further delay and distraction through process, rather than a laser focus on delivery.

I know that Members across the House share my outrage at the almost £14 billion backlog maintenance bill facing NHS trusts after years of historic under-investment. I understand that many in the Chamber are concerned about the condition of the health facilities that serve their constituents, and I reassure them that my right hon. Friend the Chancellor has given us the funding to begin immediately reversing the trend of decline that started under the last Government. This financial year, we are backing NHS systems through over £4 billion in operational capital; a lifesaving cash injection of £750 million of targeted estate safety funding, as a vital first step towards fixing our crumbling estate; and £440 million to tackle crumbling RAAC, keeping staff, patients and their families safe. We are empowering systems to manage their capital allocations locally and assign funding to local priorities, ensuring that money is spent as effectively as possible, as soon as possible.

[Andy Slaughter]

My local hospitals were evicted from the new hospital programme when the RAAC schemes came along. There was nothing to delay—there was no money there at all. Does the Minister recognise that some very innovative schemes are now going on locally? We in the Imperial College healthcare trust are partnering with Paddington Life Sciences, Imperial College in South Kensington and White City, and the Hammersmith and Fulham industrial strategy to maximise the available resources so that we can rebuild three world-class hospitals.

[Stephen Kinnock]

My hon. Friend is making some very strong points on behalf of his constituents. We would certainly be very happy to work more with him on some of those innovations. So often, hospitals are anchor institutions—alongside universities—for driving forward innovation, harnessing the power of technology and contributing to the Government’s growth mission. There are huge opportunities there, and I would be happy to explore them further with my hon. Friend.

[Manuela Perteghella (Stratford-on-Avon) (LD)]

Despite overwhelming support, the Coventry and Warwickshire integrated care board has decided to cut all beds at the Ellen Badger hospital in Shipston-on-Stour, an anchor building and community hospital that is at the heart of our town. Does the Minister agree that cutting such vital services is unacceptable, and that community hospitals play an important role in rural areas by providing equality of access to our health services?

[Stephen Kinnock]

The hon. Lady is absolutely right that community hospitals play a vital role, and I share her disappointment with the decisions that are being made. The fact of the matter is that we are in a hole, and we have to dig ourselves out of that hole. It is going to take some time to do that. We are getting the public finances back on an even keel, we are getting our public services back to where they need to be, and we are getting the economy back on a sounder footing. As we make those achievements, I hope that we will be able to reverse some of the decisions that are being made—decisions that are, of course, damaging to the hon. Lady’s community—but we are in a very difficult position, and it will take some time for us to get over that.

[Several hon. Members rose—]

[Stephen Kinnock]

If hon. Members will bear with me, I will make a little bit more progress and then come back to them.

Many Liberal Democrat colleagues have made the argument that with hospitals in the state they are in, it is more important than ever to have a robust social care system in place. As the Minister for Care, I agree with them wholeheartedly, but it is simply not true to portray the Government as sitting on their hands while Baroness Casey gets cracking on her vital work. In fact, we have hit the ground running through a plethora of measures. We have legislated for the first ever fair pay agreement for social care in order to tackle the 130,000 vacancies we see today. We have delivered an extra 7,800 home adaptations through the disabled facilities grant to change the lives of thousands more disabled people for the better. In the Budget, the Chancellor provided the biggest increase in carer’s allowance since the 1970s, worth £2,000 a year to family carers and with an extra £3.7 billion for local authorities.

We are not hanging around on more structural reforms, either. We are introducing new standards to help people who use care, their families and providers to choose the most effective new technology as it comes on the market. We are joining up care and medical records, so that NHS and care staff have the full picture they need to provide the best possible care, and we are training more care workers to perform more health interventions, helping people to stay well and at home. Just two weeks ago, we announced a new qualification for social care staff, training them in artificial intelligence to automate routine tasks and motion sensors to detect falls. We are seizing the opportunities of care tech and harnessing it for the benefit of thousands who draw on care across our country.

[Layla Moran (Oxford West and Abingdon) (LD)]

We are desperate to help the Minister in this endeavour, and look forward to receiving our invitations to the cross-party talks, which have yet to be issued. However, the Health and Social Care Committee heard today from an organisation called Think Ahead, which is the only organisation in the country that trains mental health social care workers. I have just heard that the Department of Health and Social Care is not refunding that organisation. Can the Minister explain why?

[Stephen Kinnock]

I thank the hon. Lady for that intervention. Baroness Casey is working at pace to get the commission up and running, and that will be launched this month. On her point about Think Ahead, the fundamental challenge we had with that programme was its relatively high unit costs. We are aiming to ensure that we deliver value for money for the taxpayer—I am sure that the hon. Lady shares that objective. We have to ensure that we deliver a programme for mental health social care work that delivers not only the best possible outcomes for our communities, but the best possible value for taxpayer money.

A lot has been done in the nine months since the election, but there is a huge amount more to do, and this Government are getting on with the job. Alongside the work I have described, the Government are putting record levels of investment into healthcare, with capital spending rising to £13.6 billion over this year and the next. That includes £1.5 billion for new surgical hubs, diagnostic scanners and beds across the NHS estate, as well as new radiotherapy machines to improve cancer treatment; over £1 billion to tackle RAAC and make inroads into the backlog of critical maintenance, repairs and upgrades across the NHS estate; and over £2 billion to be invested in NHS technology and digital. We are also taking the pressure off our hospitals through care in the community, and I am sure the whole House will welcome the fact that we have recruited 1,500 extra GPs on to the frontline.

[Martin Wrigley (Newton Abbot) (LD)]

Coming back to community hospitals, I came to this House to try to save Teignmouth community hospital, which has been under threat of closure because Torbay, its parent hospital, has such a massive maintenance backlog that it cannot afford to maintain both itself and Teignmouth hospital, so it is shutting down community hospitals. In Devon, we have just three principal hospitals: North Devon, which we understand is under pressure, Torbay, which is under pressure, and Exeter. We need the community hospitals. Will the Minister stop Teignmouth hospital from being shut, so that we can maintain it until it can be rebuilt?

[Stephen Kinnock]

These decisions are the responsibility of ICBs, and the ICB is having to balance a range of pressures, as the hon. Member points out, created largely by the neglect and incompetence of the previous Government. It is now a question of ICBs having to cut their cloth to make the finances work with the limited resources they have. I am afraid that is symptomatic of the mess we found when we took over on 4 July.

[Chris Ward (Brighton Kemptown and Peacehaven) (Lab)]

The Royal Sussex in my constituency is in desperate need of a new cancer centre, and I am delighted that the centre is being added to wave one. I would be even happier if the Minister also added a new accident and emergency department, but we will come back to that another day. Is the reality not that we all want to build these new hospitals, but we all have to be honest with the public about how we will pay for them? The Liberal Democrats never are, and the motion is not. Bringing forward construction dates is a multibillion-pound commitment, but all the motion talks about is creating a taskforce. Is that not fundamentally unserious? This is an incredibly serious issue, and we should put forward proper proposals.

[Stephen Kinnock]

My hon. Friend is an outstanding champion for his constituents. I noted the point he made about A&E; that was nicely done. He is right in what he says about the motion. The broader point to make is that thanks to the necessary decisions that my right hon. Friend the Chancellor of the Exchequer made in the autumn Budget, we have generated the revenue that we will need to rebuild public services, and in particular our NHS, which was brought to its knees by the previous Government. I cannot claim to be a careful student of the Liberal Democrat manifesto for the last election, but I did notice that the revenue that would be generated by their measures was, I think, about £8.4 billion. Last time I checked, that was significantly lower than the £23 billion raised by the Chancellor’s Budget. The Liberal Democrats should probably get their calculators out and figure out exactly how they will generate this revenue, rather than criticising us constantly for the decisions we have taken.

[Several hon. Members rose—]

[Stephen Kinnock]

I will just make a little more progress, if I may. We are committed to rebuilding our NHS and rebuilding trust in Government. We will never play fast and loose with the public finances, and we will never try to pull the wool over the public’s eyes. Everyone in this House remembers, or should remember, that the last Labour Government cut waiting lists to their lowest level in history, raised patient satisfaction to the highest level in its history, and brought in historic health interventions, such as the smoking ban. What is less remembered is that they also delivered the largest hospital building programme in NHS history. All that meant that when the coalition took over in 2010, it was presented with a strong national health service that was firing on all cylinders. Tragically, that coalition Government and their successor Governments set about weakening and undermining every aspect of our precious NHS, to the extent that by the time this Government took over in July, the NHS was well and truly on its knees. Today, it once again falls to a Labour Government to take the necessary and right decisions for the future.

We have now put the new hospital programme on a sustainable footing. It has a timeline that can be met, and a budget consistent with our fiscal rules. That is how we have turned the programme from empty rhetoric into reality, and in doing so, we have provided the construction industry and its supply chains with vital certainty, while also restoring confidence in public sector procurement. We are on the side of the builders, not the blockers. Our plan is credible, achievable and fully funded. It is a programme grounded in fact, not fiction. I was born in Tredegar, the very same town as Aneurin Bevan, so it is the privilege of a lifetime to be part of a Government who are carrying his torch into the 21st century, building a generation of hospitals that would do Nye proud.

[Madam Deputy Speaker (Judith Cummins)]

I call the shadow Minister.

13:35

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

We can all agree that we want a world-class NHS, and that includes having the very best hospitals, technology and staff. I have been delighted to see the brilliant facilities created in my area, including a new A&E in Boston, new mental health wards at Lincoln county hospital, and new operating theatres at Grantham and District hospital. These upgrades mean that patients can receive the best possible care in appropriate settings, and staff can go to work each day proud of their workplace environment. However, we must be alive to the challenges that face the NHS. We live in an ageing society where people have more complex comorbidities. We also have a growing population, so there is more demand for services. In fact, the NHS treats 25% more patients every single day than it did back in 2010. New treatments, technologies and procedures have been developed, saving and improving lives, but they come at an ever more expensive price. We also had the covid pandemic, which I noticed the Minister did not mention.

According to the King’s Fund, in 2023 prices, spending on capital in Labour’s last year in office, 2009-10, was £6.9 billion. In 2023-24, that had nearly doubled to £11.4 billion. Even before the pandemic, capital spending was nearly £1 billion higher than when Labour left government. That helped us to open 160 community diagnostic centres and more than 100 surgical hubs, and to invest more in scanners, beds and operating theatres to deliver a million more checks, scans and procedures closer to home. We were committed to delivering the new hospital programme in full.

There was more to do. The challenges were evolving, the demand for care was growing and the pressure on the NHS was ever increasing. It now falls to the Labour Government to address those problems. I want them to succeed—that is in all our constituents’ interests—but what we have seen so far does not fill me with hope. One of the Health Secretary’s first choices on entering government was to pause the new hospital programme and put its future at risk. That was despite the fact that he and the Chancellor travelled the country throughout the election period, meeting candidates and promising a new hospital in their area. Just like the Government’s promises to the farmers, the pensioners and businesses, those were hollow words.

[Dr Neil Hudson (Epping Forest) (Con)]

The Conservatives committed to restoring and renewing our hospitals. My constituents in Epping Forest depend on the Princess Alexandra hospital in Harlow, and on Whipps Cross hospital in Leytonstone. Despite Labour making clear promises about those two vital hospitals prior to the election, the Labour Government have delayed their rebuilding. It is particularly galling because Whipps Cross has planning permission, and work on the car park has already started. Does my hon. Friend agree that the Labour Government should re-evaluate their priorities and crack on with delivering the rebuilds promised at the Princess Alexandra and Whipps Cross?

[Dr Johnson]

I absolutely agree that the Labour Government should do that, but unfortunately, we have learned that their promises do not mean much at all.

[Daisy Cooper]

On promises not meaning much, the hon. Lady will be aware that the previous Conservative Government promised West Hertfordshire a new hospital. In 2023, they said it was fully funded, yet there is still not a spade in the ground. Can she explain where that money disappeared to, please?

[Dr Johnson]

The previous Secretary of State made it clear that the hospital was fully funded and would be built. What has changed since then is that we have a new Government who made the choice not to build it. These are choices that the new Government must own.

When the Government came to power, the Secretary of State commissioned the Darzi review, which highlighted the need for more capital investment in the NHS, but decided not to prioritise the delivery of the new hospitals. To govern is to choose, and the Secretary of State has chosen not to deliver the hospitals. We set out our commitment to delivering them on time, with the agreement of the then Chancellor. Of course, spending decisions cannot be made for a future Parliament, but the Secretary of State has chosen not to make the same commitment.

[Ben Coleman]

It may be helpful I correct a couple of “facts” that the hon. Lady has given. In his election literature, my predecessor as Member of Parliament for Chelsea and Fulham made the clear statement that he had secured the funds for the rebuilding and refurbishment of Charing Cross hospital. When I spoke to the chief executive of the hospital, he said that he had received no such reassurance from the Government, and on coming to power we found that no money had been set aside for the guaranteed refurbishment.

Moreover, this did not just apply to Charing Cross hospital. Across the country, the last Government’s claims to have found the funding were discovered not to be true when we came to power. The right hon. Member for Melton and Syston (Edward Argar), who is talking to the hon. Lady at the moment, lives in my constituency, so he is well aware of the accuracy of what I am saying. [Laughter.] I know; I will get complaints about the bins again now. Would the hon. Lady like to reflect on the accuracy of what she is saying, in the light of the facts as I have set them out?

[Dr Johnson]

I am afraid that the hon. Gentleman is not correct. The previous Government, and the previous Chancellor, made a clear commitment to providing the money, and to the hospital building project, but the current Government have not chosen to meet that commitment. These are choices that are being made. For now, patients and staff are being denied the quality facilities that they have deserved for decades. For some hospitals, construction work will not even begin until 2039. Will the Minister write to me, giving the date on which each hospital will be completed?

We can see the Labour Government’s lack of ambition. There are 40 hospitals in waves 1 to 3 of their programme—40 hospitals over 15 years—but there are 515 acute, specialist and community hospitals in England. At this pace, the replacement of the NHS estate will require a cycle of nearly 200 years. That is the equivalent of a hospital built in 1825 not being replaced until this year. That is Labour’s ambitious programme.

We can all see the pressures facing the Chancellor as her economic mismanagement hits the country. We cannot tax our way to growth. Perhaps that is yet another reason why growth forecasts have been cut yet again. How do we know that Labour will not come for those already delayed new hospitals in a year or two, and that there will not be further delays or cancellations? The Government have made it clear that the new hospitals are not their priority. Will the Minister give us that guarantee?

[Andy Slaughter]

May I return the hon. Lady to the subject of Charing Cross hospital for a moment? It used to be the main hospital in my constituency, before it became part of the constituency of my hon. Friend the Member for Chelsea and Fulham (Ben Coleman). The Conservative Government proposed to demolish it, and it took a seven-year campaign by residents to secure a reprieve. It went into the new hospitals programme, and then came out again in 2023, under the Conservatives, because hospitals with reinforced autoclaved aerated concrete were going in. That is the history.

Has the hon. Lady been living in a different world for the last decade? In that time, there has been not just underfunding, but threats to demolish and close hospitals, and then to remove them from a programme that the Conservatives invented. Only now is this hospital in a viable programme, and being given the help and support that it needs to become the world-class hospital that it has been.

[Dr Johnson]

I must confess to not being terribly au fait with the position of Charing Cross hospital in 2012, which was before I was elected. It is not a hospital in which I have worked as a doctor, but I am advised that it was my right hon. Friend the Member for Godalming and Ash (Sir Jeremy Hunt), when he was Health Secretary, who kept it open, and I am sure that local residents will be disappointed that this Labour Government have chosen not to rebuild it until 2035.

