Hospitals

Andy Slaughter Excerpts

Wednesday 23rd April 2025 Commons Chamber

[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.

--- Later in debate ---

[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.

--- Later in debate ---

[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.

--- Later in debate ---

[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.