Friday 10th September 2021

(2 months, 3 weeks ago)

Commons Chamber

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Department of Health and Social Care

Motion made, and Question proposed, That this House do now adjourn.—(Rebecca Harris.)

Philip Hollobone Portrait Mr Philip Hollobone (Kettering) (Con)
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It is a delight to see you in the Chair, Madam Deputy Speaker. I thank Mr Speaker for granting me this debate, and I welcome the hospitals Minister and my hon. Friend the Member for Wellingborough (Mr Bone) to their places. My hon. Friend the Member for Corby (Tom Pursglove) would be here, but other engagements sadly prevent him from being here. I thank all staff at Kettering General Hospital, who always perform magnificently but have done so especially over the pandemic period, and in particular Simon Weldon, the magnificent group chief executive.

I commend and thank the Minister for his personal interest over a number of years in this important issue. He visited the hospital on 7 October 2019. He responded to an Adjournment debate that same month, when he outlined plans for a £46 million investment in the new urgent care hub. He also responded to the last Adjournment debate, on 8 June earlier this year, and met the hospital and the three local MPs in February. May I also thank the Prime Minister, who undertook a five-hour nightshift visit to the hospital in February last year?

I welcome the Government’s unprecedented investment in the NHS and their commitment to the national hospital building programme. This has resulted in promised commitments to Kettering hospital of £46 million for an on-site urgent care hub, £350 million in health infrastructure plan 2 funding for 2025 to 2030, and a write-off last year of £167 million of trust debt at the hospital. That is a total investment of a staggering £563 million in Kettering hospital, which is a record-breaking figure. However, the Minister will appreciate that promises are one thing but delivery is another. The problem that the hospital faces is that these two funding streams from the Government—£46 million for the urgent care hub and £350 million for the phased rebuild—are not being meshed together by the Health Department and Her Majesty’s Treasury.

In a way, the problem is a nice one to have. Kettering hospital has successfully won access to these separate funding streams. To explain in a bit more detail, this is £46 million of STP—sustainability and transformation partnership—wave 4 capital, to be spent by 2024, to build a new on-site urgent care hub to replace and enhance one of the most overcrowded accident and emergencies in the country, and £350 million of HIP2 funding, for the period 2025 to 2030, for a phased rebuild of the hospital on the existing site, as one of the 40 designated hospitals in the national hospital programme.

Peter Bone Portrait Mr Peter Bone (Wellingborough) (Con)
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I am grateful for my hon. Friend’s persistence on the issue of Kettering General Hospital, which serves my constituency as well. I had to go to Kettering General Hospital A&E with my son last week, and I can only confirm exactly what my hon. Friend says. It needs to be completely—well, knocked down, really, and a new A&E built. Because we had the Corby urgent care centre, I could go there and then to Kettering hospital, which helped. He will have an urgent care centre at Kettering, and I hope in due course that we will have the same thing in Wellingborough.

Philip Hollobone Portrait Mr Hollobone
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I am sorry to hear about my hon. Friend’s recent visit to the hospital, but I hope he is better now—he certainly looks fighting fit.

The problem that we face at the hospital is twofold. If the hospital goes ahead and builds the £46 million urgent care hub as a stand-alone project, there will not be enough room on site for the future HIP2 works and the hospital will effectively be ruling itself out of the much-heralded national hospital rebuild programme. On the other hand, if the hospital delays the £46 million urgent care hub development until the start of the HIP2 programme in 2025, it will lose the £46 million funding allocation, which expires in 2024, and the urgent care hub will not be built.

If there is a delay to the funding, the biggest headache may well be the failure of the existing, very high-risk, old steam boilers at the hospital site. This is the main thing that keeps the hospital chief executive awake at night. Part of the extra money that is being requested as part of the advance from the HIP2 funding is for a new net zero on-site power plant, so that the old boilers can be replaced and the power systems needed for the HIP2 programme installed. The value-for-money solution is to dovetail the two funding streams by advancing 15%, or £53 million, of the hospital’s already allocated £350 million funding over three years—£6 million in 2021-22, £29 million in 2022-23 and £18 million in 2023-24—and blending it with the £46 million urgent care hub funding.

I wish to make it clear to the Minister that we are not asking for more money; we are asking for an advance of just 15%—£53 million—of the £350 million of HIP2 funding already allocated to the hospital, so as to facilitate a value-for-money start to the hospital’s promised redevelopment.

I have five main asks of the Minister. First, will he confirm that the £46 million STP allocation for the urgent care hub can be combined with the new hospital programme funding scheme to create a single development scheme that can proceed to an outline business case on that basis?