Will Labour—in an attempt to fill the black holes of their creation—return to private finance initiative contracts, to bridge the gap between the spending that they want and the fiscal situation that they have created? I saw at first hand the disastrous agreements that were reached, which led to extortionate costs and ridiculous inflexibility. Let me give just one example. I remember being very pleased to have an office of my own for the first time when, as a doctor, I was promoted. I was given a desk, a computer and a large whiteboard. When I asked, “How do I get this put up on the wall?”, I was told, “You can’t have it put up on the wall, because it would cost £800.” That was more than a decade ago. I thought, “Why is it costing £800?” and I said, “I can go and buy some ‘no nails’ from the local hardware store and put it up myself!” I was then told, “You can’t do that, because a deal was negotiated, and it would be against the contract.”

In total, there are about 700 PFI contracts with a capital value of £57 billion, and there is about £160 billion still to be paid for them and their maintenance. During covid, in 2020-21, analysis from The Guardian found that nearly half a billion pounds was being spent purely on interest charges. That is money that is not being spent on patient care, and it is a long-lasting legacy from the last time a Labour Government were in power and trying to get around their fiscal rules. These were fundamentally bad deals. Yet again, we see that when Labour negotiates, the taxpayer loses.

Despite 14 years in opposition, Labour came to office without a plan for what it actually wanted to do for the NHS. Instead, we have seen review after review and consultation after consultation, with very little action or delivery in return for what this means for patients and the taxpayer. The Labour Government hiked taxes on general practices, community pharmacies and even children’s hospices, only to give them some of that money back and expect them to be grateful for it. They cut the winter fuel payment for millions of the most vulnerable people in the country, and then sat back and watched as the number of pensioners attending A&E this winter soared. They caved in to the trade union demands with an inflation-busting pay rise in return for no modernisation or productivity reforms, and the threats to strike again are already back. They scrapped our productivity plan, which we had already fully funded and which would have unlocked billions in savings by the end of the decade.

[Mark Ferguson]

I have a question to which I know the answer. The question is “How many new hospitals were built in the last five years?” and the answer, of course, is “Zero”. Is it not the case that the 40 new hospitals promised by the last Government were not new and were not hospitals, and there certainly were not 40 of them?

[Dr Johnson]

Actually, we use the definition of “new hospitals” that Tony Blair used when he was Prime Minister.

Let us turn to where we are now. We welcome the capital funding to continue the programmes that we started in government for new surgical hubs and diagnostics, but how much of the additional capital funding allocated in the last Budget will be used to carry out repairs in hospitals that should be rebuilt? Let me repeat the question asked by the Liberal Democrat spokesperson, the hon. Member for North Shropshire (Helen Morgan). Will those delays cost more money, both because work that would otherwise be unnecessary will have to be done to keep hospitals open and because of inflation, which is rising under this Government? How much extra will the national insurance jobs tax cost the contractors building the new hospitals and undertaking maintenance and repairs? Those additional costs will be passed on to the NHS. Will that mean less repair work being undertaken, or will the Government make cuts elsewhere—and if they do, where will those cuts fall? The Chancellor has already hiked taxes on working people and businesses, and today we saw that borrowing has also increased by £30 billion a year, with debt piling up and inflation on the rise. How does the Minister intend future repairs and builds to be funded—through yet more tax rises, more borrowing, bringing back PFI, or cutting other areas of spending?

Ultimately, these are decisions for Governments. To govern is to choose. This Government must own their choices, but sadly it is the public who will have to pay for them.

[Several hon. Members rose—]

[Madam Deputy Speaker (Judith Cummins)]

Order. I must now announce an immediate five-minute time limit for Back-Bench speakers, with the exception of the Chair of the Select Committee.

13:48

[Chris Curtis (Milton Keynes North) (Lab)]

A few months ago I stood in this Chamber and told a story that I wished I did not have to tell. It was about my 91-year-old grandmother, and the night that we had to rush her to hospital with a suspected heart attack, only to be told on arrival that the average waiting time was nine and a half hours. Our brilliant NHS staff worked tirelessly, but after 14 years of Tory neglect the truth is painfully clear: our health service has been pushed to breaking point, and my family did not receive the urgent care that we needed and deserved.

I know that my story is not unique. I hear it time and again, on the doorstep, in community centres and in my constituency surgeries. There is a painful fear, shared by so many, that the NHS on which we all depend will not be there when we need it most. Let us be honest about why that is: it is not because our NHS staff are not working hard enough—far from it. They are heroes in every sense of the word.

[Lola McEvoy (Darlington) (Lab)]

I thank my hon. Friend for giving way on his point about how brilliant our NHS staff are. First, will he commend my dad for his 40 years’ service badge as an NHS staff member? That has to be put on the record. Secondly, does my hon. Friend agree that the Government are laser-focused on supporting NHS staff to stay in the NHS, work their way up the ranks and lead a fulfilling career in serving our constituents?

[Chris Curtis]

I thank my hon. Friend for her intervention, and for the work that her family have done for our national health service.

It is not the staff’s fault that our NHS has been let down; it is because of Tory Government after Tory Government, and decision after decision. Fourteen years of Conservative mismanagement have hollowed out our health service, and I welcome the opportunity to discuss this important issue today. Although I might not see eye to eye on everything with the Liberal Democrats, there is one truth that we cannot ignore: the NHS is facing serious challenges, and real change and investment are needed. However, people back home are not crying out for more motions; they are crying out for action, for delivery, and for change that they can see and feel. With this Labour Government, they are finally getting it.

When we came into office, we did not come in to manage decline; we came in to turn things around, to rebuild, and to restore a sense of hope and pride in our public services, starting with our NHS. We have seen that work across the country, with waiting lists falling for six months in a row. In my city, this Government have finally secured funding for the new women and children’s hospital that residents in Milton Keynes—a growing city—so desperately need, and construction is set to start in 2027-28. For too long, families have walked through the doors of my local hospital, which is simply not fit for purpose and has some of the longest waiting lists in the country. Let me be clear: it is completely unacceptable that it has taken this long to get funding in place. Milton Keynes has been one of the fastest growing cities in the country for years, and we have been left with far fewer hospital beds than we deserve and far fewer than the national average.

Despite some of the comments from Conservative Members, and despite the Conservative Government plastering the new hospital on all their leaflets, how much funding was actually secured by my hospital under the last Conservative Government? Given that it was “fully funded”, one would assume the figure was 100%. Was it 50% or 10%? No, just 4% of the “fully funded” hospital promised was actually secured by the previous Government. It is this Government who have found the other 96% to ensure that we can finally build the hospital that my city so desperately deserves. We are now trying to deliver a hospital that has been delayed not by local failure, but by national dither. Thanks to this Government, I get to be the MP who delivers what Tory MP after Tory MP promised my city but failed to deliver.

I want to ensure that we do not face further delays—not just because of the health risks to my city, but because of the cost increases. I have been told that every single month this project is held up costs an extra £700,000. That £700,000 could be invested in other important projects that have been mentioned by Members across the House. One potential hold-up is the Hospital 2.0 programme, which I am told is still not complete. Will the Minister look at whether that important work will hold up projects that we know are ready to go, such as in Milton Keynes? We need to fast-track these projects through the Treasury to ensure that there are no further bureaucratic blockages once the go-ahead has been given, especially bearing in mind that we have a track record in Milton Keynes of building to budget and on time. Give us the tools and we will build the hospital.

We must also be honest about what happens after the ribbon is cut. Even if we build the hospital, our health system in Milton Keynes will still be operating under immense strain. Thanks to the legacy of the last Government, our integrated care board is one of the most, if not the most, underfunded per person in the entire country. That has real consequences. It means that places including my local hospice, Willen hospice, which has provided vital end of life care to many members of my family, are being left to scrape by. This Sunday I will be running the London marathon for our local hospice, because I care deeply about the work it does. Marathons should not be the funding model for our healthcare system. We need sustainable investment, which starts with fairer funding for our ICB and fairer treatment for a city that has been overlooked for too long.

I will support anything in this House that helps us fix our NHS, and I will work with anybody who wants to rebuild it, but I will also say this: I am proud to be a member of a Government who are finally not just talking about the problem, but getting on with the solution. Let us build that hospital, let us fund our services properly, let us fix what is broken, and let us give people back the healthcare system they so desperately deserve.

[Madam Deputy Speaker]

I call the Chair of the Health and Social Care Committee.

13:54

[Layla Moran (Oxford West and Abingdon) (LD)]

Lord Darzi’s independent investigation clearly set out the impact that “capital starvation” has had on the NHS in recent years, and the importance of capital spending to fixing the health service. The report highlighted substantial shortfalls in capital investment, combined with a tendency to raid capital budgets to cover in-year spending deficits, so I welcome today’s Liberal Democrat motion, which allows Parliament to highlight how important these issues are to the public. This is the second Liberal Democrat Opposition day, and it is the second time we have debated health and social care. It is because it is a priority for the country that it is a priority for us.

The Health and Social Care Committee has taken a keen interest in the new hospital programme. We have challenged the Government to maintain their capital spending and not fall into the traps of the past, when capital spending was redirected to fund day-to-day spending, so I was pleased to receive confirmation from the Department, and now from the Dispatch Box, that the Chancellor’s changes to the fiscal rules will stop future raids on the capital budget, or CDEL, to fund the day-to-day spending budget, or RDEL. That is hugely welcome. However, although the protection of capital budgets is reassuring, I remain concerned about the lack of transparency around how the funding is allocated by the Treasury.

The charge levelled at the Government is that funding is being funnelled into acute care to tackle waiting lists, at the expense of funding primary care, infrastructure and care in the community. Clearly, on current commitments, we will not see capital funding that is sufficient to meet anything close to the unfunded promises made by the Tories in 2020. Nevertheless, the principle of investing in our hospital infrastructure is good; money will be saved in the long run on maintenance and emergency repairs, as well as providing a better quality of care.

In the policy paper on the plan for implementing the new hospital programme, the Government stated that funding will reach only £3 billion in the early 2030s due to

“other key priorities in health spending, such as funding to enable the Secretary of State’s 3 shifts”.

That is good, but we need transparency around how decisions were made and which projects were chosen. In January, the Secretary of State provided the criteria by which the schemes were scored and funding was allocated, such as site constraints and maturity of planning permission, but it is disappointing that, as I understand it—I am willing to be corrected—the review was conducted without the involvement of the trust teams responsible for delivering the rebuilding programmes. As of last month, no trust with a new hospital programme scheme has been provided with the full details of how it scored specifically against the criteria.

The Health and Social Care Committee has asked how the Department is prioritising schemes and has not received a clear answer, so my question is very simple: in the interests of transparency, will the Secretary of State publish, for every single new hospital programme scheme that was subject to last year’s review, the details and findings of the Department’s assessment of them against each of the criteria that were published alongside his statement in the House of Commons on 20 January 2025? It is the very least that the schemes that felt deprioritised deserve, and we are hearing many examples of those from Members of different parties. I choose to believe that this outcome is inadvertent but, frankly, it just looks a bit shady. We have seen it happen before with the levelling-up money under the previous Government. The Public Accounts Committee, on which I know many Members have served, as have I, has a motto: sunlight is the best disinfectant. If the Government will not publish the detailed assessment, the Minister needs to explain why.

My local area, like so many others, has been affected by this issue. Last year I visited the John Radcliffe hospital, which serves much of Oxfordshire, and I saw at first hand how its capacity to deliver care is being severely constrained by the size and condition of the physical estate. We went to visit the old site of the neonatal intensive care unit, which had to be moved because the staff were worried about the ceiling literally coming down on sick children and on incubators. It was atrocious.

The John Radcliffe hospital wants to be world-leading. It is a specialist tertiary care hospital, which means it is able to perform very specialist surgery, and it wants a new building to do that in. When it put to the Government a bid for £28 million, it was rejected. Instead, it has gone out to seek private financing, and it will now cost the trust £46 million to deliver the exact same building. Would it not have made sense for the Government to allow the trust to borrow from the Government to build it, and then to pay the money back from its own reserves over time? Think what it could have done with that £18 million.

[Sean Woodcock (Banbury) (Lab)]

I know the John Radcliffe hospital, which serves some of my constituents. The hon. Lady has made a powerful case about the amount of money that has potentially been lost through this process. Would she, however, reflect on the role played by her party, particularly the right hon. Member for Kingston and Surbiton (Ed Davey), and the amount of money wasted on the disastrous top-down reorganisation of the NHS under the coalition Government?

[Layla Moran]

I have to say that that was quite a segue. We are focusing on the capital estate. We all know that there were problems with the Lansley reform. In fact, I welcome the fact that it is being unravelled, and I was pretty vocal about it at the time.

The savings the John Radcliffe could have realised might have been spent on hospital at home services and other ways to divert people away from coming into A&E in the first place.

Across the wider Oxford university hospitals NHS foundation trust, £100 million of backlog is deemed as high or significant risk. Pausing or delaying plans to rebuild hospitals is a false economy, and hospitals around the country, including the John Radcliffe, are overspending on maintenance as a result. That is not limited to our hospitals; we are also seeing it in GP practices, many of which date from well before 1948. I will declare an interest in that my own surgery—the Summertown health centre—is one of those practices. It is doing incredibly well, despite working out of a very old Victorian building. It is desperate for a new site, and it was deemed one of the top priorities for the ICB. I note that the Minister mentioned a figure of £102 million, but, frankly, that does not touch the sides.

As in the case of the John Radcliffe, the Summertown health centre is now going out to seek private finance, which it will find a way to pay back slowly over time. The Exchequer would not even have to lay out this money in advance, and even with inflation, the amount it would get back is less than what the health centre has to pay to do this with private finance. I ask the Government to think about this innovatively. It is not the same as the PFI. It is the Government using their own borrowing rules to allow investment in vital public services, and it makes no sense that they cannot do it.

When it comes to mental health services, we have the incredible Warneford hospital in Oxfordshire, and Warneford Park in Oxford will provide a new cutting-edge mental health hospital surrounded by a research and innovation hub. Groundbreaking research is planned on understanding brain health and discovering new drug therapies and new forms of treatment. This is a great vision, but it will cost £500 million. We do have private benefactors, including local businesses, willing to feed into it, but where is the funding pot for mental health trusts? They were excluded from the new hospital programme, and it is not at all clear where that kind of money may be found.

[Monica Harding (Esher and Walton) (LD)]

I would like to share a story from a constituent who called me last night. Her daughter had psychosis and was locked in a room at the local hospital, with a mattress on the floor and two security guards outside. She was there for a week waiting for mental health provision in a setting outside the hospital. I would like the Minister to tell me what mental health provision will be in place.

[Layla Moran]

I am so sorry to hear about the experience of my hon. Friend’s constituent. In Lord Darzi’s report, there are some stark pictures of him sitting in substandard accommodation for the very sickest in our society. The Health and Social Care Committee is currently undertaking an inquiry into severe mental ill health, because we know that mental health is so often forgotten in the NHS. It is good that the mental health investment standard has been continued, but it is sad that the overall spend as a proportion of NHS spend is going down this year for the first time in the last few years. We very much hope that this is not a trend, but a one-off, and that it will continue to rise from next year.

For the Warneford, we need to understand what new innovative funding pots we can put together. We understand that the Government are working across Departments, and this project would be as much of an advantage to the Department for Science, Innovation and Technology as to the Department of Health and Social Care. Where are these pots of money, because they are important?