Secondly, will the Minister confirm that the £46 million allocated to the hospital can be used to progress early enabling works that are essential to meeting its delivery timescales?

Thirdly, may we have an early advance of £53 million, spread over the next three years, from the £350 million HIP2 commitment, so that the urgent care hub can be built not as a stand-alone project but as the initial part of the phased hospital redevelopment?

Fourthly, will the Minister confirm that, when delays occur in other larger hospital-rebuilding programmes throughout the country, he will look to create an opportunity for Kettering to receive some of the money to move beyond enabling works before 2025?

Fifthly, will the Minister be kind enough to visit the hospital again? It is two years since his last visit. Kettering General Hospital is only 30 miles from Charnwood, straight down the A6. If he is kind enough to visit, I would be keen to show him the boilers in the power plant, which is a critical part of the required new infrastructure.

Those five asks are not about asking for extra money over and above that which has already been promised; instead, they outline a sensible, flexible, dovetailed approach to funding commitments already given so as to maximise value for money for the taxpayer and ensure that local people get to see as soon as possible the badly needed improvements to our local hospital that we have already been promised. Simply put, the problem is that building the promised urgent care hub is no longer an option on a stand-alone basis, because if it is built as stand-alone project, there will not be enough room on the site for the subsequent HIP2-funding works. The value-for-money solution is to integrate the two funding schemes.

The Minister will know, but I will repeat, that the hospital is ready to go on this work. It owns all the land, so no land deals are required and no extra public consultation is needed. It has written, confirmed support from local planners and the regional NHS. The phased approach would deliver visible and real benefits. It is shovel-ready and has far lower risks than many other hospital-build projects. In developing a whole-site plan that integrates the two funding streams, the hospital has identified the best way of delivering value for money and getting the buildings up, operating and serving local people as quickly as possible.

Kettering General Hospital is unique among the 40 designated hospital rebuilds scheduled to be completed by 2030. First, it already has the Government commitment for a new £46 million urgent care hub, so its future funding is complicated as it comes from two separate funding pipelines; secondly, it is ready to go with an innovative, phased, value-for-money rebuild on land that it already owns, with no planning or consultative hold-ups; thirdly, it serves one of the fastest-growing areas in the whole country; and fourthly, it has one of the most congested A&Es of any hospital—as my hon. Friend the Member for Wellingborough recently experienced—and this needs to be addressed as a matter of urgency. I do not believe that any other hospital in the whole country has such a unique set of circumstances.

Why are improvements at the hospital needed? Kettering General Hospital is a much-loved local hospital. With 500 beds, it has been on its current site, in the heart of the town of Kettering, since 1897—that is 124 years. Most of the residents in the parliamentary seats of Kettering, Corby and Wellingborough were either born there, have been repaired there or, very sadly, have passed away there. There can be few local residents who have not accessed the hospital at some point in their lives. It also has a superb, dedicated, talented and loyal workforce.

The pressure on the hospital is primarily being driven by the very fast population growth locally. The Office for National Statistics shows that we are one of the fastest growing areas in the whole country, at almost double the national average. Kettering ranks sixth for growth in the number of households and 31st for population increase, Corby has the country’s highest birth rate and Kettering Hospital expects a 21% increase in over 80s in the next five years alone.

The area has committed to at least 35,000 new houses over the next 10 years, which is a local population rise of some 84,000 to almost 400,000 people. The A&E now sees up to 300 patients every single day, in a department that is sized to see just 110 safely. Over the next 10 years, the hospital expects the number of A&E attendances to increase by 30,000, equivalent to almost 80 extra patients every day. That is why the improvements are so desperately needed.

The big problem at Kettering Hospital is that the A&E is full. It was constructed in 1994 to cope with 45,000 attendances each year. Now, it is already at about 100,000 attendances a year, which is well over 150% of its capacity. By 2045, 170,000 attendances are expected.

The solution, which everyone agrees, including the Government, is for a new urgent care hub facility, costing £46 million. It would be a two-storey, one-stop shop, with GP services, out-of-hours care, an on-site pharmacy, minor injuries unit, social services, mental healthcare, access to community care services for the frail elderly and a replacement for the A&E. All the NHS organisations locally, as well as NHS Improvement nationally, agree that this is the No. 1 clinical priority for Northamptonshire.

I am glad that the Government have recognised the hospital’s superb business case for this fit-for-purpose emergency care facility, and that it will meet local population growth for the next 30 years. All the local health and social care partners have been involved in its design, and local people need it to get the local urgent care service that meets Government guidance on good practice. When built, the facility will ensure that people who come to the hospital are seen by the right clinician at the right time, first time.

I also warmly welcome the Government’s inclusion of the hospital on the list of 40 hospitals in the national hospital rebuilding programme, and the funding kicks in from 2025. That is important for Kettering Hospital because 70% of the buildings on the main site are more than 30 years old, there is a maintenance backlog of £42 million and 60% of the hospital estate is rated as either poor or bad.

The hospital plan for the redevelopment of the site, as part of the HIP2 programme, offers a phased approach over a number of years, with the extra ward space provided by the funding to be built on top of the urgent care hub. This is in contrast to a number of other hospitals in the HIP2 programme that are seeking an all-in-one-go funding package.

Kettering Hospital is not asking for its HIP2 allocation in an up-front £350 million, all-in-one-go lump sum; instead, it is seeking a modular, annual funding requirement for what would be a phased and, crucially, value-for-money rebuild up to 2030. Out of the £3.7 billion national hospital rebuild programme, just £6 million would be needed this year for Kettering Hospital to get the project started, and just £29 million would be needed next year.

I know Her Majesty’s Treasury is currently completing a commercial strategy for all the hospital rebuilds, so as to standardise hospital redesign, to secure key commercial efficiencies in procurement and to address digital and sustainability requirements. Kettering Hospital is 100% committed to these Treasury objectives. Value for money is extremely important in delivering the hospital rebuild programme across the country, and if Kettering Hospital’s innovative and sensible approach could be matched with sufficient flexibility from the Government in applying the relevant funding streams from the Department of Health and Social Care and Her Majesty’s Treasury, it would be an exemplar hospital redevelopment that others could follow.

I urge the Government, both the Department of Health and Social Care and Her Majesty’s Treasury, to do the sensible thing and dovetail together the two presently separate funding streams for Kettering Hospital not only to optimise value for money for the taxpayer but to deliver sooner, rather than later, the urgent improvement of Kettering General Hospital that all local residents need, wish and deserve to see.

Edward Argar Portrait The Minister for Health (Edward Argar)
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I thank my hon. Friend the Member for Kettering (Mr Hollobone) for his speech. It is almost two years to the hour since I was appointed by the Prime Minister to this job, having just by a few days beaten your record in doing this job, Madam Deputy Speaker. He was one of the first colleagues in this House to raise an issue with me, so it is appropriate that he is raising this with me again today. I join him in paying tribute to all at his local hospital for the work they have done in the past year and a half, and for the work they continue to do and have done before the pandemic for his constituents and many others. Equally, I join him in paying tribute to the work of my hon. Friend the Member for Wellingborough (Mr Bone), whose constituents are also served by this hospital, and of my hon. Friend the Member for Corby (Tom Pursglove), who, sadly, cannot be here today but who has been equally vociferous in campaigning on behalf of his constituents.

Before I turn to the main points that my hon. Friend the Member for Kettering raised, I will answer his fifth question now. He is right to say that I am probably overdue another visit to Kettering. Although in a private capacity I passed through it recently, that is as nothing compared with visiting with him, as the local Member of Parliament. So I am happy to see whether we can find a date to do that, as it would be a pleasure. He is, of course, nothing if not constant and courteously persistent on behalf of his constituents. He rightly highlighted the context of this: the challenges faced by the accident and emergency department at Kettering, with it being congested and facing increasing demand from development in the area, and with the pressures it is feeling. He also highlighted that the solution, or the best way forward for his constituents and for this hospital, is not just the urgent treatment hub that he secured the £46 million-worth of funding for, but for us to look at this hospital in the round to see what needs to be done more broadly in the services and infrastructure available there to meet the changing needs of his constituents and those of my hon. Friends the Members for Wellingborough and for Corby.

I am grateful to my hon. Friend the Member for Kettering for rightly highlighting the track record of investment in Kettering under this Government: the write-off of £167 million-worth of debt; the £350 million allocated, with £25 million to £30 million for HIP2; and the £46 million investment in the urgent treatment centre. He should be proud that his campaigning helped secure that for his constituents. He touched on a key element of this: given the subsequent allocation of the £350 million-worth, there are benefits to be had from understanding the project as a whole, rather than simply looking at one thing as one pot and one as another. This is in no way a criticism of Her Majesty’s Treasury or of any other Department, as I would never dream of doing such a thing, but often in government individual pots of money and individual projects are looked at as exactly that, rather than taking a step back and looking at the synergistic opportunities that could be achieved by looking at things as a whole.