I will end simply by saying that I completely agree with the thrust of the motion—and, indeed, with what the Government have themselves said—which is that if we invest in capital expenditure, we need to take an invest to save approach. We know that this matters to our constituents, and we know that they cannot get the services they so desperately need. If we are to achieve the three shifts, we should not be pitting them against each other. Investing in capital will help the three shifts to succeed, and we do will the Government and the NHS to succeed.

[Madam Deputy Speaker (Judith Cummins)]

With an immediate four-minute time limit, I call Emily Darlington.

14:05

[Emily Darlington (Milton Keynes Central) (Lab)]

I thank the hon. Member for North Shropshire (Helen Morgan) for introducing the debate. We will be talking a lot about Milton Keynes, because if you wait for a speech about its hospital, you get two at once.

For me, the story about Milton Keynes hospital is really personal, as it involves my family and my in-laws. Unfortunately, I lost both my in-laws in the years leading up to my being elected to this place. What I would like to say about the care my family, my in-laws and my children have had is that the team at Milton Keynes hospital—the staff from the chief executive to the consultants, the doctors, the nurses and the porters—are all so professional. I am sure everyone in this House would want to join me in thanking them for their absolute persistence in the work they have had to do just to keep the NHS going over the last 14 years.

I worked closely with the hospital in my constituency for many years as deputy leader of Milton Keynes council, and the council had to step in when the Government did not. It was with funding from the council that we were able to build the new cancer centre and the new radiotherapy unit that will open very soon. It is because of the close working relationship with the council that the hospital has some of the lowest bed blocking waits in the country. With our teams integrated into the hospital, we make sure that the people who are able to go home go home with a care package as soon as possible, because it is our belief in Milton Keynes, and it was my belief as deputy leader, that people want to be in their homes.

Despite all that work, Milton Keynes hospital has had some of the longest waiting lists in the country. That is partly due to the 14 years of underfunding of Milton Keynes. When there are over 30,000 people waiting for non-urgent elective operations, with 1,762 of them having been waiting for more than a year, these do not feel like non-urgent cases, because those people are not allowed to live a proper life, to play with their grandchildren or to go back to work as fast as they should. There is both a social cost and an economic cost. I am pleased to say that, with the investment by this Government to reduce waiting times, we have seen waiting times go down, but they are still too long.

Unlike a lot of other hospitals we will talk about today, much of the issue for Milton Keynes is that it serves the fastest growing area in our region. In fact, it is growing at double the rate of anywhere else in the greater south-east. That means that our population is set to double to 410,000 people by 2050. On average, 11 people move to Milton Keynes every single day. That is not new in Milton Keynes, because we have been developing communities, homes and businesses for quite some time under the leadership of the Labour council. What has failed time and again in Milton Keynes is the investment that we need in our local hospitals, but this Government and these Milton Keynes MPs will actually deliver what was promised over and over again but never delivered by the Conservative party.

14:09

[Ian Roome (North Devon) (LD)]

Laying in an operating theatre, a patient at North Devon district hospital in my constituency can take great comfort in knowing that they are surrounded by some of the most dedicated healthcare professionals in the world. But astonishingly, the operating theatre around them is little changed since it was first built in 1978. The theatre is barely 60% of the size the NHS now expects, and it cannot accommodate more modern equipment. Much of the air-handling system and ventilation infrastructure has either never been upgraded, or is simply beyond repair when it breaks down. That is a critical risk to patient care. North Devon district hospital now has a maintenance backlog of £44 million, over £13 million of which is for its operating theatres alone. There are no independent providers, and the next nearest NHS acute hospital is more than 40 miles away. The trust says that failing theatre facilities are the most urgent threat it faces during the next five years—not 10 years, but five—so what happens next?

Well, we know what happens, because that exact scenario struck Torbay hospital in 2018, with failing air-handling infrastructure closing down a number of operating theatres and causing widespread cancellations of surgery for more than a year. North Devon district hospital faces the same nightmare. Thanks to woeful behaviour by the last Conservative Government, not a single penny was put in place to do something about it. Now the Labour Government say that none of the planned rebuild will be delivered until after 2035. North Devon is one of nine hospitals pushed right to the back of the line by the new hospital programme review, and the Government still fail to recognise the increased maintenance costs that will flow from that decision.

If the Government ignore the symptoms, the problems will only get worse. Our hospital trust has put forward alternative plans for a lasting refurbishment at North Devon district hospital that would cost just £250 million—a fraction of what is really needed, but enough to keep the maximum number of operating theatres open beyond 2027 and avoid spiralling costs down the line. I thank the Minister for agreeing to visit North Devon district hospital to see the facilities and to listen to the trust board’s proposals. I am really grateful to the Minister for listening, but I urge the Government to seize the initiative and act now before it is too late.

14:12

[Connor Naismith (Crewe and Nantwich) (Lab)]

In 2020, the Conservative Government announced the new hospital programme. The Prime Minister at the time, known for his complicated relationship with the truth, said that spades were in the ground, but it is clear from their disastrous 14 years in power that we cannot build on promises alone and we cannot change the country on empty slogans.

Fast forward to today, and the Labour Government have committed to building the hospitals not just with words, but with cold hard cash and a credible plan for delivery. I note that the Liberal Democrats appear to try to draw a comparison between the inheritance left to the coalition Government and that left to this Government by the previous Conservative Government. I have to take the opportunity to remind them that the coalition Government were left an NHS with the highest patient satisfaction on record and the lowest waiting lists on record. I welcome the progress made once again by this Labour Government in bringing down waiting lists six months in a row.

I am delighted that Leighton hospital in my constituency will be in wave 1 of the new hospital programme. Leighton has been in desperate need of an upgrade for some time. Building began on a new modular unit in January 2025, with some services due to move there by the summer of 2025. The original out-patient department has RAAC planks in the roof that are now well beyond their lifespan. Recent risk assessments have graded the condition as catastrophic, with an incident likely. That compounds the betrayal of the empty promises from the previous Government. The rebuild will mean that the hospital can serve my constituents, who desperately need medical facilities, for many years to come. The value of that is immeasurable.

I also welcome the Government’s commitment to changing the way we use health services. The NHS is our most beloved institution and it has served us effectively for a long time, but it must adapt. That is why I particularly welcome plans to turn Leighton into a health and care neighbourhood, transforming it into a site where provision is joined up; a place where resources are utilised well and people are actively involved in their care; a place where technology, digital and data help both proactive and personalised care to be more effective; and a place where we look after each other, we collaborate and people join forces to improve the whole.

[John Milne (Horsham) (LD)]

In my constituency, there has been a popular campaign for a general hospital for many decades without success. Given that we did not even make it on to Boris’s fantasy list of 40 hospitals, we are certainly not going to succeed now. In the absence of that hospital, what we need is a strategy to move more of the treatments for which distance really matters into smaller local clinics. In Horsham, that might include wound dressing and sexual health services. Does the hon. Member agree that if we are going to continue to be denied the hospital we deserve, the kind of localised treatment strategy he is suggesting could be implemented at very low cost?

[Connor Naismith]

I agree with the hon. Member that we must move care into the community. Where we are not able to build hospitals as quickly as we would like to, community care is so important.

The NHS needs to be reformed to serve an ageing population, taking long-term patient care out of hospitals and putting care back into the heart of communities. We need more joined-up proactive, health and social care services, and we need to change our mindset from sickness to prevention. In support of that, the NHS Confederation set out in a recent report that working more at the neighbourhood level, which the Government intend to do, can improve people’s health and wellbeing.

I appreciate the efforts and sentiments from the Liberal Democrats today, but big promises with no clear plan are what got us into this mess to begin with. Empty words to gain votes have destroyed voters’ confidence in our politics, and only a sensible Government with a credible plan for delivery of their commitments will restore that trust, so I am thankful that this Government’s approach has been to set out a clear plan to deliver. Labour is the party of the NHS, from the original conception of the service back in the ’40s to the modern day. I am confident that, as we have already seen in the example I cited from Leighton, this Government will deliver for the British people.

14:17

[Rebecca Paul (Reigate) (Con)]

I am grateful for the chance to speak in today’s debate and to be able to give voice to so many of my constituents’ frustrations about how their right to access quality healthcare has been deprioritised by this Labour Government.

Many of my constituents, especially those in the north of my constituency, are served by the Epsom and St Helier university hospitals NHS trust. To be blunt, the situation at the trust today is simply not sustainable—clinically, financially or structurally. The trust currently operates two acute hospitals, in Epsom and St Helier, with duplicate services spread across both sites. The arrangement, while a product of historical necessity, today places considerable pressure on clinical teams. Allocation of staff members between sites is challenging and service delivery is stretched. No matter how committed the staff—their dedication is beyond question—they are constantly being asked to do more with less, in buildings that are often quite literally falling apart around them.

To give just one brief example, earlier this year St Helier was forced to cancel scheduled blood tests because of widespread flooding in the phlebotomy section. We simply cannot go on like this. Indeed, time is not a luxury we have, with the estate now deteriorating faster than it can be fixed. The trust is spending millions every year simply to keep the most urgent problems at bay: patching leaks, coping with flooding, and addressing the worst outbreaks of damp and mould. I think we all agree that these are not the conditions in which 21st-century healthcare should be delivered.

That is why it was so disappointing to learn earlier this year that the planned specialist emergency care hospital in Sutton—a long-standing scheme under the new hospital programme that was carefully conceived to address the very issues I have mentioned—has been delayed to the point that work will now not even begin until 2030 to 2035, with opening coming in 2037 at the earliest.

The new hospital will consolidate emergency care into one state-of-the-art facility, delivering world-class treatment, faster access to care, and safer outcomes. At the same time, it will allow for major investment at Epsom and St Helier hospitals, helping to modernise crumbling buildings, improve planned care pathways and ensure that most services remain close to home. Under the trust’s plans, 85% of services would remain on the Epsom and St Helier sites, including out-patient care and diagnostic appointments. Local people would continue to receive the vast majority of their care where they always have done, but would benefit from shorter waiting times and access to better facilities, particularly for surgery. I passionately believe that the new hospital at Sutton is a once- in-a-generation chance to overhaul healthcare provision and ensure that my constituents receive the high-quality care they deserve in a timely fashion.

[Luke Taylor (Sutton and Cheam) (LD)]

The new Sutton hospital will sit in my constituency. In 2020, we were promised by the former Member for Sutton and Cheam that the hospital would open in 2025; indeed, he continues to have that claim on his website. Does the hon. Lady agree that the failure to deliver any new hospital in Sutton borough, whether at Belmont or St Helier, is entirely down to the failure of the previous Government to fund and bring forward these projects while they were in power?

[Rebecca Paul]

I can confirm to the hon. Member that if the Conservatives were in power, we would be delivering that hospital.

I want to be clear: the trust is ready to move forward, and clinical consensus has been secured; what is now urgently needed is commitment from the Government to drive the programme forward. After all, patients and staff alike deserve better than to spend another decade or more in facilities that are not fit for modern healthcare delivery. They deserve to know that promises made through the new hospital programme will be honoured, not quietly shelved or endlessly deferred by this Government.

I urge Ministers in the strongest possible terms to look again at the decision to delay Sutton emergency care hospital and to provide the long-term certainty the trust needs to proceed—not in 2035, but now.

14:22

[Danny Beales (Uxbridge and South Ruislip) (Lab)]

I am glad that we are taking the time today to discuss the immensely important issue of the state of our NHS hospitals. Nowhere is it more obvious that our NHS has been broken over the past 14 years than in our crumbling NHS estate. Our NHS has been starved of capital funding, and the backlog maintenance bill now stands at more than £11 billion. Research from the NHS Confederation shows that nine in 10 NHS leaders believe that the crumbling NHS estate is undermining their ability to tackle the elective backlog. This is devastating. It is apparent in my constituency, with Hillingdon hospital plagued by flooding, sewage overflows, failing lifts and outdated equipment.

The need for a new hospital in Hillingdon is not new—my predecessor’s predecessor described the hospital as no longer fit for purpose many years ago, and pledged at the time to replace it. The Lib Dems are right today in their condemnation of the previous Government’s record, with their fantasy hospital programme that seemed to exist only in the mind of Boris Johnson, and never in the reality of the Treasury’s decisions. Residents in Uxbridge have been led up the garden path time and again, with false promises upon false promises, a funding package that was never approved and building works that never began—to this day, not a stone has been laid and no ground has been broken. At the election, no business case had been agreed, the hospital design was still being tweaked, and no contractor had been appointed. Rather than being fully funded, only £70 million of £1 billion had ever been provided.

I am glad, therefore, that the Labour Government have prioritised capital investment, with capital spending increasing by £13.6 billion in the Budget, and I am grateful for the progress we are now making with a realistic, honest and deliverable timescale for the programme. After years of broken promises, people are fed up and need action, delivery and credible commitments. That is why it is disappointing that the Lib Dem motion today, if approved, risks leading again to unfunded commitments, promising to deliver all the hospitals simply through a new taskforce. That is not how hospitals are built or paid for. It does not feel to me like a credible funded programme; instead, it is a recipe for more talk, more delay and more inaction.

I know that the community in Uxbridge and South Ruislip are now reassured that Hillingdon hospital has been included in wave 1, with a capital envelope agreed in recent weeks of nearly £1.4 billion. Instead of more words or a taskforce, we have delivered solid agreements and funded commitments—a real plan for change. The hospital is now finalising its business case and design. A contractor will be appointed and on site in 2027, and construction work will start in 2028. It is essential that the new hospital programme continues to work at pace to provide my constituents and all residents in this country with the quality of care they deserve. I am sure the Minister would expect all Members to hold the Government to account for the delivery of the programme.

Turning to the concrete actions we could take to deliver the hospital programme more quickly, long-term revenue funding for new wave 1 teams is much needed so that they can work at pace, as well as a simplified planning process for new hospitals. I welcome the Government’s planning reforms and Planning and Infrastructure Bill. I hope that Lib Dem Members will support the Bill, which seeks to speed up the delivery of critical national infrastructure.

As well as investment in hospitals, we need investment right across our NHS estate, as has been discussed today. I have met GPs who are using store cupboards as consulting spaces and heard from pharmacies that want to do more but are desperately lacking the space to deliver Pharmacy First services in privacy. The Wakley centre, which provides sexual health services in my constituency, is crammed into an outdated building, using every inch of space, and is desperate for more modern space to do preventive work.

[Edward Morello (West Dorset) (LD)]

I agree entirely with the hon. Gentleman on the need for investment outside of hospitals, but does he agree that we also need smarter investment? Dorset NHS foundation trust, along with Somerset NHS foundation trust and university hospitals Dorset, has submitted a business case for an integrated electronic health record system that would allow them to work together, share information and, ultimately, save the NHS money. Does he agree that this is exactly the kind of technological advancement the NHS should be funding?

[Danny Beales]

We need to think not just about buildings, but about digital infrastructure and investment in a whole range of capital investment needs for the NHS for it to be a modern, fit-for-purpose service. It sounds like the measures the hon. Gentleman suggests are sensible.

There is a strong desire in the emerging 10-year plan to shift to neighbourhood health services, which would also require capital investment. Three neighbourhood hubs are planned in Hillingdon, but there are still no clear sites and no capital investment to make them a reality. We need a long-term infrastructure strategy for the NHS, alongside our 10-year health plan. I welcome the significant increase in capital spending for the NHS at the Budget. I also think the Government’s new commitment to protect capital budgets in the NHS is vital. Far too often, under the previous Government, those budgets were raided for short-term investment to plug revenue-based gaps; now that has come to an end, which is very welcome.

My constituents have waited long enough for Hillingdon hospital. We do not need more taskforces or reviews, but concrete funded plans of action. At last, we have from this new Labour Government a fully funded new hospital programme ready to be delivered. I look forward to construction starting and working with this Government to deliver health services that are fit for the future.

14:27

[Brian Mathew (Melksham and Devizes) (LD)]

I fully support reversing the delays to the new hospital programme and want to emphasise the importance of investment in community health provision, which offers multiple benefits to patients and the health service.

There is currently no out-of-hours healthcare provision anywhere in my constituency. Patients typically have to travel to Swindon, Bath or Salisbury for urgent medical treatment or, at best, the minor injury units in Chippenham or Trowbridge. Most of the constituency, including Melksham and Devizes towns, has limited public transport options to get to major hospitals, with patients unable to travel by car facing lengthy bus journeys.

In Melksham, we already have a working community hospital that offers a range of healthcare services, from physio to consultant out-patient appointments, but it has been without a minor injuries unit since 2008. On occasion, people in need of urgent treatment for cuts and broken bones turn up at the hospital only to be turned away without so much as a sticking plaster. That simply is not good enough.

Melksham is seeing ongoing development in and around the town, which is driving population growth, yet we have not seen the investment in services and infrastructure to match. If the long-term strategic goal is to shift more care out of larger hospitals and into community hubs, is there not a clear case to consider expanding services at under-utilised sites, such as at Melksham community hospital? Investment in services, such as in a minor injuries unit at a Melksham community site, not only offer greater convenience and potentially improved outcomes for patients, but is cost-effective, decreasing demand on overstretched services at major hospitals and reducing congestion on our roads.

I very much hope that the Department will consider the compelling case for upgrading community hospitals, and I would welcome the chance to meet the Minister to discuss the specific case for Melksham and to bring representatives from the Friends of Melksham Hospital with me.

14:30

[Andrew Cooper (Mid Cheshire) (Lab)]

It is a pleasure to follow the earlier speech of my constituency neighbour, my hon. Friend the Member for Crewe and Nantwich (Connor Naismith). I hope Members will forgive me, but they are about to be treated to more information about the hospitals of Mid Cheshire and south Cheshire.

We on the Labour Benches are incredibly proud of our NHS. It is one of our country’s greatest achievements, and is founded on the principle that everyone, no matter their background or circumstances, should have access to high-quality healthcare that is free at the point of use. That simple idea has saved millions of lives, and offered comfort, healing and hope to generations. However, after 14 years of Conservative failure, the NHS was left on life support, with record waiting lists, surgeries and appointments cancelled or delayed, a workforce worn down and undervalued, and hospitals crumbling. That is the legacy of the previous Conservative Government— a legacy of neglect, underfunding and broken promises. Nowhere is that clearer than in the new hospital programme that they introduced in 2020. This was meant to be their flagship plan to modernise the NHS estate—to replace crumbling buildings and ensure that patients and staff had the safe, modern environments that they deserve—but the scheme was built on shaky foundations.

From the start, the scheme was plagued by delays, confusion and a complete lack of proper funding. The reality behind the headlines was that very few hospitals saw any real progress. In many cases, the money simply was not there. Let me take the case of Leighton hospital, which serves my constituents in Northwich, Winsford and Middlewich, and four other hospitals across the country. All are known to be riddled with reinforced autoclaved aerated concrete. Experts warned of a “catastrophic” risk to patient safety. Structural engineers said an incident was “likely”. In simple terms, these buildings were falling down, but what did the previous Government do? When the programme was first published, the plans to rebuild those five hospitals were blocked. The previous Government chose to ignore the warnings, ignore the patients and ignore NHS staff working every day in buildings that had been declared unsafe.

It was not until 2023 that the previous Government finally amended the new hospital programme to include Leighton and the other RAAC-affected hospitals. By then, years had already been wasted—time that we did not have—and even that decision came without a real plan, without a timeline and, crucially, without the funding needed to do the job.

What was offered to my local community was not a solution; it was false hope dressed up as progress. The promises crumbled faster than the hospitals that the previous Government failed to rebuild. In contrast, this Government are delivering. We are not just talking about change; we are making it happen. We are rebuilding the NHS from the foundations up and, just as importantly, rebuilding trust that the Government will deliver on their promises on the NHS. At Leighton hospital, we are proving it: the funding has been confirmed to the trust; the ground investigations are under way; and the project is moving forward. This is not just talk, but action. But let us be clear: rebuilding Leighton is not just a matter of replacing concrete; this is our opportunity to do something bigger. We have a chance to build a healthcare neighbourhood that reflects the future—a modern, resilient facility that will serve communities for generations to come and will meet the challenges of 21st century healthcare. This is not just about bricks and mortar; it is about people, it is about care and it is about building a system that reflects our values.

We are tackling the root causes of the crisis that the Conservatives have left behind. We are reducing waiting lists through more appointments, better use of technology, and support for our overstretched staff. We are training and recruiting the doctors, nurses, and carers of the future. We are ending the sticking plaster politics of the last decade and a half and building an NHS that is fit for the future.

14:34

[Tim Farron (Westmorland and Lonsdale) (LD)]

In rural communities like mine, our issues are very often about the distances that we have to travel in order to get any kind of healthcare, but particularly to reach hospitals. In Morecambe bay, which covers three quarters of my constituency population-wise, we are funded as if we have one hospital, but have to have three. One way that we have got around that is to have funding for GP surgeries to provide minor injury care in places like Grange, Ambleside, Hawkshead and beyond—yet, as of 1 April, our local integrated care board has cancelled that funding. There was a total of 1,221 minor injury assessments last year; they are now pushed on to the urgent treatment centre at Kendal, potentially overloading that excellent centre, but also causing huge harm to people who live in those rural and dispersed places, and undermining the funding model for those GP surgeries and putting them at risk. I would love it if the Minister had words with the ICB to challenge it on this.

Tomorrow, the ICB for Lancashire and South Cumbria will meet. On its agenda may or may not be, but jolly well should be, the decision to approve and to seek a new provider of GP services in the community of Coniston. We have known for three months that the excellent Dr Frey and Dr Abbas were retiring and leaving their posts in July, and the ICB has dragged its feet for three months, despite the community clamouring for action. We presented a petition of over 1,000 signatures in this place just a few weeks ago for there to be a replacement of the GP surgery to serve the community in Coniston.

When it comes to the new hospital programme, I acknowledge the fantasy figures behind the previous Government’s non-existent programme, but I point out that land is available in the larger district general hospital site serving Lancaster in the southern part of my constituency. It is right next to the new medical school at Lancaster University and it is absolutely shovel-ready. There is no logical reason for it to be in the last division of the third phase of the programme, which means that it will not be built until the 2030s. I urge the Minister to think again on that point.

The Minister will be unsurprised to hear me use my last minute and a bit to talk about radiotherapy. In the northern part of my constituency, in places like Appleby, people who have cancer are able to get good quality radiotherapy treatment at Carlisle, but in the southern three quarters of my constituency, people have to make return journeys, sometimes of four hours a day for weeks on end, to get radiotherapy treatment at our nearest centre in Preston. That is outrageous. That is why we are asking for there to be a satellite radiotherapy unit at the Westmorland general hospital in Kendal. This is not just about convenience. According to an OECD recommendation, radiotherapy should be the primary treatment for cancer in 53% of cases; shamefully, in the UK, it is in only 36% of cases. Lancashire and South Cumbria ranks 42nd of 42 ICBs, with only 29% of people with cancer receiving radiotherapy. That is in no small part down to the failure to provide that treatment within our communities.

It is absolutely the case that the longer the journeys to treatment, the shorter the life expectancy of the people suffering with cancer. I urge the Minister finally to make the decision, which we have been demanding for years, to add to the chemotherapy service, to the diagnostics and to the cancer surgery that we now have at Kendal. It was wonderful to win those campaigns, but the one thing that we are missing is radiotherapy. It is time that we brought it to the people of Westmorland, so that they can have shorter journeys and longer lives.

14:38

[Dame Siobhain McDonagh (Mitcham and Morden) (Lab)]

I have a unique case to make in this debate on behalf of my constituents and Merton council. We do not want the new emergency hospital at Belmont, which is in phase 2 of the hospital rebuilding programme. In direct contrast to the hon. Member for Reigate (Rebecca Paul), I have fought this scheme for 25 years against all Governments—my own Government, the coalition Government and the Conservative Government. This plan will take the hospital away from my constituents with the greatest health needs, the largest levels of deprivation, the lowest car use, the highest hospital admissions and the greatest level of chronic conditions, and take it to healthy, wealthy Belmont at a cool cost of £1.5 billion.

The hospital will provide 80 fewer beds than we have at the moment, serve 83,000 fewer patients, and put increased pressure on St George’s hospital in Tooting and Croydon University hospital—both hospitals that the Care Quality Commission has said need fewer patients to arrive at their sites. This scheme would give them more patients. Worse than that, it depends on a 3% annual reduction in lengths of hospital stays and a 3% annual reduction in activity. What hospital in the country has experienced a reduction in activity? It is also based on increased access to mental health services, which should have been provided last year, the development of community paediatric pathways, a child development centre—yet to be seen—and the reopening of the Wilson hospital in Mitcham. That hospital has not been reopened; the money has not been found, so it remains closed.

The scheme is also dependent on an increase in home births in Mitcham and Morden, which has the highest levels of social housing, the greatest housing deprivation and the most overcrowded conditions in the region. This is the Tudor Hart law writ large, where hospital services are taken away from those who need them most and given to the areas that need them least. I ask the Minister: save taxpayers’ money. Already £50 million has been spent consulting on this scheme. Nobody wants it and nobody supports it. Leave St Helier hospital as it is. Spend the money that the Government have on St Helier hospital and give better services to those who need them most.

14:41

[Robin Swann (South Antrim) (UUP)]

The motion starts by referring to “hospitals across the country”, but most of the debate today has been about England. I want to highlight the situation that has arisen from the decisions made in this House on capital investment and changes to fiscal rules, and how that affects Northern Ireland and the capital investment there.

Capital investment in the health estate in Northern Ireland has been broadly stable for the 15 years prior to 2019—until 2020 when the covid pandemic brought about increased capital investment. The long tail of the pandemic, compounded by Russia’s invasion of Ukraine, significantly disrupted global supply chains and increased construction costs. Those price increases have compounded a subsequent and very serious problem in Northern Ireland: the outcome of the two most recent Budgets, which has meant that the funding available for capital investment in Northern Ireland is now projected to be 16% lower per head of population than England for ’25-26, and therefore much lower than any assessed relative need would suggest. While I listened to the complaints of many English colleagues across the House about capital investment, in some cases I am quite envious of what they are being allocated, because it is a contrast to what we have.

Much of our health and social care capital budget is project-based. As the former Minister of Health in Northern Ireland, I am acutely aware that there is an increasing need to address the serious risks across our health and social care estate. That includes tackling its backlog maintenance liability, which currently sits at £1.4 billion. Now, as a constituency MP, I see the impact of below-needs budgets on projects in South Antrim. The new Birch Hill mental health centre is a much-needed, purpose-built facility to provide the very best environment for assessment, treatment and recovery. Yet under the budget that the Executive have provided the Department of Health, there is not enough to fund what has already been committed to, including the Executive’s flagship projects, to meet current contractual commitments, to progress projects in design or development, or to fund even limited maintenance of existing property assets.

Good projects and massive potential are being lost because the Executive cannot seem to think even six months down the line, never mind one or two years. Nevertheless, Birch Hill remains high on the agenda of our Department of Health, and I hope that the Executive parties responsible for funding allocations consider the consequences of their decisions and recognise the critical need for the project. For mothers and babies in Northern Ireland, it would also provide a centre for perinatal mental health and wellbeing.

I join the hon. Member for Milton Keynes North (Chris Curtis) who said that the motions are welcome but what we would like to see is action. That action would be the certainty of having budget, and assurance that it will be a recurrent budget. I look to the words of the Secretary of State for Health, who talked about transformation in the health service and how it needs both funding and political will. I hope that following today’s debate he can get both.

14:45

[Dr Simon Opher (Stroud) (Lab)]

I must confess that I am slightly surprised that the Lib Dems have brought forward an Opposition day debate about hospitals and are stating their case in such a way, because the last thing we need in this country is a load of promises we cannot keep. I am proud that we Government Members have provided sustainable and affordable plans for the new hospital programme. I have been on the doorstep the last few weeks in the run-up to the county council elections, and the No. 1 priority that comes up is GP access. We have provided 1,500 new GP posts in this country, and waiting lists have been going down for the last five months. Emergency dentistry is also very commonly brought up on the doorstep, and we have provided 700,000 new dentist appointments.

There are many other parts of the NHS that are crumbling. I see the crumbling of the hospital buildings as a metaphor for what has happened to the NHS over the last 14 years.

[Melanie Ward (Cowdenbeath and Kirkcaldy) (Lab)]

My hon. Friend is talking about the important work done by Lord Darzi, and the findings on crumbling hospitals in England. He may be interested to hear that recent figures show that the bill for the high-risk repairs needed to Scottish hospitals stands at £64 million. Those repairs have not been carried out under the SNP. They include two high-risk repairs that are badly needed, and have been outstanding since 2016, at Cameron hospital in Fife, which is used by some of my constituents. Does my hon. Friend agree that the Scottish Government should use some of the record funding provided to them by this Labour Government to fix our hospitals in Scotland?

[Dr Opher]

Of course it is essential that we maintain hospitals so that they are safe to treat patients in, so I agree with my hon. Friend about spending the money. In fact, the backlog bill for repairs in the NHS runs to £13.8 billion. I work as a GP in a GP practice, and I note that Lord Darzi estimates that £37 billion more should have been spent on the NHS since 2010, but was not. For those of us working in the NHS, it does feel like that. There is a massive building project ahead of us.

I point out that the previous Labour Government built 100 new hospitals. One was the Vale hospital in Dursley, which we started in 2008, and which I had a hand in. As hon. Members have said, community hospitals such as Vale hospital are crucial to how the NHS works. We must invest in our community hospitals and use them properly. The Vale hospital provides excellent minor injuries unit services, a specialist stroke service and in-patient beds for the community. We must invest in our community hospitals going forward. As we have heard, there were meant to be 40 new hospitals in the last few years, but none of them got built, and it turned out that they were not even funded.

We need to get care out of hospitals and back into the community. The hon. Member for Oxford West and Abingdon (Layla Moran) talked about GP premises; 20% of GP premises were built before the inception of the NHS, and I inherited one of those premises in Dursley. Twenty years ago, we opened a purpose-built surgery at May Lane, and we are still enjoying the benefits; it provides patients with excellent services. We must therefore invest. I was glad to see the Government investing £100 million in GP surgeries. I was pleased to see £80 million put into GP advice and guidance; that will allow consultants to give GPs advice, so that they can care for patients in the community. I am also really delighted with the push for neighbourhood health centres; that must be the way. We must bring back the family doctor, as that continuity of care is what really makes patients better. That is so important.

We must also integrate health and social care in the community, so that we can pull patients out of hospital. That also applies to emergency care, as far too many people are having to go to overwhelmed A&Es at big district general hospitals. At the moment, only 20% of acute admissions go through GPs, who are the best people to ensure that we avoid admissions. We have to change all of this. Our NHS staff and patients deserve better; they deserve facilities that reflect the excellence of the care provided within them. The Labour Government are committed to rebuilding not just our hospitals, but trust, and the integrity of our public services.