I turn now to my hon. Friend’s specific questions, which I am sure he would wish me to answer. I will do so in order not to run out of time and then I will perhaps say a little more. He asked about the ability to combine the £46 million with the £350 million, and the flexibility to do that. He will know that he and I, and my officials, have had conversations with his hospital trust’s chief executive, Simon Weldon—I join my hon. Friend in paying tribute to him for the work he does. We wrote to him on 16 June to confirm that the urgent care hub and the HIP2 scheme would be able to be brought together as part of the wider development at the Kettering General Hospital site. The urgent care hub and the new hospital that is to be built share, as my hon. Friend said, a common set of enabling works that are being factored into the new hospital development. So I hope that gives some reassurance on his first and second questions as to whether the two could be brought together as a single project. As I said, we wrote to the hospital chief executive on 16 June. There is the opportunity to use that provision, rather than purely for the urgent treatment hub, as the enabling works are part of a broader scheme. I know that conversations continue about the mechanics of that, but in principle it appears a sensible approach.

Philip Hollobone Portrait Mr Hollobone
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I thank the Minister for those encouraging remarks, May I draw his attention to the good work being done by Natalie Forrest in the national hospital rebuilding programme? She has developed a good relationship with Kettering General Hospital, and has been extremely supportive in getting the hospital rebuild delivered.

Edward Argar Portrait Edward Argar
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I am grateful to my hon. Friend. This is a challenging programme, and each of the 40 hospitals and their respective representative Members of Parliament argue their case hard, as do their chief executives. He is right to highlight the work of Natalie Forrest, the senior responsible officer for this project, in managing expectations and working collaboratively and openly with hospital trusts—including that of my hon. Friend—to try to achieve the right outcome for the taxpayer and the Exchequer, and for his constituents and others around the country.

Peter Bone Portrait Mr Bone
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I know this looks like a constituency debate, but is it not actually a litmus test for the new policy? The announcement of £36 billion and a new tax to be put into the health service is great, if we get the outcomes right. As I consider how to vote on Tuesday, it would be helpful if I knew that this programme had been agreed for Kettering General Hospital.

Edward Argar Portrait Edward Argar
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My hon. Friend tempts me to stray not only into the territory of my right hon. Friend the Chancellor but, possibly even more dangerously, into the territory of my right hon. Friend the Government Chief Whip. As ever, he makes his point courteously but firmly.

My hon. Friend the Member for Kettering posed two remaining questions. If there are delays in the profiling of other projects, would we be willing to consider whether there was an opportunity to move unspent money in a financial year to Kettering, or to other projects that could move ahead? I have spoken with Natalie Forrest, and we are keen to have that flexibility. He asked about a request for further money—this refers to my hon. Friend’s third question, and is the one area where I will have slightly to defer to ongoing discussions and the spending review. As he will appreciate, although £3.7 billion has already been allocated, the overall programme will be more than that across the 40 hospitals. That is subject to the spending review, and as he will appreciate, the Treasury sets annual caps on how much can be drawn down in order to manage public expenditure. To answer my hon. Friend’s fourth question, that is where, if we have an underspend against allocations in year, we will have in mind those projects that are ready and willing to go a bit faster if they are able. I take his representations in that respect as a request for his hospital to be considered in that category.

In the few minutes before you call me to order at the end of the sitting, Madam Deputy Speaker, let me return briefly to the ongoing conversation with Simon Weldon and the hospital trust. As a result of the letter we sent and the willingness to be flexible about using the money for enabling works more broadly to maximise benefits from a synergistic scheme, the urgent care hub will now be part of that first stage, obviously utilising the expertise of the hospital trust to see how the money can be spent most effectively .

In conclusion, I once again pay a fulsome tribute to my hon. Friend and his work to support the redevelopment of Kettering General Hospital. As I suspect his constituents know—certainly his election results demonstrate they do—they are extremely lucky to have such a persistent, hardworking and passionate Member of Parliament representing them in this place, as indeed are the residents of Wellingborough and Corby. At times my hon. Friends perhaps leave a few scars on the backs of Ministers on behalf of their constituents, but that is what this House and our representative democracy are here for.

I am delighted we have managed to make progress in addressing the alignment of the urgent care hub and new hospital programme funding streams. I look forward to continuing to work with my hon. Friend the Member for Kettering to ensure that this ambitious and innovative approach to building new hospitals—a common national approach—is a success, not only in Kettering but across the country. I particularly look forward to visiting my hon. Friend in Kettering, and perhaps in another two years we can hold a debate to celebrate the scheme’s significant progress on the ground.

Question put and agreed to.

House adjourned.