14:51

[Freddie van Mierlo (Henley and Thame) (LD)]

Hospitals matter to everyone, but hospitals falling apart help no one—not patients, not staff and not the economy. The Government have called the NHS “broken”. They rightly blamed the Conservatives, and criticised the NHS’s management under their leadership, so why are the Government now making the same mistakes?

Under the revised new hospital programme, the building of the Royal Berkshire hospital will not commence for another decade. There is little prospect of a new Royal Berkshire to serve the communities of Henley, Reading, Newbury, Bracknell and Windsor until the 2040s. Doctors who have worked in the NHS for over 30 years believe that they will never work in modern buildings. The cancer centre alone is 164 years old.

[Sarah Dyke (Glastonbury and Somerton) (LD)]

My hon. Friend talks of members of staff with long service. A former nurse with 40 years’ experience in the NHS recently contacted me. She took her husband, who has complex needs, into hospital, as he had a hand infection, and they were forced to wait for over 12 hours in a tiny cubicle with no ventilation. It pained me to hear that story. She worked so hard for the NHS, which she felt was down on its knees. Does my hon. Friend agree that this is a damning indictment of the state of our hospitals, and that we urgently need to pursue a major 10-year capital investment programme to get them back up to speed?

[Freddie van Mierlo]

My hon. Friend is right to point out the impact of the state of the NHS on the brilliant people who work there. My sister is a nurse in the Royal Preston hospital, and she tells me just how hard it is to walk past people who are being cared for in corridors. Every week at the Royal Berkshire, an operation is cancelled due to power cuts, water supply issues, broken lifts or malfunctioning temperature controls. Those are lost appointments and lost efficiency for the NHS. Floods and sinkholes plague the foundations of the Royal Berkshire hospital, which now requires relocation, and identified suitable sites are set to be put on the market at the end of this year. Further inaction by the Government will mean that those carefully laid plans and that funding will amount to nothing.

There are also hospitals that were never considered for the programme, as my hon. Friend the Member for Oxford West and Abingdon (Layla Moran) pointed out. I recently visited the Warneford hospital in Oxford, which gives in-patient care to patients with severe mental health conditions, including schizophrenia, personality disorders and psychosis. I was shocked by the conditions that patients live in. They are in tight spaces in dark rooms, and the infrastructure is Georgian. There were rooms that reminded me of recent visits to HMP Huntercombe. I said that rather nervously to the member of staff showing me around, worried that I might offend them. They gently held my arm and said, “Freddie, why do you think we showed you these rooms?”

Staff told me that cramped conditions make it difficult to take breaks during the day. One worker showed me their windowless cupboard office—hardly great for their own mental health. Staff also told me how working in Georgian buildings impacts the quality of their work. Sight lines in common rooms are obstructed by pillars; rooms are difficult to heat; and security is difficult to maintain. A new Warneford would cost a fraction of the price of a physical health hospital, and the Government promised to put mental health on the same footing as physical health, so why does the revised new hospital programme not include a single mental health facility?

Both the Warneford and the Royal Berkshire have been devastated by the Government’s lack of foresight. The cuts to hospital spending are a decision made to save money, but that is a false economy. Over the next 10 years, repairs to the Royal Berkshire hospital are projected to cost £400 million—a quarter of the cost of a new hospital. Add to that the many other neglected hospitals, and the loss is unthinkable. Proper investment in modern infrastructure is needed now.

In my constituency we have the Townlands Memorial hospital, which shows how good the NHS can be with modern infrastructure. Anyone who receives care there, whether through the Royal Berkshire NHS foundation trust or the Oxford Health NHS foundation trust, sings its praises. It hosts over 30 specialities and plans to expand further. Let us give our hospitals the chance to excel.

[Several hon. Members rose—]

[Madam Deputy Speaker (Judith Cummins)]

Order. There is an immediate three-minute time limit.

14:56

[Laura Kyrke-Smith (Aylesbury) (Lab)]

It is a pleasure to speak in the debate. The previous Government made off-the-cuff commitments to new hospitals that were never going to be affordable or deliverable; I am really proud to be part of a Labour Government who commit only to what we can afford. We stick to our promises and deliver them. The rapid progress that we have made towards improving the NHS, reorienting it towards frontline delivery, is a fantastic example of that.

Over 3 million more appointments were delivered in the first nine months of this Government—that is well ahead of the target—and over 100,000 people have been treated on time. Those are great statistics, but when I knock on doors and meet residents, I hear about the difference that that has made to them and their families. People are back on their feet, back at work, and back being active parents and grandparents sooner than they could have imagined. This is politics that is delivering for people. It is not the politics of easy answers, but the politics of progress, and of change to people’s lives.

I will highlight one change that will be particularly important in my constituency of Aylesbury as we continue the work of transforming the NHS, including through the new hospital programme: the need to better integrate primary and secondary care. There is great potential for savings there, if we think about the secondary and primary care estates in the round. More importantly, that will help bring traditionally hospital based-care closer to the community; it will be better care that has better outcomes for people.

As I have said in this place before, we face an acute challenge in Aylesbury with our GP surgeries. We had new housing estates built in a poorly planned way under the previous Government, without the necessary GP services being provided. We also have particularly high levels of deprivation in Aylesbury and the county of Buckinghamshire—it is really marked by inequalities—which contributes to the pressures on our GP services.

The Government have already made significant progress in improving GP provision; 1,500 new GPs have been recruited, and successful negotiations with the British Medical Association have resulted in the biggest uplift in funding for GPs in years. I think that will start to make a real difference.

[Lincoln Jopp (Spelthorne) (Con)]

Has the hon. Lady had any feedback, in conversations with her GPs, about what the increased employer national insurance contributions will do to their growth of provision?

[Laura Kyrke-Smith]

I am in regular contact with my GPs, and I know that they are really pleased, actually, with the uplift in funding that they have received through the contract, and with what they will be able to deliver with that.

As we think about the future of hospital provision, we must think about our healthcare in the round—what each community needs more broadly, and how we join up hospital services with those provided by our GPs, and with other community services. I am really excited by the work already under way in Buckinghamshire to establish integrated neighbourhood teams and I am pleased at this Government’s commitment to neighbourhood health centres.

In Buckinghamshire, and particularly in Aylesbury, all our key health organisations are coming together—including the acute and community NHS trusts, primary care, the local authority, public health, the mental health trust and voluntary sector organisations—to agree a collective plan for the next 10 years, which I think could be transformative. They are pooling their collective resources and teams across Stoke Mandeville hospital and three primary care networks, and looking not only at creating a centre in Aylesbury for shared delivery of services, but at providing better care out in the communities.

As we build our hospitals of the future across the country, it is essential that we plan in that way—not just for in-hospital care, but for a joined-up approach across all our services, bringing that care closer to our communities. Ultimately, that is what people want and what people need: a future healthcare system in which as many people as possible can access care close to home and manage their health in their own homes and their own communities as best as possible.

15:00

[Charlotte Cane (Ely and East Cambridgeshire) (LD)]

Many of our hospitals are crumbling, but even those that appear sound may contain hidden dangers, notably asbestos. Last week I met a constituent who is suffering from mesothelioma, contracted from asbestos. He was very concerned that so many of our hospitals and other public buildings still have asbestos within them, putting more people at risk of getting that terrible disease. We need a proper survey to find out where all that asbestos is and a plan for its safe removal.

I was pleased to hear the Minister talk about the work he is trying to do to get more funding for GPs, because that is one of our big problems in Ely and East Cambridgeshire. A while ago, when we nearly lost our GP in Sutton, residents were told, “Never mind—you can go to nearby GPs.” In rural areas, however, a GP even a few miles away is inaccessible to anyone who does not have a car. More recently, unexpected changes to the bus route with no notice left patients of the Bottisham practice suddenly unable to get to their GP.

We have seen a lot of new build around my constituency, not least in Soham, which desperately needs a larger surgery. I went there and saw the conditions staff were working in, the tiny space they now have for their pharmacy area and the difficulties they face in serving a much larger community than the surgery was built for. The practice has been trying for years to get a new surgery, but the procedure for keeping or enlarging a surgery or building a new one is incredibly complex, and GPs must put together funding from a range of sources. Those GPs should be spending their time trying to help patients, but they are instead spending their time building business plans and looking for funding. As we heard earlier from a Government Member, we desperately need NHS dentists in my constituency too, and they in turn will need premises.

We do not have any major hospitals in Ely and East Cambridgeshire, but we rely on those elsewhere to be in good condition when we need them. We need our own Princess of Wales hospital to be in good condition, and we need excellent GP surgeries and NHS dentists who can serve us into the future.

15:03

[Josh Fenton-Glynn (Calder Valley) (Lab)]

Today’s debate is a welcome chance to talk about the challenges of our health service. The Darzi report was a stark demonstration of the state in which the health service was left by the last Government. I know that part of the game today is for our colleagues on the Liberal Democrat Benches to say, slightly deceitfully, “Oh, the Labour MPs are supporting the delay.”, but Members across the House will know, if we are honest with ourselves, that we cannot delay something that was not going to happen.

What of our inheritance? It stretched far further than just the buildings; it included the staff and the patients in them, weakened by austerity and decimated by covid. Lord Darzi talked about £37 billion of under-investment in our hospital buildings in the 2010s. On top of that, what else did we inherit?

[Perran Moon (Camborne and Redruth) (Lab)]

Does my hon. Friend share my real discomfort at the gall of the hon. Member for Henley and Thame (Freddie van Mierlo) in suggesting that somehow this Government are making the same mistakes that the Conservative Government made, when it was in the 2010s—under a coalition Government—that the rot started, with the Liberal Democrats?

[Josh Fenton-Glynn]

I think if the hon. Member for Henley and Thame (Freddie van Mierlo) were to reflect on what he said, he would know that these things always go a lot deeper.

What have we inherited? We inherited 14,000 unnecessary deaths in A&E alone each year. NHS waiting lists peaked at 7.7 million. That is people waiting anxiously, needing treatment, tumours growing, their bodies getting further from being well, and every day 2,000 people were being sent to hospital who did not need to be there, because social care had been failed and forgotten by the previous Government and by the coalition Government. In my constituency, that means 20% of beds in our hospitals are taken up by people who do not need to be there.

We have work to do, and I am concerned that in this debate we will get caught up in a discussion about hospitals and will not fix the systems within them that we need to fix. That is why we have talked about three shifts. The first is from hospital to community. We have to stop people needing hospital care because they have been failed by care closer to home. That is why our revolution in GPs will make a real difference. The second is the shift from fitness to prevention. We can have the best buildings, but with less prevention they will still be full. Finally, there is the shift from analogue to digital; every week, the Health and Social Care Committee hears about people caught between systems and between computer systems.

Although I welcome this debate, we must not fetishise buildings over people. We need to think holistically about our system and deliver the decade of national renewal that the public voted for. We need to look at all of our health service, across parties and in good faith.

15:06

[Alex Brewer (North East Hampshire) (LD)]

My constituents are predominantly served by two hospitals: Frimley Park to the east and Basingstoke and North Hampshire to the west. Some 65% of Frimley Park is RAAC concrete, known to be highly unstable, so it is right that it is included in phase 1 of the new hospital programme and prioritised as urgently needing a complete new build. Basingstoke and North Hampshire hospital, however, has been moved to phase 3 and building is now scheduled to begin some time between 2037 and 2039, leaving staff and patients to endure the crumbling buildings for another 15 years.

That decision was made without a single ministerial visit—not one. However, I have visited the hospital and seen what is needed, so I can tell Ministers about the repairs needed to the ceiling to stop rain coming into patient wards and the windows that cannot open, cannot close or are not double-glazed. I can tell Ministers about the air conditioning and filtration systems that keep the air clean in the hospital’s operating theatres, which are already at their maximum capacity. Replacing those systems will become essential within five years, and there is no physical room to add to what is there.

I can tell Ministers about the flooring that connects two important parts of the hospital over a car entrance, which is in a poor state and held together with industrial tape. Patients are being trolleyed across that uneven, unstable flooring on a daily basis. The tape holding the site together is both literal and a metaphor for the state of the system and of hospitals right now in this country. Ministers would know that if they had visited the hospital. One third of the repairs needed are high-risk—not a phrase we want to hear associated with our hospital structures and systems.

[Lisa Smart (Hazel Grove) (LD)]

I completely agree with my hon. Friend that in none of the repairs we are talking about to our hospital infrastructure do any of us want to use the phrase “high-risk”. Stepping Hill hospital serves my constituents; I have met the Minister about it and I look forward to welcoming her to visit it later this year. Despite needing a reported £134 million spent on it, Stepping Hill is not on the new hospital programme. I am sure my hon. Friend agrees that the health of our nation is directly related to the wealth of our nation, and that investing in hospital infrastructure is thus an extremely good investment in all of our population.

[Alex Brewer]

I thank my hon. Friend for her intervention. Health and wealth are two sides of the same coin and we need to invest in both, which is why the delays are a false economy. Maintaining Basingstoke and North Hampshire hospital for the next 15 years will cost almost as much as the rebuild, making it a false economy and a categorically bad financial decision as well as a bad health decision. There is no point in investing in a multimillion-pound brand new air filtration system in a building that is falling down.

In June 2024, the Prime Minister who was then the Leader of the Opposition visited Basingstoke town but not the hospital. Assurances were given and reported in the Basingstoke Gazette that the hospital would be built by 2030. In February after the announcement, I asked the Prime Minister about the logic of the delay, given that it will clearly be a significant financial burden for taxpayers while continuing to limit healthcare delivery. I was told that the hospital would be built, but not when. This is a clear step backwards. With the exception of the shadow Minister, we all know the situation in which the previous Government left the country, but that is not a reason for economically and medically unsound decisions now. I invite the Minister—or any Minister—to visit Basingstoke and North Hampshire hospital with me to understand the full financial and health implications of this decision for local people in North East Hampshire.

15:11

[Mark Ferguson (Gateshead Central and Whickham) (Lab)]

I refer the House to my entry in the Register of Members’ Financial Interests.

This has been an interesting and enlightening debate in some ways. Of all the subjects on which the Liberal Democrats might have brought a motion to this House, it is fascinating that we are talking about new hospitals, as I think everybody would agree that the Labour party has invested both historically and under this Government in the national health service. In fact in the last Budget back in the autumn, £13.6 billion extra was allocated to NHS capital expenditure—a record amount. I know that Opposition Members have not particularly enjoyed repeated references to the coalition years. I do not think anybody in this House particularly enjoys remembering the 2010 to 2015 period. The Conservatives certainly do not, and apparently the Liberal Democrats—

[Luke Taylor]

Will the hon. Gentleman give way?

[Mark Ferguson]

I am barely getting going but would be delighted to add an extra minute to my speech.

[Luke Taylor]

It is amazing how short memories are on the Labour side of the Chamber. The note from the right hon. Member for Birmingham Hodge Hill and Solihull North (Liam Byrne) which said “I am afraid there is no money” led to decisions that were apparently “ideological”, yet difficult decisions now being made by the Labour Government are “mature and realistic”. It is amazing how short the memories are to make those two things different. A lot of time and patience are being given to this Government for the delays to our hospitals; if their tone were more constructive, more patience would be given.

[Mark Ferguson]

If we want the tone to be constructive, we should be constructive about the fact that Labour is going to be building hospitals, when no hospitals were constructed over the last five years. The reality is very clear: hospitals do not simply appear; we cannot wish a hospital into existence. They require two things: money and time. If we wish that there were more new hospitals in this country, we should go back in time to 10 to 15 years ago. That would have been a fantastic time, when borrowing was much cheaper than it is today, to have invested in hospitals in all our communities. Unfortunately, the cancellation of the building schools for the future project was basically the first act of the coalition Government, and there was a lack of investment in schools and hospitals. As the shadow spokesperson the hon. Member for North Shropshire (Helen Morgan) has said today, we are cleaning up the mess that has been left. That was the characterisation of the early 2010s, but it is very much more realistic today. The shadow spokesperson accused the Government of a lack of imagination. Well, there has been no lack of imagination here; there has been magical thinking from the Liberal Democrats, who apparently believe that a taskforce will generate the billions of pounds necessary to build hospitals immediately.

[Helen Morgan]

Will the hon. Gentleman give way?

[Mark Ferguson]

I am keen to make progress.

I have repeatedly made this point to Conservative Members, who I do not feel are taking the advice, but I will repeat it to the Liberal Democrats, who I equally do not think will do so. I have a huge amount of experience in opposition—a lot of us on the Government Benches have a lot more experience of it than we ever wanted. If we are really serious about what this country needs, we cannot just say that we want to have hospitals now and expect them to be delivered if we simultaneously oppose revenue-generating measures in the Budget. I am afraid that what this motion is about, which has been revealed by many of the speeches, is opportunism.

We all want more investment in the NHS and that is what this Government are delivering. A great point was made by my hon. Friend the Member for Calder Valley (Josh Fenton-Glynn) when he said that it is not simply a matter of buildings, but a matter of people too. The best maternity facility in the country is in my constituency at the Queen Elizabeth maternity hospital, yet it is in a very old building. I want a new building for that maternity hospital. I want far better resources for the staff. I hope that it will come in time, but they are doing a fantastic job with what we have got. We need to support those in the NHS rather than knocking them down.

15:15

[Steve Darling (Torbay) (LD)]

Torbay hospital is very much a family affair for me. My wife has worked there for more years than she would let me admit in this Chamber and my son is now a registrar there, so I thought I knew the hospital quite well until I was elected, and then the chief executive of Torbay and South Devon NHS foundation trust opened the Pandora’s box of pain and challenges that the hospital faces. That made me really angry at how the previous Conservative Government failed to invest in the desperate needs of our NHS, both in Torbay and across the country.

So it was with hope in my heart that I came to this Chamber in July, hoping that over the next few months Labour would be part of the solution. It is extremely sad and disappointing that Torbay feels as if it has been kicked into the long grass. We know that this means that there will be a failure in serving our communities. We are expecting outstanding staff to deliver services in poor conditions, and Torbay is one of the most deprived communities in the south-west, so we are letting down some of the poorest in our communities.

I want to share some of the contents of this Pandora’s box with the Chamber. On visiting the hospital, there is a vista of hope, as there is scaffolding around the main tower, but it is actually there to stop pieces of the tower falling on NHS workers and visitors to the hospital, rather than because repairs are under way. There are almost 700 sewage leaks across the hospital, many impacting on clinical areas. Whole wards have been shut down and had deep cleans due to these sewage leaks within Torbay hospital. Only 6% of the hospital is of A1 standard—that shows starkly how poor the situation is.

We face immediate pressures in Torbay. There are cuts to out-of-hours coronary care services that could put those in Torbay and nearby constituencies such as South Devon at risk of tissue death because there are not fast enough interventions for coronary conditions.

[Caroline Voaden (South Devon) (LD)]

I represent that neighbouring constituency, and those in the largely rural area of South Devon will be severely threatened by the closure of out-of-hours coronary care in Torbay because somebody decided it would be a good idea to merge it with coronary care in Exeter, meaning a potential increase of up to 45 minutes in ambulance times for constituents from the south of my constituency to get to hospital. It is clearly going to put people in critical danger, and I am sure my hon. Friend would agree that we desperately need the integrated care board to reconsider this poorly thought-out decision.

[Steve Darling]

I strongly agree with my hon. Friend that this wrong-headed approach needs urgent review.

In Paignton, there are threats to the long-term delivery of ambulance services, which would add delays to communities getting support. Perhaps the biggest threat is a financial one. Down in Plymouth, £60 million of cuts to health service budgets were announced in the last few days. In Torbay, the hospital admitted that it is looking at £40 million of cuts to NHS services. With £100 million of cuts and the pressures on our services in south Devon, will the Minister tell us where that money has gone and how she will intervene and support our services, because our hospitals in Torbay are crumbling?

15:20

[Chris Vince (Harlow) (Lab/Co-op)]

In all sincerity, I thank the Lib Dems for bringing the debate to the House. It is fair to say that Labour Members are more than happy to discuss the NHS and the new hospital programme at any opportunity. I would again like to put on the record my thanks to all the staff at Princess Alexandra hospital in Harlow. I also pay tribute to the staff of the East of England ambulance service, who go back and forth to the hospital.

I often visit the Princess Alexandra—I actually visited it today—and I see a workforce who work incredibly hard in difficult circumstances. They are a credit to not only my town of Harlow, but the NHS as a whole. As has been mentioned, the new Princess Alexandra hospital was one of 40 new hospitals that only existed in the mind of the former Prime Minister Boris Johnson. When I was elected, I found a project without any funding, without a business plan and without even a site to build the new hospital on. The idea that it would be built by 2030 was an absolute pipedream. The current Princess Alexandra site is too small. The corridors and wards are too small, the A&E department is crammed, and it is literally falling apart. We have seen sewage leaking into the wards and we saw the roof of the ICU falling down. Fortunately, nobody was injured. [Interruption.] My speech is so riveting that I have woken Jennie up, so I apologise for that.

I support the Government’s amendment and pay tribute to the work already done by this Labour Government. Waiting times are down, and we finally have a realistic, achievable and fully funded timetable for a new Princess Alexandra hospital and at least £1.5 billion of investment in our town. In the meanwhile, of course the Princess Alexandra hospital will need funding. I have met the chief exec a number of times and will meet him again next week to discuss the matter. I know that the Minister is already preparing herself for the lobbying she will get from me in the Tea Room next week.

I would like to end my speech on something that there will be consensus on across the House.

[Charlie Dewhirst (Bridlington and The Wolds) (Con)]

Does the hon. Member agree that the new hospital programme is just one part of the jigsaw and that facilities such as Bridlington district hospital and Alfred Bean hospital in Driffield in my constituency are much under-utilised resources? We should be making the most of every NHS facility by bringing community services back into those places.

[Chris Vince]

I thank the hon. Member for his intervention. As a fellow Leeds United supporter who is celebrating this week, I took his intervention just to have the opportunity to mention that. I add that Harlow Town were also promoted on Monday.

The hon. Member makes a valid point, and a hospital like Princess Alexandra is only part of the jigsaw. Just over the road, there was the walk-in centre, which was sadly closed in 2013. Ideas such as care in the community, which mean that fewer people need to go to hospital, need to be looked at. At Princess Alexandra hospital, one of the biggest issues is the number of people who need to go to the A&E department. We need to consider how we can avoid that and free up more medical staff to do other things, so I absolutely take his point.

I will end on another area of consensus. This is an issue that Members who have hospitals in their constituencies will all be aware of: NHS nurses, doctors and staff suffering abuse at work. I would like to put on the record that NHS staff are absolute heroes and that any abuse, be it physical or verbal, is totally unacceptable. I am sure that that is something we can all agree on across the House.

15:19

[Helen Maguire (Epsom and Ewell) (LD)]

The crisis in our NHS and the scandal of crumbling hospitals are a daily reality for my constituents and all communities served by the Epsom and St Helier university hospitals NHS trust. We have allowed our healthcare infrastructure to decay to a point where it hinders the delivery of care. These are not minor cosmetic issues; many of our hospital buildings predate the NHS and are riddled with damp, mould and leaking roofs. Yet we expect our dedicated doctors, nurses and support staff to deliver world-class treatment under those appalling conditions. The consequences run far deeper than peeling paint: patient safety is jeopardised, staff morale is crushed, and the basic functioning of our hospitals is compromised. Staff are stretched to their limits, struggling to provide the care that our communities deserve in facilities that are simply not fit for purpose. They deal with the consequences of decades of under-investment, where patching up failing infrastructure has become the norm—a short-sighted and ultimately more costly approach.

The impact of the ageing estate on elective recovery has meant that since April 2024, more than 600 operations have had to be cancelled. The lifts break down and cannot be fixed simply because they do not make the parts any more. Over the past five years, over £60 million has been spent on improving the Epsom and St Helier estate just to keep it operational. At St Helier, 46% of repairs are identified as high risk.

The human cost of this crumbling infrastructure is evident. Patients are forced to endure unacceptable waiting times, often in undignified conditions. A&E waiting times at the Epsom and St Helier trust are among the worst in London, with over a third of patients waiting more than 12 hours for a bed.

[Luke Taylor]

My hon. Friend mentions corridor care. That is a recurring theme in Members’ inboxes. A constituent recently told me that her husband, who is immunosuppressed because of his chemotherapy, had to wait 54 hours in A&E at St Helier with sepsis, exposing him to more infections on top of his existing conditions. Does she agree that without a proper rescue package for crumbling hospitals like St Helier, immunosuppressed patients will continue to be put at unnecessary risk?

[Helen Maguire]

I am sorry to hear that story. It is just one among a catalogue of incidents that we hear of on a regular basis.

This past winter, more than 2,000 patients waited over half a day just to be seen. The delays not only cause distress and anxiety but can have serious and long-term consequences for patient outcomes. The Epsom and St Helier university hospitals NHS trust has worked diligently, developing detailed plans for a new specialist emergency care hospital alongside the modernisation of Epsom and St Helier hospitals. This state-of-the-art facility would be a beacon of hope, improving outcomes for our sickest patients and consolidating acute services in a way that strengthens staffing and keeps care local. But that promise has been left to wither. The Health Secretary’s latest announcement pushes the start of construction of the new specialist emergency care hospital to 2032 at the earliest, adding to decades of false promises that have let my constituents down time and again.

That is why, this Friday, I will be abseiling 125 feet down St Helier hospital to raise funds for the Epsom and St Helier Hospitals charity and shine a spotlight on the urgent need for investment in our hospitals. The funds raised will provide extra support to our hospitals, over and above what the NHS can currently deliver.

Charity can only fill so many gaps; it cannot substitute for the Government action that our hospitals desperately require. The Government should reverse the delay to the new hospital programme and urgently deliver the new hospitals that patients have long been promised. They must prioritise the construction of the specialist emergency care hospital and fund the long-overdue repairs at St Helier. My constituents deserve nothing less than modern, safe and high-quality healthcare.

15:28

[Ms Julie Minns (Carlisle) (Lab)]

I declare an interest: my daughter is an NHS nurse. I want her, her colleagues and the patients they care for to have buildings that are safe, secure and suitable for their needs.

Nowhere is it more apparent that our NHS is broken than in our crumbling hospitals. My own mam recently spent two and a half months in hospital—the majority in one of our local community hospitals, which I am sure is not alone in being held together by the professionalism and care of its staff, rather than by the fabric of the building itself. Lord Darzi’s report paints a stark picture of the crumbling buildings in our health service and of a primary care estate in which 20% of the buildings predate the founding of the health service.

I am very much an advocate for preserving historic buildings, but I draw the line when it comes to hospitals that are not fit for purpose. That is why we need an NHS fit for the future, which starts with buildings fit for its staff and the patients they care for. Crumbling old buildings, and indeed modern buildings with inadequate staff facilities, lead to low morale and low productivity. That is why repairing, rebuilding and improving our healthcare estate is central to this Government’s plan for change and to our health mission.

We are delivering that plan. It includes, as we have already heard, £13.6 billion in healthcare capital spending, over £4 billion in operational capital, and over £1 billion to tackle critical NHS maintenance. Let us compare that with the record of the previous Government: under-investment in the estate, record low public satisfaction in the NHS, record high waiting lists, doctor strikes allowed to drag on and on, and a new hospital programme years behind schedule with no money beyond March 2025.

This Government are committed to rebuilding our NHS, and that is happening on the ground now in my Carlisle constituency, with funding for a new £12 million urgent treatment centre, which was approved in December and is on track to be opened by the end of this year. That is the change that Carlisle needs, it is the change our country needs, and it is the change our Government are delivering.

15:31

[James Wild (North West Norfolk) (Con)]

My local hospital, the Queen Elizabeth hospital in King’s Lynn, is one of the seven RAAC hospitals. I have campaigned for a new hospital since I was first elected in 2019. The QEH has had the dubious honour of being the most propped hospital in the country. Today, steel and timber supports hold up the roof to keep the hospital safe. Staff and patients should not have to put up with that.

Initially, QEH was not part of the new hospital programme, but through campaigning in Parliament and strong local support, it was added to the scheme as a priority by the last Conservative Government—part of a fully funded scheme that is being funded in the same way as this programme: through future spending reviews. After the election, this Government’s review of the new hospital programme cast doubt on our new hospital, but I am glad that, after pressure, RAAC schemes were removed from that review and restored as the priorities they should be. That was warmly welcomed by patients, staff and my constituents.

The clock is ticking, however, and the Government’s decision to delay the timetable for a new hospital opening from 2030 to 2032-33 is unwelcome and, I would argue, unnecessary. It also means spending money propping up the roof, wasting millions of pounds that could be spent getting on with the new scheme. The trust has well-developed plans and an experienced team in place. The Health Secretary has said that if we can go faster than the 2027-28 start date for construction, he will pursue that. When I went with the Minister to the hospital trust, she repeated that commitment, which I welcomed.

There are concerns that the NHS England reorganisation could cause issues with approvals, but the Health Secretary told me in the House that we would use it to take an axe to the multi-layered approvals process. I am not sure that he has swung it yet, but I hope he does, because the savings in business cases, consultant costs, other costs and time are considerable.

There has been much talk across the House of the need for action. I was at QEH last week with the chief executive. My ask is that the business case for the multi-storey car park is approved as rapidly as possible, so that work can start next year at the latest. That is the key enabling scheme to free up the existing car park so that we can get on and build the new QEH. The recent confirmation of the available funding was welcome and I thank the Minister—it will be a major investment in my constituency. Let us now get on with the new QEH that the staff, patients and the community it serves across Norfolk, Cambridgeshire and Lincolnshire deserve.

11:30

[Sean Woodcock (Banbury) (Lab)]

For years, my constituents in Banbury have lived with the consequences of a health system that has been allowed to fall apart bit by bit, service by service. Our mental health services, especially for children and adolescents, are severely under-resourced. Families are waiting far too long for help, even in the most serious cases. Our maternity unit in Banbury was downgraded under the Conservatives, so those having complex or emergency births have to travel to Oxford or Warwick, with all the risk that that brings, especially when delays are caused by our inadequate transport infrastructure. There is no overnight surgery or day-care surgery available locally, and patients fall through the cracks because of poorly co-ordinated services between Oxfordshire, Warwickshire and Northamptonshire.

Under the Conservatives, and with the support of the Liberal Democrats in coalition, money was diverted away from vital health services into a disastrous and unnecessary reorganisation of our national health service. The result is what we are seeing now: fragmented care, overstretched services and communities like Banbury being left behind. My constituents are not going to be pleased by Governments making promises that they cannot keep and when they have no realistic plan or funds to deliver them.

[Helen Morgan]

Multiple Government Members have made that point, but surely they can see that promising to build a hospital in a decade’s time when they may not be in power is a meaningless promise.

[Sean Woodcock]

I suggest that our decade of national renewal will ensure that the hospitals that we have promised will be delivered. I am confident about that because things are changing. The new hospital programme has been put back on a firm footing, with every project backed by real funding and a realistic plan, which is equally important.

Crucially, this Government are not stopping there. Labour’s 10-year health plan is about improving how the whole system works with patients. That means better co-ordination between GPs, hospitals, mental health services and social care, and ensuring that wherever people live, even if that is on the border between counties, which is an issue close to the hearts of people in my constituents, they are not passed from one part of the system to another without support. It also means doing more locally, with more care available close to home, so fewer people have to travel longer distances to get basic treatment, and earlier invention, so that problems are picked up before they become emergencies.

We have already seen progress. We have cut waiting lists by over 200,000, delivered over 3 million extra appointments, recruited more GPs and invested £26 million in mental health crisis centres to alleviate the pressures on A&E services. Some £2 billion will be spent on technology and digital improvements to increase productivity and ensure patients are seen faster. We are starting to turn things around and doing so in a way that puts patients first, without making undeliverable, unrealistic promises that damage trust in politics and the power of politics under our democratic system. For too long, people in Banbury have been left wondering if their NHS would be there when they needed it. After 14 years, they can see that help is finally on the way. With this Labour Government, things are changing practically and with purpose.

15:38

[Josh Babarinde (Eastbourne) (LD)]

I start by declaring an interest that will prejudice me in this debate: I was born in Eastbourne district general hospital; I have said farewell to cherished folks there; and I have been brought back from the brink in the DGH myself. I express huge thanks to the incredible staff in A&E, the resuscitation area, the acute medical unit and on Jevington ward who treated me and got me back into action last year.

However, for years, our DGH services have been eroded, with core services like consultant-led maternity moved to the Conquest hospital in Hastings, an unacceptable 20 miles away. I will keep fighting for the return of consultant-led maternity services at the DGH, just as I fought alongside local campaigners to reopen our midwifery unit for births after months of closure. I fight standing on the shoulders of local campaigning giants for our NHS, such as Liz Walke. I have known her since I was seven, and I am proud to welcome her to the Gallery today alongside Rose Bunn.

Beyond services, our DGH buildings are crying out for help. Our DGH bosses have said:

“The age and standard of current hospital buildings presents challenges for the consistent delivery of safe, effective, responsive and efficient care.”

The trust’s backlog maintenance bill stands at £460 million. That is one of the largest in the country, and it is why we were included in the new hospital programme in the first place. Our town was therefore appalled that the Conservatives put our hospital to the back of the queue when they were in office, and Eastbournians are further outraged that this Government are keeping us there in wave 4. In fact, having been born in that hospital 31 years ago, I will be nearly 50 by the time it is set to be completed.

In the light of the mismatch between the size of our maintenance backlog and our place in the queue, my key ask of the Minister is whether the Government will review our wave 4 position in the programme as it stands. If they will not, what extra support will the Government provide to address the growing, nearly £500 million maintenance bill across our trust? Eastbourne needs answers and deserves action, and Eastbourne, together with campaigners such as Liz, will be listening very closely to her answers.

15:39

[Matt Turmaine (Watford) (Lab)]

I draw attention to my entry in the Register of Members’ Financial Interests. I welcome this Opposition day debate on hospitals and the state of the NHS, which is on its knees after 14 years of mismanagement by the previous Government, but I find myself blinking in the dappled light of a new reality.

Reading the motion as drafted, one could be forgiven for thinking that an unchallenged Tory Government over the last 14 years alone were responsible for the chaos that we witness but, pinching myself to wake from the dream, I recall that the Liberal Democrats were part of that Government for five long years. They may want to forget about it, but we remember it. We remember the rose garden, where the blue Tories and the yellow Tories harmoniously, hand in hand, drew up their plans to devastate our health and social care public services through the austerity programme. We remember the bedroom tax, which was voted for multiple times by the Liberal Democrats. We remember the Lansley reforms and the Liberal Democrat spokespeople squirming in television interviews as they tried to justify the chaos into which they were about to plunge the NHS.

Under the previous Labour Government, we had the highest satisfaction levels and lowest waiting times, but what we inherited in July last year was an unmitigated disaster. The Tory-Lib Dem coalition tore up the last Labour Government’s plans for a new hospital in my constituency as part of the austerity programme. The staff at that hospital do a remarkable job, and I put on record my gratitude to them, even when I was wandering around dressed as a giant bunny rabbit on Sunday.

The Tories and the Liberal Democrats—nobody else—are responsible for the 14-year delay in getting a new hospital in Watford. If they had not done what they did, we would have had a new hospital by now, but we do not. Not a brick has been laid. They should hang their heads in shame at this total betrayal of Watford’s residents. The new hospital programme was not funded beyond March, and as the Prime Minister said in response to my question to him a few weeks ago, the hospitals existed only in the imagination of Boris Johnson.

I welcome this motion recognising the devastating state of the NHS, but let us be acutely aware that responsibility for that lies with the Liberal Democrats, who table this motion, and with the Conservatives in the previous Government. It is all very well to want to magic a hospital out of thin air, but it will be this Labour Government who finance and deliver it.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Picturing the hon. Member in a rabbit outfit has woken us all up.

15:44

[Ben Obese-Jecty (Huntingdon) (Con)]

I will focus my speech specifically on Hinchingbrooke hospital, and highlight some key issues that will impact delivery of our new hospital in Huntingdon. During the general election campaign, I pledged to fight for the resources to rebuild Hinchingbrooke, and I will continue to push this Labour Government to ensure that they follow through on the programme they committed to deliver.

In May 2023, the then Health Secretary, my right hon. Friend the Member for North East Cambridgeshire (Steve Barclay), announced that Hinchingbrooke was part of the Government’s new hospital programme. Since that time, I have been concerned that this Government are not acting with enough haste to address the issues faced at Hinchingbrooke. There has been a lack of clarity, particularly regarding the ongoing traffic issues around Hinchingbrooke and the lack of a firm commitment to upgrade the road network as part of the project, which has caused concerns across my constituency.

While I welcome the fact that Hinchingbrooke is rightly in wave 1 of the programme, we need clarity on the timeframe. Although this Government are aware of the RAAC issues, they have still not given a detailed timeframe as to when we will get our hospital built; there is a vague start date, but no completion date. Crucially, in September 2024, the Minister for Secondary Care confirmed in a written answer to me that the detailed structural assessment of Hinchingbrooke hospital in 2022

“estimated that the remaining life of the RAAC panels”

extended to “approximately 2030”, even after

“the installation of fail-safe steelwork.”

In February, she stated that this summer, the Government will publish a report

“assessing the clinical and operational impacts of the running of the existing hospital beyond the estimated life of the current hospital site”.

With the delays already caused by road access and grid access, and the lack of clarity about a start date or a completion date, what assurances can the Minister give that my constituents will not find themselves in a condemned hospital building after 2030, with the DHSC simply owning the risk that it will collapse? If the new hospital is to be completed by 2030, we need plans, action, and focus on making sure that any changes are usable, safe and fit for purpose, with no more delays.

In short, the following issues must be addressed in order for Hinchingbrooke to be delivered: the programme business case for the NHP must receive ministerial approval; a hospital 2.0-compliant design must be approved and delivered; a capital envelope of at least £900 million and a realistic contingency must be allocated; and mobilisation of the programme must be quick. It is clear that the 2030 target might now be unreachable, but mobilisation by spring 2026 seems realistic, and I will push the Government and all stakeholders to work towards that target. There also needs to be further work between Hinchingbrooke and the NHP to develop a strategic outline case, and it is crucial that that case is then approved as soon as possible in order to complete the new hospital by as close to 2030 as possible.

We also need grid access that is fit for purpose, as the current grid access will not be sufficient for Hinchingbrooke. Currently, the gap between sufficient grid space being approved and meeting that which is required will be a year—that is clearly not appropriate. There are issues regarding a vital new access road to alleviate traffic. Those issues are caused by land owned jointly by Cambridgeshire constabulary and National Highways. The Government must get all stakeholders around the table to reach a solution, given that they are public bodies.

To conclude, I reaffirm that I will do all I can to work with the Government, the NHS and others to make sure that my constituents get the new hospital they so desperately need.

15:47

[Lisa Smart (Hazel Grove) (LD)]

The very first thing I did when I came to this place was write to the Secretary of State for Health and Social Care—along with my constituency neighbour, my hon. Friend the Member for Cheadle (Mr Morrison)—about the state of Stepping Hill hospital. It is consistently the biggest issue raised with me by patients and staff, many of whom are my constituents, and there are few ways to see more clearly how the last Government let down my constituents than by considering the state of the buildings at Stepping Hill hospital. A number of buildings have had to be closed because they were deemed unsafe, placing more pressure on staff and services. The press reports that the repairs backlog at Stepping Hill exceeds £130 million, with millions needed to eradicate the most high-risk problems.

That sounds abstract—that amount of money is difficult to get your head around—so what does it mean to staff and patients? It means that my constituents write to me about having experienced major health issues, like cardiac arrest, and having been forced to wait in overcrowded areas without seating because there is not the space available. It means hospital corridors flooding and medics having to wade through the water to get to their patients. On one occasion, it means a constituent writing to me about what should have been the utter delight of having a baby delivered safely into the world—but 30 minutes before the baby arrived, the light fitting in the delivery suite fell down in the middle of active labour.

Stepping Hill sees about half a million patients each year. When I ask my constituents about their experiences of Stepping Hill, many tell me that they are worried about the buildings, but so many of them praise the phenomenal staff. I will share a few of those remarks with the House. Chris said that the staff could not have been kinder or more efficient.

Alan said:

“All staff at Stepping Hill, from top to bottom, were absolutely brilliant”.

Brenda said that the staff remained dedicated despite the state of the buildings. Amanda said,

“Without Stepping Hill and the wonderful doctors and nurses there, my son would not be here today”,

and Sheila said:

“Staff were run ragged but were amazing.”

The previous Government failed to provide the funding that Stepping Hill needs, and despite the huge repairs bill, it was left out of the new hospital programme. The legacy of that decision and of the failed Conservative Government hangs over my constituents, who deserve better. That Government broke their promise to my constituents, and I will continue to work with this and any future Government to get Stepping Hill what it needs. In part, that involves a new site in Stockport town centre. I am working closely with Stockport council and the trust to push for that. It could act as a diagnostic centre and an out-patient centre, and it is surely part of a strong, long-term solution to ensure that patient needs are met and my constituents get what they need.

The health of our nation is directly linked to the wealth of our nation and my constituents, whether patients or staff, are looking for the Government to have their back, to fund the repairs in Stepping Hill and to deliver the new additional site in the town centre.

15:50

[Caroline Voaden (South Devon) (LD)]

I am going to change the tone of the debate a little bit from the hon. Member for Watford (Matt Turmaine) and welcome the Minister’s comments about a strategy for hospital building that is based in reality and not on a fantasy programme that had no funding behind it. It is also good to hear that capital funding will be ringfenced.

When Labour came into office, it promised to end sticking-plaster politics, but that seems to be exactly what it is offering to Torbay hospital: a small sticking plaster to hold together a gaping wound. Torbay hospital serves a critical role for my largely rural constituency of South Devon and faces immense pressure every single day. Nearly all of the hospital estate is currently unfit for purpose, yet under the Government’s timeline, construction on a rebuild is not due to begin until 2032. That means seven more years of staff working in outdated, inadequate conditions and patients receiving care in a facility that no longer meets the basic standards expected of a modern health service.

The case for urgent and sustained investment could not be clearer. The total cost of eradicating the maintenance backlog at Torbay hospital now stands at £53.6 million—small beer compared with some colleagues’ constituencies. Of that, £4.6 million is needed to address high-risk issues, which are those, in the NHS’s own terms, that pose a direct threat to the safety of patients or the day-to-day functioning of the hospital. Nearly £1 in every £10 needed for repairs is to fix problems that are considered an urgent threat to health and safety. That is simply unacceptable in any modern healthcare system.

Last year, the ear, nose and throat department was forced to cancel a full week of out-patient care after a sewage leak. The main tower of the hospital is literally being held together by scaffolding, which costs £1 million a week. Operating theatres lack adequate temperature control, and the pathology department, which plays a critical role in cancer diagnosis and other urgent care, is operating out of a rotting portacabin with holes in the walls. That temporary accommodation has been in place for more than 40 years. This hospital is operating at 98% capacity—far above safe levels. It is running at full tilt every day under conditions that make effective, safe care more and more difficult to provide. I have to give a huge shout-out to the incredible staff at Torbay hospital who keep that place going. The situation is not sustainable and nor should it be acceptable.

The current Government’s decision to delay urgent repairs is not just a poor decision, but a false economy. We are spending so much money shoring up a hospital, when fixing it would cost less than holding it together with scaffolding. Keeping hospitals such as Torbay going with temporary fixes and emergency maintenance is far more expensive in the long term than investing in the proper infrastructure now. We need the Government to find innovative ways to finance critical repairs. Patients and staff in Torbay and across the country deserve better than another decade of waiting.

15:53

[Clive Jones (Wokingham) (LD)]

I am proud to declare my interest as a governor of the Royal Berkshire hospital. The Royal Berks is an incredibly important place for me. I have been treated there many times, friends and family work there, and my constituents rely on the dedication of its hard-working staff. The way that this important community asset was treated by the previous Conservative Government is a scandal. They have left a record of broken promises and a building that in many places is literally crumbling.

Looking at the Conservative legacy, before the 2024 general election, they introduced a seven-year delay to the construction of the new hospital in 2023. That is a seven-year delay for something that was never funded in the first place. The Conservatives’ dithering and delays have resulted in £7 million being wasted at the Royal Berkshire hospital on surveys, investigations and the development of a hospital programme that was never going to go anywhere, and the Conservatives knew that all the time. Their behaviour over the last five years has been shameful, and they have deceived my constituents.

My hon. Friend the Member for Henley and Thame (Freddie van Mierlo) has highlighted many of the issues at the Royal Berkshire, so I will not repeat his points, but there is a maintenance backlog amounting to £102 million, and staff have recently told me that an additional £300 million is needed for maintenance. Will the Minister confirm that there will be a proper maintenance programme for the next 20 years? I have to thank her for her guarantee that when the Royal Berkshire NHS Foundation Trust requires funds to purchase land for the new site, her Department will provide those funds. I would be grateful if she could confirm that that position has not changed, and also that the planned cuts and savings at the trust to balance its budget will have no impact on its ability to deliver vital maintenance at the hospital site.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

I call Danny Chambers to wind up the debate for the Liberal Democrats.

15:55

[Dr Danny Chambers (Winchester) (LD)]

It seems that Members on both sides of the House have been experiencing similar problems in the hospitals that they represent. Years of under-investment has left many hospitals with leaking roofs, for instance. My hon. Friend the Member for Torbay (Steve Darling) spoke of sewage in clinical areas—I thought that sewage was the subject of the next debate; it is outrageous that we should be discussing its presence in our hospitals—and my hon. Friend the Member for Oxford West and Abingdon (Layla Moran) told us about a room full of incubators which had to be removed because the ceiling was at risk of collapsing. It is crazy that operating theatres and hospital rooms are unused not because of a lack of staff, but because they are not safe enough for people to work in.

Like many other Members, I regularly meet hospital leaders and managers—in my case, at our local hospital in Winchester—to discuss the problems that they are experiencing. Despite the heroic efforts of the staff at the Royal Hampshire County hospital, they are facing a set of issues similar to those that have been raised time and again this afternoon, including, again, leaking roofs over treatment areas. Like the hospital mentioned by my hon. Friend the Member for Epsom and Ewell (Helen Maguire), ours has old, outdated lifts that fail, making it difficult to transport patients from wards to the operating theatre. It has no back-up power generators, so there is a risk to patients’ safety during power cuts.

[Gideon Amos (Taunton and Wellington) (LD)]

My hon. Friend has mentioned faulty buildings and roofs. In Musgrove Park hospital in Taunton, staff are fainting in temperatures of 30°C in temporary buildings where there is no cooling machinery, while mums are trying to give birth in the same ward. That is completely unacceptable. We need interim funding if the hospital—which was mentioned earlier today by my right hon. Friend the Member for Kingston and Surbiton (Ed Davey)—is to survive until 2033, when the promised funding is meant to arrive.

[Dr Chambers]

It is indeed unacceptable, in respect of patients’ safety but also health and safety at work, because the health of the staff is being put at risk as well.

These are not minor inconveniences; they are daily threats to patients’ care and they cost us dear, so why are we not fixing them? Failure on the part of the last Government is no excuse for continued delay, and saying “We cannot afford it” when the cost of inaction is higher is simply nonsensical. The longer we wait, the more it will cost the taxpayer. Much has been said about trust in politics, and we will not forget what happened in our part of Hampshire when Conservatives stood on election manifestos promising to deliver a new hospital for which they never had any funds. There was no funding secured and no shovel-ready plan, but they campaigned on the issue repeatedly, hoping that the voters would not find out until it was too late.

Other Members have pointed out that GP surgeries are being particularly neglected. The Budget allocated funds to cover additional upgrades for just 200 GP surgeries out of a total of 6,000. With the Government’s jobs tax hitting GPs, it is becoming harder for those practices to fund their own improvements. However, I was pleased that the hon. Member for Stroud (Dr Opher) mentioned the importance of primary care and mental health. This is, of course, a debate on hospitals and hospital infrastructure, but I know there is cross-party agreement on the fact that keeping people healthy in the community—whether that involves investment in primary care, mental health or public health services—is much more cost-effective for taxpayers as well as being better for patients.

We really welcome the Minister’s warm words on social care. We had a social care roundtable just yesterday, and we heard that every pound spent on social care saves the NHS £3. We urge the Government to hold cross-party talks as soon as possible, because for every year that we delay getting a plan for social care, people are languishing in hospitals on delayed discharge which is costing us a huge amount of money.

We have to end the vicious cycle of false economies and fortunes being spent on papering over the cracks. The total repair backlogs at the delayed new hospital sites could reach an estimated £5.7 billion by the time construction starts. Are the Government really of the view that keeping hospitals on life support is a good use of taxpayers’ money? Repairing and replacing crumbling NHS buildings is not just about treating more patients; it is about reviving and boosting our economy. Here is the truth: we will not grow our economy unless we reinvest in the services that support it.

Let us change course. We urge the Government to reverse the long delays in the new hospital programme, because many will not be open until the 2040s on the current timeline, and those hospitals have to be kept functioning until then; to set out a 10-year investment plan to fix hospitals and GP surgeries; to urgently release funds that have already been committed, to start construction straightaway; and to publish a plan to recruit and retain a skilled workforce to carry out the work efficiently. That is what investing to save looks like. It means improving care, lowering long-term costs and building a stronger, healthier economy. The Conservatives chose to cut investment, which led to higher costs. Our plan is to increase investment now so that we can lower costs in the future.

We urge the Government not simply to patch over the damage done to our NHS. As the Liberal politician William Beveridge, who was a visionary behind the formation of the NHS, said:

“A revolutionary moment…is a time for revolutions, not for patching.”

Let us be bold, and let us invest now. It will be better for the taxpayer, it will be better for patients, and it will boost our economy.

16:02

[The Minister for Secondary Care (Karin Smyth)]

It really is a pleasure to close this debate on behalf of the Government. I think there have been 33 contributions from hon. Members from across the House.

Nowhere is it more apparent that the NHS is broken than in our crumbling hospitals. Over 14 years, the NHS was starved of capital and the capital budget was repeatedly raided to plug the holes in day-to-day spending. Lord Darzi’s investigation into the NHS in England made it clear that we have crumbling buildings and IT, mental health patients sharing showers in Victorian-era cells infested with vermin, and parts of the NHS operating in decrepit portacabins. Some 20% of the primary care estate predates the founding of the health service in 1948.

I thank the Liberal Democrats for bringing forward this debate. We broadly agree on the disgrace that the backlog of repairs, the decades-long cannibalisation of capital budgets and the unfunded fantasy of the new hospital programme had become. Where we disagree is on the cause and the solution. As we have heard today, the Liberal Democrats are completely silent on the part they played as members of the coalition Government. They were active and enthusiastic partners in the decision to impose austerity, and our NHS was starved of funding on their watch. The practice of raiding capital budgets to keep things afloat started in 2014, on their watch. The disastrous top-down NHS reorganisation, which wasted billions of pounds and contributed to record-high waiting lists, happened on their watch.

As for the solution, the Liberal Democrats are silent on how they would pay for and accelerate the new hospital programme. They are playing the same cynical game that we saw from the Conservative party: they are dangling the prospect of a new hospital while being unable to explain where the funding would come from or how the construction industry could deliver it within the timeframe. It is indeed opportunism, as my hon. Friend the Member for Gateshead Central and Whickham (Mark Ferguson) said. We all remember the Rose Garden, as my hon. Friend the Member for Watford (Matt Turmaine) said. The Liberal Democrats opposed the autumn 2024 Budget, which delivered record investment in our NHS. In sharp contrast, this Government are prepared to take the decisions needed to back up our promises with the funding needed to deliver them, and we are determined to rebuild confidence and trust in politics by promising only what we can deliver.

I have met many hon. Members in person and heard them in the Chamber today, and I know others are not here who would have wanted to contribute. As the Minister, let me say plainly that I agree with everyone’s anger. I share that anger because, when I tour hospitals up and down the country—I did so recently in Doncaster and in Oxfordshire, where I visited the Warneford hospital—I often see equipment and infrastructure that was procured 20 years ago when I was working for the NHS in Bristol. Seeing these physical reminders of the past when I tour hospitals fills me with a mixture of pride and shame. I feel pride because I was part of a generation of leaders who delivered hospitals fit for patients in the biggest hospital programme in NHS history delivered under the last Labour Government, and I feel shame because our legacy was squandered and patients have paid the price. We understand the legacy, and Lord Darzi was very clear that the task for us is to take action. That is why the Chancellor took the necessary decisions in her Budget to meet this challenge, and why we have put the programme on a firm financial footing.

As my hon. Friend the Minister for Care said, we are not just writing the wrong; we are taking pressures off hospitals, shifting the focus of our NHS from hospital to community, recruiting over 1,500 more GPs to take the pressure off A&E and harnessing the power of AI to help people who depend on care to stay at home. That point was well made by my hon. Friends the Members for Stroud (Dr Opher), for Aylesbury (Laura Kyrke-Smith), for Milton Keynes Central (Emily Darlington) and for Calder Valley (Josh Fenton-Glynn). As he made me sponsor him, may I wish my hon. Friend the Member for Calder Valley good luck in the marathon this weekend? The challenge before us is immense, but every member of this Government is up for the fight.

Members made a number of points, and I will try to get through them in the time available. I could not agree more with those who made the point that we have to break out of the vicious cycle of false economy. This Government were elected on a manifesto to end short-termism, easy answers and sticking-plaster politics. When we came into government we were saddled with a bill of almost £14 billion in backlog maintenance. My right hon. Friend the Chancellor has given us the funding this year to back NHS systems with over £4 billion of operational capital. A lifesaving cash injection of £750 million for targeted estate safety funding is a vital first step towards fixing our crumbling estate. That is crucial not only for patients, but for staff morale, as my hon. Friend the Member for Carlisle (Ms Minns) said. There is also £440 million to tackle crumbling RAAC concrete, keeping patients and their families safe. We are opening new mental health facilities, with more in construction, and that state-of-the-art provision will give the best possible care outcomes.

Furthermore, I assure Members that, unlike the previous Government, we will never raid capital budgets to plug day-to-day spending, and the Treasury has updated its fiscal rules to make that impossible. My hon. Friend the Member for Crewe and Nantwich (Connor Naismith) said that big promises with no plans are what got us into this mess, and that was echoed by my hon. Friend the Member for Mid Cheshire (Andrew Cooper), who talked about the false hope and the waste of the past. My hon. Friend the Member for Banbury (Sean Woodcock) echoed that point and reiterated the point about trust, which was almost shared by the hon. Member for South Devon (Caroline Voaden).

Members have called on the Government to reverse course and commit to a timeline that is unfunded, unrealistic and undeliverable. That has been recognised by a National Audit Office report, which stated that

“some schemes publicly promised in 2020 now face substantial delays and will not be completed by 2030…with implications for patients and clinicians.”

The delivery of these hospitals existed only as a figment of Boris Johnson’s imagination and this Government are doing the hard yards of putting the new hospital programme back on track. The NHP previously received a red rating from the Infrastructure and Projects Authority, now known as the National Infrastructure and Service Transformation Authority. Its latest review, which it carried out in January, rated the NHP as amber. That reflects the measures that we took to put the programme on a firm footing, as my hon. Friend the Member for Harlow (Chris Vince) rightly said.

Some Members, including the Chair of the Select Committee, the hon. Member for Oxford West and Abingdon (Layla Moran), have asked us to publish the individual scores of each scheme following the outcome of the review, but may I just take issue with the hon. Lady’s use of the word “shady”? The Secretary of State and the Department will continue to co-operate with her Committee, but to be clear, as part of our analysis, schemes were prioritised into upper, middle and lower thirds, which gave a delivery schedule for the programme to align with the funding envelope, and there was no final individual score for each scheme. There is no formal delineation among schemes in wave 2, and schemes remain scheduled to start construction as outlined in our plan for implementation.

I briefly say to my hon. Friend the Member for Mitcham and Morden (Dame Siobhain McDonagh) that it was a pleasure to meet Councillors McCabe and Garrod from her constituency and to understand their passion about the loss of resources. That is echoed in many low-income areas, and we have to reverse that loss of resources as we go forward with our 10-year plan.

We are taking a systematic approach to building the next generation of hospitals, known as Hospital 2.0, allowing trusts to benefit from economies of scale, provide excellent patient care and facilities, and ensure that staff are supported with technology for decent working environments. It contributes to our growth mission, putting more money in people’s pockets and supporting our supply chains. In response to my hon. Friend the Member for Milton Keynes North (Chris Curtis), we do abide by the Hospital 2.0 scheme. It is a systematic and centralised approach that will save taxpayer money, while driving innovation and laying the foundations for a new relationship between Government and industry. I am disappointed if it is official Liberal Democrat policy to oppose that approach.

I know the clock is against me but I want to end by saying that I completely understand why colleagues are so concerned about the plans, when previous Governments have so badly let them and their constituents down. I also hear the point made by the hon. Member for South Antrim (Robin Swann) about Northern Ireland. Northern Ireland benefits from the Barnett consequentials for revenue and capital. It is devolved and it can look at alternative means. The Department will continue to work with all devolved Administrations across all issues, but they do have particular problems.

Staff and patients deserve better, so I want to offer them some reassurance about our record since July. We promised to sit down with resident doctors and end the damaging strike action—promise made, promise kept. In October, we said we would recruit more GPs by April and we recruited more than we said—promise made, promise kept. We promised 2 million extra appointments in our manifesto and we smashed that target seven months early—promise made, promise kept. Last month, over 80% of patients in England referred for cancer had it ruled out or diagnosed within 28 days, the first time that target has been met for years, and waiting lists are now consistently falling.

We have gripped this critical issue since July, from day one with the review. The Secretary of State and I met MPs and the NHP team before the completion of the review. I met all colleagues the day after the announcement in January and I have had individual meetings. I will keep my promises to visit, when the diary allows. I am really looking forward to North Devon. I am also visiting Hillingdon, where I grew up, with my hon. Friend the Member for Uxbridge and South Ruislip (Danny Beales), and possibly visiting some old haunts. I have committed to visiting Basingstoke, with my hon. Friend the Member for Basingstoke (Luke Murphy). We will progress at pace on RAAC and wave 1. I am committed to holding more meetings with wave 2 and wave 3 MPs in the coming weeks and months to keep colleagues abreast of updates and to provide them with the opportunity to ask questions directly of the team. That is how I will work with colleagues across the House to make sure the programme happens.

Finally, the hon. Member for Sleaford and North Hykeham (Dr Johnson) talked about her experience of the PFI scheme she worked under and the nonsense she had to deal with. Her Government could have changed that at any point. My experience of a PFI scheme in Bristol was waking up about a year ago after I had had my melanoma removed, in an almost brand new hospital with fantastic facilities in a single, individual ward with my husband beside me. Maybe it was the drugs that made me feel a little bit bleary-eyed, but what I thought then was how proud I was to have been part of the development team, as part of the primary care trust board, bringing forward a fantastic hospital for north Bristol that serves patients so well. That would never have happened under another Administration. We rebuilt the hospitals under the previous Labour Government. I am proud of that record. We did it before; we are going to do it again. That is what a Labour Government do.

Question put (Standing Order No. 31(2)), That the original words stand part of the Question.

16:13

Division 171

Ayes: 77

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Liberal Democrat: 65
Independent: 4
Reform UK: 3
Green Party: 3
Traditional Unionist Voice: 1
Democratic Unionist Party: 1

Noes: 307

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Labour: 304
Independent: 3
Ulster Unionist Party: 1

Question put forthwith (Standing Order No. 31(2)), That the proposed words be there added.

Question agreed to.

The Deputy Speaker declared the main Question, as amended, to be agreed to (Standing Order No. 31(2)).

Resolved,

That this House regrets the appalling state of repair of NHS hospitals across the country; notes that the NHS maintenance backlog rose to £13.8 billion in 2023-24; further notes the sustained pattern of cannibalising NHS capital budgets to keep day-to-day services running; condemns the previous Government’s record of starved repair budgets and exploding maintenance backlogs, which made sewage leaks, cracked walls, crumbling ceilings and sinking floors commonplace; further condemns the previous Government for launching the New Hospitals Programme with no realistic plan to fund or deliver it; also notes that the Chancellor has announced new fiscal rules to ensure capital budgets can no longer be cannibalised, with transfers from capital to resource budgets not permitted; recognises that the previous Government left a New Hospital Programme which was unfunded, unrealistic and undeliverable; welcomes that the Government has taken action to review that Programme and has published the New Hospital Programme Plan for Implementation, to put the Programme on a sustainable footing; supports the Government’s investment in the Plan, which will increase to up to £15 billion over each consecutive five-year wave, averaging around £3 billion a year from 2030; and further supports the work being done to bring forward construction of the reinforced autoclaved aerated concrete replacement schemes wherever possible, to ensure that patient and staff safety is prioritised.

[Karin Smyth]

On a point of order, Madam Deputy Speaker, could you advise me whether it is in order that the hon. Member for Sleaford and North Hykeham (Dr Johnson), who opened the debate for the Conservatives, was not in her place for the close of the debate? I think that is discourteous to the House, and I would like your advice on how we rectify this matter.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

The point of order is most definitely on the record. It is a point of courtesy to be here for the close of a debate if you are here for the opening. No doubt, Opposition Front Benchers will make that very clear to the Member.